“It housed, fed and furnished medical and surgical treatment for 34,000 sick people, 1000 tuberculosis patients, and 3000 aged, infirm or irresponsible people.
“It supplied food, clothing and fuel to about 200,000 persons; buried 978 pauper and friendless dead, and granted $165,000 to 350 indigent mothers for the support of 1126 children. To perform this service it required the full time of 3000 employees and part time of about 10,000 others. The appropriations of Cook County for 1913 total $7,072,486.96.”
Such is the budget of what we may call the human problem of a great metropolitan county. Between the services rendered in such a unit and those of a sparsely settled, back-country county, almost anywhere in the United States, the difference is one of degree rather than of kind.
This is the ancient heritage of the church, which it has gradually transferred to the shoulders of the State, beginning at a time when the treatment of unfortunates was yet mostly a matter of getting undesirable citizens out of the way without actually assassinating them. The recipients of relief in early times were all treated as just so much of a public charge and all were obliged to wear the letter “P.” There was no science of penology, and the insane were treated as possessed of devils. Modern institutional care was practically undreamed of.
But the care of unfortunates within the last half century has come under the dominion of the scientific spirit. The old way was to “bunch” all kinds of poor and all kinds of dependents and all classes of criminals, regardless of all antecedent circumstances and all hope of betterment. Science, on the other hand, has demanded first, investigation into the causes and nature of crime and deficiency, then classification of cases. New York led the way in the treatment of these social relief problems by starting the process of segregation. In the early part of the nineteenth century the almshouses in America and the workhouse in England began to be built, as an expedient for facilitating investigation of applicants and decreasing expense. These institutions were soon used to house all sorts and conditions of men, women and children. Says one authority[4]:
“If you went into an almshouse in any of the counties of this State as recently as the ’70s of the last century, you would have found a mixture of the aged, who were in the almshouse simply because they were old and misfortune had come to them and they had lost their money and were therefore obliged to spend their last days in the almshouse. In addition, you would find children of all ages, beginning with infants. A large number of infants, especially illegitimate children, would be housed in the same building and would be cared for promiscuously with the older groups. You would also find large numbers of the insane, as there was no separate provision for them at that time. So with the epileptic and feeble-minded and every class of dependent vagrant and inebriate. It was a veritable dumping-ground for all sorts and conditions of humanity.”
In the movement for segregation of cases the first step was to secure a prohibition against the commitment of children to the almshouses. Special provision was later made for the insane. From time to time other classes of cases, including the feeble-minded, the epileptics and vagrants, have been transferred for appropriate treatment elsewhere. Later came the public health movement, the basic idea of which is the segregation of the sick poor from those who are sound in body but destitute. Even at the present time the almshouses are used for inebriates.
In a later period the standards for the treatment of prisoners have been advanced somewhat more slowly but along the same scientific principle of classification and segregation, but less with reference to psychological and sociological causes or the nature of crime than to the conveniences of administration. But segregation has been prescribed by law in generous measure according to certain crude principles of decency and justice. Thus the New York Prison law provides at least ten classifications, involving separation of men from women, men from boys, persons awaiting trial from those under sentence, civil prisoners and witnesses from criminal prisoners.
So much for the modern standards. Against such standards the success or failure of the county as a humanitarian agency must be measured.