they receive. Experience teaches that to do for an individual that which it is possible for him to do for himself will invariably tend to harm, unless he gives in return an equivalent, either by actual payment or in gratitude. And experience also teaches that human nature can only feel gratitude toward an individual.
Besides this tendency in hospitals as charitable institutions to increase pauperism, another serious objection to the use of public hospitals for the purpose of treating the sick beyond the extent absolutely demanded by necessity is, that every time an individual is removed from his home—let that home be ever so humble—and taken to a hospital, the family as an institution receives a blow.
Then, too, except to those already degraded, life in a pauper hospital, especially in the case of the young, is hardening to the feelings, while in many cases it subjects the moral to the influence of the immoral.
Another objection to hospitals is the bad sanitary condition of many of them, and unless this is improved, both as to the plan and the construction of the buildings, and the general and internal management, so as to give a smaller death-rate and fewer deaths from hospital-diseases than in the vast majority of hospitals now in use, it will be decidedly better, on sanitary grounds alone, to treat in their homes all the sick poor who have homes, even though they may be very bad and unhealthy places to live in. As to the expense of treating the poor at their homes, it certainly would not be greater than the expense of running the hospitals, if the interest-money is added which could be had from the immense sums that are sunk in the massive, many-storied hospital buildings, and the expensive city lots on which they stand.
But as poor-relief is now administered, and, no doubt, under the best system that could be devised, a certain number of hospitals for treating the sick poor will be necessary. When properly constructed and managed they are a great blessing to the poor, while, from the advantages they afford for the study and teaching of clinical medicine and nursing, they are of incalculable value to the whole community.
Since the establishment of the Training-School for Nurses in connection with St. Thomas's Hospital, by Miss Nightingale, in England, fifteen years ago, and, in this country, of the School for Nurses in connection with Bellevue Hospital, New York, three years ago, the great advantages of hospital-instruction are recognized for those who are studying nursing.
In the founding of hospitals, the question of their usefulness to medical education has not been given due consideration. As a rule, the idea of rendering immediate personal relief to the suffering poor is the first, and in many cases the only acknowledged object aimed at in establishing them.
