The spirit of the average almshouse is illustrated in this—one Illinois county has a contract with a dentist to pull the teeth of poor farm inmates. There is no provision for saving teeth. If the inmate is writhing with toothache, he must take his choice; lose a good tooth on contract, or grin and bear the pain. The supervisors can see no reason why a pauper should want to save his teeth or why he should be permitted to do so. And yet a cheap filling would cost little more than the primitive and mutilating operation of extraction.
These are mere instances of the obvious curative possibilities in the almshouse—instances where the county's duties are so apparent, in which the right and humane way is so clearly the cheap and economical way that the matter should require no discussion. It is the line of direct cure which the county, as a matter of sound administration, should make it possible to carry out. It means first the careful physical examination of every inmate of every almshouse, not by the medical man who bids lowest to get the contract, but by the most capable diagnostician available.
But this is only the beginning. The big possibility is what the almshouses of the nation can do to ascertain the more remote causes of poverty and destitution, for, as in the case of the insane, when we know the causes of destitution, we can carry out our most effective work before the pauper becomes a pauper—before he comes slinking, wretched and despondent, to the door of the county farm.
Tuberculosis will never be eradicated by merely treating the sick; yellow fever could not have been stamped out by simply caring for the afflicted; pauperism will never be materially affected by what we do when the pauper has reached his last ditch. We must fight tuberculosis by striking at its causes; we have already eliminated yellow fever by the same sane process. We would have gone further in our battle against pauperism, perhaps, were it not that pauperism is the only disease that has never invaded the home of the rich. No multi-millionaire has ever endowed a research laboratory for the study of destitution in memory of a petted child struck dead by its poisonous fangs.
But every almshouse has its clinic in poverty and I am convinced that if every inmate in every poorhouse throughout the nation could be made to tell the story of how he came to be there; if every one could be examined for physical and mental causes, and if all these data could be gathered together in systematic form, a great stride would have been made in formulating an intelligent campaign against dependence.
[COMPENSATION FOR OCCUPATIONAL DISEASES]
JOHN B. ANDREWS
SECRETARY AMERICAN ASSOCIATION FOR LABOR LEGISLATION