BLACKWELL FAMILY ELIZABETH BLACKWELL Printed MatterPREVENTIVE HYGIENE. The International Conference at Brussels, September, 1899. BY ONE WHO WAS THERE. PUBLISHED BY F. BURFOOT, 55, ELLERDALE STREET, LEWISHAM S.E., September, 1900. PRICE ONE PENNY.6 The following pages have been compiled, partly from personal recollection, partly from the official Report of the debates ("Compte Rendu des Séances"). But the debates themselves do not represent the whole of the ground covered by the Conference ; and in the four volumes of Preliminary Reports, Enquiries (into the Conditions of Prostitution and the Prevalence of Disease in different countries), and Communications, the reader will find a more detailed treatment of the various branches of the subject, both from a medical and a social point of view. The official literature of the Conference consists of five volumes large octavo, as follows: - "Rapports Préliminaires." 1 vol. "Enquêtes sur l'Etat de la Prostitution et la fréquence des maladies dans les différents Pays." 1 vol. "Communications." 2 vols. "Compte Rendu des Séances." 1 vol. The volume can be obtained direct from the Publisher, M. Henry Lamertin, 20, rue du Marché-au-Bois, Bruxelles, price 40 francs, or from Messrs. Williams & Norgate, 14, Henrietta Street, London, W. As we go to Press, the announcement reaches us that the "Société International de Prophylaxie Sanitaire et Morale," proposed by the Conference, has actually been organized, and "invites the adhesion of doctors and all other persons who by their works, their official functions, or their special knowledge, are designated as competent to render useful aid." The General Secretary is Dr. Dubois-Havenith, 19, rue du Government-Provisoire, Bruxelles. The annual subscription is 20 francs (16/-). PREVENTIVE HYGIENE. THE BRUSSELS CONFERENCE SEPTEMBER, 1899 So much has been said of late as to the prevalence and character of certain maladies affecting, in one form or another, not only the least reputable members of the community, but innocent victims in all ranks of society, and so many vague fear have been set floating in the public mind, that it seems desirable to lay before the reader in a concrete form the results arrived at by an assembly of experts of all countries, called together in Brussels last September to discuss this very subject. I.- The Conference Itself. THE conference was organized by a Committee of medical experts in Brussels, on the initiative of Dr. Dubois-Havenith, a distinguished Belgian specialist, and under the presidency of the Minister of Health and the Burgomaster of Brussels. It was specialist and authoritative in the highest degree. Roughly speaking, it numbered some 360 members, of 33 nationalities. Of these, 107 were Government delegates, representing 29 different countries, mostly European, but including the United States, Persia, and Japan. Our own War Office and India Office were represented, together with the Royal College of Surgeons, the Irish College of Surgeons, and the British Medical Association. Out of the entire number, 295 were doctors, and a large number of these held public posts in the "Service of Health" or as professors of the special subject. The 65 non-medical members included Ministers of State, heads of police or health departments, delegates of municipalities, legal authorities and professors, and a few other persons individually invited on the ground of special competence, and representing, for the most part the "sociological" side of the subject. Among these were several ladies. The Conference lasted five days. It met in the Palais des Académies, a handsome building standing in its own garden among fine trees, close to the Palace and the little Park, in the highest and pleasantest part of Brussels. M. Le Jeune, a former Minister of Justice, presided at its sittings, its evenings were spent in banquets and public receptions, and the King received the members at the close of their labours. Their errand, indeed, was grave enough. People in England are apt to imagine that what has been euphemistically termed "preventable disease" is a purely British problem, long ago solved by Continental Governments; and a sort of sub-cutaneous agitation has long been going on in this country to bring about some assimilation to foreign methods.4 But the terms of the Brussels invitation lent little support to any theory of Continental superiority, and put the whole matter on a far more serious footing. "The incessantly increasing propagation of these maladies" - so ran the opening sentences of the invitation- "has become a serious social danger. It behoves us, now while there is yet time, to take steps to endeavour to arrest the invading progress of the scourge. With a view to grouping and consolidating all efforts, a Committee has been formed, and an International Conference is being organised for the prevention of these diseases." An invitations couched in such terms as these, coming as it did, from a country which has exhausted every resource in way of administrative measures, and addressed largely to other countries in a similar position, implied not only that the difficulty was general and not particular, but that no measures yet devised had proved capable of affording a solution. At the same time it pointed to the one remaining hope- the bringing together of all experiences, so as to obtain some clues for future guidance. And here be it said that though the debate, always keen, became sometimes very heated, and broke into sharp little fusillades of controversy between the attackers and defenders of existing methods, yet in the main the true scientific spirit prevailed, and speaker after speaker, as he brought his quota of observations and deductions to the common fund, seemed anxious not so much to bolster up a cause as to help forward an honest enquiry and practical result. Certainly this was the spirit in which the organisers of the Conference had set about their work. "To get at the truth" said Dr. Dubois-Havenith, as he greeted the arriving members, "that is all we want. We want all the light we can get." II.- The Debates The Work of the Conference was mapped out into six questions. To facilitate discussion, two pr three papers by selected writers on each of these questions had been prepared beforehand; and these, together with a mass of statistical informations relating to various countries, were placed, in the shape of two thick volumes and an appendix, in the hands of members as they arrived. The first four questions dealt with the existing forms of State control [1], and their possible improvement from a police or medical point of view; the other two invited suggestions as to legal measures for diminishing the number of women living by immorality, and the means of preventing the transmission of disease among the populations generally. 5 The first question was the appeal to experience:-"What has been the influence of existing systems of Regulation on the prevalence of disease?"- and round this question the tide of debate surged for a long day and a half. The first morning was full of surprises, Three out of the first four speakers- all foreign doctors, condemned the existing system. The first, Dr. Blaschko, of Berlin, struck the keynote of many later speeches by pointing to the age of the women as a factor in the question of contagion. The French writers, he said, drew and argument in favor of Regulation from a comparison of the condition of the registered and unregistered women- disease being more frequent in the latter. But this was accounted for by the fact that the unregistered women were the younger women, who were always the most dangerous. It was not Regulations that rendered the courtesan less dangerous; it was Time. Besides, comparisons as to the women proved nothing. the only true test of value of Regulation was the increase or decrease of disease among the male population. A careful study of all the reports and statistics showed that it was impossible to establish any general rule as to things being better under Regulations and worse in its absence. "There is not on of us," he said, "who is content with Regulations as it exists to-day." Finally, he warned that Conference against approaching the question from an exclusively medical standpoint. Hygienic Utopias might be very attractive in theory; but methods which ignored the complex interests of the community- economical, social, ethical- would always defeat themselves. If the Conference was to have enduring results, they must build on a broad foundations [1]. Dr. Augagneur, of Lyons, said doctors were beginning to see the uselessness of Regulation; it partisans complained of it almost as much as its opponents [2]. In common with Prof. Neisser [3] and others, he pointed to the worthlessness of military statistics for purposes of comparison, whether between army and army, station and station, or even regiment and regiment, the question being complicated by incalculable differences of other kinds. Dr. Fiaux, of Paris, followed on the same side. Dr. Barthélemy, on of the medical chiefs of St. Lazare, the great Lock-Hospital prison of Paris, replied that disease was due to immorality, not to Regulation; that passion was an eternal and imperative factor in human life; and that Regulation was a means combatting its atten- [1] It may be pointed out that there are two essentially different modes of State intervention which may be adopted with a view to checking the spread of these maladies. The system at present in force in the principal countries of Europes regards persons of a particular class and sex as the chief agents in the diffusion of disease, and seeks to prevent it by keeping these persons under constant sanitary supervision- the supervision consisting of periodical medical inspections, necessarily of a very revolting character, in order to ascertain whether the disease is present or not, and compulsory detention and treatment in hospital in case it is found to exist. The progress of science has shown that these inspections are and must be extremely fallacious. In order to ensure that the regular attendance of the women, they required to enter their name and addresses on a register kept by the police, and those who fail to attend the inspection are liable to be arrested and imprisoned. This is the system commonly known as "Regulation." The difficulty of enforcing registration and attendance is however, very great; and in many countries the police encourage, as far as possible, the aggregation of the women in houses of ill-fame, which are "tolerated," or licensed, by the State on the understanding that the mistress of the house insists on the observance of the regulations by her inmates. These maisons tolérées are regarded by many Regulationists as the very core of the system. The other mode of possible State intervention is to require doctors and others to notify all cases of actually existing disease of this kind, in persons of whatever class or sex, to the health authority, who is to enquire into the means of segregation and treatment (as in the case of other infectious diseases), and is empowered to remove the patient to hospital if necessary. It has been urged in favour of the latter method that it is not open to the objections brought against the former, as being unequal between men and women, or as encouraging immorality by superintending, in its interests, the health of those who minister to it. It may be questioned, however (1) whether this advantage could be maintained in practice as well as in theory; and (2) whether every scheme of this kind yet proposed does not contain elements likely to defeat its own object and endanger rather than protect the public health. (see note 4 on p. 14) [1] "conference Internationale pour la Prophylaxie," &c. "Compte Rendu des Séances," pp.17-20. [2] Ibid. p. 21. [3] Ibid. pp. 35, 36 6 dant evils. If it had not yet succeeded in eradicating these evils, that was not a reason for abolishing, but for improving it. He agreed that there was much room for improvement and recommended gentler methods.[1] He joined with Dr. Fiaux in begging Prof. Fournier, the head of the french delegation, to give them his views. Thus appealed to, the illustrious Professor came forward. First, he discarded statistics. You could get nothing out of them. The conditions were too variable to admit of comparison. There remained one simple argument - the argument from commonsense. Isolate an infected women, and the infection would go no further; leave her at liberty, and within twenty-four hours three or four men would be contaminated. That argument was worth all the statistics put together. He added a frightful picture of the varied forms and consequences of syphilis, and of its prevalence in Paris, affecting, as nearly as he could calculate, a seventh, if not a sixth, of the whole population. Not that he thought the disease more virulent than before, but only better known, since recent science had revolutionised the whole subject. "You see, gentlemen," he concluded, "to what dangers we should expose the community by abolishing the regulations."[2] To this M. Pierson replied, later in the debate, that the gravity of the danger unfortunately did not prove the value of the remedy. Disease appeared to vary in a manner totally irrespective of the regulations. If Regulation was indispensable to the public health, why were London and New York, where it had never existed, in no worse condition than Paris? This also was an argument from commonsense.[3] A similar line of argument was taken up in the debate on English and Anglo-Indian Army statistics, which occupied part of the afternoon. Doctors on either side disputed each other's figures; and the same thing happened later with regard to the statistics of Christiana, warmly disputed between two Christianian professors, Dr. Holst and Dr. Bentzen,[4] and those of Strasburg,[5] cited by Prof. Wolff, and combated by Dr. Hoeffel on the ground that they did not tally with the German official statistics. It then appeared that Prof. Wolff had obtained his favourable results by eliminating all "imported" cases[6] - a method which should have been explained on the face of the statistics, and which naturally invalidated them for comparison with statistics drawn up in the usual way.[7] The Italian doctors drew attention to the very serious increase in disease in Italy on the abolition of Cavour's system by Signor Crispi in 1888,[8] but added that the experiment had been too short to be of any value,[9] and that the Lock Hospitals had been closed without any adequate provision being made for voluntary patients.[10] Dr. Bertarelli, of Milan, while defending Cavour's system, did not wish to see it restored; the world had progressed since then, and better methods might be looked for.[11] [1] Pp. 22-27 (see also pp.126 & 213). [4] Pp. 109-115. [7] See concluding Note, p. 19. [2] Pp. 29-31. [5] Pp. 216-222. [8] Pp.124; 149, 150. [3] P. 91 (see also pp. 117, 118). [6] P. 220. [9] P. 129. [10] P. 150. The same thing seems to have taken place in India in 1885, when 15 of the principal hospitals were closed by way of experiment. The experiment is said to have been unsuccessful, and they were re-opened two years later. But apparently nothing had been done to prevent its being unsuccessful. Experiments of this kind require careful scrutiny in relation to the attendant circumstances before any practical deduction can be drawn from them. See also Galewsky (Compte Rendu, pp. 161, 162), as to the temporary closing of the "much frequented" houses of ill-fame in Dresden and Leipzig, and Dr. Hoeffel (pp. 215, 216) in answer. [11] P. 131. 7 But the interest of the discussion was far from being mainly controversial. It consisted rather in the numerous important points brought out on all sides, and in the growth and shaping of opinion which was visibly going on under our eyes. Perhaps no subject took larger proportions, as the debate went on, than that of the danger to the public health resulting from the prostitution of minors. Elaborate charts and tables were produced by the Paris doctors - the younger Fournier, Dr. Jullien of St. Lazare, and others - showing the years from 17 to 20 to be the most dangerous age as regards syphilitic infection.[1] Dr. Augagneur suggested that this was not because the girls were young, but because they were novices, syphilis being almost invariably contracted within a year or two of the adoption of that career.[2] Dr. Edmond Fournier urged, amidst applause, that such girls should either be placed in reformatories or compelled to return to their homes. He did not believe that at that age they were necessarily irreclaimable.[3] Another point, brought forward by M. Pierson, was the danger from "mediate contagion," i.e., the transmission of the disease from one client to another, even by women who, having passed through all stages of the disease, had themselves become immune. He thought this fact, indicated by the great discrepancies between the statistics relating to men and women respectively, had been too much overlooked by the French and German doctors.[4] A third fact, admitted on all hands, whether with satisfaction or regret, was the progressive decay of the tolerated houses.[5] This was attributed to various causes - to their having been cleared of minors by the police, and to the discouragement of the White Slave Traffic, which deprived them of their most attractive inmates;[6] to their terrors for the women, owing to loss of freedom, strictness and frequency of inspection, etc.;[7] while, on the other hand, it was found that they afforded no guarantee of safety.[8] The business of immorality was now carried on under other names in small beerhouses, cafes and dancing places, and maisons de passe, where all sanitary inspection was evaded.[9] It was also generally admitted that the system failed to reach more than a fraction of those it professed to control;[10] and that it afforded a very imperfect protection even as regards these last, the period of enforced segregation covering only a few weeks and ceasing with the disappearance of the primary symptoms, while the disease remained uneradicated for years, the external symptoms recurring from time to time, and the risk of contagion being almost as great in the latent as in the apparent intervals.[11] It is less easy to describe the movement of feeling and opinion which seemed to be taking place among the listeners during the long debate. Already, as the Conference rose from its first sitting, doctors were exclaiming that they had had no idea there was such an amount of medical [1] Pp. 53-59; 69-82. [2] P. 95. [3] P. 82. [4] P. 90. [5] See Fiaux, 203; Barthelemy, 215; Fournier, 259; Mireur, 304; Bourgeois, 335; Augagneur and Santoliquido, 186, &c. [6] Rethaan Macare, 317. [7] De Wyslouch, 239; Bourgeois, 335. [8] Perrin, 178 (see below, pp, 10, 11). [9] Le Pileur, 211; Honorat, 224; de Sturmer, 239; Commenge, 240, &c. [10] Fournier, 100; Mireur, 305, &c. [11] De Sturmer, 147, 238; Dron, 226; de Wyslouch, 229, &c.8 evidence and medical opinion unfavorable to the existing systems. The speech of Prof. Fournier, describing the condition of Paris after a hundred years of Regulation, made a profound impression. It was felt that, whatever the great Professor's opinion, his facts spoke for themselves. It is hardly too much to say that there were moments when a sort dismay seemed to spread through the assembly, as of men who begin to face for the first time the possibility that a cherished scheme may prove hopelessly impracticable; and it was with aces of graver anticipation that members took their places again for the afternoon. Many eminent voices were heard in defense. Professors Neisser, of Breslau, Lassar, of Berlin, and de Stürmer and Petersen, of St. Petersburg, together with many others, declared themselves convinced Regulationists. But the defence itself surrendered almost everything. Prof. Lassar argued that isolation was essential, and that Regulation was a means of isolation; it was defective, inadequate, even cruel, but what could you put in its place? (p. 33). Prof. Neisser took similar ground, admitting a minimum of success and insisting on a maximum of reform (pp. 35-37). Both discarded statistical evidence as hopelessly contradictory. Others relied on statistics to prove that however bad things were under Regulation, they would be worse without it, and urged that its incapacity to do so all that had been expected of it was no reason for condemning it altogether, but rather seeking to improve it. The doctors of St. Lazare themselves protested against the prison system of treatment in that famous hospital (Barthélemy, pp. 26, 213-215), and, while insisting on retaining the power of compulsory detention as regards their present class of inmates, asked for the addition of free consultations and treatment for patients voluntarily presenting themselves - which, however, would never succeed "till the last vestige of imprisonment should have disappeared" (Jullien, p. 160), to give place to the benevolent and intelligent discipline of the hospital proper. One familiar argument was chiefly conspicuous by its absence. Very little was heard of the reforming and moralising influence of Regulation. Most of the speakers, if they touched on its moral results at all, touched them only to exclude them, with an apology. But all these speeches made little impression on the growing discouragement. Members had come up, bringing each his profession of faith and his confession of difficulty, and each expecting to obtain from his learned confréres the confirmation of the one and the solution of the other. Instead, they found the difficulty everywhere, and the solution nowhere. Prof. Fournier's unanswerable "argument 'from commonsense" had the usual weakness of à priori arguments - that it left out most of the factors in the problem, and consequently bore little relation to the actual results. Very striking was the subtle modification perceptible in the tone of Prof. Fournier himself. "In my opinion," he said in his first speech, "Regulation is imperative (s'impose); and we shall have more and more of it as the danger is seen to be greater" (p. 30). In the afternoon of the same day he frankly defined his own position in these words:- "You ask me, am I content with Regulation as it is?-No, I am not.-Yet I approve it?-Yes, because it does a little good (un peu de bien). It controls but a small number of the women, but at least it does control those few" (p. 100). He added an allusion to the "syphilis of the innocents" (pp. 100; 135, 6). It was for the sake of the wife and the child that he supported the cause of Regulation. Later on he was 9 advocating with characteristic warmth and energy the suppression of the prostitution of minors; and on the last morning, in introducing his scheme for gratuitous voluntary treatment, he based it on the recognised inefficiency of the existing method. "Whatever the authorities have been able to do in the way of Regulation," he said, "it still remains inadequate; and the disease abounds and superabounds to-day, as it did before Regulation existed." 1 Finally, to bring the question to an issues, Prof. Petersen proposed a resolution to the effect that "the sanitary control of prostitution was one of the most efficacious means diminishing the spread of disease" (p. 134). Several members objected, on the ground that a scientific question could not be decided by resolution; and the President pointed out that it had been understood that there would be no voting. Prof. Petersen persisted. The Governments had sent delegates, and would expect them to report some definite results of the Conference. The President suggested that the delegates might meet and vote among themselves; but added that such a vote would be in no way equivalent to a resolution of the Conference (pp. 139, 140). Other members objected to this plan. Dr. Fiaux pointed out that the resolution would apparently bind the Conference to an approval of the actual status quo, whereas the majority of the members favorable to Regulation had expressed great dissatisfaction with the status quo (p. 140). He suggested that any vote should be deferred till after the discussion of the questions dealing with possible improvements. The resolution was accordingly withdrawn, and was not again brought forward. III.- PROPOSED IMPROVEMENTS AND REFORMS Then came the question of reforms. And here, amidst the infinite variety of opinions, three principal groups may be distinguished-those who would simply reinforce the existing system on its own lines, those who would retain some parts, abolish others, and run measures of a different character alongside what remained of it, and those who considered it a total failure, and abolition the only possible improvement. Perhaps the majority of the members belonged to the middle group. The purely medical proposals included more thorough, more frequent, and more competent inspection, combined with longer isolation, and with treatment covering a series of years; the use of hydropathy; free dispensaries, and the encouragement of voluntary attendance. Prof. Petrini de Galatz, together with Dr Pontoppidan, of Copenhagen, Dr. Blaschko, Prof. Neisser, and others, recommended an inversion of the existing relations between the doctors and the police. Instead of placing the whole trade of prostitution under police control, and making the treatment in hospital an appendage to the periodical inspection conducted by the police surgeon, they would make the entire administration purely medical, and the inspection itself an appendage and continuation of the hospital treatment. This, it was urged, was in accordance with modern ideas, which no longer regarded those who had passed the inspection as P. 341. See below, p. 17.10 healthy, but only as less immediately dangerous than those relegated to hospital. 1 The action of the police was objectionable in many ways; 2 it gave an odious character to the system, and was evaded by those who most needed it. It should only be admitted where patients failed to continue their attendance, or in the case of women denounced as centres of infection.3 The question of the maison tolérées was very closely argued, and evoked sharp differences of opinion. Many were willing to acquiesce in their disappearance, and to concentrate the efforts of the police on a more thorough registration of women living in their own lodgings. Others insisted that the houses should be maintained at all costs, and the women compelled to reside in them. M. Bourgeois, Chief Commissioner of Police at Brussels, said this was the opinion of the Brussels medical service (p. 335). Dr. Mireur, of Marseilles, said Regulation apart from the houses was little better than a farce. Out of 5,000 women on the streets at Marseilles only 300 were on the register (p. 305). It was impossible for the police to deal with such numbers. He would retain the houses. abolish the police des moeurs, and punish solicitation under the vagrancy laws (p. 306). On the other hand, Dr. Perrin, also of Marseilles, declared that, so fas as Marseilles was concerned, the maison tolérée was a thing of the past. "That isd the brutal fact," he said "and with it crumbles the whole fabric of the existing regulations" (pp. 177,8). Some defended the houses on the ground that they tended to clear the streets; but this again was denied by Dr. Hoeffel (p. 216) and others, and Brussels itself was alleged as an instance, M. Hirsch asserting (p. 183) that 15 or 20 years ago, when the tolerated houses of Brussels were famous all over the Europe, the streets were full of solicitation, but now that the number of these houses was greatly reduced, the streets were proportionately improved. Several Russian and other doctors spoke against them in the strongest terms as schools of profligacy4, and even as centres of disease.5 Professors Neisser, Jadassohn, and others suggested that it should be plainly printed on the women's papers that the medical certificate afforded no guarantee of safety to clients.6 "It must not be a certificate of health," said Dr. Schrank, of Vienna (p. 153), "but only a permit to practise." Prof. Fournier, on the other hand, spoke of the houses as affording : the summum of security"(p. 180),7 and said that very few of his patients traced their infection to them; to which Dr. Augagneur replied that patients naturally brought the infection from ---- 1 See "Conférence Internationale," &c., "Communications relatives aux Questions," &c., Vol. I., Dr. Pontoppidan, p. 47. No one seems to have gone into the question whether, in the course of hasty and crowded inspections, or of inspections by careless or ill-trained assistants, the contagion may not be conveyed, in many cases, from the sick to the healthy by the use of imperfectly sterilised instruments. The insistence of several speakers on a larger and a better trained staff probably had reference partly to this point, but it does not seem to have been brought out clearly. Amidst all the discussion on the advantages and disadvantages of Regulation, the possibility of its involving a positive danger to the public health seems hardly to have been fully appreciated. 2 Petrini de Galatz, p. 155. 3 Blaschko, pp. 251-3. 4 Petrini de Galatz, p. 189; Pouschkine, 282. 5 de Wyslouch, pp 230, 231, "foyers de la syphilis." 6 Neisser, p. 173 (French), 175 (German); Jadassohn, p. 202 (see also Schmölder, 301-2). 7 See also de Stürmer, 237-9; Peroni, 241-5. 11 the places they frequented, not from those they did not frequent (p. 185). Several proposed to improve the medical supervision, making the inspections more frequent and rigorous, and never entrusting them to the mistress of the house, whose examinations were valueless.1 To this others, again, replied that it was precisely where the medical supervision was most strict that the houses were dying out; 2 the only ones that continued to attract were those containing very young or newly-arrived girls, and these had been shown to be the most dangerous.3 Dr. Fiaux said the great Russian specialist, Dr. Sperck, had found that the amount of syphilis conveyed by the registered women was proportionate to the recruitment of their ranks by healthy women. These were soon infected themselves, and spread the disease with great rapidity.4 Four or five members suggested that the women themselves ought to be protected from contamination by the inspection of their clients on arrival; 5 but it was added that the houses might as well close their doors at once. Several schemes of reform seemed to have been elaborated with a view to theoretical completeness, quite apart from any consideration of the possibility of carrying them out in practice. Dr. de Stürmer (p. 146), Prof. Jadassohn (p. 202), and one or two others drew attention to practical difficulties, and to the hopeless disproportion between the numbers to be dealt with, the necessary duration of detention, &c., and the length of the public purse.6 Dr. Achille Dron, formerly of Lyons, occupied a place by himself as the author of a scheme by which (to use his own words) the police should not only control but recruit the ranks of prostitution. Every syphilitic patient, he said, should be kept under treatment for three years or more, and forbidden to practise her trade, under pain of imprisonment, until the doctor should pronounce her completely cured. "You will ask," he said, "how she is to be maintained during that time. I answer that the charitable public will see to that." On her complete recovery she should be entered at the regístry (bureau de placement) kept by the police for that purpose, and handed over to one of the maisons tolérées when applied for (pp. 225,6). The third group--that of the abolitionists pure and simple-- was small in number, but the speeches attracted attention and sympathy by their conspicuous ability, moderation, and breadth of view. One of the most eloquent was that of M. Rethaan Macaré, one of the Dutch Government delegates. He said his Government had sent him to learn rather than to speak, but the Conference might like to know the impression made by the debates on one chiefly occupied with matters of legislation, and who had come with an open mind (sans parti pris). He thought the doctors asked too much of the legislators, and things incompatible with sound law. M. Fournier pleaded to be allowed to do "a little good." But in order to do that "little good" they were compelled to do incalculable harm. ---- 1 Schrank, pp. 152, 247. 2 de Wyslouch, p. 232. 3 Augagneur, p. 185; de Wyslouch, p. 232. 4 Fiaux, p. 107. See also de Wyslouch, pp. 228,9. The whole speech is very striking, as is also Dr. Pouschkine's, pp. 281-3. Evidently the question of the houses turns partly on local conditions. In Russia they appear to be less unpopular, but more dangerous; in France and Belgium, less dangerous but more unpopular. 5 Petrini de Galatz, 156; Kromayer, 166, 7; Lassar, 181; de Wyslouch, 231; Schrank, 247. 6 See also Dr. Schmölder, pp. 299, 300.12 He did not deny the importance of isolating the sick, but how was it to be done? the vast majority of the women outside the licensed houses escaped the regulation altogether. The houses themselves were high schools of immorality in its worst forms. It was there the procuresses of the future were trained to prey upon society. It was there that numbers of young lads began their downward course. They were the resort of married men and old roués. M. Fournier said, "Save the wives and children!" but it was largely from these houses that the disease was taken home to wives and children. Was there nothing, then, that the law could do? It could do much. M. Fournier said, "Look to the minors!" That word went to the root of the matter. It was there that improvement must begin. But he would extend the meaning of the word to minors of both sexes.1 He was followed--or preceded--on the same side by M. Minod, who, in two eminently clear and practical speeches,2 insisted on the disproportion between effort and result, as demonstrated by the debates; M. Pierson, who demanded the punishment of all who make their gain out of the debauchery of others;3 Mr. percy Bunting, President of the International Conference on the White Slave Traffic held in London in June, 1899, who drew attention to the recommendations of that Conference; Drs. de Wyslouch and de Pouschkine, of Warsaw, Dr. Schrank, of Vienna, and M. Youri'evitch, of the Russian embassy in Paris, who attacked the keepers of the houses as the chief instigators of the White Slave Traffic;5 and Madame Bierberboehm, of Berlin, who urged various measures for the protection of girls, including the suppression of the Regulation system, which was simply a trap for them (p. 271). To this group belonged also Dr. Fiaux, whose long and brilliant paper in the Rapports Préliminaires was summed up by himself in the one sentence: " On soignera plus de malades par la libert'e que par la force."6 By this time the Conference had entered on the fifth question: --"By what legal measures can the number of women earning their living by immorality be diminished?" --and Prof. Fournier once more came to the front with a definite proposition (pp. 259-262). It was impossible to do away with prostitution at a blow, he said; but it was not impossible to make a beginning. Let them begin with the minors. Two things were needed--a law for the sequestration, until their majority, of girls found practising prostitution, and refuges to which they could be consigned for reformation, treatment, and instruction in some means of earning a decent living. He proposed a Resolution inviting the Governments to use their utmost powers for the absolute suppression of the prostitution of girls below the age of civil majority (pp. 287, 293). The age would differ with the age of majority in different countries, 21 in France and Belgium, 23 in Holland, &c. He saw no objection to that (p. 290). The Resolution was seconded by ---- 1 Pp. 254-259. See also, re procuresses, Dr. de Pouschkine, p. 282; and Youri'evitch, p. 269; and re schoolboys, Prof. Petrini de Galatz, p. 189. 2 P. 116-120; 245-247. 3 P. 266. See also Le Pileur, p. 321; and Bourgeois, pp. 336-338. 4 i.e., the international trade in young girls fraudulently procured for immoral purposes. 5 Pp. 232; 281, 283; 248, 9; 268. 6 Roughly, "We shall get more patients to submit to treatment by voluntary means than by compulsion." "Rapports Préliminaires," Question II., p. 110. 13 the President, M. Le Jeune, who said that in Belgium they had both the law and the institution recommended, but funds were needed to work them (pp. 262, 3). They had also a law for the protection of boys (p. 293). He defined civil majority as the age of subjection to paternal authority (pp. 290, 91). The Resolution was passes unanimously and with great enthusiasm. IV.--MEASURES AFFECTING THE CIVIL POPULATION. The sixth question dealt with preventive measures bearing on the population generally. Here again the usual cleavage between coercionists and non-coercionists was observable, but in a less degree, the tendency in favour of non-compulsory methods being very marked, especially among the more advanced communities. The most drastic propositions same from Norway, Spain, and Roumania. Prof. Morgenstierne, of Christiania, described a Bill which was under consideration in Norway for enforcing the medical inspection, not upon prostitutes as such, but upon prisoners of both sexes committed for whatever offence; and empowering the Board of Health to order, from time to time, the medical inspection of all persons whose conditions of life and work might render them likely to transmit the disease (pp. 346-349). To this Dr. Holst, also of Christiania, replied ridiculing the bill clause by clause, and showing its absurdity, whether from a regulationist or a non-regulationist point of view (pp. 349, 50). Dr. Castelo, of Madrid, detailed the provisions of a Bill for preventing the contamination of wet-nurses by syphilitic babies, and of babies by syphilitic nurses. A medical examination and certificate were to be required on both sides (pp. 387-395). Dr. Georgesco, of Bucharest, proposed a series of measures for bringing under medical supervision various classes of persons, including young and unmarried men generally. He advises the weekly inspection of pupils in secondary schools, and the inspection of all domestic servants of both sexes before entering service (pp. 396, 397). But the majority of the proposals were remarkable rather for the absence of attempts at coercion, and the effort to conciliate the goodwill and win the confidence of patients, so as to lead them to seek early and effectual treatment. The first essential was improved medical education, in order to ensure a supply of competent doctors;1 the next was diffused information--i.e., protection by knowledge.2 Dr. Boureau, of Paris, gave public lectures on the subject every year to students and working men (p. 366); Prof. Neisser had a full course every winter for all university students, each of whom also received, on matriculation, a notice warning him of the danger attending an irregular life, and putting the moral aspect of the question before him. The Minister of Education had recommended that similar measures should be taken in all the Prussian Universities (p. 373). Professors Fournier (pp. 344, 5), Neisser (pp. 378, 9), Troisfontaines (pp. 354-7), and others proposed, or had already adopted, the practice of issuing a printed warning to patients, instructing them as to the necessity ------ 1 Kaposi, pp. 339, 340; Fournier, 341; Hutchinson, 351, 2; Lesser, 359; &c. 2 Hallopeau, pp. 384, 385, and others.14 of prolonged treatment, and of abstention from any contact, accidental or otherwise (including the use of the same cups, pipes, and other utensils), which might convey infection to others. Prof. Fournier presented a detailed scheme1 --anticipated, to a certain extent, by some earlier speakers-- for the establishment by the State of voluntary free hospitals and dispensaries, open to all comers, conveniently situated, with an adequate medical staff, with evening or Sunday consultations to meet the convenience of the working classes, and with every consideration for the privacy and comfort of patients. This, it was thought, would meet the needs of decent married women, betrayed girls, and others, who, in many cases, have nowhere to go for treatment, the ordinary hospitals being very commonly closed to cases of this kind; and would also gradually attract the large body of insoumises, or " clandestine" prostitutes, who, in evading the police, evade treatment of any kind, and remain a constant danger to the community.2 Several speakers laid stress on the absence of compulsory detention as an essential of success. Dr. Nevins instanced the case of the Glasgow infirmary, where for some years patients of this kind were required, on entering, to sign, and presently ceased to come at all, and the rule had to be rescinded.3 The fear of compulsory detention had been fatal to success everywhere. Dr. Boureau said there was a philanthropic society in Paris which maintained a free dispensary for these patients. " The clandestines whom the police fail to reach come to us," he said "At first they feared we should detain them; but now they come freely, and often bring their companions" (pp. 365, 366).4 One of the most interesting of these later speeches was that of Mr. Jonathan Hutchinson, the English specialist, who attended as one of the representatives of the Royal College of Surgeons, and whose European reputation made him the object of the most respectful attention. He deprecated panic and exaggeration; said there were many evidences that disease was not increasing but steadily diminishing in England; and pointed out that it could hardly be called a danger to the race, since it is scarcely traceable in the third generation. Scientific treatment had improved, and was lessening the duration of secondary syphilis. Patients were now advised not to marry till completely cured, and the consequence was that hereditary syphilis was already extremely rare among the educated classes. The same ideas would gradually permeate all classes. He advocated medical education and the establishment of general rules as to treatment to be adopted by the profession generally. Young men in public schools and colleges should be warned and instructed, and the instruction should include moral considerations and respect for the purity ----- 1 Pp. 340-345. 2 Jadassohn, p. 203; &c. 3 Pp. 367, 368. This argument gains force in view of the importance of early treatment, which in this case was sacrificed to the unsuccessful attempt to ensure prolonged treatment. See also Dr. Santoliquido, p. 186. 4 Prof. Lesser, in this printed report on this question, laid stress on the maintenance of professional secrecy. Sufferers from these maladies, he said, had motives for secrecy which did not apply to ordinary diseases, and any measures tending to destroy the confidence of the patient in the silence of the doctor would only drive him into the arms of the quacks (" Rapports Préliminaires," Question VI., p. 8). 15 of women. A diminution of vice would bring with it a diminution of disease. He thought that already a better tone was asserting itself among medical students and other young men of that class, and that officers in the army no longer looked on dissolute habits as inseparable from military life. Our recruits now enlisted young, and left the army early, and there was nothing unreasonable in expecting them to keep straight from eighteen to twenty-seven. The effort would have collateral advantages in developing character, self-respect, temperance, and industry. He did not think public opinion would long endure the association of life in the army with the moral degradation of the soldier. If the matter were put before the men in a reasonable way, he was convinced they would respond, and that would do more to diminish disease in the army than all the regulation that could be devised (pp. 351-354). V.-- THE RESOLUTIONS. After all, the Conference did not separate without passing a number of resolutions, which may be summarized as follows. The Conference recommended:-- (I.). That the Governments should use their utmost powers to suppress the prostitution of girls under age. (II.). That a permanent International " Society of Social and Moral Prophylaxis" should be constituted, having its headquarters in Brussels, issuing a quarterly journal in French, English, and German, and holding Congresses from time to time; the first Congress to meet at Brussels in 1902. (III.). That--since a through knowledge (connaissance approfondie) of venereology is one of the most important means of effectually combating the spread of disease--complete and compulsory courses of instruction in the subject, for all medical students, should be instituted in every University, so as to ensure the training of really competent practitioners. (IV.). That guardians of orphans, and others charged with the education of the young, should use every effort to promote their moral development, and to teach them temperance and respect for women of all classes.1 (V.). That the utmost rigour of the law should be enforced against souteneurs.2 (VI.). That the Governments should appoint in each country a Commission charged to ascertain the amount of these diseases, apart from temporary fluctuations, among the civil population, to enquire into the existing means of treatment, the distribution of hospitals in various localities, etc., and to collect opinions and formulate proposals as to the best means of preventing the dissemination of the malady.3 (VII.). That the Governments should find means to warn the public, and especially young persons, of the dangers attending an immoral life. ------ 1 This was brought by a Russian delegate, Dr. de St"urmer, from a Russian Medical Congress, where it had been unanimously adopted. 2 i.e., men who live upon the earnings of prostitutes. 3 Proposed by Dr. Saundby on behalf of the British Medical Association.16 (VIII.). That the statistics of disease should be drawn up in all countries on a common basis.1 All those Resolutions were passed unanimously. It is interesting to compare this summary of the conclusions arrived at with the six questions with which the Conference started. The comparison marks the distinction, not, indeed, between points regarded as vital and points regarded as of secondary importance, but between those on which the Conference could and could not agree. None of the resolutions touched the question of "State Regulation" at all. It was felt that if the Conference was to speak with authority it must speak unanimously, and on this subject it was evident that opinions were hopelessly divided. Still, taking the resolutions simply as points of agreement, it is interesting to notice that none of them recommends any form of administrative coercion as applied directly to the communication of disease; and that four of them aim at the prevention of vice, as the root of the whole evil, while the remainder seek to increase the efficiency and accessibility of medical aid, to apply a stimulus to research, and to bring all results into the common treasury. Some of this research may perhaps take a form which the public will regard with little confidence. The formal sittings of the Conference left plenty of time for private discussion among the more advanced experts, and it is not unlikely that one topic of which scarcely a breath was heard in the Conference itself -- the question of inoculation -- may have received full attention there. A question asked in the German Parliament some weeks later elicited the fact that Prof. Neisser had been carrying on experiments of this kind at Breslau, and that the Government was by no means inclined to encourage them. But there is no reason to fear the light, if only there is light enough. Two things are to be hoped -- first, that the new Society will be based on lines as broad as those of the Conference itself, and will, as Dr. Blaschko insisted, admit all considerations and all orders of effort -- social, moral, and economical as well as medical -- towards the common aim; and next, that the representatives of these broader aspects of the question will accept the responsibility thrown upon them, and lend their patient aid to the building up of a scheme of things which shall conduce at once to public virtue and the public health. VI. -- RESULTS. "I DON'T think we have done much," said one of the English delegates as the Conference separated. In a sense, it was true. In another sense, time will probably show it to be most untrue. It was impossible that the Conference should begin with construction. No doubt it was disappointing to many that it should begin at chaos, but chaos is the raw material of creation, and it was very necessary to get back to the raw material. Most of the structures of the past are crumbling, and it was high time to know the extent of the damage, clear out the rotten foundations, and make room for something more organic. It was this that made the work of the Conference look almost like a work of demolition. But the Conference has done more 1 See "Compte Rendu," &c., pp. 423-426. 17 than demolish. It has served to lift a number of eminent practitioners above the ruts of practice and to make them thinkers. And this is due to the splendid courage and initiative of Dr. Dubois-Havenith. The Conference itself was hardly so much at a beginning; it was only a starting point. It was a mere search-light cast over the field where the work is to be begun. But it has roused the workers and shown them their tasks and that is no small achievement. The search-light naturally produced some disillusion. Delegates from non-regulationest countries were there, some of them with an inclination towards administrative coercion, to learn from the ancient wisdom of the Continent. They found that in those experienced countries administrative effort had got to the far end, and was beginning to come back. "We are waiting to see how you get on in Europe," said an American delegate to one of the German doctors. "After a hundred years of it, you don't seem much better off than ourselves. At present we are not much tempted to copy." 1 One or two incidents may be quoted to show how the leaven of ideas has gone on working since the Conference dispersed. It has been mentioned that ladies were invited, and that several were present and took part in the proceedings. They were warmly welcomed by some of the delegates. "Three ladies this time," said Professor Vassar, "that is alright. Next time there will be thirty." Mme. Bieberboehm's speech on the fifth question elicited cordial and outspoken admiration. A month or two later one of the German delegates, a University professor announced a course of lectures on the social question, open to both men and women, alleging that women took a great interest in the subjects, and could contribute much to their discussion. The Professor was in advance of his audience; the students would have none of it, and he was compelled to relinquish the attempt. This, too, is probably a question for Time. Another incident was the reading by Prof. Fournier at the Paris Académie de Médecine, a few weeks after the Conference, of a paper on "Prevention by Treatment," 2 in which he set forth in detail the scheme of free dispensaries and adequate attendance, which eh had sketched at Brussels in the debate on the sixth question. In this paper he repeats with added emphasis the striking language he had used at Brussels. "A long experience," he says, "has fully demonstrated the inadequacy of the whole system of administrative measures which constitute at present our only means of defence. The proof is that, in spite of that system, the disease is with us as in the past, an incurable ulcer in the side of our social system." "The administrative measures have been long tried, and have done all they are capable of doing. Without ignoring their advantages (which would be an ingratitude and an error) we must admit their insufficiency." "I will add, that they are likely to become even less useful as time goes on." He then proceeds to develop his scheme of purely medical prevention (i.e., the prevention of danger to others by the effectual treatment and cure of the patient), "a method which can awaken no distrust, and in the success of which everyone must needs be interested." 2 1 "Compte Rendu," &c., pp. 128, 129. 2 Published in the "Bulletin de l'Academie de Medicine," Paris, Nov. 14th and 21st, 1899.18 So, again, Prof. Neisser, in his report on the means of diminishing pros- titution,1 comes very close to the root of the matter when he says, "The question of prostitution is essentially and primarily a men's question rather than a women's question;" and adds that the "physical necessity"so commonly pleaded is not entirely natural, but is " artificially and abnormally increased," not only by immoral literature and entertainments, and the solicitation of the streets, but "by the very widespread belief that chastity is harmful in a man, which causes many, without any strong impulse of their own, to allow themselves to be led astray" (p. 7). " I personally," he observes (p. 6), "do not believe in this necessity, or the harmfulness of abstention." All this shows a growing appreciation of some, at least, of the neglected elements in the problem. Nevertheless, we must not expect too much. Amidst all this reaching out in new directions, many stand fast by the old system, and can see no defect in it except the want of more stringent and universal application. It will take time for the rankand file of the profession to become imbued with the new ideas, and more time still for the old ideas to die out. Nor is there anything to gain from an exaggerated enthusiasm for new methods, which can only lead to a proportionate reaction when the result of those methods is found to be as limited as--at first--it assuredly will be. It has been the misfortune of this conflict with disease, wherever and however waged, to be judged always at short range. It was so with the old methods, and it will be so with the new. The cry for voluntary hospitals and gratuitous treatment is all very well, but it takes time and a patient and sympathetic eye for detail to adjust these public benefactions precisely to the public need. It is possible that the results may at first be disappointing in the extreme, especially in countries where Regulation has left its mark, and where the dread of compulsory detention makes patients shy; and this may even produce a reaction in favour of sharper methods which seem to promise more, though they perhaps effect even less. We must be prepared for these disappointments, and must realise that, whatever the means adopted, they will have to be judged not by their instantaneous but their prolonged and progressive results, and by the whole of their action, indirect as well as direct, upon the national life. It is here that the old methods have conspicuously failed; it is here, above all, that any true method must secceed. Meanwhile the experience of the Continet affords a timely warning to speculative administrationists on this side of the channel. We had better not be in a hurry. Schemes for introducing futile fragments of State supervision in England are being propounded from time to time, with astonishing lightness of heart, by medical men and others, who appear never to have given the slightest consideration to what they are saying.2 ------ 1 "Rapports Preliminaires," Question V., pp. 1-18. 2 Witness the amazing paper contributed to the Brussels Conference by one of the English delegates, in which he first explains that Regulation would be impossible in England, and that he, for one, would never support it, and then proceeds to recommend that women frequenting the music halls for immoral purposes should be entered on a register and subjected to precisely the same conditions as the registered women of the Continent. 19 Between writers like these and the British public it is a case of the blind leading the blind, and it it likely to provoke a more or less sharp reaction when the latter discovers where he is being led. In any case, the new International Society should start on its way amidst the good wishes of all. The title bestowed on it, as a society for the moral as well as sanitary prevention, suggests the hope that it will look at this complex question in all its bearings, and attempt to deal with it in its profounder as well as its more superficial aspects. If so, we may hope that the era embittered controversy on this most melancholy subject is about to pass away, and give place to an era of mutual aid and common effort. NOTE (see p.6) So far as statistics are concerned, the discussions seem to have demonstrated, not for the first time, (1) the worthlessness of comparisons between selected town, garrisons, or periods, where all sorts of different conditions affect the result ; (2) the uselessness of statistics specialized (like Dr.Wolff's) from a local point of view, for comparison with statistics not so so specialised ; and (3) the absolute chaos introduced into the statistical argument by changes--possibly informal and unnoted--in the nomenclature, grouping, and identification of diseases, and in modes of treatment (in or out of hospital, brief, or prolonged, &c.). A remarkable instance of the effect of altered modes of treatment on the statistics is mentioned in the British Medical Journal of December 30,1989 After commenting favourably on the improvement reported in the Indian Army statistics in 1898, shortly after the introduction of Lord George Hamilton's new Cantonment rules, it says:-- "There is another measure by means of which the admission-rate can be reduced, and which we venture to think has had some effect in reducing the figures from 486 per mille in 1897 to 363 in 1898, and that is more efficient treatment. We had occasion some eighteen months ago to call attention to the fact that in very many instances soldiers were only treated as long as there was some outward sign of the disease, and that no regular and constitutional treatment was carried out until the disease broke out again, often in a more virulent form. This was largely owing to the difficulty under army regulations in continuing treatment after a man has been discharged form hospital. . . . It is obvious that under such conditions the same men were repeatedly being admitted for relapses of the disease, and in this way the admission-rate per mille was greatly swollen. "The lengthy correspondence which ensued on this subject in our columns showed that widespread interest had been aroused, and we have since that time, by frequent inquiries, learnt that regular and systematic treatment, in the Indian Army more especially, has recently been greatly extended. . . . This must have prevented many relapses, and so have lessened the admission-rate." It is indeed matter for congratulation that such an obvious reform should at last have been introduced. But how infinitely strange that the "difficulty under army regulations" should not have been removed before, during the years of panic and feverish excitement which preceded 1897! Chattam: W. & J. Mackay & Co., Ltd.WOMEN AS POOR LAW GUARDIANS. THE time is now approaching when those ladies whose attention has been drawn to the great need that exists for their co-operation in stemming the increasing evil of pauperism, should take pains to see that they are duly qualified for election as Guardians of the Poor, so that no technical difficulty may interfere with their performance of this most womanly occupation. The importance of having sensible and practical women on the Board of Guardians cannot be too often dwelt upon. The duties of a guardian are firstly towards the poor and helpless, to whom he may be either a most efficient friend, or little better than a tyrant; secondly to the ratepayers, on whose account he must try by a wise and careful economy, and by judicious repression of pauperism to save the public money. The diminution of pauperism is a subject which all philanthropists ought carefully to consider. This must be mainly effected by the better education of the children; there is little chance comparatively of helping an adult pauper back into the ranks of the independent, wage-earning classes, but there can never be any need that a pauper child should grow up to consider the workhouse as his ultimate destiny. In some places the plan has been tried with success of boarding out the children singly in respectable families; in others of bringing them up on the cottage system in groups of 12 or 20, where they learn independence, energy, self-control, and other moral qualities which are unattainable in the large workhouse schools. These systems have been very slowly and partially adopted; much more slowly than if ladies had been among the Guardians who had to decide upon the comparative merits of home-life and school-life. But this is a matter which much needs the attention of women. How best to give a happy child-life to all these forlorn little creatures who will infallibly drift into pauperism, unless their healthy energies and affections are roused, is a work which is peculiarly womanly; and if there must still be large schools where great masses of children are herded together, the im-2 portance of having qualified ladies to superintend and control the details of such education is all the greater.* Women are more economical than men, it is said. The ordinary teaching of life for men is to earn money, and for women to lay out the money so earned to the best advantage. Partly from this cause, and partly from having usually less money to spend than men, and being obliged to make a little go a long way, women do study economy, and would be more likely than men to be careful of the public money and not lavish it uselessly. Constant supervision and checking of expense is a most necessary part of a guardian's work, and I believe that if women were to help in this duty, a real gain would ultimately be made to the pockets of the ratepayers without causing the paupers to suffer. Again, the office of a guardian is unpaid, and takes up a great deal of time—more time than the majority of men who have a profession of their own are able to spare. A much larger proportion of women have leisure at their command, which could not be more usefully employed than in trying to alleviate the sufferings and remedy the ignorance of our lowest classes. Women already do much in this direction. They are district visitors, deaconesses, Bible-readers; they have organised clothing clubs, mother's-meetings, soup-kitchens, and thus their training has already brought them into close acquaintance with the habits of the poor. This past experience will make them less likely to be imposed on by false pretences of want, and more keen to discover real cases of misery than men who have seldom had time to give to these details. Not only do women and children form the very large majority of paupers, so that it seems natural and fitting that the Board which controls and takes care of them should not be composed entirely of men; but every Poor Law Union employs a good many women in subordinate capacities, and it would be a great advantage to the nurses, matrons and female school teachers to have ladies among their employers whom they might consult on difficult questions, or offer their suggestions or complaints to. There are numerous cases which will readily occur to the mind of every woman, in the management of the sick and the babies, or the feeding and clothing of the children, especially the girls, which a matron is most unwilling to bring before a Board of gentlemen, and which for that reason are either ignored ———————————————————————————— *Any lady intending to offer herself as guardian should carefully study these questions beforehand. The "Reports of Conferences by Poor Law Guardians," published by Knight & Co., 90, Fleet Street, will be of great use to her. She should also study the means that have been successfully taken to diminish pauperism in the east of London by reducing out-door relief. 3 or mismanaged. We all know how important it is to have ladies on the School-Boards, though children only spend six or seven hours at lessons. How much more necessary it is to have ladies engaged in the supervision of workhouses, and the control of workhouse-schools, which are the homes as well as schools of the children. Also, when the girls of 14 or 15 go out to domestic service, there ought to be some ladies in a position of authority to give them kind advice and encouragement. There is a good deal of rough and disagreeable work, undoubtedly, to be encountered in this duty. Some of the cases which come before the Board of Guardians are painful in the extreme, and if there is but one lady on the Board it will be a particularly hard trial to her to listen to them. But she must remember that possibly as a guardian she may be enabled to say the right word in season, to comfort, advise, or, it may be, save some poor creature driven almost to despair. If it be hard for her to sit and listen, how much harder is it for the young girl or poor mother under discussion if none of her own sex are there to countenance her? It is the most Christian work a woman can take up. The poor we have always with us, and the very poorest of the poor are in charge of the guardians—mostly old and sick, and women and infants, people to whom kindness and sympathy are almost of more value than the bread they eat. Indiscriminate alms-giving is not Christian charity, neither is paying your rates. But giving time and trouble to see that the rates are applied properly for the greatest benefit, morally as well as physically, is the noblest charity of all. In London, last spring, seven ladies were elected Guardians, and two in the country. These ladies have already aided in some necessary reforms, and so far their election has been of use. But they are like drops in the ocean, for there are about 630 Unions, and parishes having each its Board of Guardians. How urgent, therefore, is the want of more ladies to help in the work. I would earnestly entreat all women to see what they can do in this matter. They may help the cause in many ways. The most important is by being willing to undertake the duty of guardian themselves. Ladies must remember that to be eligible for election they must be householders, and have themselves paid the last rate (due in January) before the election. (In most London parishes the house must be of £40 value, but it is lower in some places, and this a lady desiring to be Guardian will ascertain.) If she is not already a householder, she should take pains to qualify herself as soon as possible. Sometimes a mother living with her daughters would make over the house to one of them to give her the necessary qualification; or sisters living together should take care that the name of that one4 who is going to stand is entered on the rate-book. In every case women should take legal advice so that the qualification may be thoroughly sound: both time and money may be wasted without this precaution. Next, all those ladies who are unable to offer themselves as guardians personally can help in other ways; by joining, or persuading their friends, men as well as women, to join the Association for Promoting the Return of Women as Poor Law Guardians, (Miss Eva Muller, 86, Portland Place, London, W., is Hon. Sec., and the subscription is 2s. 6d.), or by acting as corresponding members, or forming local committees, like one already at work in Bristol, to look out for, and help some suitable lady in her election. The method of election is by filling up a voting paper, which is given to every householder, women as well as men: mistakes often occur in doing this, and no lady can give better help than by going before the election to explain to her neighbors the right way of recording their votes. In Ireland there is no possibility of carrying out this reform till the law is altered. Neither women or clergymen are eligible as Poor Law Guardians, and this double restriction has been found sometimes to work very injuriously. It is probable that a measure may be passed with little difficulty to assimilate the Irish law in this respect to the English law, provided that a sufficient body of public opinion be favorable to the change. There is, therefore, equal need for Irish ladies also to express their willingness to serve as Guardians, and to qualify themselves for doing so, that this great reform, when it comes, may not find a want of earnest and efficient helpers to carry it forward. C. A. BIGGS. [Reprinted from Englishman's Review, 22, Bernes Street, W, London] [*With the Author's Compliments*] From "THE PRACTITIONER" for October, 1896. HYPNOTIC ANAESTHESIA. BY J. MILNE BRAMWELL, M.D. [*2 Henrietta Street Cavendish Square W.*]From "THE PRACTITIONER" for October, 1896. HYPNOTIC ANÆSTHESIA. BY J. MILNE BRAMWELL, M. D.HYPNOTIC ANÆSTHESIA. By J. MILNE BRAMWELL, M.D. ESDAILE'S MESMERIC OPERATIONS. No account of hypnotic anæthesia would be complete without reference to Esdaile. When he commenced his experiments Braid had not established the subjective nature of the phenomena, and Esdaile shared the erroneous theories of the mesmerists. This apparently had little effect upon his success. His first painless mesmeric operation was performed at Hooghly on April 4th, 1845. At the end of a year he reported 100 successful cases to the Government. A committee, largely composed of medical men, was appointed to investigate his work. Their report was favourable, and Esdaile was placed at the head of a Government hospital in Calcutta for the express purpose of mesmeric practice. From this date until he left India in 1851 he occupied similar posts. He recorded 261 painless capital operations and many thousand minor ones, and reduced the mortality in the removal of the enormous tumours of elephantiasis from 50 to 5 per cent. Patients flocked to him from all parts of the country. Before employing mesmerism he had only operated on eleven scrotal tumours in six years. Afterwards he had more cases of this kind in a month than all the other hospitals in Calcutta in a year. In 1853 Esdaile indignantly protested against the statement that either was the earliest anæsthetic. He said: "The simple and notorious fact is that painless surgery by means of4 HYPNOTIC ANAESTHESIA. mesmerism, years before ether was heard of, was as common in my hospitals as it has since become in Europe under the influence of chloroform." While Esdaile was performing mesmeric operations in India, similar ones took place in England, but were badly received. The subject of a painless amputation of the thigh was described by one medical critic as an impostor, while another asserted that pain during operation was a wise provision of nature, which assisted recovery and which it was impious to interfere. HYPNOTISM IN SURGERY: THE AUTHOR'S RESULTS. The introduction of ether and chloroform was a death- blow to mesmerism. Now that hypnotism has gained a place amongst the sciences and is largely employed abroad by many distinguished members of our profession, we again hear of its use in surgery. When I commenced hypnotic practice seven years ago, I found I could often induce anaesthesia. As we already possessed trustworthy anaesthetics, I regarded this as mainly useful in demonstrating the genuine nature of hypnotic phenomena. Nevertheless, as the following cases show, hypnotic anaesthesia is not without value. Miss A., aged twenty. Double strabismus. Operated on by Mr. Bendelack Hewetson, of Leeds, November 24th, 1889. The only anaesthetic was hypnotic suggestion. The patient held her eyes in the position required, and turned them in any direction necessary to put the muscular fibres on the stretch. No pain during or after the operation. On December 26th, 1881, she sustained a severe fracture of the nose. Hypnotic anaesthesia was induced and the bones moulded into position. Mr. B., aged forty. January, 1890. Severe fracture of bones of the arm and shoulder girdle, with much injury to soft parts and subsequent ankylosis of joints. On several occasions he was put under chloroform and the adhesions broken down; this was always followed by swelling, inflammation, and renewed immobility. Ultimately he refused the anaesthetic, and would not allow passive movement without it. He was hypnotised at the first attempt, and the adhesions broken down without pain from time to time. Recovered. 5 HYPNOTIC ANAESTHESIA. The late Mr. A. Turner, L.D.S., published an account in the Dental Journal for March, 1890, of some of his operations on my patients. He said: "I had a large choice of patients, and selected those which I considered would afford a severe trial of this method. I extracted in all about forty teeth, tried my best to discover defects, and questioned the patients myself, but the results were most satisfactory. . . . Hypnosis was induced and removed almost instantaneously. . . . . A young girl, suffering from valvular disease-- a week, anaemic subject whom one would expect to find 'deepen' consider- ably under nitrous oxide and remain in a state of collapse for a whole day after ether-- was quickly and quietly rendered unconscious. Two left molars, two right molars, and a lower bicuspid, all difficult teeth, were painlessly extracted, and there was no pain afterwards. . . . " A number of my patients were operated on at Leeds, on March 28th, 1890, and according to Mr. Pridgin Teale, who, together with about sixty other medical men, was present, "the experiments were deeply interesting, and had been marvellously successful." He also said: -- "I feel sure that the time has now come when we shall have to recognise hypnotism as a necessary part of our study." The following were two of the cases:-- Miss C., aged nineteen. Dental. A weak anaemic girl. Hypnosis and anaesthesia were produced by means of my written suggestion, and sixteen teeth extracted, while I remained in another room. No pain during or after the operation. Master D., aged eight. Exostosis of great toe. Hypnosis first induced two days previously, Mr. Mayo Robson removed the great toe-nail; then the exostosis and part of the first phalanx. No pain during or after operation. Some of the patients were nervous subjects, highly sensitive to pain in the normal condition; others were strong, healthy working men. They all returned home the same day, over an hour's railway journey, laughing and singing as if coming from a fair. None kept the house, except the boy whose foot had been operated on, and in all, the healing process was remarkably quick.6 HYPNOTIC ANAESTHESIA. RESULTS OF OTHER PRACTITIONERS. Numerous other operations during hypnotic anaesthesia have recently been reported. The following are a few examples:-- France: Dr. Schmeltz, Carcinoma of Breast; Dr. Bourdon, Uterine Fibroid; Dr. Taillaux, Colporrhaphy. Germany: Dr. Grossmann, Fractures and Dislocations. Sweden: Mr. Sandberg, Deltal operations. Switzerland: Prof. Forel, Cataract. Cuba: Dr. Diaz, Dental operations. America: Dr. Wood, Necrosis of Humerus. Holland: Drs. van Eeden and van Renterghem, Dental operations. Many painless confinements, mostly primiparous, have been recorded--in France by Drs. Mesnet, Dumontpallier and Fanton; Germany by Dr. von Schrenck-Notzing; Austria by Dr. Prtizl; Belgium by Prof. Fraipont; Switzerland by Dr. Dobrovolsky; Sweden by Dr. Wetterstrand; England by Dr. Kingsbury, etc. OBJECTIONS TO HYPNOTISM FOR SURGICAL PURPOSES. The chief objection to hypnotism in surgery is the difficulty and uncertainty in the induction of the primary hypnosis. Susceptibility varies widely. Recent statistics show that about 94 per cent of mankind can be hypnotised. With a considerable proportion, however, many preliminary attempts are necessary, and sometimes hypnosis never becomes deep enough for operative purposes. As an almost invariable rule the nervous and hysterical are the most difficult the healthy and mentally well-balanced the easiest to influence. Some years ago, when in general practice, I could usually rapidly induce hypnotic anaesthesia among my own patients. Now, when my practice is confined almost entirely to those suffering from chronic nervous affections, I find it more difficult to obtain deep hypnosis with insensibility to pain. Under these circumstances, unless grave reasons existed for the non-employment of other anaesthetics, I should consider it a waste of time to attempt to hypnotise a patient for operative purposes alone. ITS ADVANTAGES. Apart from this, hypnosis possesses many advantages. (1) Once deep hypnosis, with anaesthesia, has been obtained, 7 HYPNOTIC ANAESTHESIA. it can be immediately reinduced at any time. (2) No repetition of any hypnotic process is necessary, the verbal order to go to sleep being sufficient. (3) The hypnotiser's presence is not essential. The patient can be put in touch with the operator by written order, or by other means previously suggested during hypnosis. (4) No abstinence from food or other preparation is requisite. (5) Nervous apprehension can be removed by suggestion. (6) Hypnosis is pleasant and absolutely devoid of danger. (7) It can be maintained indefinitely and terminated immediately at will. (8) The patient can be placed in any position without risk, a not unimportant point in operations on the mouth and throat, and will alter that position at the command of the operator. Gags and other retentive apparatus are unnecessary. (9) Analgesia alone can be suggested, and the patient left sensitive to other impressions-- an advantage in throat operations. (10) In labour cases, the influence of the voluntary muscles can be increased or diminished by suggestion. (11) There is no tendency to sickness during or after operation, a distinct gain in abdominal cases. (12) Pain after operation, or during subsequent dressings, can be entirely prevented. (13) The rapidity of the healing process, possibly as the result of the absence of pain, is frequently very marked. HYPNOTIC ANAESTHESIA A THING APART. It is possible that improvement in the method of inducing hypnosis may arise, but, until then, its usefulness in surgery will ever remain restricted. Hypnotic anaesthesia, however, must always be of keen interest to both physiologist and psychologist. As has been pointed out, it is a thing apart, and by no means an ordinary narcotic, a fresh specimen of the methods already familiar for preventing pain by checking all conscious cerebration. It is a new departure; it is the first successful attempt at dissociating forms of sensation which throughout the known history of the human organism have almost invariably been found to exist together. The suppression of pain is achieved by the selection and inhibition from among all the subject's possible sensations of precisely those which be in any way disagreeable to him.STATE SANCTION OF VICE. A brief statement as to the nature and tendency of the "Contagious Diseases Acts," and why their re-introduction should be opposed by all honest men and women to whatever party they belong. (March, 1897.) WHAT THE CONTAGIOUS DISEASES ACTS WERE. About thirty years ago the Authorities of the Army and Navy contrived to pass through Parliament what were known as the "Contagious Diseases Acts, 1866-69." These Acts introduced into this country a horrible system, which has long been in existence in Continental cities, - of licensing and sanctioning immorality. They were in operation in eighteen military and naval districts in England and Ireland. Their object was to enable immoral men - particularly soldiers and sailors - to sin without risk to their health (if that were possible, though it is not), by setting women apart to be enrolled, registered, medically examined, and certified for this indescribably degrading purpose. It may be thought that this language is exaggerated. But in the Report of a Royal Commission appointed in 1871, the object in view was described, as "to render the practice "of prostitution, if not absolutely innocuous, at least much "less dangerous." AGITATION AGAINST THE ACTS AND THEIR REPEAL. At first only a few persons knew of the existence of the Acts, but thanks to the efforts of the London Rescue Society, Mrs. Butler, Sir James Stansfeld, Professor Stuart, and others, moral and Christian people were roused from one end of the country to the other, and a struggle was carried on for 18 years, which probably has no parallel in any country. As the result, the Acts were suspended in 1883, and repealed in 1886. THE INDIAN SYSTEM. The authorities in India have endeavoured for about a hundred years to carry out similar arrangements for European soldiers. Dr. Ross, an Army Surgeon, gave the following evidence before the Royal Commission in 1871 :- "When a regiment arrives in India, a certain establishment is told off for each regiment as it arrives, and amongst others there is an establishment of prostitutes, who are housed in the bazaars, and regularly looked after by the matron appointed 2 for the purpose, and superintended and examined by the surgeon of the regiment." (Q. 15,129.) "When a regiment goes on a line of march, there is a form to be filled up, and in one column there is amongst the camp-followers one for prostitutes, showing the number who are permitted to follow the regiment; and those women we made a point of examining every fortnight." (Q. 15,168.) "There is a head woman under the name of the Matranee, who is at the head of the kusbees or prostitutes. She selects the women; she is told that such and such a regiment is coming into the station, and, according to whether the regiment has had a name sent before it or otherwise, she gets a small or a large number of women to come to her." (Q. 15,179.) "When I got to India with my regiment . . . there were only 12 women came, but I desired that they should increase the number, because I knew it would only be a source of disease afterwards, having such a small number of women for such a large number of men." (Q. 15,180.) These practices were zealously fostered by the Authorities. Laws were passed and numerous official instructions were from time to time given in regard to them. One of these (dated 12th July, 1884) drew attention "to the desirability "when constructing free quarters for registered women, of "providing houses that will meet the wishes of the women. "Unless their comfort and the convenience of those who "consort with them is considered, the result will not be "satisfactory." In other words efforts were to be made to render immorality as agreeable as possible to both of the parties to it. Another of these instructions, which has been well designated "the infamous memorandum," was issued in 1886 under the authority of Lord Roberts -- then Commander-in-Chief of India. It stated among other things that it is necessary " . . . to arrange for the effective inspection "of prostitutes attached to regimental bazaars, whether in "Cantonments, or on the line of march, . . . to have "a sufficient number of women, to take care of that they "are sufficiently attractive, to provide them with proper "houses . . . " Is it surprising that among several commanding officers who promptly acted on this advice one made a "requisition for extra attractive women for regimental "bazaar in accordance with circular"? And is it any wonder that the result of such provisions should be the increased vice which has led to the development of such an amount of disease as we hear of now in the Indian Army? As already stated, the Acts in England were abolished in 1886; and in 1888, on the motion of Mr. Walter McLaren, a resolution condemning the whole system in India, and urging its discontinuance was carried in the House of Commons without any one venturing to vote against it. 3 The practices, therefore, ought to have been discontinued at once, but the military authorities having disregarded instructions to that effect, they were, in 1893, proved to be going on as before. Whether the authority of Parliament has, or has not, been respected since that date is not definitely known. DANGER OF RE-ENACTMENT. Certain newspapers and military men have continued to urge the re-introduction of these practices. In 1896 questions were repeatedly asked in Parliament, and have been recommenced in 1897, showing how strong the desire for this is in certain quarters. The Government have yielded to the pressure put upon them, and in the Autumn of 1896, they appointed a Committee to make some enquiry into the subject. There is grave reason to fear that the advocates of the iniquitous system will resolutely endeavour to persuade the present House of Commons to commit themselves to its reenactment in India, and it may be in England also. REASONS FOR OPPOSING THE REGULATION OF VICE. It should be clearly understood that the opponents of Regulation believe that all kinds of sufferers -- even when they suffer from their own vice, ought to be succoured, relieved, and healed. But they support the following declaration of the first Congress of the "British, Continental "and General Federation for the Abolition of Government "Regulation of Prostitution," held at Geneva in 1877. I. -- That impurity in men is as reprehensible as it is in women. II. -- That the regulation of prostitution tends to destroy the idea of the unity of the moral law for the two sexes, and to lower the tone of public opinion in this respect. III. -- That every system of organized prostitution encourages profligacy, increases the number of illegitimate births, developes clandestine prostitution, and lowers the standard of public and private morality. IV. -- That the compulsory medical examination of women, the basis of every system of regulation, is an outrage on women, and tends to destroy, even in the most degraded, the last remnant of modesty which she may retain. V. -- That the registration of prostitutes is contrary to common law, and to the principle of liberty. VI. -- That in regulating vice the State forgets its duty of affording equal protection to both sexes, and in reality degrades the female sex and corrupts both.4 VII. -- That the State, whose duty it is to protect minors and to assist them in every good effort, on the contrary incites them to debauchery, in so far as it facilitates it by regulation. VEN. ARCHDEACON WILSON, Vicar of Rochdale, in his speech at Birmingham, 13th November, 1896, said: -- "We think them (the Acts) immoral and degrading. Something has been said of their immorality, but let me say how degrading they are. They have led to an evasion of truth, and to prevarication on the part of some high officers in the Army. That has been the inevitable result, and those who have followed the evidence know that what I say is true. They have degraded our doctors who have to carry out these Acts. They have degraded our men by confusing their sense of right and wrong. They have degraded, in turn, our own villages and towns, to which these men, accustomed to this provision of vice, return after a few years. "Do not forget that these men come back to us with their habits for prostitution formed in India . . . Then the Acts are not only immoral and degrading, but they are deeply sinful, for it is sinful to aim at making sin safe." THE LATE JOSEPH MAZZINI: -- "In these Acts lies the germ of moral disease, far more terrible than the physical evil they thus brutally and importantly endeavour to stamp out; this step backward, taken in selfish fear, will, if not speedily retraced, be followed by others, until the moral sore, neglected, will become a cancer, infecting the very life blood of your nation." THE CATHOLIC EPISCOPATE OF BELGIUM, in a letter (June, 1894) to His Holiness Pope Leo XIII: -- "The fact of the attempt to regulate vice implies a sanction given to the monstrous theory of a 'necessary evil'; it incites young men to immorality, and strikes a fatal blow to the dignity of humanity by compelling a multitude of women to endure the deepest of all insults." Published by the British Committee of the Federation for the Abolition of the State Regulation of Vice, 1, King Street, Westminster, S.W., where may also be obtained: -- Personal Reminiscences of a Great Crusade. By Josephine E. Butler. Price 7s. 6d. Postage 6d. The History of a Sanitary Failure. By H. J. Wilson, W.P. Each 1 d. Per 100 6/- Understood but not Expressed. By Jos. Edmondson. Each 1 d. Per 100 6/- An Enquiry into the Causes of the Great Sanitary Failure. By. Jos. Edmonson. Each 1 d. Per 100 6/- A Doomed Iniquity. Each 1 d. Per 100 6/- Indian Cantonment Scandals. By Rev. J. P. Gledstone. Each 1 d. Per 100 6/- Re-enactment Threatened in India. Per doz. 3d. Per 100. 1/6 A Constitutional Iniquity. Per doz. 3d. Per 100. 1/6THE POOR LAW SYSTEM OF ELBERFELD. TO THE RIGHT HON. JAMES STANSFELD, M.P. SIR, I HAVE the honour to inform you that, in compliance with your instructions, I have visited Elberfeld, and made inquiry into the system of Poor Law Relief that is in operation in that town. Having ascertained that the same system had been adopted in the towns of Barmen and Crefeld, it appeared to me to be important to extend the inquiry, not only to those towns, but also, for the purpose of comparison, to the towns of Düsseldorf and Aix-la-Chapelle, in which the Poor Law is still administered under the old system that formerly prevailed in Elberfeld. I was able to do this in the short time at my disposal by the aid that was most kindly and zealously given to me by Mr. Crowe, H.M. Consul-General in Saxony, who, under instructions from H.M. Chief Secretary of State for Foreign Affairs, was associated with me as a colleague in this inquiry. The Report which I have the honour to submit to you is, therefore, the result of an inquiry made by Mr. Crowe and myself. The desireableness of instituting this inquiry was, I believe, in the first instance suggested to you by Mr. Rathbone, M.P. for Liverpool. While Mr. Crowe and I were at Elberfeld, Mr. Rathbone visited the town, and made inquiry himself into the system in which he takes so great an interest. How far Mr. Rathbone may concur 28419. Aii in the view of the system presented in this Report, I am of course unable to say. But in considering the question whether it would be possible or expedient to engraft any part of the Elberfeld system upon our own, the opinion of one who has had so much practical experience, not of Poor Law administration only, but of the organised administration of private charity, cannot fail to be of great value; and I may be allowed, I hope, to express satisfaction that an opportunity may be afforded of comparing, by an independent authority of so much weight, the efficiency of two systems that are in many respects so greatly at variance as are those of Elberfeld and Liverpool. I have the honour to be, Sir, Your obedient servant, ANDREW DOYLE, Poor Law Inspector. REPORT. IN the year 1852-the year before the present system of Poor Law Relief was adopted in Elberfeld-the total number of persons relieved out of a population of 50,364 was 4,000, or just 8 per cent., at acost of 47,149 thalers, or 7,072l. 7s. The present system was established in 1853-4. In 1857 the population had increased from 50,364 to 52,590; the number of paupers had decreased from 4,000 to 1,528, or from 8 per cent. to 2 9 per cent. on the population; the expenditure from 47,149 thalers (7,072l. 7s.) to 17,487 (2,623l.) The history of the means by which this extraordinary change was effected is the history of what is known as "the Elberfeld system" of poor law relief; the origin, constitution, and general results of which I shall state as briefly as is consistent with the giving of a fair and sufficiently full account of it. By a Royal Prussian Decree, dated May 21, 1823, applicable to the Province of Dusseldorf alone, the municipalities (politische Gemeinde) were constituted the legal authority for poor relief, and from that time forward the poor law in Elberfeld, Barmen, Dusseldorf, Remscheid, Solingen, and other places within the Keris or circle of Dusseldorf, was administered by the municipalities. Down to 1850 the poor laws in operation within the district or circle were based upon the French legislation under the Empire in the Rhenish provinces. It was only in a certain number of the towns that, until a very recent period, local regulations for the relief of the poor superseded the Bureaux de bienfaisance. Elberfeld was one of the towns the municipality of which took advantage of the right to establish a local system of poor law administration. In 1850 the town was divided into sixty districts, a visitor or Armenpfleger being appointed for each district. It is not necessary to enter into any details respecting this earlier organisation further than to observe that it proved to be unsuccessful. The number of visitors was found to A2iv be too few; the duties of the visitor were neglected; the pauperism and expenditure increased; and the condition of the town with reference to its pauper population--their complete demoralisation--was a source of much uneasiness to the more respectable inhabitants. Before the establishment of the present system an attempt was made to cope with the difficulty through the agency of the religious bodies, each community being invited to take charge of its own members. This proposal was accepted by the Lutherans alone, reputed to be the least pauperised class of the community. As the relief of the poor of the whole town was paid out of a common fund, it will be easily understood that for this reason, if for no other, the plan was altogether unsuccessful. The state of pauperism and the amount of expenditure were in 1852 found to be such as to excite very general apprehension, and it was determined by the municipality of effect a complete revision of the system then in operation. It is worth observing that in the early constitution of the new system, the Lutherans were excepted, being allowed to retain the administration which, as I have stated, they alone had adopted for their own community. Within two years, however, after the introduction of the Lutheran community, under its separate administration, exceeded the proportion of the rest of the town by about 30 per cent. The result was the abandonment of this exceptional administration, the experience of which, however, is of value as illustrating the effect of two different systems working side by side in the same community and under similar circumstances. The existing " Elberfeld system" of poor relief originated with one of its most distinguished citizens, the banker Daniel Von der Heydt. Although the infirm state of this gentleman's health prevents him, unhappily, from longer taking an active interest in the municipal affairs of the town, he has succeeded, mainly by the influence of his high personal character, in so far recommending the system of poor law administration that it may be now considered as firmly established, men of all classes freely admitting its complete efficiency. Indeed a comparison of the pauperism and expenditure of the town before and after the introduction of the system will be found to exhibit results that it would be hard to match in the administrative history of any English union. v The principles enunciated by Mr. Von der Heydt, and which he has unceasingly enforced in his annual addresses, are embodied in a general law ("Ordnung") and a code of rules ("Instruction"), the former drawn up by the present Ober Bürgermeister, Dr. Lischke, a man of great energy and force of character, and the latter suggested by the experience of Mr. Von der Heydt himself. The Poor Law administration which Mr. Von der Heydt originated is constituted under the provisions of an Armen Ordnung, or Poor Law, framed in July 1852 and revised in January 1861. Provision is made in the Ordnung for the constitution of the several administrative bodies. Their duties and relations to each other are determined, and their proceedings regulated by certain rules. Appended to the Ordnung is an "Instruction"which embodies the whole of the rules that regulate the administration of relief. The Ordnung and Instruction taken together are to the Elberfeld system what "the Consolidated Orders" are to English Poor Law. I shall state the effect first of the Ordnung and then of the Instruction, and in doing so, instead of following exactly the terms or the order of either I shall embody such portions of each as may appear to be immediately connected. Under the provisions of the Ordnung the administration of the Poor Law devolves primarily upon the Armenverwaltung or town administration of the poor. This body consists of a President, four members of the Municipal Council, and four citizens, usually selected from the wealthy and more distinguished inhabitants. They are appointed by the Municipal Council for a period of three years, and retire by rotation. Two members, one being of the number appointed by the Municipal Council and one of the number appointed from amongst the general ratepayers, retire every first and second year, and two of each class every third year. This arrangement, while it secures the renewal of the whole body within each period of three years, secures permanently the services of a certain number who have had some considerable previous experience. The retiring members are eligible for re-election, and are in fact generally re-elected. The only other point in the arrangement of this rotation is that the retirement of the first year is by lot, of every subsequent year "according to age." Subordinate to the Armenverwaltung are-- 1. The visitors or Armenpfleger. 2. The overseers or Armenvorsteher.vi The offices of Armenpfleger and Armenvorsteher-- visitor and overseer--are unpaid and compulsory. The citizens of each district ascertain by inquiry amongst themselves who of their body are likely to make the most efficient visitors or overseers, and having ascertained, as a matter of courtesy, that they are not unwilling to serve, nominate them for appointment to the Municipal Council. These nominations are usually accepted as a matter of course by the Council, and in the same way sanctioned by the Ober Bürgermeister. These formalities of selection and appointment are found to have the effect of conferring considerable dignity upon the office, which is not lessened by the fact that the selections and appointments are made in the most liberal spirit, without reference to politics or religion, or to any consideration save fitness for the office. The "oath of office" is simply a handschlag or grasp of the hand, which is possibly found to be not less binding than the more solemn form of obligation so often exacted from English officials. The administration of out-door relief is entrusted to eighteen overseers (Bezirksvorsteher), or in case of unavoidable absence, substitutes elected from amongst the visitors or Armenpfleger, and to two hundred and fifty-two (252) visitors (Armenpfleger). The overseers and visitors are elected for three years, substitutes for one. One third of the overseers and visitors retire every year and are elected for three years, substitutes for one. One third of the overseers and visitors retire every year and are eligible for re-election. Each visitor or Armenpfleger has under his charge a certain section of the town, and fourteen of these sections are under the general superintendence of one overseer or Bezirksvorsteher. The visitors of each district meet at least once a fortnight, the meeting being presided over by the overseer of the section. Every application for relief is made to the visitor of the section. Upon receiving the application the visitor is bound to make minute personal inquiry into the circumstances of the case. It will be seen in a subsequent part of this report that the inquiry is of the most searching character. If he be satisfied that a claim to relief, under conditions to be noticed hereafter, is established, and the case be one. The form and amount of this relief is so prescribed as to obviate, as far as possible, the chance of abuse or imposture. vii Reports of relief that may have been given by the visitor, and all applications made to him for relief, are submitted for consideration at the fortnightly meeting. They are disposed of in accordance with certain rules, here-after to be noticed. Each case is decided by a majority of votes, the President having a casting vote. The President may also object to any decision of the meeting, and carry it by appeal to the next higher tribunal. The conditions upon which relief may be granted, and under which applications are determined, are laid down in an "Instructions" drawn up by the Town Administration. I shall hereafter refer to this "Instruction" more fully, and would merely observe of it here, that it defines with great precision the duties and the powers of the visitors. That portion of it which refers immediately to the giving of relief may be regarded as "the Prohibitory Order" of the Elberfeld system. From this account of the mode in which the meetings of the visitors or Armenpfleger are regulated, it will be observed that there is no corresponding administrative body in our poor law system. The counterpart to it with us would be a meeting of fourteen relieving officers, unpaid, each with a district comprising not more than four ases, bound to administer relief in accordance with certain fixed and very stringent rules, each responsible to the majority of his fellows, and all responsible to the higher administrative tribunal, the town administration or Verwaltung. It may be further observed that these relieving officers should be selected from amongst well-to-do citizens, shopkeepers, manufactures, master mechanics, and men engaged in various professions, and that they should be selected upon the simple ground of their fitness for the office. An opportunity was obligingly afforded to Mr. Crowe and me of attending one of these meetings on the 18th of October. (With a view of avoiding expense, all these district meetings are held in the schoolroom of the district.) Of the fourteen Armenpfleger of the district, twelve were present, the meeting being presided over by Mr. Kost, the overseer of the district. Each Armenpfleger produced the sheet that is equivalent to our Application and Report Book (Abhörbogen), from which the particulars of the cases were read. There was no new case--no fresh application for consideration. Eighteen cases, however, were reheard or revised. Oneviii was a case of non-resident relief, an aged widow resident in Elberfeld, but settled in Düsseldorf. The only peculiarity about the case was that the pauper received from Düsseldorf a larger amount of relief than she would have received had she been settled in Elberfeld; that is she received 32 instead of 25 silber groschen, 3s. 2 1/2 d. instead of 2s. 6d. Some of the applications showed that the visitor within whose district they were comprised had very minute knowledge of the circumstances of each case. In one case a visitor proposed that the relief of an aged widow should be reduced upon the ground that the doctor had certified that she was capable of getting more than the sum returned as "earnings." The visitor of the district thought there must be some mistake, he "knew that she could not get more."The medical certificate was examined and was found to be dated so far back as April. Temporary relief was sanctioned, and an order made that a fresh medical certificate should be obtained and produced at the next meeting. Another case was that of a widow with two children who was in receipt, as weekly relief, of 45 silbergroschen (or 5s. 6d.) It was reported that since the last meeting the two children had got employment, and were now able to earn 20 silber groschen per week. After some discussion it was resolved to reduce the relief by 5 silbergroschen, with an intimation that a further reduction would be made as soon as it was seen that the earnings of the children were a source of permanent income. Before the termination of the sitting, each visitor received from the overseer the amount in cash of the estimated expenditure of his district for the next fortnight. The source from which these moneys are provided I shall explain presently. If it should be thought that the cases to which I have just referred are so trivial or common-place as to be hardly worth recording, I can but say that they fairly illustrate the every-day working of the system. They show minute knowledge of the circumstances of each case by the district visitor, and they show the consideration as well as the care with which was merely one of business, not enlivened by speeches, wrangling, or irrelevant talking, lasted just one hour and ten minutes, and would have terminated sooner, but for the courtesy that allowed us to make inquiry on any point on which we might take an interest. The secretary, always one of the visitors who ix may be present, made minutes of the proceedings, and these, with the minutes of the several meetings of the other districts, all held upon the same day, would be presented for consideration and confirmation the following week at the fortnightly meeting of the Verwaltung or town administration of the poor. The meetings of the town administration, like those of the visitors, are held fortnightly, but on the alternate Wednesday. These take place in the Town Hall, and in the absence of the President, Mr. Von der Heydt, are presided over by the Vice-President, Mr. Gustav Schlieper. The proceedings of these meetings, like those of the visitors, are conducted in accordance with prescribed forms. They take into consideration the minutes of the district meetings which they may alter or annul. The overseers attend these meetings, give information as to the state of the poor in their districts, and such further information as may be required of them; submit for consideration such decisions of the district meetings as they may object to or consider to be of doubtful legality; submit such questions as may have been reserved by the district meetings as not being within their jurisdiction; submit estimates of expenditure, including money, food, clothing, for the ensuing fortnight; receive from the town assembly the sums appropriated to each district, which they are bound to hand over to the visitor. The town assembly also receives and considers the reports of the several committees, or Directione, consist of one member of the municipal assembly, and two inhabitants in possession of the municipal franchise. They are elected for three years, one retiring each year by rotation. We were permitted to attend the meeting of this body on the 11th of October. The proceedings were merely routine, that is, the relief lists of the several districts were examined, not as a matter of form, but carefully, and were passed, and orders upon the town treasury for the next fortnight's expenditure were given to the several overseers. To a stranger the impression conveyed by the constitution of this body, and the demeanour of the members, would be what in England might be produced by attending a board meeting of the directors of some important public institution or large commercial enterprise.xii Persons hiring domestic servants are bound to support them, or pay the cost of their relief, for four weeks after they become destitute through sickness; so also the obligation to support a destitute person may be incurred by contract, as in cases of benefit societies, burial societies, &c. Nowhere is the legal obligation of supporting relations, especially the duty of children to contribute to the support of parents, more rigidly enforced than in Elberfeld. It is enjoined in the "Instruction" upon overseers and visitors to impress and enforce this duty upon all occasions. A person who is by law liable to contribute to the support of a resolution and, being able, neglects, upon being called upon, to do so, was, if the relation become chargeable, liable by the police regulations to imprisonment during such time as the relief might be required. The second exception must be taken with some qualification of the terms. Although the Elberfeld administration are desirous of keeping charity and poor law relief wholly distinct, and such is the object of this provision, yet it is found to be practically impossible to refuse altogether to relieve poor persons who are in receipt of charity, and if so, the source, and sum; and relief is granted only to such an amount as to bring the whole income, including the receipt from charity, up to the scale already given. The system of medical relief for out-door poor is this: The Town is divided into five districts; each district being in charge of a medical officer and of a subordinate of a lower status termed a "Heil-diener," the equivalent, I suppose, of the extinct "barber surgeon;" whose functions are only occasional, and confined to the performance of the simplest operations. The medical officer is bound to attend every pauper who applies to him for medical aid with an order from the Armenpfleger. This order is essentially the same as our own order for medical relief. The medical officer writes a prescription in every case, which is taken to the apothecary who for the current year has the contract to dispense medicine. In the course of the year 1869 the medical officers wrote for the whole town 2,882 prescriptions, which are produced as vouchers for payment, and attended as medical officers 51 cases of xiii midwifery. The salary of three of the medical officers in 250 whalers or 37l. 10s. per annum; of the other two, 200 thalers or 30l. The five Heil-diener receive 12 thalers or 1l. 16s. per annum each. The cost of medicines for the year was 1,400 thalers of 210l. The whole cost of outdoor medical relief for the year 1869, therefore, was -- Salaries - 1,210 thaler or £ 181 Medicine - 1,410 " " 210 Total - 2,610 " " £ 391 In-door relief, as understood in English Poor Law administration, -- that is as a test of destitution, -- forms no part of the Elberfeld system. The Armen-haus or poorhouse has more the character of an almshouse than of an English workhouse. The Kranken-haus or hospital does not correspond to our union hospital; nor does the Orphanage (or Waisen-haus) to our district school. The Armen-haus, a large building on the outskirt of the town, contains on an average about 180 inmates. These are old and infirm people who are without homes or families. Although the arrangements and general management of the Armen-haus contrast not very favourably with those of an average English workhouse, yet the inmates appear to be comfortable and contented. They live very much as people of their class live in their own homes -- but little attention being paid to floor space or cubic space, and still less to ventilation; they enjoy more freedom in every sense than would be consistent with the discipline of a union workhouse. In short, an old Elberfeld pauper smoking his eternal pipe in the Aufenthaltszimmer or "day-room" of the Armen-haus may well feel that he has got a comfortable asylum for the close of his days. It does not always happen, however, that he does close his days within its walls. Those who are capable of doing any work go out and earn what they can. The wages are paid to the manager of the Armen-haus, and when the amount exceeds the cost of their maintenance they are allowed to retain the difference. Through this practice these poor people not unfrequently find permanent work sufficient to maintain them out of the house while owing to the great demand for labour in Elberfeld and the very limited supply as well as the character of this sort of labour wages can in no way be affected by it.xiv The cost of maintenance in the Armen-haus is 1 th. 5 sgr. (or 3s. 6d.) per week. The establishment consists of-- £ s. d. Master, 400 th. per annum or 60 0 0 Surgeon, 50 th. " 7 10 0 Clerk, 200 th. " 30 0 0 Assistant, 125 th. " 18 15 0 4 servants, 40 th. " 36 0 0 Cook, 60th. " 9 0 0 Groom, 70 th. " 10 10 0 Carpenter, 17 th. } " 7 10 0 Barber, 33 th. } " 24 10 0 2 nurses, 160 th. " General expenses, } " 150 0 0 fire, &c. 1,000 th.} ____________________ Total expense of } officers and main-} " 338 6 0 The hospital or Kranken-haus is the general hospital for the town to which paupers are sent and paid for at the rate of 9 groschen (or 10 4/5 d.) per day. The total number of patients of all classes admitted to the hospital during the year 1869 was 1, 611, of whom 456 were paupers; 207 admitted by order of the overseers, and 249 transferred on account of sickness from the poor-house and orphanage. All that seems necessary to say of this establishment is that it appeared to be well managed. The orphanage or Waisen-haus is fairly well arranged and administered. All orphan and deserted children who become dependent are sent to it. The number in the house is about 260. The number of admissions to this establishment in the year 1867 was--orphans, 63, deserted, 51. The total number of children is large in proportion to the pauperism, and the number of deserted large in proportion to the orphans. I could not ascertain, however, that the care in bestowed upon these children in bringing them up, educating them, and providing situations for them was considered to afford any inducement to desertion. In the instruction of the children, reading, writing, arithmetic, and singing are varied by industrial work. It may be admitted that the arrangements and management of the Elberfeld orphanage are inferior to those of our own district schools; but on the other hand it may xv be said of it, in the first place, that the cost of maintenance is only 70 thalers or 10l. 10s., instead of from 18l. to 20l. per annum; and, secondly, that the children who are brought up in it turn out creditably as factory hands, shoemakers, tailors, domestic servants, &c. The work proposed may not be very ambitious, but it seems to be thoroughly done. Indeed the character of the people is in some sort reflected in this and similar institutions-- plain and unpretending,--and, if somewhat rough, eminently practical, even in their teaching of singing,--for not otherwise than "practical" I suppose might be considered the zealous efforts it must have cost to teach the large class of infants to chant with so much spirit as they did upon the occasion of our visit the now national hymn of the Wacht am Rhein. Into these establishments no person is admitted who would not be entitled to out-door relief. It will thus be seen that no stress is laid on these institutions as "tests,"or as means of checking pauperism. In fact, as I have already said, "the workhouse," in our theoretical sense of the term, is no part of the Elberfeld system; so that with the account that I have just given of the Poor-house, the Hospital, and the Orphanage, I may dismiss the subject of in-door relief. It was assumed by the framers of the English Poor Law, and is still assumed by those who continue to take any interest in administering it upon the principle upon which it was founded, that no real test of destitution can be devised except the test of the workhouse. As the application of that test is as yet no part of the Elberfeld system it will be asked--what is the substitute for it? In the first place the applicant for relief is subjected to an examination so close and searching, so absolutely inquisitorial, that no man who could possibly escape from it would submit to it. He is not one of several hundreds who can tell his own story to an overworked relieving officer, but one of a very few, never exceeding four,-- frequently the single applicant--who is bound by law to answer every one of that long string of questions that his interrogator is bound by law to put to him. One of the peculiar merits claimed, and I believe rightly claimed, for this system is that before a man can obtain relief it must be shown that he cannot exist without it. When an application is made for relief the applicant is in the first instance bound to state whether he has a settle-xvi ment in Elberfeld, that is, whether he has resided in it without receiving relief for a period of twelve months, how long he has resided in it, where he resided before, whether he reported himself to the police and obtained permission to reside, or whether he has resided without permission; he is bound to give, with his own name, the name of every member of his family, the day, month, and year of the birth of each, his religious profession, his birth-place, and how long his family resided there, the street or district in which he lives, the number of his house and the name of his landlord, the description of his dwelling and the yearly rent, the state of health of each member of his family, his occupation, the name of his employer, his average weekly earnings, proved, if possible, by a voucher; he must declare whether the family leads a moral and honest life, specify which of the members does not, whether or not the children are sent to school, and where; the name, dwelling, business, and circumstances of surviving parents, parents-in-law, and grand-parents, as well as of the children not living with the head of the family. In addition to this information, which the applicant is bound to give, the visitor is to ascertain, as far as he can, and report "the causes of the pauperism of the applicant." Be it observed that this is not a merely nominal or superficial inquiry in which the applicant has no difficulty in palming off some plausible story of distress and the cause of it, but is, what it professes to be, a strict investigation into the circumstances of the man's life and present position. When the case is satisfactorily proved to be one in which the applicant is entitled to relief he gets it to such an amount only as will furnish the bar necessaries of existence for himself and his family; it is given to him from week to week in money or in kind as may be thought most advisable; if articles of furniture or clothing are given the visitor must satisfy himself from time to time that they are not pawned or sold. If a member of the family is buried at the public cost, and any of the family follow the hearse "in a coach" the fact is assumed as evidence of ability to repay, and on thaler (3s.) is exacted for the use of the hearse: "No "carriage, as this would prove that the relations of the "deceased were able to spend money, and prove that "they had obtained the use of the hearse under false "pretenses." The applicant having established his claim, xvii and being allowed weekly relief, is constantly "looked up" by the visitor; every change, however minute, in his own condition or in that of his family is noted and reported, -- the pauper is, in fact, kept under constant surveillance; he is urged to find work, and if he cannot find it, labour is provided for him. It rarely happens, however, that the town is compelled to find work for individual cases; the conditions of relief are found to be sufficiently stringent to induce a man, if he can work and if work is to be found, to find it for himself, if not in Elberfeld, elsewhere, for the circulation of labour is now sufficiently free, and the law of settlement sufficiently liberal. If however, when this system was first introduced, the administration had to deal with, what in other countries is a too common case, one whose pauperism is the result of idle, drunken, or dissolute habits, no scruple or hesitation was felt in bringing to bear upon such a case the direct influence of a remarkably strict police regulation. It was declared by article 51. that "where a pauper wastes the money granted to him, or "sells the clothing, beddings, or furniture granted to him, "the relief may be entirely withdrawn or reduced to a "minimum." By article 52. the following offences were punishable with imprisonment for seven days to one month: 1. "When a person so far abandons himself to play, drink, or idleness as to require relief either for himself or for those dependent upon him for support." 2. "When a person refuses to do the work assigned to him and suited to his strength." 3. "When a person, after losing the means of support that he possessed, fails to obtain a livelihood within a period to be limited by the police of the place in which he resides, or cannot prove that he is unable to obtain a livelihood after doing all in his power for the purpose." [This provision of the police law has been within the last year repealed, much to the regret of those who are responsible for the administration of the Elberfeld system. It remains to be seen how far this relaxation of the police law will in the future affect injuriously the administration of the poor law.] In the event of any large number of persons being out of work and requiring relief, some public work, generally the making or improving of a road, is at once undertaken.xviii (I may observe, incidentally, that in few towns in which I have ever set foot is there a wider field for such public works as drainage and sewerage.) The efficiency of this test is strongly dwelt upon by the Bürgermeister of the neighbouring town of Barmen, where the Elberfeld system, recently adopted, is now in operation. The giving of relief is still further fenced round by minute regulations, such as the keeping of a wages book (Verdienst buch) by the pauper, the particulars of wages, &c. to be entered by the employer, all framed with a view to discourage applications save under circumstances of absolute necessity. It was not to be expected that the lax system which had heretofore prevailed could be replaced by one, comparatively speaking, of extreme rigour without exciting a good deal of discontent. The change, though effected in a small community, was in principle as great as that which in England attended the passing of "the new Poor Law," and was followed by the same clamour of the pauperized masses, the same dissatisfaction amongst the philanthropic distributors of other people's money. Against this feeling Mr. Daniel Von der Heydt appears to have taken successive occasions to remonstrate in his annual address to the Poor Administration of the city. I offer no excuse for quoting somewhat fully from the characteristic address which he delivered in 1866-7. " Last year," he remarks, "we referred to the difficulties " that beset us in the administration of this " system; we observed how hard it was to refuse the " pressing demands made for assistance out of the town " funds in cases in which we knew that misery was " great, yet the town was not bound to grant relief. " We added, 'what we administer is not our thalers " 'and groschen, but funds raised by the taxation " 'of our fellow citizens, money meant to be expended " 'under certain rules.' An insufficient scrutiny of an " application for relief followed by an unjustifiable grant " of relief is a great error; but so also is the granting of " relief in cases where a sufficient scrutiny has satisfied " us that the applicant is already in receipt of an income " from private charity or from the funds of a religious " endowment. Both of these are errors neither of which " can be justified by the duties of our office nor be " excused under the plea of 'love to our neighbours.' A xix " form of this 'love' which should exhausted the town " funds for the purpose of assisting persons not entitled " to relief in accordance with the positive conditions imposed " by our laws can have neither moral nor social " value, and would simply represent our overstepping of " the duties that we have promised to perform. It will " be a useful and proper effort for us all to make, to " accept without murmur the disagreeable position in " which we must be often placed. One of the most " difficult of the duties imposed upon us in administering " a poor law is to distinguish correctly the circumstances " which in particular cases involve the responsibility of " giving or withholding state relief. I do not mean the " difficulty of ascertaining correctly the income of an " applicant or pauper from work or form other sources; " the means of doing this are indicated clearly in the " 'Instructions.' What I mean is that after it has been " shown that the head of a family has according to the " scale fixed in our instructions a sufficient income for " their support, or after it has been proved that though " the income is insufficient the applicant is sufficiently " able-bodied to earn a livelihood if he exerts himself, " the question not unfrequently arises, 'Is the town bound " 'in such cases to give relief?' It is in the nature of " an application for relief in such a case that it is often " accompanied by indications of moral debasement or by " sickness or bodily defects; but there are also examples " of applications on the part of able-bodied persons with " incomes in favour of members of their family who are " infirm or otherwise not able-bodied, say of children of " tender age or of school age. The father says he spends " his day at work, will not the town take his wife, who is " enfeebled, and their children, who are untaught, into " the town establishments, the poorhouse, the hospital, or " the orphanage? In such cases, I ask, is the Poor " Administration legally bound to relieve? If not, then " would it be justified in exceptionally sanctioning a " system of relief to which it is not legally bound? My " answer is, were we to sanction one or more of such " cases we should be flooded with them. But it may be " said by a district visitor, for instance, 'suppose we " 'obey the instructions and refuse the application of the " 'husband or parents, what say our feelings as men, " 'what say our pity and our thoughts as to the future " 'of these poor people?' The answer must be, "Let " 'the man who has sworn to carry out the regulations B2xx " ' Keep within the limits of his office. Let him remember " ' that the town (gemeinde) has given him the " ' charge of relieving the poor only in exchange for his " ' assurance that he will strictly keep within those limits; " ' that it has told him clearly what applicant, if he be in " ' distress, he is to relieve, and how he shall relieve him.' " Let us then remain modestly within the bounds of the " duty prescribed for us by our superiors. Upon that " field we shall find plenty of work to do, even though a " section should for a time have no poor in receipt of " relief." The result of administration upon these principles is that there is no able-bodied pauperism in Elberfeld, and, as will appear presently, very little of any kind. If it be thought that the conditions of obtaining relief are harsh and oppressively rigorous, it is but just to bear in mind not only the instructions that are given to the visitors, but how these instructions are practically observed. Repeatedly throughout the regulations are found injunctions to deal with the poor mercifully, and, if the provisions of the law be unavoidably hard, to administer it at least in a spirit of kindness and Christian forbearance. The visitor is enjoined to "hear the prayers of the poor with love and heart," to impress upon the father the duty that he owes to his child, and upon the child the reverence that is due to the parent ; he is to be, in short, the friend and adviser of the poor who apply to him for legal relief. Although in the same breath, so to speak, in which good advice is tendered bread may be refused, nothing would be further from the truth than to regard this as any indication of a merely sentimental, still less of a pharisaical, interest in the welfare of the poor. It would be easy to illustrate by many cases that were mentioned to us the beneficial effect upon individual families of firmness in refusing to allow them to become paupers while they were helped over temporary difficulties by some slight aid and judicious friendly counsel. Indeed, I have heard men who appear to have given much thought to the subject observe that the influence of this sort of intimate intercourse between the poor and those in a much higher social position reaches far beyond the temporary result that is immediately aimed at. Without pretending to say how far such a mode of administering not charity but poor relief would be consistent with the freedom of English domestic life or would be tolerated by a people so jealous of personal and family xxi independence, I am satisfied, from what I have seen and ascertained by inquiry, that in Elberfeld and the few other towns that have adopted it, this part of the system works with complete success. Possibly, however, in England it might be less difficult to reconcile the poor to such a system than it would be to find amongst the well-to-do middle classes fit and willing agents for its administration. Having only incidentally referred to the results of this system as shown by the great reduction effected by it in the pauperism and expenditure of the town, I may now state more precisely the actual income devoted to poor relief, the sources whence it is derived, and the comparative expenditure and pauperism for a given number of years. The revenue appropriated to the relief of the poor is derived partly from taxes devoted to that special object and partly from the general municipal taxation. The former is derived from interest on moneys invested, from reserve fund of Savings Bank, from the profits of the Tüglicher Anzeiger newspaper, from police fines, license of theatres, concerts, &c., repayments from patients in hospital, and some other sources, amounting in all to 39,345 thalers or 5,901l., to which is added 49,498 thalers or 7,424l. from the municipal funds, which latter sum, by the way, includes five thalers, the tax on the one caged nightingale that appears to be kept in Elberfeld. The expenditure for the two years preceding the adoption of the present system was:-- Population. Expenditure. 1851 - 49,058 - 43,879 Th. or. €6,581 17s. 1852 - 50,364 - 59,548 Th. or €8,932 4s. The immediate effect of the adoption of the present system was in 1853, with a slight increase of population, a decrease of, upon the expenditure of the preceding year, 29,521 thalers or 49.5 per cent. The comparative expenditure for the last four years, with a considerably increased population, was:-- Population Thalers € 1852 - 50,364 - 59,548 or 8,932 [The year before the system was adopted.] 1866 - 64,963 - 24,842 " 3,726 1867 - 65,321 - 27,182 " 4,077 1868 - 67,000 - 25,559 " 3,833 1869 - 71,000 - 25,739 " 3,860xxii that is, the expenditure of 1869 was 56.7 per cent. less than the expenditure of 1852, the year preceding that in which the system was adopted, while the population of 1869 exceeded that of 1852 by 40.9 per cent. It should be observed, however, that the expenditure of 1852 was exceptionally high. I had increased from 32,286 thalers, of 4,824l. in 1850 to 43,879 thalers or 6,581l. in 1851, and to 58,548 thalers or 8,932l. in 1852. It should also be observed that the year 1852 in which the pauperism was exceptionally high was a year of great plenty in which labour was not affected by any disturbing cause. To the uneasiness created by this rapid increase of expenditure, accompanied by a corresponding increase in pauperism, may be ascribed the adoption of the present system and the energy with which it was administered. The comparison of Pauperism is not less remarkable than that of Expenditure. The Reports of Mr. Von der Heydt for 1867 and of Dr. Lischke for 1868, 1869, and 1870 contain tables of the pauperism for several years, from which it would appear that the average number relieved was in- Population No. of Paupers. 1852 - - 50,364 - 4,000 1853* - - 50,418 - 1,460 1866 - - 64,963 - 1,370 1867 - - 65,321 - 1,496 1868 - - 67,000 - 1,408 1869 - - 71,000 - 1,062 * The first year under the present system. The general opinion of those persons whom we had an opportunity of consulting is that the system of Poor Law Administration has had a marked effect upon the habits of the people - inducing much greater thrift and providence. This seems to be conformed by such returns of Benefit Societies as we had access to. The number of contributors appears to increase steadily from year to year. It was in- 1867 - - 5,175 1868 - - 5,790 1869 - - 6,251 The constitution of these societies - the Zwangs Kassen, or compulsory clubs, to which employers as well as operatives are bound to contribute in certain proportions and the Frei Kassen, or free clubs, to which the work-people alone contribute - is well deserving of separate xxii and full examination. I only advert to the return here as an indication not to be lost sight of in appreciating the general results of the Elberfeld system. There are persons in Elberfeld and elsewhere who appear to think that as this system could never have been successfully introduced except by the personal influence of M. Von der Heydt, so, if that influence were unhappily withdrawn, the administration of the Poor Law would by degrees relapse into its former unsatisfactory state. One can easily believe that but for the courage and energy of Mr. Von der Heydt and the great weight attached by his fellow citizens to his opinion, as the system might hardly have had a fair chance. As it was, even Mr. Von der Heydt's character did not save the proposal, when first made, from being publicly characterized as "utopian" and "impracticable," or from being exposed not only to open hostility but to that sort of hesitating support that is often a greater obstacle than open hostility to the success of any scheme that involves radical change. The success of the system, however, no longer depends upon the influence of any individual. It is in successful operation in Barmen and Crefeld. In neither of these towns could there be said to have been any one person the counterpart of Mr. Von der Heydt. But amongst the wealthiest and most distinguished citizens of both there were found men and of sufficient energy and self-devotion to take up the work and carry it through in the face of difficulties even more formidable than it had to encounter in Elberfeld. There would be little danger I apprehend that the offices now filled in Crefeld by such men as Mr. Seyffardt and by Alexander Heimendahl would not hereafter be accepted by others of the same social position and the duties discharged with the same good-will, though never with greater energy, or with a more just appreciation of the system to which these good citizens have already given such valuable aid. The success of the system in Elberfeld led to adoption in 1863 in the neighboring town of Barmen. In 1862 with a population of 53,831 the number of "cases" in receipt of relief in Barmen was 914, of person 3,259. Although the year 1863, being a year of great depression in the trade of Barmen, was unfavorable for the application of the new system, yet the pauperism was through its operation reduced from 914 cases to an average of 678, and the individuals form 3,259 to anxxiv average of 1,915. The average number of "cases" relieved in 1870, with a population of 71,000 was 693, of individuals 1,893. The expenditure for out-door relief in Barmen was- In - - - - 1862 50,236 thalers. It was reduced in - - - 1863 to 42,300 ,, The in-door relief was in - 1862 to 42,300 ,, Which was reduced in - 1862 6,838 ,, The cost of management was in 1862 6,838 ,, Which was reduced in - 1863 to 4,073 ,, If the results of the system in Barmen have not been altogether so striking as in Elberfeld, this may perhaps be accounted for by certain differences in the administration, as well as in the previous history of the place. The greatest importance is attached in Elberfeld to restricting the number of cases of which a visitor may take charge to four. The limitation in Barmen is six. The old system in Barmen was that each religious community took charge of its own poor, and this distinction is still observed in the establishments for in-door relief. It may be easily supposed that under such a system habits would have taken root not easy to extirpate however unfavorable they might be to the administration of state relief upon strict principles. Still the complete success of the system in Barmen is undoubted. It should be noticed in Elberfeld and Barmen that the cost per head of each pauper is considerably higher than it was under the old system. So in England the cost per head in a well managed in Union is invariably much higher than in Unions that are greatly pauperized. The deserving poor only are relieved, but they are relieved liberally. In the least pauperized Union in the district under my supervision the cost per head of out-door paupers is 4l. 6. 8d. ; the pauperism in that Union is only 2 . 2 per cent. In an adjoining Union in which the door pauperism is 6.1 per cent. the cost per head of out-door paupers is 3l. 1. 10ld. The per-centage of pauperism in Crefeld before the present system was introduced cannot be ascertained with any degree of accuracy. Indeed, the administration of relief was so unsystematic that no records are to be had from which a trustworthy statistical comparison can be instituted between the actual results of the two system mendicancy had grown to be an intolerable public nuisance. xxv Street-begging is unknown in the town now. Formerly the distribution of relief gave rise constantly to scandalous disorders that sometimes necessitated the interference of the police. Instead of two or three hundred people collecting and scrambling, as I believe used to be the case, for the bread to which few of them had any real claim, the relief is now regularly paid personally by the Armenpfleger, and only to those whose cases have been already carefully scrutinized. Substantially the system adopted at Crefeld is the same as at Elberfeld. Some differences, however, may be noticed. The most important is that while at Elberfeld the scale of earnings above which no relief is granted is fixed at 25 Silbergroschen, or 2. 6d., for a single man, and 3 thalers 12 groschen, or 10s. 2 1/2 d., for a family consisting of man, wife, and five children, at Crefeld the corresponding sums are 17 1/2 sr. gr., or 1s. 9d,, 2 thalers, or 6s. This scale is fixed upon the calculation that a single man (able-bodied) must pay 7 1/2 sr. sr., or 9d., per week for his lodging, and 10 sr. gr., or 1s., for his maintenance, and that for a family of five the rent will be 10sr. gr., or 1., and the maintenance 10 sr gr., or 1s., each for man and wife, and 6 sr. gr., or 7 1/2 d., for each child. If a man or family earn, or it is proved that they can earn, this amount, no relief is granted. To this severe rule there are, however, exceptions in favor of aged and infirm people to whose relief some addition in kind may be made, and in favour of the children of paupers, to whom clothing to enable them to go to school and school-books, &c. may be supplied and school fees paid. Provision is also made for the payment of the communal taxes for the pauper, and also for the Imperial capitation tax. On the 1st of January 1870 the number of person in receipt of relief in Crefeld was 1,206 or 509 cases. This upon a population of 55,539 would be 2.17 per cent. This is somewhat higher than the pauperism of Elberfeld, but the system was not introduced into Crefeld until 1864, that is not until eleven years after is had been in successful operation in Elberfeld. Such being the effects of the Elberfeld system in the three town in which it has been adopted, it will be of interest to contrast with them that state of pauperism and expenditure in two towns which still adhere to the old system that Elberfeld rejected some eighteen years ago. No more striking illustration of the success of "the Elberfeld system" can be given than the contrast pre-xxvi by the two neighbouring towns of Dusseldorf and Aix-la-Chapelle. When in 1850 the administration of the Poor Law was entrusted to the municipalities, the town of Dusseldorf was divided into thirty (30) districts. The control of the administration of relief was entrusted to a body elected from the Municipal Council, consisting of a President and six members. Each district was placed under the supervision of a Pfleger, unpaid as in Elberfeld, to whom was entrusted the general control of out-door relief. Within the following year the number of districts and Pfleger was increased to 44, at which it still remains. Applications for relief are made direct to the Pfleger, who inquires into the cases through the agency of persons selected by himself, called Armen-Freunde, and who generally comprise the clergymen for relief belongs. Upon their report relief is usually granted, though not in accordance with prescribed rules such as restrict the authority of the Armenpfleger under the Elberfeld system. Once in every month the Pfleger of the several districts appear before the town administration and report their proceedings during the preceding month. The relief which has been given in "cash, bread, coals, payment of rent. clothes, bedding, or furniture" is either confirmed or disallowed; almost always, however, confirmed. As might be expected, the effect of such a system is an amount of pauperism exceeding that of Elberfeld by more than a hundred per cent. In the year 1868 the average number of persons relieved was 3,077, or about 797 families, out of a population of 62,700, while in the same year the number relieved in Elberfeld out of a population of 67,000 was 1,408. It is scarcely possible to institute a comparison between the administration of Aix-la-Chapelle and of any of the other places referred to in this Report. With the exception of one section of the town, or rather of the inhabitants (the Evangelicals), the administration is by a law (Armen Ordnung) of 1822 in the hands of a Commission, under whose authority the town is divided into eight Pfarrei or parishes. Each Pfarrei is directly under the management of five Pfelger, who receive applications for relief and cause inquiry to be made into them by Armenpfleger, who are usually members of the society of Sr. Vincent de Paul. No Armenpfleger has under his care less than 15 or more than 30 cases or families. The reports of the Armenpfleger xxvii are brought before the monthly meetings of the District Verein, who decide upon the several cases. We were unable to obtain any statistical account of the pauperism of this town. The Ober Burgermeister stated that he believed there were about 1,600 cases or Positionen in receipt of relief, and that the expenditure was about 116,000 thalers, of which 56,000 is derived from interest of charitable bequests and 60,000 contributed from the municipal funds. Assuming these statements to be accurate, the pauperism and expenditure of Aix-la-Chapelle would appear to be about four times as great as those of Elberfeld. The population of the two towns is, as nearly as may be, the same, some 70,000. It only remains to add, with reference to these two towns, that the Ober Burgermesiter of each expressed strongly his opinion that the state of pauperism was such as would compel the municipalities within a short time to adopt the Elberfeld system. That some change of the kind must be effected in the present anomalous system, not in these towns only, but eventually throughout the German Empire, hardly admits of doubt. Within the last few years all restrictions upon the circulation of labour have been removed, while a still more liberal reform has been effected in the law of settlement. By a change made within the last year, Prussia has effected a most important improvement in the law of settlement, one more advantageous to the mass of the people than has even yet been effected in England. An industrial residence 'without relief' of one year now confers, not mere;y the status of irremovability, but a settlement in the place of residence. One effect of this change will obviously be that, if only as a matter of self-protection, the municipalities throughout the country will be compelled to adopt a much stricter system of Poor Law administration. As it is, we were assured that many of the poor of Elberfeld and Crefeld find their way to towns like Dusseldorf in which the system of relief is so attractively lenient. When this change in the law of settlement is considered in connection with the law of November 1867, to which I have just referred, which removes all artificial restrictions upon the circulation of labour, it appears evident that the adoption of an improved and uniform system of Poor Law administration, throughout North Germany at least, can be only a question of a few years. xxviii Although my instructions from your Board are simply "to inquire into the system of relief that is in operation "in Elberfeld," I would ask permission to notice briefly some of the more striking points of contrast between that system and our own. The administrative body in England is the Board of Guardians assisted by relieving officers; in Elberfeld it is the overseers assisted by the visitors. The duties that in England are discharged by the guardians and relieving officers in Elberfeld devolve upon the overseers, "the visitors" or Armenplfeger discharging the duties of relieving officers. In addition to this there is the important provision that the proceedings of the Armenpfleger and visitors are revised fortnightly by the Armen- Verwaltung or higher Poor Law tribunal. Theoretically at least this system of checks appears to be admirably devised, and is said to work perfectly. From the nature of the duties that devolve upon the visitor or Armenpfleger, as already described, his office is obviously the most important connected with the administration of the Poor Law, as in our system is, or ought to be, that of the relieving officer. Between the duties of these officers, as practically administered, it is difficult to imagine a greater contrast. The framers of the English Poor Law of 1834 started with a theory of administration not unlike that of the Elberfeld system. Every application for relief was to be rigidly inquired into. All the circumstances of the family, the number of children, occupation, earnings, resources of every description, with other facts more or less relevant, were to be ascertained and communicated to the Board of Guardians for their information and guidance. It was further contemplated by the framers of the English Poor Law that the relief was to be delivered, as a general rule, at their own homes to the paupers by the relieving officers. It is assumed in the English system that all this can be efficiently done by paid officers, many of whom, are no doubt zealous, intelligent, and fairly remunerated, but very many of whom, accepting these offices at salaries less than the wages of a skilled mechanic, have barely the qualifications of knowing how to read and write and keep the simplest form of accounts. It is further assumed in the English system that the relieving officer can efficiently discharge the important and multifarious duties of personally visiting and inquiring into and reporting upon all the circumstances xxix and distributing the relief of, let us say, from 400 to 1,000 paupers, the numbers varying according to pauperism of districts of very unequal population. The last Annual Report of the Poor Law Board contains numberless illustrations of this statement. Thus, opening it at hazard, I find that in the Hoo Union "there is one " relieving officer attending on an average to 112 paupers, " of whom upwards of 50 are children." In the next Union, Medway, on the same page of the same Report, it appears "there is one relieving officer who attends on an " average to 1,313 paupers, oh whom 606 are children." Assuming that each family of papers in the Medway Union consists of four persons, the number of "cases" that a relieving officer would have in charge would be 328. In the table annexed to Mr. Henley's Report it appears that the population to the relieving officers districts varies from 5,645, the lowest, to 50,261, the highest. Assuming the pauperism of these unions to be 4 per cent., and that each family consists of four persons, the relieving officer in the one case would have to attend to about 224 persons or 56 cases, in the other to about 2,000 paupers or 500 cases, and so on through the whole kingdom. When the Elberfeld system was first established in 1853, the number of visitors or, as we should say, relieving officers, was sixty, to a population of about 50,000. It was found, however, to be impracticable for even this large number of officers to personally make the strict inquiries and frequent visits that are required by the regulations already described. The number of visitors was therefore at once increased from sixty to two hundred and fifty-two, and no visitor is allowed to have in charge more than four cases, or, as they are termed, Positionen. When the number of visitors was fewer, the duties of visiting, inquiring, and relieving was not always discharged personally. By men occupied in business the duties were found to be too onerous. The office of Armenpfleger was accepted with reluctance, the cases were either left unvisited or were visited by deputy. Indeed one half of the number of offices were practically unfilled, and there was but little personal intercourse between the administrators and the poor. But the men with whom the system originated, and the men who now carry it out in the spirit in which it originated, attribute the whole success of the system to the strict personal discharge of duty. "Everything can " be done by personal intercourse with the poor, nothing xxx " without it," was the remark of the Ober Burgermeister in discussing the practicability of introducing some such system into large towns in England. The mode of appointment and the duties of the Armenpfleger I have already stated. His qualifications are thus indicated in " the instruction" issued to the overseers (Art. 6). " The offices of overseer and visitor are the most important " of civic honorary offices, requiring in the persons who " accept them a large measure of human kindness " and an earnest sense of duty, - kindness to hear the " prayers of the poor with love and heart, duty to " withstand demands urged upon insufficient grounds, " so that idleness and immorality may not follow " from indiscriminate almsgiving." Again in article 18 of the same instruction it is laid down to be the duty of the visitor (Armenpfleger) "to visit the poor of his section " frequently - not less than once in every fortnight; " to note in the Abhörbogen (application and report book) " any changes that may have taken place in the condition " of the family, in their income, number, &c.; to satisfy " himself that such articles of clothing, furniture, &c., as " may have been given or lent are in the possession of " the pauper; to reprimand disorderly conduct and immorality; " to enforce order, cleanliness, and honesty; " to warn parents of their duties to their children, especially " as regards education and their attendance at " school; to impress upon children that they are to be " reverent towards their parents, and to contribute to " their support. In short, he must strive to exercise a " healthy influence over the moral feelings of the poor." Strangely will such "regulations" as these sound to the ears of English Poor Law administrators; yet in such regulations do the municipality and citizens of Elberfeld believe that they have found the solution of a special problem of great difficulty. The principle of their Poor Law is strict almost to harshness; the administration of it is tempered by a spirit of benevolence that seems to elevate the system from being merely an instrument of severe repression into an effective means of prevention. Although this constant persona;l intercourse between visitors and the poor is the essential characteristic of the Elberfeld system, and that in which it contrasts most strongly with our own, yet hardly less important are some other regulations of the "Instruction."(To face p. xxxi.) SYNOPSIS of the FLUCTUATIONS in PAUPERISM during One Year in ELBERFELD. [From the following Table it will be seen that in the 26 sittings there were 822 new cases. Of these, 52, taking round numbers, in each hundred were discharged in the next following fortnight, and 9 in the second next following fortnight. Thus in one month after the admission of the cases 60 out of every hundred were discharged.] 1870. Paupers. January 2 650 Remaining. " 15 Discharged 44 Remaining 606 51 Admitted. " 29 Discharged 19 25 Remaining 587 26 58 Admitted. February 12 Discharged 17 4 32 Remaining 570 22 26 60 Admitted. " 26 Discharged 11 3 7 31 Remaining 559 19 19 29 48 Admitted. March 11 Discharged 13 2 4 2 24 Remaining 546 17 15 27 24 46 Admitted. " 25 Discharged 11 2 2 6 6 22 Remaining 535 15 13 21 18 24 37 Admitted. April 8 Discharged 9 1 1 2 1 10 19 Remaining 526 14 12 19 17 14 18 39 Admitted. " 22 Discharged 16 2 2 1 -- 5 4 28 Remaining 510 12 10 18 17 9 14 11 39 Admitted. May 5 Discharged 20 3 2 4 1 -- 5 1 23 Remaining 490 9 8 14 16 9 9 10 16 19 Admitted. " 20 Discharged 22 -- 1 1 1 1 -- 2 6 13 Remaining 468 9 7 13 15 8 9 8 10 6 26 Admitted. June 3 Discharged 16 1 2 -- 1 -- -- 2 2 2 13 Remaining 452 8 5 13 14 8 9 6 8 4 13 41 Admitted. " 17 Discharged 14 -- -- -- 1 2 1 -- 2 1 3 20 Remaining 438 8 5 13 13 6 8 6 6 3 10 21 33 Admitted. July 1 Discharged 11 -- 2 -- 2 1 1 -- 3 1 3 2 12 Remaining 427 8 3 13 11 5 7 6 3 2 7 19 21 32 Admitted. " 15 Discharged 4 -- -- 1 1 -- 1 -- 1 -- -- 3 3 17 Remaining 423 8 3 12 10 5 6 6 2 2 7 16 18 15 23 Admitted. " 29 Discharged 17 -- -- -- -- -- -- -- -- -- 1 -- 3 -- 13 Remaining 406 8 3 12 10 5 6 6 2 2 6 16 15 15 10 18 Admitted. August 12 Discharged 19 -- -- -- -- 1 -- -- -- -- -- -- 2 2 1 11 Remaining 387 8 3 12 10 4 6 6 2 2 6 16 13 13 9 7 19 Admitted. " 26 Discharged 8 -- -- -- -- -- -- -- -- -- -- 3 -- 1 1 1 11 Remaining 379 8 3 12 10 4 6 6 2 2 6 13 13 12 8 6 8 36 Admitted. September 9 Discharged 7 -- -- -- -- -- -- 1 -- 1 -- -- 1 -- -- 1 2 19 Remaining 372 8 3 12 10 4 6 5 2 1 6 13 12 12 8 5 6 17 21 Admitted. " 23 Discharged 7 -- -- -- -- -- -- -- -- -- -- -- -- 2 -- 1 -- 5 13 Remaining 365 8 3 12 10 4 6 5 2 1 6 13 12 10 8 4 6 12 8 22 Admitted. October 7 Discharged 5 -- -- 1 -- -- -- -- -- -- 1 1 -- 1 1 -- -- 3 3 13 Remaining 360 8 3 11 10 4 6 5 2 1 5 12 12 9 7 4 6 9 5 9 18 Admitted. " 21 Discharged 12 -- 1 -- -- -- -- -- -- -- -- 1 1 -- -- -- 1 1 2 -- 12 Remaining 348 8 2 11 10 4 6 5 2 1 5 11 11 9 7 4 5 8 3 9 6 24 Admitted. November 2 Discharged 6 -- -- 1 1 1 -- -- -- -- -- -- -- -- -- -- -- 1 1 1 2 12 Remaining 342 8 2 10 9 3 6 5 2 1 5 11 11 9 7 4 5 7 2 8 4 12 25 Admitted. " 18 Discharged 8 -- -- -- 1 -- 1 1 -- -- 1 -- -- -- -- -- 1 1 -- -- -- 1 11 Remaining 334 8 2 10 8 3 5 4 2 1 4 11 11 9 7 4 4 6 2 8 4 11 14 22 Admitted. December 2 Discharged 9 -- -- -- -- -- -- -- -- -- 1 -- -- 1 1 -- -- -- -- 1 -- -- 2 13 Remaining 325 8 2 10 8 3 5 4 2 1 3 11 11 8 6 4 4 6 2 7 4 11 12 9 34 Admitted. " 16 Discharged 2 -- -- -- -- -- -- -- -- -- -- -- 1 -- -- -- -- -- -- -- -- -- -- -- 18 Remaining 323 8 2 10 8 3 5 4 2 1 3 11 10 8 6 4 4 6 2 7 4 11 12 9 16 31 Admitted. TOTAL. Remaining at the end } 323 8 2 10 8 3 5 4 2 1 3 11 10 8 6 4 4 6 2 7 4 11 12 9 16 31 510 of the Year Single Cases 151 2 1 7 5 2 4 3 2 -- 1 3 3 2 2 2 3 4 -- 2 3 2 3 4 3 9 223 Heads of Families 153 6 -- 1 2 1 1 1 -- 1 2 6 6 6 4 1 1 2 2 4 1 9 7 4 10 19 250 and Their Dependents 367 18 -- 1 3 3 5 6 -- 3 12 16 16 14 11 4 1 15 7 9 1 21 20 9 46 82 690 Orphans & deserted Children 20 -- 2 2 1 -- -- -- -- -- -- 3 1 -- -- 1 -- -- -- 3 -- -- 2 1 3 3 42 TOTAL of Persons Relieved 691 26 3 11 11 6 10 10 2 4 15 28 26 22 17 8 5 21 9 18 5 32 32 18 62 113 1205 28419. B 8 xxxi Relief is never granted for longer periods than fortnightly. Under our system a large per-centage of pauperism is "permanent," irregularly visited at long intervals, and only as a matter of form. It would, however, be unjust to ascribe this, the great blot in our system of administration, as a fault to the inefficiency of relieving officers. Looking to the tasks imposed upon them by the short-sighted parsimony of guardians, it is simply impossible for them to discharge efficiently what is perhaps the most important of their duties. The effect of constant revision and inquiry into cases is most forcibly illustrated in the table on the opposite page, which exhibits the fluctuation of pauperism in Elberfeld for the year 1870. From this statement it will be seen that in the 26 fortnightly sittings there were 822 new cases. Of these 52, taking round numbers, in each hundred were discharged in the next following fortnight, and 9 in the second next following fortnight. Thus in one month after the admission of the cases 60 out of every hundred were discharged. They had during that period been the subject of constant and careful inquiry, each case being re-visited "not less than once a fortnight," every change in the circumstances of the families being noted and reported within every fortnight. Relief is as much as possible in kind, so as to meet the special wants of cases as ascertained by inquiry. Instead of the demoralising system of distributing relief at "pay-statins" to the agents of paupers (who frequently deduct a small per-centage on the amounts) or to children who may here receive the fist taint of pauperism, the relief is delivered generally at the home of the pauper as it was originally contemplated should be done under our administration. In conclusion, I may observe that although the "workhouse test" is not part of the Elberfeld system, yet some of the most experienced administrators of Poor Law in Crefeld as well as in Elberfeld look upon this as a serious defect, and one that in course of time must be remedied. Their view of a workhouse, however, is that as a means of testing destitution it should be used not until all other means have failed, and should be used only in cases that would justify the application of such discipline as would make it effective. They would regard as worse than useless a "workhouse" in which the condition of an inmate, whose pauperism was the result of idleness and xxxiii vice, was better than that of hundreds of ratepayers who are compelled to contribute to his support. For the facilities and assistance afforded to us in this inquiry Mr. Crowe and I have to express out acknowledgements to Dr. Lischke, the Ober Bügermesiter of Elberfeld, to Mr. Schlieper, the Secretary Mr. Schwanenberg, to Mr. Alexander Heimendahl, and Mr. Seyffardt, of Crefeld, and to the Ober Bügermeister of Düsseldorf and Aix-la-Chapelle. LONDON: Printed by GEORGE E. EYRE and WILLIAM SPOTTISWOODE, Printers to the Queen's most Excellent Majesty. For Her Majesty's Stationery Office. [8498.-1000.-11/71.]A reference to Sir C. Adderley's Bill, founded on the report of the Sanitary Commission, ss 6 & 7 will show the probable Sanitary Districts of the future. I am not entitled to commit myself at presentbut I have little if any practical doubt that this will be the result. We shan't touch LondonOUR LADS: A Letter to Fathers and Mothers. PRICE ONE PENNY. 10d. per doz., 6/6 per 100. Postage Extra, 2d. per doz., 6d. per 100. To be had from The Secretary, THE MORAL EDUCATION SOCIETY OF MANCHESTER, 4 Prince's Chambers, John Dalton Street, Manchester.OUR LADS: A LETTER TO FATHERS AND MOTHERS.OUR LADS. A LETTER TO FATHERS AND MOTHERS DEAR FRIENDS, As a former letter about "Our Girls" was written to mothers, you may perhaps wonder why this one is not to fathers alone; and I will tell you the reason why I want mothers also to read this one. Just as no one is so suitable to tell a young girl what she ought to know about herself as she grows up, as her mother; so I believe that earnest words of teaching and counsel from his father, are of untold value to a young lad, just crossing the threshold of manhood. To speak to his lads, is the duty and privilege of the father, and many who have done so, have found that they have thus won the confidence of their sons, and by being able to help them at a difficult time in their lives, have been more than repaid for the effort the conversation may have cost them. I hope therefore, that every father who has this 4 letter, will read it thoughtfully to the end, and will determine to do his part towards his lads, by telling them what they ought to learn, and also what they must avoid; for, as the children belong to both parents, both are equally responsible for their future, and surely, if the mother speaks to the girls, the father ought not to shirk the task with the lads, nor expect his wife to do his duty in this matter, as well as her own. But, as it is of the greatest possible importance that our lads should be instructed in a pure and wise way about these things, if the father will not undertake it, the mother must; and that is why this letter is written to both, so that one or other may be encouraged to speak reverently and earnestly to "Our Lads," about their bodies, and the powers which God has given them. The reason this matter is so very urgent is, that doctors and others who know most about it, tell us that a vast amount of the sin and immorality which are such a disgrace to this Christian land, is the result of ignorance, more than of downright wickedness, and that they often hear the pathetic cry, "If I had only known"; "If only my father or mother had told me." 5 The first thing to be done in the matter is to root up from our own minds the common idea, that there is anything indecent, or to be ashamed of, in what we are dealing with. Let us remember that "It is God that hath made us, and not we ourselves," and therefore, as it is His wise and perfect plan we have to tell of, there can be no feeling of shame connected with it, if we look at it in the right way, only the deepest reverence, as we realize how holy and sacred the whole subject is; that the body being the "Temple of God," we are here entering indeed into "The Holiest of all," as we speak of the highest privilege God has given us, the power of passing on the great gift of Life. Then we must decide WHEN we should begin to give this teaching, and WHAT we are to tell the lad. When? When the first awkward question is put, probably to the mother, about the new baby, "Where does it come from?" What is to be told? The truth, and that without shirking or deceit. Let there be no putting off with falsehoods, as is so common; but just the plain unvarnished truth, that "God sent the little baby, and when you are older I will tell you more about it." Your little son will then expect you to fulfil that promise, and if you fail, you may be sure he 6 will learn what he wants to find out from someone else. for get to know he will, seeing that the desire for information on this subject is right and natural, as is the thirst for knowledge on other matters. Even a young boy may rightly be told by his mother something of the mystery of life, that his body was developed within her own, according to God's beautiful and wonderful arrangement, and that when the little one is ready to live its own life, it is born into the world a helpless babe. Tell your little son this, reverently and without false shame, and he will learn that the bond between him and his mother is only mysterious, because it is so holy; he will understand your next words, that this is why a mother's love is so deep and strong, and he will also see the reason why he owes obedience and love to his mother. Tell him not talk to any companions about what he knows, for it is too holy; and bid him come fearlessly to ask about anything further he wants to know. You may also rightly tell him when he grows a little older, that God gives to both father and mother together, the wonderful power of producing another life like their own, and that this is what we 7 read in the story of the creation; when God said to the first man and woman,, "Be fruitful and multiply, and replenish the earth." It will not be hard to explain that certain parts of the body are created for this holy purpose, and that they must not be dishonoured or played with, or used apart from the great object for which they were made. If your lad is going away to school, it is most important that he should not go among other lads ignorant on these points. You may say perhaps, that "you would rather he remained innocent," but if he is still to be innocent (which means "free from guilt,") he must have pure knowledge and clean thoughts on a subject about which he is certain to learn evil if left to pick up his information from schoolfellows, who will be only too ready to defile his mind by foul talk, and to teach him evil habits which may result in life-long trouble. It is sadly true that this danger meets young lads, in both public and private schools, and as "Forewarned is fore- armed," and "Prevention is better than cure," you will prepare your son to stand against the two temptations he is most likely to meet, viz., indecent talk and self-abuse. 8 The only way to strengthen him against the degrading power of both these evils, as well as against others he must meet by-and-by, is to give him very plain teaching on the body and its powers; that the body from head to foot belongs to God, and is His Temple, to be kept pure for Him; that the organs referred to should not be touched except to keep them clean, and that it is wrong to talk or joke about these matters with his companions. If he has thus been taught to regard his whole body as holy, before the time when his own instincts are awaking, he will find it easier when stronger temptations comes, to conquer it. When a lad grows older bodily changes come, and with them new thoughts and desires, which, unless he learns to control them, will lead to ruin of health and character; and now is the time when a father's words will be so helpful to him; for who can advise and warn so well as one who has passed through the same dangers? Fathers, you know the strong impulses your lad has to contend with—you know how overmastering bodily desires can become, if uncontrolled by a strong will; so you can enter into his feelings, and your words of encouragement will help him to fight and overcome. Your son will not honour you less, but far more, for thus treating 9 him with confidence, and the feeling that you know his difficulties and sympathise with them, will make you "friends" more than anything else can. And when once the ice is broken and the subject is begun, the talk will not be as difficult as you fear, for there is in every lad a spirit of honour and noble desire which will answer to your words. Awaken this angel, nay, we may say, this God, in him before the slumbering demon is aroused and overpowers him. In this battle it is everything to be first in the field. If, however, you refuse the task, the mother must bravely face the difficulty you have not courage to meet; for one thing is certain, and cannot too often be repeated or too plainly stated, that those who are responsible for bringing a child into being are bound to see to it that he is armed for the battle of life. If the mother is left to buckle on the armour, she may be comforted by knowing that other brave women have done the same, and have been rewarded by the deeper love and devotion of their sons who have learned from their mother's wise and earnest words not only a greater respect for herself, but to honour and reverence all women for her sake. A lad of this age will understand10 that she is setting aside her own feelings in order to help him, and he will appreciate the love that can do so. Now is the time to tell him in plain, simple and yet reverent words what the bodily changes mean, and that the natural instinct which God has ordained to lead to the growth of our race is not in itself wrong, but that it needs to be kept under strong control, and that to exercise before marriage the power with which in his opening manhood he becomes endowed, is a grievous sin. Tell him, what is undoubtedly true, as all the best doctors bear witness, that no man is the worse in his health, but infinitely the better, for leading a pure life; and above all make it clear to him that the rule as to this is the same for men as for women. There are not two different standards of right and wrong for thetwo seces, as some say, for this would be to make man the lower animal, whereas, the truth is that if he has a harder battle to fight, he is also stronger, for no one can believe that the name "the stronger sex," means only greater power for evil! Speak to him of Love as a high and holy thing, a feeling which God Himself gives to lift up the 11 whole nature, to make it more noble, unselfish, and manly; not a base passion, which would drag a man down to the level of a beast, and lead to the degradation of another for its gratification. The well-known words of King Arthur were true when he said of the power of Love : . . . . "Indeed I know Of no more subtle master under Heaven, Not only to keep down the base in man, But teach high thought and amiable words, And courtliness, and the desire of fame, And love of truth, and all that makes a man." If you have known the happiness which this true love brings, you will want your son to experience it also; if Memory tells you that yours was different, do not sneer at the real thing, because you missed it, but be all the more careful to set the true ideal before your sons and daughters. The rough, unseemly joking, which often takes place about a "love affair," makes our sons and daughters think of it as something to be lightly treated, instead of its being to them the most sacred and beautiful thing in life, as it certainly is. Teach your son that just because he is a man, 12 with a stronger body than a woman, therefore he has to protect all women from injury; that to insult and wrong any woman, no matter who or what she may be, is not only to degrade her and himself, but is dishonouring the mother who gave him birth; that for her sake, because of her womanhood, and the bond between them, all other women must be treated with respect. It is natural and right that he should look forward to the time when, united to the wife of his choice, he may have children of his own; tell him therefore, that is he has not yet met her, the girl who is to be his future partner is waiting somewhere for him, and so he must keep himself pure for her, as of course he will expect her to be when he claims her for his bride. Tell him how men, from want of self-control, bring life-long suffering and shame on woman, and in doing so lose all their true manliness, for such acts are cowardly and degrading to manhood, as the woman, who is the weaker, is left to bear all the consequences. And yet, not "all," for, (to quote the words of a well-known Physician), "There are terrible diseases resulting from impurity, which may completely blight the whole of his future life, and it is nothing less than a crime to let a 13 lad run this awful risk, without a single word being said to warn him about it." One more caution should be given -- against quack doctors -- who do the deadliest harm to many young men by their disgraceful advertisements and pamphlets, and then induce them to pay large sums for so-called remedies, which may be most injurious. Urge your son, if he needs a doctor, to go to a well-known respectable one, and never to an advertiser. Having told our lads all this, in as simple words as possible, so that they cannot fail to grasp our meaning, we must not fail to point out three great helps in striving after true manliness. 1st, Cold Water. All are agreed that perfect cleanliness by frequent bathing, strengthens the body, and braces the mind. 2nd, Healthy Exercise, not only for the sake of the health and interest it produces, but as a means to sound and refreshing sleep; and lastly, Self-Restraint in thoughts and words, as well as in eating, drinking, and smoking; for lack of self-control in any of these, weakens the character and opens the door to let out all the finest parts of manhood, and to let in other degrading habits. 14 Those who look at this matter from the highest standpoint will feel that no lad should be left to fight this battle by himself. He needs the help of God, and should be urged to ask for that help which is promised to all who seek it in earnest Prayer. Do not let him think Religion is a thing for women and children, something weak and unmanly. Remind him, on the contrary, that the greatest heroes of our own, or of any other age, have been those who feared God, and therefore have feared no one else, who in His strength have struggled and overcome. We are proud of the courage of Englishmen, and boast of the "British pluck" which never knows when it is beaten. Shall we look in vain for the greater moral courage, which will face a parent's duty, no matter how distasteful? We admire the heroism which enables men to march unflinching to the cannon's mouth, which mans the lifeboat or the fire-engine, which volunteers for the "search party" at a mining disaster, ready to risk life and limb to save comrades, and even strangers, from death and injury; what shall we say of men who quail and run away at the prospect of a little earnest talk with their own 15 flesh and blood, to save them from far worse than death, or who shelter themselves behind a woman rather than face it? The glory of fatherhood is great, but the responsibility is greater, so I ask you, fathers and mothers, to think over this letter, decide together what you are going to do, AND DO IT! Dally no more, too long already have parents put off this matter, and excused themselves from undertaking it, while our young lads, - the hope of our land, and of greater lands beyond the sea, - have fallen by thousands into the snares set for them, untaught and unwarned - falling, alas! many of them, only to sink deeper and deeper in the mire of sun, and dragging down our fair daughters with them. We have warned our young folks against drink, gambling, dishonesty, and other things, while we have been silent about these more common temptations. But while we have been silent, the enemy has spoken, though perhaps only in a whisper, which we have not heard till the sad day has come, when the tale of shame and disgrace has reached our ears, involving at least two young lives, the result of ignorance which ought to have been taught, of "innocence" which should have been warned, and who is to blame? 16 This is not a matter for weak sentiment, it is one for brave and wise action. The dying words of Lord Nelson inspired his men to do and dare, it is no less true in this fight against wrong, than at the battle of Trafalgar, "England expects every man to do his duty." Do not answer feebly " I cannot," but say rather, "I OUGHT, I CAN, and by God's help I WILL." Your true friend, S.M.H. Wm. Neill & Sons, Printers, Longsight, Manchester, By the same Author. The same size and price as this Booklet. OUR GIRLS: A LETTER TO MOTHERS.The Bridge of Allan Hydropathic Establishment. BRIDGE OF ALLAN, situated midway between Edinburgh and Glasgow, on the Scottish Central Line of Railway, possesses unrivalled advantages for Hydropathic treatment. Resting on the southern slope of the Ochil Hills, at their western extremity, in a rich central district, it enjoys a happy mean of climate, and commands prospects of surpassing beauty, variety, and extent, with charming walks and drives, free access to extensive woods and grounds in the immediate neighbourhood, affording shelter from the cold in winter and from the heat in summer. The whole region around is classic soil, invested with the enduring interest of historical and poetical associations. Its views embrace the fine chain of the Western Grampians, with the towering summits of Benlomond, Benledi, Benvenue, &c., the picturesque castle and town of Stirling, and the windings of the rivers Forth, Teith, and Allan. The celebrated Trossachs, Loch Katrine, Loch Lomond, &c., and the other beautiful scenery of the "Lady of the Lake;" the Gardens of the Drummond Castle, Castle Campbell, the Rumbling Bridge, the Falls of the Devon, the2 Fields of Bannockburn and Sheriffmuir; and many other interesting localities, are all within an easy drive. The Establishment itself, which, in point of elegance, comfort, and completeness, may fairly rank among the foremost in the United Kingdom, is beautifully situated, on a plateau of deep gravel, at the foot of the Ochil Hills, in a locality remarkable for its purity of atmosphere and salubrity of climate. The buildings comprise spacious Dining and Drawing Rooms, Ladies' Drawing Room, Recreation Hall, Two Billiard Rooms, and Bedroom Accommodation for a Hundred and Twenty Visitors, all furnished in the most substantial and comfortable manner. The Turkish and other Baths are superior in their arrangements, and can all be entered from the House. There has also been added a set of Galvanic Appliances, so that in appropriate cases advantage may be taken of the valuable influence of electricity in its various forms. The Garden and Pleasure Grounds, including a well-kept Croquet Green, are of considerable extend and tastefully laid out, and immediately adjoin those of the celebrated Airthrey Spa. Omnibuses await the arrival of each train, and convey Visitors to the Establishment free of charge. TERMS FOR PATIENTS AND VISITORS, &c. Board, Lodging, and Baths, - - - - - - per day, 7/6. Do. when Two occupy the same Room - " 6/6. Do. Servants, and Children under 12 years, " 3/ to 6/. Do. for residences less than a week, 1/ per day extra. Fires in Private Room--per day, 1/; per evening, 6d. Visitors to Breakfast or Tea, 1/6; Dinner, 2/6. Serving Meals in Private Room, 6d. each extra. A few Superior Bedrooms, from 4/ to 5/ per day. Discount at the rate of 5 per cent. will be allowed when the Accounts amount to £10 and upwards. The day of arrival is not charged, but the day of departure is reckoned a full day. ALL ATTENDANCE INCLUDED IN THE ABOVE CHARGES> N.B.----Visitors are expected to conform strictly to the Rules of the Establishment, which are to be seen hung up in each Bedroom. 3 PLEASURE WALKS AND PLACES OF INTEREST IN THE NEIGHBOURHOOD. 1st. The "Macfarlane Museum," east end of Village (admission 6d.). 2nd. "Keir" Grounds----open on Fridays from 2 till 5 P.M. 3rd. "Airthrey" Grounds----open on Thursdays all day. 4th. "Kippenross" Grounds----open on Wednesdays and Saturdays. 5th. The Wallace Monument. The Abbey Craig, geographically in the centre of Scotland, is 360 feet above the level of the River Forth. The Tower is 220 feet in height, and 36 feet square. The walls 15 feet thick at the base----staircase of 246 steps leads to the top, from which there is a fine view. 6th. Demȳat, one of the highest of the Ochil Hills, is about 2½ miles north-east of the establishment, and commands a magnificent view. 7th. Cambuskenneth Abbey, founded in 1147 by David I. A Tomb raised by command of her Majesty the Queen marks the spot where King James III., and his Queen, Margaret of Denmark, were buried. The Tower, which is 70 feet high, is of the early English style of architecture. 8th. Scene of the Battle of Sheriffmuir, 2 miles north of the establishment. 9th. Stirling. The Castle and Cemetery, from which there are some splendid views. In the latter is observable the "Star Pyramid," erected to typify the stability of Bible truth; the beautiful glass-covered monument to the Virgin Martyrs, and many other statues of interest. 10th. Old Greyfriars' Church. Here John Knox preached the coronation sermon of James VI., in 1567. 11th. The Smith Institution. It consists of three principal apartments, a Museum, a Library and Reading Room, and a large and small Picture Gallery.----Charge of admission, 2d. 12th. The Old Bridge of Stirling--is of unknown antiquity. 13th. The Field of Bannockburn, where may be seen the celebrated "Borestone," which marks the spot where Bruce raised the Standard of Independence on the eventful 24th June, 1314. 14th. Dunblane Cathedral, which contains, according to John Ruskin, the finest window in the world.AIRTHREY MINERAL SPRINGS. Airthrey Mineral Springs, in reference to which Professor Christison of Edinburgh asserts, that— "That water of Airthrey is the strongest, and inferior in no respect to the strongest purgative waters of England. they seldom tend to enfeeble the stomach, like artificial laxative salts, but, on the contrary, increase the appetite for the succeeding meal, and accelerate digestion." Dr. William Hutton Forrest of Stirling states, that "in the amount of their saline impregnation they far suppress the springs of Dunblane and Pitcaithley." Chiefly recommended in cases of habitual constipation, in curing affection of the skin, stomach, and liver. ANALYSIS OF THE WATER. Specific gravity, 1,008,145, 1000 grains contain Common Salt, - - - - - - - 5'923 grains. Muriate of Lime, - - - - - - 5'250 " Sulphate of Lime, - - - - - - 0'488 " Muriate of Magnesia, - - - - 0'086 " ———————————————————————————— PLACES OF WORSHIP, And the Hours of Divine Service on the Sabbath. The Parish Church of Lecropt, at 11.45 A.M. The Parish Church of Logic, at 11.30 A.M. The Parish Church of Bridge of Allan, Fountain Walk, at 11.15 A.M. and 6.30 P.M. The Free Church, at 11.15 A.M. and 2.15 P.M. St. Saviour's (Episcopal) Church, at 11.15 A.M., Morning Prayer and Sermon; 3 P.M., Litany and Sermon; 6.30 P.M., Evening Prayer and Sermon. N.B.—The Holy Communion is celebrated every Sunday. The following Episcopal Services are held at the Well House, on Sunday. Morning, at 11.15 A.M.; Evening, at 6.30 P.M. LECTURES TO ADULTS ON CHRISTIAN MORALITY. ——————— ADMISSION FREE. ——————— TO WOMEN ONLY. ——————— MRS. MEREDITH, (Of the Princess Mary Village Homes,) SUPPORTED BY OTHER LADIES, Will Address a Meeting of Women only, "On the Duty of Christian Purity," AT THE QUEEN'S AVENUE ASSEMBLY ROOMS, ON MONDAY EVENING, March 19th, At 8 p.m.Lectures to Adults on Christian Morality. A series of Addressed by earnest and able Christian men, will be given in St. Leonards and Hastings, at 8 p.m., on successive Mondays, as follows: - February 26th. - At the Warrior Square Concert Hall. The duty of Christian Churches in relation to Social Purity, by Rev. H. R. Baker, M.A., of Woolwich. March 5th. - At the Music Hall, Hastings. Immorality versusChristianity, by Rev. H.P. Hughes, M.A., of Oxford March 12th. - At the Music Hall, Hastings, Morality and Temperance, a Ratepayer's Question, by Mr. James Ockenden, of London. March 19th. - At the Music Hall, Hastings, (to Men only). The Advantage and Obligation of Chastity, by Rev. Henry Varley. Christian Morality 55, CAMBRIDGE ROAD, HASTINGS, February, 1883. REV. SIR, We earnestly ask your assistance in making known these Lectures on the vital subject of Christian Morality. Will you kindly announce our Meetings on Sundays to your Congregation, and do what else you can to promote their success. The attached half-sheet can be torn off, and taken or forwarded to your church. We are, REV. SIR, Yours faithfully, E. BLACKWELL, M.D. W. HENRY CLAPHAM. Hon. Secs. In behalf of the Society for the Protection of the Young. THE NATIONAL CANINE DEFENCE LEAGUE HAS BEEN FOUNDED: Firstly - To oppose, in the strongest manner possible, the vexatious, unnecessary, and most cruel application of the muzzle. Secondly - To bring about the rescinding of the law that gives the Board of Agriculture the power to impose the muzzle, and to replace that power in the hands of the local authorities, who are necessarily the best judges as to the need, or otherwise, of such an imposition. Thirdly - To investigate all alleged cases of rabies, to obtain accurate information thereon, and to refute erroneous reports of the same where necessary. Fourthly - To protect dogs from all cruelty on the part of the authorities and others, and, wherever their destruction is compulsory, to endeavour to have it humanely and quickly carried out. Pamphlets for distribution can be had gratis on application to the Hon. Treasurer, FRED. E. PIRKIS, Eqs, R.N., THE HIGH ELMS, NUTFIELD, SURREY. By whom Subscription will be gladly received. "Surrey Mirror" works, Brighton Road, Redhill.THE WHITE SLAVE TRAFFIC AND PUBLIC VICE CAN BE AND MUST BE ANNIHILATED NINTH INTERNATIONAL PURITY CONGRESS San Francisco, California, July 18-24, 1915. A WORLD gathering in connection with the Panama-Pacific Exposition for the eradication of White Slave Traffic, suppression of public vice; the promotion of personal and social purity, the highest standard of private and public morals, and the furthering of such educational, legislative, sanitary, and civic measures as will improve the social health. Non-sectarian; non-racial; non-political. A program covering every phase of the movement by the world's most eminent authorities will be carried out. The Governments of the United States and Canada and most State and Provincial governments have extended co-operation and encouragement to these congresses. National, State or Provincial governments are invited to send delegates, also churches reform societies, clubs, vice commissions and all other organizations interested. Everyone interested in the movement is invited to attend. Help us to reach everyone in the world who is actively interested in this great cause by enclosing these announcements in letters and sending direct to those known to be interested. We especially desire to reach workers in countries outside of North America and to secure their co-operation in having delegates sent from their respective countries. For further information and printed matter for distribution, write to the WORLD'S PURITY FEDERATION, International Headquarters: La Crosse, Wisconsin, U.S.A.WOMEN'S MEDICAL SOCIETY OF NEW YORK STATE CONSTITUTION AND BY-LAWS Society Organized March 11, 1907WOMEN'S MEDICAL SOCIETY OF NEW YORK STATE [*p. 14 p. 17*] CONSTITUTION AND BY-LAWS Society Organized March 11, 1907 DEMOCRAT & CHRONICLE PRESS, ROCHESTER, N. Y. March 11, 1907, in honor of the seventy-eighth birthday of Dr. Sarah R. Adamson Dolley, the Blackwell Medical Society of Rochester, The Physicians' League of Buffalo, The Women's Medical Association of New York City, and The Dr. Cordelia A. Green Society of Castile, affiliated and invited the Women Physicians of the State to join them at a Banquet. On this occasion the organization of the Women's Medical Society of New York State took place. It seems eminently fitting that this should occur in Western New York, where the opportunities for medical education and a medical degree were first given to women. Dr. Blackwell graduated at the Geneva Medical College, Geneva, N. Y., in 1849, and Dr. Dolley graduated at the Central Medical College of Syracuse and Rochester, in 1851. We are all familiar with and justly proud of the work accomplished by Dr. Blackwell. In Western New York, Dr. Dolley, as a successful physician, by her dignity and scientific attainments, has made the way easier for all women. In her quiet way she has been an unseen force constantly on the alert to open positions to effect organization, and to mobilize the forces that act for the helpfulness of the individual and the success of the whole. These women should go down in history not as Pioneers, merely, but as Reformers, for they 2 not only opened up a great field for women, but an important advance work in social economics. This Society is organized with the distinct understanding that it is not to divert interest from the Medical Society of the State of New York, but rather to encourage greater activity in organized work, and to cultivate social relations and mutual helpfulness among women physicians. 3"Medicine is so broad a field, so closely interwoven with general interests and yet so personal a character in its individual applications, that the cooperation of men and women is needed to fulfill all its requirements." ELIZABETH BLACKWELL. CONSTITUTION ARTICLE I. NAME This Society shall be known as the Women's Medical Society of New York State. ARTICLE II. PURPOSE OF THE SOCIETY. The purpose of this Society shall be to bring the Medical Women of New York State into communication with each other for their mutual advantage, to encourage social and harmonious relations within the profession, to extend medical knowledge and to advance medical science. ARTICLE III. MEMBERS SECTION I. Active members of this Society shall be women graduates in medicine in good professional standing and who are members of a County Medical Society. They shall be elected by a three-fourths vote of the active members present at a regular meeting in the manner provided in the By-Laws. Any member ceasing to be a member of a County Medical Society shall cease to be an active member in this Society. 5II. Associate members shall be women graduates in medicine from recognized Regular Medical Colleges. They shall be elected by a two-thirds vote of the active members present at any regular meeting, in the manner provided in the By-Laws for active members. They shall pay a fee of two dollars, but be exempt from annual dues. They shall enjoy all the privileges of the Society, except the right to vote and hold office. III/ Honorary members shall be women distinguished in medicine, elected in the manner provided in the By-Laws; they shall enjoy all the privileges of the Society, except the right to vote and hold office. They shall be exempt from the payment of fees and dues. IV. The active membership of this Society shall be divided into eight district branches, according to the Medical Society of the State of New York, as provided in the By-Laws. ARTICLE IV. OFFICERS. SECTION I. The officers shall consist of a President, three Vice-Presidents, a Secretary and a Treasurer, and one Councilor for each District Branch, they shall be elected annually by ballot for the term of one year, and the majority of votes cast shall elect. No one except a charter member shall be eligible to the office of Vice-President, who has not been a member for two years and attended two annual meetings. No one except a charter member shall be eligible to the office of President who has not been a member for a period of five years and attended three annual meetings. 6 II. Nominations for Officers shall be made by the Council and a ballot containing all nominations sent to each member with the notice for the annual meeting. ARTICLE V. COUNCIL. The Council shall be the executive body of the Society. It shall consist of the officers of the Society and of the Chairmen of standing committees. The Council shall be the finance committee of the Society and shall have such additional powers and duties as the By-Laws may present. AMENDMENT. This Constitution may be amended at any annual meeting, by a two-thirds vote of active members present, provided notice of the proposed amendment shall have been sent to members one month prior to the meeting. 7 BY-LAWS. ARTICLE I. Membership. SECTION I. Every candidate for active or associate membership must sign a printed application furnished by the Secretary. This application must be endorsed by two members of the Society, personally acquainted with the applicant, and submitted to the Council for approval. Upon the recommendation of the Council the applicant may then be elected by ballot at the next annual meeting of the Society. Names of the candidates shall be written upon the notices of the meeting. $ II. Honorary members upon the recommendation of the Council may be elected by a two-thirds vote of the active members present at the annual meeting. ARTICLE II. Meetings. SECTION I. The Annual Meeting of the Society shall be held during the life time of Dr. Sarah R. Adamson Dolley in Rochester, N. Y., on her birthday, March eleventh, unless it comes on Sunday, when the Council may arrange the date of the annual meeting. $ II. Each member in attendance at the annual session of the Society, shall enter her name and address and the name of the County Society, if an active member, in the register to be kept by the Secretary of the Society for that purpose. This directory shall be published and sent to members bi-ennially. 8 $ III. The following shall be the order of business at all general meetings. 1. Calling the Society to order. 2. Addresses of welcome by the Chairman of Committee on Arrangements. 3. Reading of the minutes of the last meeting. 4. Reports of special committees. 5. Special addresses. 6. President's address. 7. Reading and discussion of papers. 8. Election of Officers. 9. Miscellaneous business. 10. Banquet. $ IV. Fifteen active members shall constitute a quorum. ARTICLE III. SECTION I. The Council shall meet on the day before the annual meeting of the Society and at other times, as occasion may arise upon the call of the President, or upon request of three members of the Council. The new Council shall meet before the closing of the session of the Society to organize and to outline the work for the ensuing year. $ II. The Council shall provide for and superintend all publications and their distribution. All money of the Society received by the Council shall be paid to the Treasurer of the Society. It shall audit the annual accounts of the Treasurer and Secretary and present a statement of the same in its annual report. In the event of a vacancy in the office of Secretary or Treasurer, the Council shall fill the vacancy until the next annual election. 9III. The following shall be the order of business at meetings of the Council: 1. Calling the meeting to order. 2. Roll call by the Secretary. 3. Reading of minutes and communications from the Secretary. 4. Communications from the Treasurer. 5. Communications from the chairman of standing committees. 6. Unfinished business and new business. IV. A majority of the members of the Council shall constitute a quorum. CHAPTER IV. DUTIES OF OFFICERS. SECTION I. The President or Vice-President shall preside at all meetings of the Society, and of the Council. The President shall prepare a program for the meetings of the Society with the aid of the Committee on Scientific Work and appoint all committees not otherwise provided for. She shall deliver an address at the annual meeting of the Society and shall perform such other duties as custom and parliamentary usage may require. She shall be ex-officio a member of all standing committees. II. The Vice-Presidents shall assist the President in the discharge of her duties, and in her absence or at her request, shall temporarily perform the duties of the President, in the order in which they are elected. III. The Secretary shall keep the minutes of the proceedings of all meetings of the Society, issue notices of meetings, notify officers and members of committees of their election or appointment and transact such other business 10 as may be ordered by the Society or Council. The Secretary of the Society shall be secretary of the Council and shall keep minutes of all its meetings. She shall receive the signatures and fees of the newly elected members and pay the money thus received to the Treasurer. She shall send notices of meetings to the members. Notices of the annual meeting shall be sent at least two weeks before the meeting. IV. The Treasurer shall be the custodian of all funds of the Society and shall disburse the same only as directed by the Council. She shall keep an account of all the funds received and expended. ARTICLE V. STANDING COMMITTEES. SECTION I. The following shall be the standing committees of the Society: A Committee on Scientific Work. A Committee on Legislation. A Committee on Public Health. A Committee on Arrangements. There shall also be such other standing committees may determine to be necessary. II. The Committee on Scientific Work shall consist of three members, including the Chairman, and with the President shall determine the character and scope of scientific proceedings of the Society for each session, subject to the instructions of the Council. Thirty days prior to each annual session it shall prepare and forward to the Secretary a program announcing the order in which papers, discussions and other business shall be presented. 11 III. The Committee on Legislation shall consist of three members, including the Chairman. It shall keep in touch with professional and public opinion. Under the direction of the Council, it shall represent the Society. IV. The Committee on Public Health shall consist of three members, including the Chairman. It shall report upon and present to the Society such subjects as may seem to the committee to be of special importance in their relation to the public health. V. The Committee on Arrangements shall consist of eight members, including the chairman. It shall provide suitable accommodations for the meeting places of the Society and of the Council and shall have general charge of the arrangements for all meetings. The Chairman of the Committee shall report an outline of the arrangements to the Secretary for publication in the program, and shall make such additional announcements during the session as the occasion may require. ARTICLE VI. ANNUAL DUES. Annual dues shall be one dollar ($1.00), and no member shall participate in the deliberations of the Society who has not registered and paid her dues. ARTICLE VII. DISTRICT BRANCHES. SECTION I. The First District Branch shall comprise the members of the Medical Societies of the Counties of New York, Westchester, Rockland, Putnam, Orange and Dutchess. 12 The Second District Branch shall comprise the members of the Counties of Kings, Queens, Nassau, Suffolk and Richmond. The Third District Branch shall comprise the members of the Counties of Albany, Rensselaer, Schoharie, Greene, Columbia, Ulster, and Sullivan. The Fourth District Branch shall comprise the Medical Societies of the Counties of St. Lawrence, Franklin, Clinton, Essex, Hamilton, Fulton, Montgomery, Schenectady, Saratoga, Warren and Washington. The Fifth District Branch shall comprise the members of the Medical Societies of the Counties of Oswego, Delaware, Madison, Chenango, Cortland, Tompkins, Schuyler, Chemung, Tioga and Broome. The Seventh District Branch shall comprise the members of the Medical Societies of the Counties of Monroe, Wayne, Cayuga, Seneca, Yates, Ontario, Livingston and Steuben. The Eighth District Branch shall comprise the members of the Medical Societies of the Counties of Erie, Niagara, Orleans, Genesee, Wyoming, Allegany, Cattaraugus and Chautauqua. ARTICLE VIII. The deliberations of the Society shall be governed by parliamentary usage, as contained in Roberts' Rules of Order, when not in conflict with the Constitution and By-Laws of the Society. 13OFFICERS. Honorary President: Elizabeth Blackwell, M.D., Hastings, England. President: Sarah R. Adamson Dolley, M.D., Rochester, N.Y. First Vice-President: Electa B. Whipple, M.D., Buffalo, N.Y. Second Vice-President: Mary H. Cotton, M.D., New York City. Third Vice-President: Mary Thresa Greene, M.D., Castile, N.Y. Secretary: Eveline P. Ballintine, M.D., Rochester, N.Y. Treasurer: M. May Allen, M.D., Rochester. N.Y. 14 COMMITTEES. COMMITTEE ON SCIENTIFIC WORK. Marion Craig Potter, M.D. Helena J. Kuhlman, M.D. Mary B. Jewett, M.D. COMMITTEE ON LEGISLATION. Margaret A. Cleaves, M.D. COMMITTEE ON PUBLIC HEALTH. Cornelia White Thomas, M.D. Ina B. Burt, M.D. Josephine Walters, M.D. COMMITTEE ON ARRANGEMENTS. Evelyn Baldwin, M.D. Mary Innis Denton, M.D. Jennie M. Turner, M.D. Kathleen Buck, M.D. Louise M. Hurrell, M.D. Helen D. Justin, M.D. Leone Todd, M.D. Sarah Pierson, M.D. TOASTMISTRESS. Ida C. Bender, M.D. 15COUNCILORS. First District Branch. Martha Woolstein, M. D., New York City. Second District Branch. Anna Craig M. D., Kings Park. Third District Branch. Hortense V. Bruce, M. D., Hudson. Fourth District Branch. Caroline S. Pease, M. D., Ogdensburg. Fifth District Branch. Angeline Marine, M. D., Utica. Sixth District Branch. Anna Bowden White, M. D., Norwich. Seventh District Branch. Lettie H. Woodruff, M. D., Rochester. Eighth District Branch. Maude J. Freye, M. D., Buffalo. 16 HONORARY MEMBERS. Emily Blackwell, M. D., Montclair, N. J. Hannah T. Croasedale, M. D., Syracuse, N. Y. Anna Broomall, M. D., Philadelphia, Pa. 17 ACTIVE AND ASSOCIATE MEMBERS. May Allen, M.D., 297 Alexander St., Rochester, N.Y. Lucia E. Aralton, M.D., - - Canton, N.Y. Evelyn Baldwin, A. B., M.D., 476 West Ave., Rochester, N.Y. Eveline P. Ballintine, M.D., State Hospital, Rochester, N.Y. Theresa Bannan, M.D., 503 Warren St., Syracuse, N.Y. Ida C. Bender, M.D., 731 Ellicott St., Buffalo, N.Y. Alice K. Bennett, M.D., 26 Allen St., Buffalo, N.Y. Inez Bentley, M.D., State Hospital, Rochester, N.Y. Mary Hess Brown, M.D., 541 W. 123rd St., New York City. Hortense V. Bruce, M.D., - Hudson, N.Y. Mary E. Bryan, M.D., 50 Greene St., Ogdensburg, N.Y. Kathleen Buck, M.D., Monroe Ave., Rochester, N.Y. Ina J. Burt, M.D., - - - Phelps, N.Y. 1Martha F. Caul, M. D., 76 West Genesee St., Buffalo, N. Y. Mamie :. Chard, M. D., 205 W. 85th St., New York City. Nellie V. Choppell, M. D., 410 Brichenridge St., Buffalo, N. Y. Margaret A. Cleaves, M. D., 616 Madison Ave., New York City. Frances Cohen, A. B., M. D., 131½ Warburton Ave., Yonkers, N. Y. Cora Belle Cornell, M. D., - Warsaw, N. Y. Mary K. Cotton, M. D., 157 W. 123rd St., New York City. Anna Craig, M. D., - - - Kings Park, N. Y. Mary Gage Day, M. D., 207 Wall St., Kingston-on-Hudson. Ruth Demarest, M. D., H. R. State Hospital, Poughkeepsie, N. Y. Mary Innis Denton, M. D., 230 Potomac Ave., Buffalo, N. Y. Mary E. Dickinson, M. D., 91 Alexander St., Rochester, N. Y. Sarah R. A. Dolley, M. D., 374 Court St., Rochester, N. Y. Elizabeth Dort, M. D., 608 Fillmore Ave., Buffalo, N. Y. Lillian C. Randall, M. D., Cor. Lafayette & Barton Sts., Buffalo, N. Y. Louise G. Robinsvitch, M. D., 28 W. 126th St., New York City. A. Josephine Sherman, M. D., 126 E. 60th St., New York City. Mary J. Slaight, M. D., 460 Glenwood Ave., Rochester, N. Y. Elizabeth M. Squires, M. D., - Albion, N. Y. Cynthia Steers, M. D., 316 Summit Ave. Schenectady, N. Y. Elizabeth B. Thelberg, M. D., Vassar College, Poughkeepsie, N. Y. Cornelia White Thomas, M. D., 470 Lyell Ave., Rochester, N. Y. Harriet M. Turner, M. D., 61 So. Union St., Rochester, N. Y. Loretta W. Turner, M. D., 82 Chili Ave., Rochester, N. Y. Jennie M. Turner, - - - - Newark, N. Y. Mathilda K. Wallin, M. D., 78 Park Ave., Office, 616 Madison Ave., New York City. Josephine Walter, M. D., 61 W. 74th St., New York City. Electa B. Whipple, M. D., 491 Porter Ave., Buffalo, N. Y. Anna B. White, M. D., 33 West Main St., Norwich, N. Y. Marie R. Wolcott, M. D., 448 Seventh St., Buffalo, N. Y. Lettie H. Woodruff, M. D., 17 Tremont St., Rochester, N. Y. Frances Hurlburt-White - - Fairport, N. Y. Clara Meltzer Aver, M. D., 107 West 122nd St., New York City. Harriet Coffin, M. D., State Hospital, Rochester, N. Y. Nancy Craighead, M. D., Clifton Springs, N. Y. Katherine L. Daly, M. D., 400 Brown St., Rochester, N. Y. Laura H Foote, M. D., 2 Emma St., Rochester, N. Y. Elizabeth H. Gerow, M. D., 30 Hooker Ave., Poughkeepsie, N. Y. A. N. Cady Harris, M. D., 402 Lake Ave., Rochester, N. Y. Lucia E. Heaton, M. D., - - Canton, N. Y. Gertrude B. Kelley M. D., 130 East 27th St., New York City. Calister V. Luther, M. D., South Orange, N. J. Susan G. Otis, M. D., 29 E. Genesee St., Auburn, N. Y. 6 Marjory J. Potter, M. D., 534 3rd St., Niagara Falls, N. Y. Elizabeth M. Schugens, M. D., 378 Ellicott St., Buffalo, N. Y. Mary I. Slade, M. D., - - Castile, N. Y. Mary N. Sloan, M. D., 194 14th Street, Buffalo, N. Y. Amelia Earle Trout, M. D., The Markeen, Maine and Utica Sts., Buffalo, N. Y. Adelaide Turner, M. D., Manhattan State Hospital, Ward's Island, New York City. Sara Craig Buckley, 301 E. 56th St., Chicago, Ill. Laura L. Liebhardt, 221 Mack Bldg., Denver, Col. Miriam Gardner Walters Park Lane, Walters, Penn. Florence Huson, - Cass Ave., Detroit, Mich. Mary Hadley Smith, California. Elizageth Shrimpton Syracuse,N.Y. Selina P. Colgin, M.D. Salamanca, N.Y. Caroline L. Garlock, M.D. Ames, N.Y. Ruth Lathrop, M.D. Philadelphia, Pa. Helen D. Justin, M.D. Castile, N.Y. Phoebe Bogart, M.D. New York, N.Y. 7Martha F. Caul, M. D., 76 West Genesee St., Buffalo, N.Y. mamie L. Chard, M. D., 205 W. 85th St., New York City Nellie V. Choppell, M. D., 410 Brichenridge St., Buffalo, N.Y. Margaret A. Cleaves, M. D., 616 Madison Ave., New York City Frances Cohen, A. B., M. D., 131 1/2 Warburton Ave., Yonkers N.Y. Cora Belle Cornell, M. D., - Warsaw, N.Y. Mary K. Cotton, M. D., 157 W. 123rd St., New York City. Anna Craig, M.D., - - - Kings Park, N. Y, Mary Gage Day, M. D., 207 Wall St., Kingston-on-Hudson Ruth Demarest, M. D., H. R. State Hospital, Poughkeepsie, N.Y. Mary Innis Denton, M. D., 230 Potomac Ave., Buffalo, N.Y. Mary E Dickinson, M. D., 91 Alexander St., Rochester, N.Y. Sarah R. A. Dolley, M. D., 373 Court St., Rochester N.Y Elizabeth Dort, M. D., 608 Fillmore Ave., Buffalo N. Y. 2 Amelia Mollie Flandler, M. D., 1897 Lexington Ave., New York City. Jane N. Frear, M. D.m 28 Orton Place, Buffalo, N. Y. Maude J, Frye, M. D., 224 Allen St., Buffalo, N. Y Lois Gannett, M. D., - - Adams, N. Y. Amelie Weed Gilmore, M. D. 30 South St., Auburn N.Y. Mary T. Greene, M. D. - - Castile, N. Y. Edith R. Hatch M. D. 82 Fargo Ave., Buffalo, N. Y. Beatrice M. Henkle, M. D., 56 West 49th St., New York City. Jeanette Himmelsbach, M.D., 382 Elmwood Ave., Buffalo, N. Y. Margaret T. Holleck, M. D., Bedford Station, N. Y. M. Louise Hirell, M. D., 123 Third St., Rochester N. Y. Mary Clayton Hurlburt, M. D., Lockport N. Y. Regina Flood Keyes, M. D., 62 Allen St., Buffalo N. Y. Helene J. C. Kuhlman, M. D., State Hospital, Buffalo N. Y. Florence Marion Laighton M. D., 8 West 91st St., New York City. 3 Annie P. Lapp, M. D., - Williamson, N. Y. Charlotte B. MacArthur, M. D., Willard, N. Y. Eva E. McKnight, M. D., 59 Bridge St., Oswego, N. Y. Marion Marsh, M. D., 205 Woodward Ave., Buffalo, N. Y. Katherine S. Marshsell, M. D., 296 Lafayette Ave., Buffalo, N. Y. Angeline Martine, M. D., - - Utica, N. Y. Katherine S. Munhall, M. D., 296 Lafayette Ave., Buffalo, N. Y. Frances Merriam Myers, M. D., 109 South Third St., Mt. Vernon, N. Y. Sophy Ellen Page, M. D., 215 Aurora St., Ithaca, N. Y. Dorothea Payne, M. D., - - Warsaw, N. Y. Caroline S. Pease, M. D., St. Lawrence St. Hosp., Ogdensburg, N. Y. Sarah H. Perry, M. D., 82 South Fitzhugh St., Rochester N. Y. Sarah Pierson, M. D., 10 Gibbs St., Rochester, N. Y. Marion Craig Potter, M. D., 10 Gibbs St., Rocheste, N. Y. Julia Kimball Qua, M. D., Amsterdam, N. Y. Sue Radcliff, M. D., 299 South Broadway, Yonkers, N. Y. 4 Lillian C. Randall, M. D., Cor. Lafayette & Barton Sts., Buffalo, N. Y. Louise G. Robinsvitch, M. D., 28 W. 126th St., New York City A. Josephine Sherman, M. D., 126 E. 60th St., New York City. Mary J, Slaight, M. D., 460 Glenwood Ave., Rochester, N. Y. Elizabeth M. Squires, M. D., - - Albion N. Y. Cynthia Steers, M. D., 316 Summit Ave. Schenectady, N. Y. Elizabeth B Thelberg, M. D., Vassar College, Poughkeepsie, N. Y. Cornelia White Thomas, M. D., 470 Lyell Ave., Rochester N. Y. Harriet M. Turner, M. D., 61 So. Union St., Rochester N. Y. Loretta W. Turner, M. D., 82 Chili Ave., Rochester, N. Y. Jennie M. Turnier, - - - - Newark, N. Y. Mathilda K. Wallin, M. D., M. D.,, Office 616 Madison Ave., New York City Jospehine Walter, M. D., 61 W. 74th St., New York City. Electa B. Whipple, M. D., 491 Porter Ave., Buffalo, N. Y. 5 Anna B. White, M. D., 33 West Main St., Norwich, N. Y. Marie R. Wolcott, M. D., 448 Seventh St., Buffalo, N. Y. Lettie H. Woodruff, M. D., 17 Tremont St., Rochester, N. Y. Frances Hurlburt-White - - Fairport, N. Y. Clara Meltzer Aver, M. D., 107 West 122nd St., New York City Harriet Coffin, M. D., State Hospital, Rochester, N. Y. Nancy Craighead, M. D., Clifton Springs, N. Y. Katherine L. Daly, M. D., 400 Brown St, Rochester, N. Y. Laura H. Foote, M. D., 2 Emma St., Rochester, N. Y. Elizabeth H. Gerow, M. D., 30 Hooker Ave., Poughkeepsie, N. Y. A. N. Cady Harris, M. D., 402 Lake Ave., Rochester, N. Y. Lucia E. Heaton, M. D., - - Canton, N. Y. Gertrude B. Kelley, M. D., 130 East 27th St., New York CIty. Calister V. Luther, M. D., South Orange, N. J. Susan G. Otis, M. D., 29 E. Genesee St., Auburn, N. Y. 6 Marjory J. Potter, M. D., 534 3rd St., Niagara Falls, N. Y. Elizabeth M. Schugens, M. D., 378 Ellicott St., Buffalo, N. Y. Mary I. Slade, M. D., - - Castile, N. Y. Mary N. Sloan, M. D., 194 14th Street, Buffalo, N. Y. Amelia Earle Trout, M. D., The Markeen, Maine and Utica Sts., Buffalo, N. Y. Adelaide Turner, M. D., Manhattan State Hospital, Ward's Island, New York City. Sara Craig Buckley, 301 E. 56th St., Chicago, Ill. Laura L. Liebhardt, 221 Mack Bldg., Denver, Col. Miriam Gardner, Walters Park Lane, Walters, Penn. Florence Huson, - Cass Ave., Detroit, Mich. Mary Hadley Smith, - - - - - California Elizabeth Shrimpton, - - - Syracuse, N. Y. Selina P. Colgin, M. D., Salamanca, N. Y. Caroline L. Garlock, M. D., Ames, N. Y. Ruth Lathrop, M. D., - - Philadelphia, Pa. Helen D. Justin M. D., - - - Castile, N. Y. Phœbe Bogart, M. D., - - New York, N. Y. 7 Adele Gleason, M. D., - - Buffalo, N. Y. C. Anna J. Brown, M. D., Seneca Falls, N. Y. Louise Westlake, - - - - Le Roy, N. Y. Leone Todd, - - - - - Auburn, N. Y. 8