they need help, and thus teaching them to become careless about avoiding sickness?
It would be more creditable to the citizens of New York if they could say that no such institution as a pauper hospital was needed within the limits of the city than to be able to say that two hundred established charitable institutions and organizations are maintained; and instead of so many millions being spent in caring for the sick, would it not be better if the same money, or perhaps only a small part of it, were spent in carrying out sanitary works, and teaching the people the laws of health?
Suppose, during the prevalence of a contagious epidemic, the authorities should content themselves with providing for those infected, and neglect to take the necessary steps to remove the cause of the disease by doing all that sanitary science indicated—they would soon be called to account for neglect of duty. It is a well-known fact that the great majority of the cases of disease treated in our hospitals are induced by the bad sanitary condition of the homes of the poor, and to the direct violation, through ignorance, of the plainest hygienic laws; yet what direct steps are taken to correct this constantly-acting cause of sickness? The Health Department of New York City is expected to do little else than prevent epidemics of contagious and infectious diseases. The meagre appropriation prevents them from doing much more.
This statement concerning the charities of New York City cannot be called a fair example of the condition of the hospitals and other charities in smaller places, but it shows very plainly and truthfully the prevailing faults in the administration of charities throughout the country; and if the condition and results of the charities of smaller places are not so bad, it is due to local circumstances, and not to a better understanding of the subject, nor to the adoption of a more enlightened system.
The circumstances are very much in favor of the smaller cities and towns. Leaving out the many well-known causes that tend to generate pauperism, and thus increase the relative number of paupers in a large city that do not exist in towns or small cities, the main reason that charity does not do so much harm in the latter is, that the circumstances and the character of every one are well known to the people, and this personal knowledge guides and directs the givers of charity; whereas in the large cities it is seldom that the giver of charity knows to whom he is giving, and personal knowledge rarely exists at all. The difference between the lives of the rich and the poor is so great that the rich cannot comprehend the real needs of the poor. Unless these personal relations exist between those that give and those that receive, no act of generosity deserves the name of that charity which "blesseth twice," for gratitude is not developed in those receiving help. They give nothing in return for what
