If these remote influences lie beyond the imaginative possibilities of the average almshouse superintendent and county official, there were certain other facts brought out in this study which should appeal to the most practical and hard-headed. These facts seem to point the way to the rehabilitation of the unfortunate; the way of placing him on his feet again. They also point directly to the reduction in the almshouse population and the consequent decrease in public expense.
Getting at the direct causes of dependence, it was found that old age was the chief factor, 47 of the inmates being over 70 years of age. This number of dependents, incidentally, could be materially reduced by tracing out near relatives legally responsible for their care.
Drugs and alcohol were responsible for 25 dependencies—a less encouraging group until we have intelligent public treatment for these cases. Twenty-five of the inmates were crippled while 18 were there on account of general illness. Doubtless many of these cases would be amenable to treatment if properly studied and diagnosed.
Six were victims of advanced tuberculosis, and it may be assumed that the nature of the illness was unrecognized as the patients were housed in dormitories with the uninfected. There were unquestionably other tuberculosis cases undiagnosed who were not only losing their chance of cure; but were exposing and infecting others. I am impressed, incidentally, that almshouses, with their armies of transients going to the crowded, unventilated quarters of the poor, are very considerable spreaders of tuberculosis.
The insane, feeble-minded and epileptic aggregated perhaps 50—an almshouse population which should be and must be decreased by more adequate state provision for these afflicted.
Syphilis was responsible for 3 dependencies, and probably many more would respond to the Wassermann test and could be restored to health by specific treatment.
The 4 blind and aged inmates might be made to see by simple cataract operations.
Many of the inmates expressed the wish that they might be restored to health that they could go out into the world again upon their own resources. But 58 replied, when asked what they wanted to do in the future, that they wanted to stay where they were, under the friendly roof of the poorhouse.
This does not imply hopeless pauperism, however. Sick, neglected, weak and despondent—of course, they want to stay in some place, even in the poorhouse, where they are not eternally ordered to move on by the police; viewed with suspicion or fear by self-respecting citizens or in constant danger of arrest for vagrancy. Such forlorn men not infrequently commit petty crimes to guarantee their being housed in jail during a cold winter.