W. Gill Wylie

“ Unless these personal relations exist between those that give and those that receive, no act of generosity deserves the name of that charity which "blesseth twice," for gratitude is not developed in those receiving help. They give nothing in return for what they receive. Experience teaches that to do for an individual that which it is possible for him to do for himself will invariably tend to harm, unless he gives in return an equivalent, either by actual payment or in gratitude. And experience also teaches that human nature can only feel gratitude toward an individual. ”

“ In some places—as New York City—hospitals are so numerous, and admission to them so freely granted, that there is little or no restraint on impostors. If refused admission to one institution, they go to another and receive treatment and care without cost, when they are fully able to provide for themselves. And so numerous are the dispensaries where medicines and medical advice can be obtained free of cost, merely for the asking, and so easy and readily can care and attention be had in free hospitals, that the poor have no necessity to make provision for sickness. ”

“ It is a well-known fact that the great majority of the cases of disease treated in our hospitals are induced by the bad sanitary condition of the homes of the poor, and to the direct violation, through ignorance, of the plainest hygienic laws; yet what direct steps are taken to correct this constantly-acting cause of sickness? The Health Department of New York City is expected to do little else than prevent epidemics of contagious and infectious diseases. The meagre appropriation prevents them from doing much more. ”

“ The dispensaries as they are now managed are nothing less than a promiscuous charity, exactly similar to the notorious "soup-kitchen"—medicine being substituted for soup. They offer to the ignorant and poor an easy and ever-ready inducement to take alms. They are the first stepping-stones to the degradation of pauperism. The self-respect of an individual is injured the moment he accepts alms, and a habit of taking alms invariably tends to a complete loss of self-respect and consequent degradation. ”

“ As to the expense of treating the poor at their homes, it certainly would not be greater than the expense of running the hospitals, if the interest-money is added which could be had from the immense sums that are sunk in the massive, many-storied hospital buildings, and the expensive city lots on which they stand. ”

“ It would be more creditable to the citizens of New York if they could say that no such institution as a pauper hospital was needed within the limits of the city than to be able to say that two hundred established charitable institutions and organizations are maintained ”

“ The truth is, the majority of our hospitals, as they are at present managed, are liable to do more harm than good. Apparently they do much good, and for the time do relieve suffering and want, but in the end may do much harm. Giving help too readily even during sickness is hurtful, and when it is offered freely without the certain knowledge that it is really needed, it very naturally removes the healthful stimulus of necessity, the dread of which prompts every individual to provide for the misfortune of sickness. ”

“ To avoid the injurious moral effects of hospitals on the characters of the inmates, and to prevent such bad sanitary conditions in hospitals as are sure to result in retarding cures, and often in the generation of fatal hospital-diseases, it is necessary to have hospitals constructed and managed in accordance with the teachings of sanitary science. ”

“ Then, too, except to those already degraded, life in a pauper hospital, especially in the case of the young, is hardening to the feelings, while in many cases it subjects the moral to the influence of the immoral. ”

“ But as poor-relief is now administered, and, no doubt, under the best system that could be devised, a certain number of hospitals for treating the sick poor will be necessary. When properly constructed and managed they are a great blessing to the poor, while, from the advantages they afford for the study and teaching of clinical medicine and nursing, they are of incalculable value to the whole community. ”

“ The inmates of pauper hospitals are liable to come in contact with bad influences: familiarity with suffering, unaccompanied by the occupation of relieving those who are suffering, ends in hardening the sensibility, especially in the young. 3. Like all public and general charities without the safeguard that personal knowledge affords, hospitals tend to foster idleness and helplessness, and their natural results, pauperism and crime. ”

“ Suppose, during the prevalence of a contagious epidemic, the authorities should content themselves with providing for those infected, and neglect to take the necessary steps to remove the cause of the disease by doing all that sanitary science indicated—they would soon be called to account for neglect of duty. ”

“ To say that $10,000,000 are expended in charities, that there are 6,000 free beds in the hospitals, and that over 300,000 persons receive medicine and medical advice free of cost at the dispensaries, is certainly evidence of the generosity and Christian spirit of charity that prevail. ”

“ The hungry must be fed; but we know that, instead of continuing to feed the hungry, and gradually destroying their power to help themselves, it is infinitely better to teach them how to help themselves and seek out and remove the cause that induced the miserable condition of helplessness. ”

“ We fully appreciate the great difficulty of organizing and uniting voluntary charities in this country, where there are so many different religious sects; but by establishing such a system as the above much could be done toward distributing help where it is really needed, and toward preventing indiscriminate charity, and in detecting impostors. ”

“ It is doubtful if the state can give direct out-door help, even medical help, without doing more harm than good. It can only be done wisely by establishing a Bureau of Intelligence in connection with the police department, with offices at each police station, where the names and the numbers of the inmates in every house in the precinct or district would be known, and where, from personal knowledge, a record of all individuals receiving help—as to their circumstances, the amount of aid given, etc.—would be kept. ”

“ In every community, especially in large cities, there are always a certain number of paupers without any homes, who must be cared for when sick, and the only practical way of providing for them is to establish hospitals. ”

“ In this country, in all large cities, any one representing himself as poor and sick can apply either to the public hospitals supported by the State or to hospitals supported by voluntary contributions, and is admitted in many cases without any special inquiry or investigation as to his circumstances. ”

“ If these official reports are to be relied upon, then, in a population of 1,000,000, over 300,000 persons receive alms every year. We doubt if the number of individuals is so large, for it is the custom of some dispensaries to count each visit a patient makes as a patient treated. ”

“ In large cities provision must be made for street casualties, and hospital accommodations are necessary. 5. On account of difficulty in making suitable provision for the insane in private houses, hospitals or asylums for the insane are necessary. ”