I am optimistic enough to believe that if the physical conditions of each inmate were studied; if his ills were cured and he was made stronger in body, he would be given courage, more ambition and more purpose in life. To this extent pauperism is directly curable.
True, there are among the destitute those who are hopelessly marked—branded by heredity; cursed by environment; wrecked by disease; deficient in body and in mind, with little or nothing to work upon. By the same token there are those in other branches of medicine who are hopelessly sick—those who are beyond the reach of the surgeon's knife or the physician's prescription. There are those among the insane who give no ray of hope to the most enthusiastic alienist.
But when we progress to the point of classifying our paupers; of studying intelligently the various causes of destitution; of endeavoring to make our almshouses places of cure rather than mere asylums for the victims of poverty, our percentage of "recoveries" will be surprisingly high.
The difference in methods between the modern insane hospital and the almshouse is striking. A man is admitted to an institution for the insane in a thoroughly irrational and excitable condition. His case is studied and it is found that he has cerebral syphilis. Proper treatment is instituted and, in all probability, the patient is returned to his family cured and a useful member of society.
In another case, syphilis has rendered a man physically inefficient, dissipated and despondent. He drifts to the poorhouse where he is catalogued simply as a "pauper." The chances are that the cause of his pauperism is not detected. If he announces it himself, he may receive the hurried, occasional visit of a contract doctor. Even the drugs that are given him may be crude and impure, bought by contract from the lowest bidder. Little or no provision is made for his intelligent and systematic treatment. He may be drugged with mercury until he is salivated; he may be neglected until his open sores cause him to be housed in the basement away from the other inmates. He is merely a syphilitic pauper and the rough fare of the poorhouse is looked upon as better than he deserves.
As a matter of fact, he is a sick man; sick of a curable disease and his cure may restore him to useful citizenship and remove him from the county expense.
Or again, there comes to the almshouse a man who is tired—a man who will not work. Perhaps he is losing a little weight and he is known to have been drinking more whiskey than he did when he worked harder. You are tempted to compel him to work; to drive him to earn his meager board and bed. The superintendent has no time to note that he has a little fever at night or to see that he clears his throat from time to time. Without physical examination, we have no way of knowing that we are dealing with an incipient consumptive. The average superintendent knows nothing of the deadly weariness of this disease; the weariness that invades every muscle of the body; which makes work impossible; which prompts men of higher moral fiber to drink whiskey or seek other stimulation.
This "lazy devil" is begrudged our poorhouse food, when, as a matter of fact, he ought to have, and at public expense, better food than we have ever thought of giving him. With fresh air, milk, eggs, nourishing food, intelligent treatment and perfect rest, this man can get well and resume a place in the world. With ordinary almshouse care and almshouse fare, we are signing his death warrant while we are guaranteeing his prolonged dependence upon public charity.
We receive old men who have worked hard and who have made an honest living before their eyesight failed and they became almost blind. We label these men as paupers and do not stop to question if a simple operation for cataract would not restore them to useful occupation.