1881: The Indoor Pauper: A Study
PAUPERISM with us is not the grim menace which it is in Europe. True, the vagabond pauper otherwise the tramp has given us a vast deal of trouble; but lie is as much outlaw as pauper, and, such as he is, he is a distinctly novel figure in American life. The normal, quiet, legally supported pauper has never taken enough money from us to startle us out of our apathy. This is peculiarly the case with the pauper whom the State supports entirely, the indoor pauper, as the reports style him. Commonly, his misfortunes or his vices are stowed away in a remote farm-house on a muddy road. Politicians do not concern themselves with his fate, for he has no vote; benevolent people have their hands full helping the poor who are not yet sunk into paupers; the very newspapers seek him out only when his woeful lot has acquired the lurid attraction of a horror. Yet this neglected and repulsive being has claims upon our attention, because upon our fears. Pauperism has increased rapidly within the last decade. Few people realize how much money is spent annually for the support of our almshouses, to say nothing of what we spend upon our other paupers, partially supported outside, or wholly supported in hospitals, insane asylums, and asylums for orphan children. The State of New York spent, during the year ending November 30, 1879, the sum of $1,618,867.63 for the keeping of 57,925 persons in almshouses and poorhouses. These same almshouses and poorhouses gave temporary aid to 79,852 persons, at an expense of $692,465.77. Pennsylvania last year supported 20,310 persons in her almshouses, at a net cost of $1,515,290. Massachusetts paid $1,776,778 for pauper support and relief. The whole number entirely supported was 13,989, and the number of the partially supported was 72,881. Ohio, which is not especially afflicted with pauperism, pays more than half the money obtained by the state taxation for the welfare of her criminals and paupers; and the estimate does not include the public charities of her cities, or any township aid. She has an almshouse population of 13,599 during the year. The Michigan paupers, in 1878 (when the last biennial report was published), showed a rate of increase four times greater than the percentage of increase in the population. Such statistics could be multiplied indefinitely. It should be stated, however, that there has been a great lessening in the number of out-door paupers aided, since the business of the country has improved; the number of almshouse inmates remaining about the same. Undoubtedly, many of the indoor paupers came to the almshouses during the hard times, but the better times fail to draw them away. Indeed, once a pauper, always a pauper, has become an almshouse axiom. The pauper being thus expensive and pertinacious, we must needs be interested in our manner of dealing with him, however unpleasant he himself may be. In this article I shall try to describe, as fully as my space will permit, the Indoor Pauper, what he is, and how we treat him. I shall not discuss here any question of the necessity of poor-laws; whatever their defects, however tragical their unforeseen results, the argument in their favor has been reinforced by the kindly sentiment of generations, until now the popular heart makes the legal care of the poor a part of our Christianity, and assaults upon such care excite overwhelming opposition. Yet, granting the necessity of poor-laws, their warmest friend will admit that they may be so framed and so administered as to do grievous wrong. To tempt the poor into pauperism is a bad business; but it is the business of every State which is unwisely lavish with its poor-fund. To brutalize men, and ruin women, and corrupt children, are acts usually called by harsh names; but they are the acts of every State which gives over the management of its almshouses to ignorant officials To load with chains helpless creatures, proven guilty of no crime; to beat them, starve them, shut them up in underground dungeons, cold and damp, with mouldy straw for furniture and rats for company, and there leave them for months and years untended, save for the daily pushing of their coarse food through a hole in the door, this conduct, when we read of it in the history of the Inquisition or the Bastile, we say is wicked cruelty; but it is cruelty which has been practiced by every State that has abandoned its insane paupers to almshouse tending.
Moreover, it is quite possible to imagine a system which shall combine all these evils; attracting unthrift and vice by its profuse gifts, while it exposes the old and feeble, and all those stricken with disease of mind or body, to intolerable sufferings, a system, in short, which shall be at once costly, barbarous, and useless. Most intelligent poor men would pronounce such a system worse than none. Is there any resemblance between such a system and our own? This question I shall try to answer by a study of the character of our paupers, and the conditions of their almshouse life. Our almshouse system is not properly a system at all; it is a congregation of systems, each State having its own. The oldest States have copied, or rather imitated, the English methods, the new States have imitated the methods of the old States, and all have improvised alterations and additions as circumstances seemed to call for them. Most of the States have what is termed the county system. Each county cares for its own poor in whatsoever manner it may prefer. The counties elect officials having charge of the poor: county supervisors, commissioners, infirmary directors, directors of the poor, ordinaries, superintendents of the poor, and the like. These send those of the poor who are, or are supposed to be, incapable of supporting themselves to houses built and conducted at the expense of the taxpayers. The houses are variously called poorhouses, almshouses, county infirmaries, and county homes. The county officials elected to care for the poor generally appoint the almshouse keeper; sometimes, however, he is elected; and sometimes the almshouse is under the control of a superintendent of the poor, who selects the keeper. The keepers are appointed or elected annually; their superiors hold office for periods of from one to three years. In some States the township is the local unit, instead of the county; some States have both the township and the county system. Massachusetts, Rhode Island, Connecticut, and New York make a distinction between state and local poor; the State caring for the former, and the counties or towns for the latter. A number of the States have no poorhouses. The paupers are boarded out, at the expense of the counties, often with their own relatives. Sometimes a number of paupers are cared for by a farmer, whom the counties pay. Usually, they select the farmer willing to take the lowest price per pauper. In Tennessee, there are public auctions held in the counties, at which the poor are set off to the lowest bidder. Nine of the States have central boards, called Boards of Charities, which inspect and to some extent control their almshouses. The nine are Massachusetts, New York, Rhode Island, Pennsylvania, Illinois, Ohio, Michigan, Wisconsin, and Kansas.
(Footnote: The Massachusetts board was organized first in 1863 (the different departments of health, lunacy, and charity were consolidated in 1879); the first New York board was organized in 1867; Illinois, Rhode Island, Pennsylvania, and Ohio organized boards in 1869, Wisconsin and Michigan in 1871, and Kansas in 1875.)
The duties and powers of the boards differ in the different States, but, in the main, their duties are to investigate, and their powers are to advise. Settlement laws, which have played so important a part in England, make but a small figure among us, save in the New England States. New York gives a settlement to any one who has resided in the State for a year; but the owner of the settlement loses it if he leave the State and remain for a period longer than one year. Sixty day’s residence in a county gives a county settlement to the citizen of New York.
(Footnote: Laws of New York, 1873, chapter 661, contains an act to provide for the support of state paupers. All blind, lame, old, impotent, or decrepit persons, who have not resided sixty days in any county of the State are deemed state paupers, and provision is made for their care by the Board of Charities.)
A year’s residence gives a settlement in any Pennsylvania district to any householder, taxpayer, servant, apprentice, holder of public office, or to any mariner or other healthy person coming directly from a foreign country into the district. Married women take their husband’s settlements, and children their parent’s. A years residence, indeed, seems to be the favorite limit, although in the West even a shorter period will secure a settlement. The New England States are more rigid. Massachusetts requires five years residence; but a settlement in Massachusetts can never be alienated; once obtained, it belongs to its owner to the end of his days, wherever he may go, however long he may stay away; it is his and his descendants after him. Every drop of Massachusetts blood, says a Massachusetts commissioner, with a touch of poetry, carries a settlement with it. It is never reversed. Massachusetts requires the payment of taxes during these five years, save in a few cases, such as soldiers, unmarried women, public officers, and the like. Vermont, New Hampshire, Rhode Island, Connecticut, New Jersey, and Delaware, likewise, make the payment of taxes requisite to the acquiring of a settlement; the other States merely ask that the person shall live for so many months or years within their borders.
There is as much difference in the views taken by the various States as to what makes a pauper, and as to who shall decide whether or no a poor person shall be considered a pauper, as there is in their settlement laws. Some States leave the local authorities no discretion in the matter. New York, on the one hand, does not recognize any able-bodied person as a pauper; Massachusetts, on the other, expressly holds that any able-bodied person without visible means of support, when he comes to the local authorities, is entitled to support. No matter how strong a man is, says Mr.Wrightington, the Massachusetts superintendent of the outdoor poor, if he is as strong as Samson, if the authorities of one town send him to us, we must either keep him, or send him beyond the state line. Of course, presuming Mr. Samson to have a settlement, he cannot be sent beyond the state line, and the commonwealth has no choice but to take care of him as long as he may choose. Other States and they are the majority leave the whole matter in the hands of the county officials. Generally, the county officials lean to the side of mercy; the quality is not strained, since it costs them nothing; for, be it noted, there are two sets of principals in the business, the county directors or supervisors, who manage the almshouses, and are responsible for their expenses, and the justices of the peace and poor overseers, who commit paupers to the almshouses, and have nothing more to do with them. It is for the interest of the poor directors and supervisors to have as few paupers in the almshouse as possible; it is for the interest of justices, who are paid for each order they write, and of overseers, who depend for reelection upon the suffrages of the poor but warm hearted populace, to show a liberal spirit. And, as Sydney Smith has observed, everybody is full of humanity and good nature when he can relieve misfortune by putting his hand into his neighbors pocket. Who can bear to see a fellow-creature suffering pain and poverty, when he can order other fellow-creatures to relieve him? The result of all this is that, practically, most States give almshouse lodging to any one having a settlement who can bring himself to ask it. What, then, are these almshouse lodgings, and what manner of men desire them?
Perhaps as easy a way as any to answer the question will be to describe a visit made by the writer, a few months ago, to a large rural almshouse in Illinois. I select this particular house because it is not the best, and is a long way from being the worst, within my knowledge. The house stands in the centre of a great coal district, thirteen miles from the county seat, but only two from a little mining hamlet. The road is fairly good in dry summers; when the weather is wet, and through most of the winter, it is almost impassable. My companion was a clever young physician, of considerable experience among the insane. After a long drive we stopped before a cluster of buildings, to which a tall windmill gave something of a picturesque and foreign air. There was a neat brown cottage; a large, bare brown house, without blinds, and seeming to have a disproportionate number of windows; along, two-storied building, shining with new paint; and a number of out-buildings, in appearance much like those to be seen on any large farm, even to the detail of a brick-red barn. The yard in front of the house had a number of trees, and a little to the right was a large garden. We saw no flowers, except the great white snowballs weighing down a half dozen huge bushes; but green things were sprouting and springing up all over the garden beds, and the foliage and the short scant grass had the fresh beauty of May. A man opened the gate. for us. He was a short, squarely built fellow, in dingy yellowish garments; and he had chains on his feet, making him take queer, short steps. His face was pale and sodden, with blear eyes and shapeless features; somehow, he seemed all of a color, hair, skin, eyes, and clothes. Several other men, also in chains, and more or less of a color like him, were hobbling about the yard; and one young man, in a long blue jean gown, was sitting chained to a post. Those must be the insane, said the doctor. Mingling with these men were others without chains, men and women, some of whom were painfully deformed. No one appeared to pay them any attention. The superintendent was away; but his daughter, a rather pretty, slim girl of eighteen, offered to show us through the house. The brown cottage was the keepers house; this we did not visit, but passed directly into the large frame building, the home of the sane paupers and of the harmless insane. At the time of our visit the house contained ninety-seven paupers, including some thirty-seven insane people and nine children. The first room we saw was a small store-room. Besides stores, there was a shelf filled with medicine bottles. The almshouse being so far from the county-seat, the almshouse keeper acts as resident physician.
‘Oh, pa’s quite a good doctor!” said the girl; at which my doctor smiled grimly. From the store-room we passed through a chamber crowded with beds and cradles into the women’s sitting-room. Both apartments were rather untidy. The bedding in the first was shabby, and made one think of Dandie Dinmonts speech in the Portanferry jail. The sitting-room had a stove, and some pine benches for furniture. On one of these was stretched a hideous old woman, very stout and red, wearing a single blue garment; she seemed to be asleep.” That woman got the dropsy, and she’s crazy, too,” said our guide. We asked if any one took care of her. The girl said, “No, she takes care of herself.” Entering the next room, we were greeted by a tremendous clamor. We had the curiosity to go out on a small porch, where the quarrelers were. They were two: an old blind woman and a middle-aged man, who were abusing each other at the top of their voices. Two younger women stood by, and flung occasional interjections into the uproar. The first was a broad-faced German, with yellow hair; she held a child in her arms. The second woman must have come from a New England village; no other place on earth could have sent into the world that lank form and long sallow visage. Just as we came upon the scene, the New Englanders shrill voice rose above the others: “Every body as knows me knows that I’d never lay a finger on nobody, except they druv me to it!”
“You tink me got nobody help me!” screamed the old woman. “Me got God; he give it to you!” We mustered enough German to speak to her. She was not a bad-looking woman: tall and thin, with a mobile dark face of the Bavarian type. Our question met instant response; with vehement gestures and quick-changing expression she told her story. They had come to the almshouse, her husband and she, because he had been ill for years, and she was blind, and they had no living children. They had been decent people in the old country, and they did not take kindly to almshouse ways. Her husband soon died. After his death, she was put in the charge of these two women. They had treated her most cruelly; they had robbed her of her little property of clothes; they beat her and persecuted her; and, with tears rolling down her cheeks, she begged us, for the love of God, to take her away. “What’s she sayin?” whispered the New England woman to the German. The latter rapidly translated the charges: “She say we steal her tings, we beat her and blague her.” “Me!” cried the New Englander, “me tech her! Why, I do her washing!” as though that settled the question. She then gave us to understand, confidentially, that Mrs. Jens (the old woman’s name) was “dretful queer”, and that nothing she said could be believed. A little money pacified the group, and enabled us to get upstairs. All the rooms there were sleeping rooms. They were not scrupulously clean, but the time being Saturday morning, we made allowance for their looking their worst. Many of the inmates were in their rooms; a few sewing, the most doing nothing. They were careless in their dress, and all the faces had a listless, vacant look. Here, also, we saw a number of cradles. We asked our guide what was done with the children. She said they tried to get homes for them among the neighboring farmers, when the mothers consented. But when the mothers don’t consent? said the doctor. Well, you know, we wouldn’t want to take them away without, said she. Then we went into the men’s department, which was much like the women’s. In one bare chamber, through which we passed (as must every one going upstairs), a man lay on a comfortless bed, turning so white and haggard a face to the wall that at first glance I thought him dead. He had bad spells, the girl said; at such times he went on awfully, but most of the time he was quiet enough. There was no one in the room; but a burly Irishman, shaving himself in the hall, was said to keep an eye on him. In another apartment we came upon a cheerful, clean old man, who was mending a pile of men’s clothing, being a tailor by trade. Ill health and partial blindness had brought him to the almshouse. He was the only sane pauper we saw who showed any sign of pleasant animation, either in face or speech. Our guide was warm in his praise. “He’s a real nice old man; works all the time,” said she, “mends all the men’s clothes.” We passed from the men’s side into the yard. There was a partition separating the two departments, but the yard seemed to be in common. The German woman who took care of Mrs. Jens came up to us while we were looking at the various groups. She was leading a little girl by the hand, and still carrying her baby. “This is my Annie,” she said, giving the girl a push forward. “She looks like you,” said the doctor. The woman held up the baby for inspection. “Do you tink he look like me, too?” We said No; perhaps he resembled her husband. She gave the abrupt giggle which in her class sometimes does duty for a blush and said, “Oh, yell my husband You see, I leff my husband. He’s not my husbands; he’s Irish.” She jerked her thumb over her shoulder at a bench where a gray-bearded, moody-looking Irishman was sitting, with his head sunk on his breast. “He’s his fader,” said she, with another giggle. The doctor asked her how long she had been in the house. “Oh, so long I can’t remember,” she answered. “I had little girl born here, but she die; I’m so fraid dis one die, too, but I take just so good care of him I can.” There was an ugly halfhealed scar on this woman’s forehead; after some further conversation, the doctor asked her how it came there. “She said a crazy girl got mad, and hit her with a tin cup. Oh, they’re always jawing and lighting,” said our guide coolly. “I can’t keep count of the rows. Would you like to see the kitchen?” As we passed through the basement, something bumped against us. I turned, and saw a twisted creature who had lost both legs, and was shuffling himself along on his back with his hands. The kitchen was crowded, and not clean; but the bread just going into the oven looked light and white. The dining-room was near the kitchen. It was in better order. Some long pine tables, not covered even with the favorite almshouse oilcloth, were set with tin cups and the heavy white ware called stone china. Our guide told us that the paupers had meat twice a day, tea and coffee, and plenty of vegetables and bread; and tobacco was given to the men.
We had time for only a hurried inspection of the insane department. It is a separate building of wood, with a brick basement, and cost the county something over five thousand dollars. It is heated by a furnace in the basement, and water is supplied from a tank in the attic filled by a wind-pump and force-pumps. There are twenty-four cells in the building. The lower story has the cells built back to back, each having a front of wooden bars opening out on the hall, which is well lighted. The upper story has a central hall, with cells on each side. The cells were very small; but they were clean. Only two of the lunatics were in their cells, and them we did not see; the others were out in their airing courts (two small spaces enclosed with a high fence), or in the yard. The girl said that there were but two attendants. They had a comparatively easy time in summer, but when winter came, it was awful! The doctor inquired what the attendant did when the insane were violent. “I don’t know what he does,” said the girl, shrugging her shoulders; “knocks ’em down, gives ’em a good thrashing.” “That’s bad,” said the doctor.” What would you have him do?” cried she, “stand still and be killed? There’s hardly a day in winter that some of ’em don’t try to do him a mischief. Every once in a while the man comes in with his linger chawed up, or his face scalded with the hot coffee they ye throwed at him.” Then she showed us the marks on the cells where the insane had beaten their heads against the walls, or gnawed at their bars like wild beasts. Respecting the general condition of the house, the girl said that the men worked in the fields during the warm weather, but there was a lack of work through winter.
We did not see a book or newspaper, nor indeed the slightest means of diverting the mind, not so much as the customary pack of greasy cards. There was no hospital, and the bathing arrangements were most primitive; but, judging from the paupers aspect, they did not bathe often enough to be troubled by any deficiencies. The keeper, himself, would gladly have had both bath rooms and a hospital, but the supervisors thought them too expensive. I have no reason to suppose that any cruelty was shown to the sane paupers, or any wanton cruelty to the insane. The keepers wife and daughters, whom we saw afterward, were neatly dressed, and gave every token of being of a kindly disposition. I believe that they tried hard to make their charges comfortable, and that whatever abuses were apparent were caused in the main by the construction of the house, which made cleanliness difficult and discipline impossible.
I have entered thus minutely into the details of this picture because it is the picture of the average large rural almshouse through the country; because, moreover, its population is the typical almshouse population everywhere. The popular impression about the pauper class is a queer mixture of indifference and sentimental pity. While not one in a thousand has ever taken the pains to see the inside of an almshouse, there is yet a prevalent idea that almshouses, for the most part, shelter the unhappy and guiltless poor, whom unmerciful disaster has followed fast and followed faster until it has chased them to this last refuge, people who have come from vine-covered cottages, or tidy rooms up one flight of stairs in tenement houses, with a big Bible on the table and a pot of flowers in the window, or even from luxurious homes desolated by commercial panics. As a matter of fact, the great majority of American indoor paupers belong to what are called the lowest classes, and seek the almshouse not because of unmerciful disaster, but because of very common vices. Between half and two thirds of them are of foreign birth. The best authority, if one wishes to study the habits, ancestry, and history of the indoor pauper, is the report of the New York hoard upon the subject. Sixty questions, most carefully framed and selected to cover the whole ground, were drawn up for the board, and were (by them or their agents) asked of every adult sane pauper in every almshouse in the State. All possible information, at the same time, was obtained from superintendents, keepers, and records. The report says on this point, The examination has made it clear that by far the is greater number of paupers have reached that condition by idleness, improvidence, drunkenness, or some form of vicious indulgence. It is equally clear that these vices and weaknesses are very frequently, if not universally, the result of tendencies which are to a greater or less degree hereditary. The number of persons in our poorhouses who have been reduced to poverty by causes outside of their own acts is, contrary to the general impression, surprisingly small.
(Footnote: Extract from Report of New York Board relating to Causes of Pauperism, page 190. The meaning of these words may he gathered from a. few figures: 2,453 of the paupers examined were in families; from these families there were known (during three generations) 14,901 dependent on public charity, 4,968 insane people, 844 idiots, and 8,863 drunkards.)
Any one who has visited many almshouses or talked with the men who know most of paupers will recognize the same old story. Paupers, said a plainspoken almshouse keeper to a convention of Pennsylvania directors of the poor, paupers, though not criminals, are, so far as my knowledge extends, largely from the lower classes of society; most of them being ignorant, and many of them possessed of all the low and mean instincts of human nature, with scarcely a redeeming quality. The writer once asked the steward of a large city almshouse if he had many persons come to him who had formerly been prosperous, and had, through disease or some other cause not their own fault, been reduced to seek public help. He said, “Never”; then added, “Well, yes, there was one man: he had seven horses, and he was taken sick, and sold one horse after another. And there was another man who was said to have had considerable property, but he drank.” I asked him if he had many applicants who had been decent, industrious, laboring people, and had come there from any other cause than disease or old age. He answered, emphatically, “Not one.” This man spoke from an experience of nineteen years.
Probably, it is a liberal estimate to put down one tenth of the paupers as to have come people deserving of sympathy; the other nine tenths are in the almshouse because they have not wit enough or energy enough to get into prison. Such people do not have a hard life in the almshouses. The squalor does not disturb men and women who have known nothing else; the immorality is a temptation; and even in the worst kept houses there is usually plenty to eat and little to do; in any case, they have not the heavy and irksome task of thinking for themselves.
The class which suffers at all our almshouses is the class for whom almshouses are presumed to be maintained, the unfortunate and self-respecting poor. A more horrible existence than a modest woman must endure at very many of our almshouses it is impossible to imagine. She lives amid unclean disorder and constant bickering; she is always hearing oaths and vile talk, the ravings of madmen and the uncouth gibberings of idiots; she is always seeing scarred and blotched faces and distorted limbs, hideous shapes such as one encounters in the narrow streets of Italian towns, but which, here, we hide in our almshouses. She is exposed to a hundred petty wrongs; Mrs. Jens’s case, already described, may give the reader an inkling of their nature. Often she is treated with absolute cruelty; in some almshouses she cannot protect herself from the grossest insults. It is only fair to say that the best almshouses classify their inmates as much as they can, and have hospitals for their sick and infirm. So far as food, lodging, and medical care go, the inmates are comparatively comfortable. Nevertheless, in the best almshouses the worthy poor have to submit to most degrading and irritating associations. Many of the aged have grown old in almshouses, and most of the invalids owe their unhappy fate to their own vices. Such people are neither pleasant nor edifying companions, but they are the companions with whom the inmates of almshouse hospitals have to live, however spotless their own lives may have been. This difficulty, almshouses being constructed as they are, must baffle the efforts of the wisest and kindest keepers.
Two other classes of paupers were noticeable in the almshouse which I have described, the insane and the children. With the insane I group the feeble-minded and the epileptic. It is difficult to describe the way in which we treat our insane paupers, because the plainest recital of facts would seem to accuse almshouse officers of revolting barbarity. Yet, in most cases, ignorance and fear are their worst faults. Often the almshouse keeper is forced to use harsh measures, because he has not enough assistants to be gentle. “I don’t want to shut them up,” is the keepers indignant plea, “I don’t want to chain them; but I cant have them running round the yard naked, or tearing things to pieces, or pitching into people! I don’t want to be killed, and I don’t want anybody else killed!” Meanwhile, his superiors, the superintendents, or, more often, the county supervisors, have plenty of other work, and take his word for the necessity of chains and dungeons. No public interest spurs the wits of either keeper or superintendent into devising better methods. And thus, within the present century, as almshouses multiplied, there grew up a tradition of torture, if one may so phrase it, a belief that the only proper treatment of a lunatic was restraint, and that the one indispensable quality of restraint was completeness; so clubs, whips, straps, darkness, and starvation supplemented chains and bolts as means to keep lunatics quiet. The rough-and-ready modes of dealing with the insane practiced in the Illinois almshouse which I have mentioned are but mild expressions of the average almshouse theory. The Boards of Charities, at the outset, found a state of things which belong to the Middle Ages. Let me give a few extracts from the early reports, dating back, however, no farther than 1873 :
The condition of those [of the insane] in the county poorhouses and jails, says the first Michigan Report, is wretched in the extreme. . . . They are generally confined in miserable cells. In many cases they are chained in pens without light or ventilation. In the Eaton County poorhouse we found a woman fastened in a pen of this kind, made in one corner of the cellar. She was put there, not from inhumanity on the part of the officers, but simply because they had no other place to keep her. Inmates are often whipped. In the Lenawee County poorhouse a crazy young man was regularly flogged as a punishment. The sentences which follow, regarding the unprotected condition of insane women, I will not quote; it is enough to say that, at the time of the boards visit, there was in the St. Clair poorhouse an insane woman with two children, both born in the house, the fathers of both being inmates. Nor was this case uncommon. One miserable woman told the board her shocking story in the presence of the keeper. He merely said, That’s so; but I see no means to separate them. Idiots and epileptics fared little better. They seem to have been chained, beaten, imprisoned, and utterly neglected. An epileptic woman in the Lenawee County poorhouse fell into the fire during a fit, and burned her eyes nearly out. The Ohio board found the entire system of infirmary management [almshouses are infirmaries in Ohio] involved in very general neglect, abuse, and cruelty. The Illinois Reports tell the same repulsive story. Lunatics chained, beaten, starved, shut in dark cells and left there to die, exposed to shameful and nameless cruelties, these are the headings of the chapters in the confessions which every State, speaking at all, has made regarding her dealings with the pauper insane. The Wisconsin Board of Charities talk of boxes built in the cellar, without light or ventilation; and say that when the board began their visits the almshouses were gradually becoming public nuisances and a disgrace to the State. New York confesses her sins in a score of dreary pamphlets. Even Massachusetts and Rhode Island, the first States to take pity on their insane poor, could show a large collection of chains, handcuffs, straps, and the like quieting instruments used in their town and city almshouses. I am speaking of a period scarcely more than ten years ago. Since then the different Boards of Charities have wrought a marvelous change in some States, and done good work in all. But they have had to fight against the system itself; and even yet the lot of an insane pauper is a very dismal one. The last Michigan Report says, The way the insane are cared for at the county houses, without judgment, without knowledge, . . is simply shocking. It would be an act of mercy, in many cases, says the secretary bitterly, to leave these poor people to starve, rather than keep them alive to drag out an existence which is a living death. The late Mr. Wines, of the Illinois board, discusses the subject at length: “On this point there is a word to be said on both sides. The amount of personal liberty allowed to insane inmates of most almshouses is worthy of serious attention. They are allowed in all suitable weather to live in the open air; they wander over the farm, unrestricted, and if they are able to work in the field they have useful employment, the want of which is the bane of hospital life. . In many almshouses no restraint is employed. . So much in favor of the almshouses; but it must now be admitted that these very almshouses are fatally deficient in other conditions, also essential to the treatment of insanity, namely, proper supervision by personal attendants, and proper medical care. It must also be said that many keepers are afraid of insane persons, and this fear begets restraint, often of a cruel sort, chains, whips, and even the firing of pistols, to intimidate the patients. . These extreme measures are not common, but what is common . . is the building of so-called receptacles for the insane, or insane departments, in which, when there are a number of insane to be cared for, many of them are imprisoned, some even for life, in solitary cells. Many of these insane departments are unfit physically for the occupancy of sane men: imperfectly heated, or not heated at all; not ventilated, often dark, destitute of furniture, sometimes in an outrageously dirty state, filled with foul odors. . . . In a few of the almshouses we have seen cells for the insane in the form of cages, without doors, where the victims are immured beyond the possibility of any entrance of the keeper himself, without tearing down or removing the bars. Even the best Illinois houses cannot give their insane much personal care.” That sentence has a harmless sound; this is what it may imply: In a respectable Illinois almshouse there is a woman who occupies a large wooden box filled with straw; she will not wear clothes, but is covered with a canvas cloth; is in constant motion; has bruised herself from head to foot, and put out her own eyes.
Ohio seems to treat her insane rather worse than Illinois. Looking through her last report, one finds such cases as these: A man becomes a violent maniac; his neighbors, scared, bind him with cords, put him on a sled, and draw him over the snow to the infirmary. There he is taken to a room without fire, and left through a bitter-cold night; in consequence, he freezes both feet, and one has to be amputated. A doctor writes a pathetic letter to the superintendent of an insane asylum, imploring him to admit an epileptic girl, whom her parents dare not send to the infirmary, because of its known immorality. The family; are in a sorrowful condition, he says, and if this distress is not alleviated it is my opinion that the mother will be an inmate of an asylum before six months. An old man, whose habits are troublesome, falls ill; he is taken to an out-building, and left there; he grows worse, but no doctor is called; at last, one of the paupers informs the county physician, who finds the old man dying; a few hours later he is dead. A hundred and fifty-six Ohio lunatics and fifty-six epileptics are reported as secluded, which rather poetical term means that they are kept in narrow stalls or iron cribs in small outer buildings, usually dark, almost uniformly without drainage or ventilation; and that they are untended, save as meals are carried to them. Others, not in seclusion, are restrained with handcuffs, chains, and hobbles. But the reader recognizes the old story; there is no need to repeat it. These three States, the most wealthy and populous in the West, may serve as examples of the treatment accorded the pauper insane by the Western States, which have central boards of inspection.
Coming East, one finds a degree of improvement. Yet even Massachusetts cannot show a blameless record. A few hundred crazy people are still kept in her town and city almshouses, and these do not always receive the best of care. Tewksbury almshouse is not without reproach, as the investigation of 1876 showed; and, although improved since then, it has the faults inseparable from large institutions. In comparison with most almshouses it shines like the just. This is the testimony of a man intimately acquainted with Pennsylvania almshouses. “There are some persons,” he says, “foolish enough to assert that the insane are just as comfortable and well cared for in an almshouse as in a hospital. Experience proves just the reverse. . . . In some of the very best of institutions there is a lamentable display of ignorance in connection with the management of the insane. . . Patients are seen confined in narrow corridors, or perhaps exercising in a small yard bounded by high walls. You are struck with the hopeless look which their faces wear. Every now and again you note some poor maniacs face, and wonder how he or she could have inflicted such a variety of .cuts and bruises. . . . Patients under restraint are noted everywhere. Upon inquiring, you are told that the bruises, etc., are the result of falls, the patient being subject to fits, and that the restraints are necessary in order to keep the unfortunates from destroying their clothing, injuring themselves or others. All this may be true; but how is it that the same things are conspicuous by their absence in hospitals properly arranged?” He speaks of their meagre diet and scant clothing, of the slender attendance, of the gloomy surroundings, but most of all complains of the almost total absence of employment. The picture is of another sort than those drawn in the Western reports, yet it is hardly less dreary. The Western lunatic is unkempt and neglected, sometimes he is harshly used, but unless he is violent he has the free air and sunshine one half the year; he has, too, the chance of resting his wandering wits by tiring his muscles. Covert for open abuse, Utica cribs, muffs and strait-jackets for chains, after all, these are not such great gains. Order and cleanliness are great gains, yet they are dearly bought when the patient pays for them with air and sunshine and work. Neither are chains and filthy dungeons quite gone out of fashion in Pennsylvania. Many almshouses still employ them.
What has been said of Pennsylvania applies also to New York. No State has struggled more valorously to provide for her insane poor; but in spite of Willard Asylum, there remain 6456 insane, idiotic, and epileptic paupers, under county and city care. Their condition is often very melancholy. To support this statement I shall not make any quotations from the horrible disclosures published periodically in the New York papers; such testimony is always received with suspicion by the sober mind; moreover, it is not needed; official reports, indictments of grand juries, and coroners verdicts contain proof in plenty. The late reports of the Boards of Charities show that the best county and city almshouses care for their insane in the manner already described; the worst have the familiar dungeon and chain, and the pauper attendants keep order with their whips and their fists. The institutions managed by New York city are as bad as any. Overcrowding; poor food served cold; insufficient clothing; neglect and abuse by the overworked and underpaid attendants; patients dying of scurvy; patients eating rat poison; patients strapped to their beds for days and weeks, until the bones started through the skin, these are some of the grim facts told of the asylums on Blackwell’s, Randall’s, and Hart’s Island. The almshouse of Onandago County may serve for an example of the rural ill-treatment of the insane. A newspaper reporter visited the house, and saw and heard enough to furnish materials for a startling article, which roused the public indignation so effectually that the supervisors asked the Board of Charities to help them investigate his charges. I have their report before me. Besides the customary cells, there were some underground dungeons of solid masonry, with concrete floors, without windows, but having a hole in each door large enough for a man to thrust his head through; both cells and dungeons being cold and damp. In summer the supply of water used to give out, although the almshouse authorities wasted very little on the paupers. The keeper of the insane department, O’Connel by name, had been a drunken pauper; he worked very cheap, and was considered a faithful fellow. To keep his patients quiet he used muffs, chains, dark cells, starvation, blows, and other straightforward arguments of force. His wife was matron. She was accustomed to mop the women; once she seized a crazy woman by her hair and flung her to the ground; but the matron of the almshouse testified that she never was particularly harsh. All the attendants were paupers; they swore at the patients, and talked loudly; it was a way they had, said the witnesses. Lunatics were shut up in the dark cells for weeks and months at a time. Two men died in these cells; one of them in a dungeon without window or bed. He wore himself out, said the keeper; he did not want to live, and I closed him in there, and he died comfortably. The attendant testified that the man was a harmless man, not ugly or vicious. The other cell had a window and a bed. Why he was put in the cell at all is not plain; he could not have excited much fear, since he had lost both arms, and was a mere skeleton, dying of consumption. But, in the language of the attendant, he was a violent man, did not appear to know nothing, which is the sole explanation given. There is no need of considering the darker charges made against O’Connel; they rest, for the most part, upon the evidence of pauper women, likely enough to avenge his blows by a cunning lie. However, no one who heard the testimony seems to have doubted that the insane suffered cruel hardships. It is only fair to add that the board of supervisors at once discharged the old attendants, and now employ paid attendants and a resident physician. The dungeons have been demolished, the building is heated by steam, and other improvements have been introduced. It is now the declared policy of the county . . . to retain only the quiet and harmless chronic insane under county care. Onandago County is not a sinner above all others. In 1878 Washington County poorhouse had a woman chained to a bar. Clinton County kept seventeen lunatics in dark, hot cells, filthy beyond description; four of the seventeen being restrained further with chains and muffs. Alleghany and Cattaraugus counties used cells very similar; and all over the State chains and handcuffs were found in the almshouses. Since then there has been a gradual improvement, or, rather, I should say a gradual abandonment of open violence; but, substantially, the situation remains unchanged. The foregoing descriptions all apply to the States having Boards of Charities, whose particular vocation is to discover abuses. Naturally, the States where the counties have had their will unchecked do not make so good a showing, when they make any showing whatever. No longer ago than 1877, a commission, appointed by the governor of Connecticut to inquire into the administration of the various charitable appropriations of the State, reported that they had found the insane at Tariffville in a condition which should shame a savage. At the New Haven almshouse there were fifty-four insane persons, some of them lying upon loose hay, without much clothing, and sorely in need of care. I have some local New Hampshire reports, all very complacent in tone, praising the county system, praising the commissioners, praising the almshouse officers, in fine, praising everything and everybody except the paupers themselves. One finds, however, that the insane are secluded and restrained in New Hampshire, just as they are in other States. Nor is the attendance more numerous or better trained than elsewhere. When a New Hampshire poorhouse burns down, no one seems to know where the keys to the cells are. This was the case at the Strafford County fire, where thirteen paupers and lunatics perished.
The Middle States, Delaware and New Jersey, have always had a tarnished fame as regards their almshouses. The almshouse at Snake Hill (Hudson County, New Jersey) is periodically abused in the newspapers. The Camden County almshouse is at present being investigated, on charges of cruelty to the insane, resulting in several deaths. A single instance of the barbarities alleged to have been committed will suffice. One patient became violent, and was strung up in a strait-jacket, and left without any attendant. A patient named Barney got a club, and beat him so terribly that he died.
The West probably treats her pauper lunatics decently, so far as food and clothing go; otherwise, the States without Boards of Charities seem to be doing much as the States with boards were doing ten years ago. The South does no better. In the States where the paupers are boarded out, and auctioned off to the lowest bidder, the insane, as may be supposed, are not desired at any price. Their place is not the almshouse, but the jail. Of their fate I say nothing; but it is sufficiently dreadful. The others lie and die in corners, tended or untended by the few private families willing to have them about. Where there are almshouses, these miserable beings go to them. What the almshouses are we can only judge from the reports of the State of Maryland, the single Southern State which has systematically investigated the matter. In 1877 John Lee Carroll, then governor, ordered an inspection of the Maryland public institutions, particularly with reference to their sanitary condition and treatment of the inmates, and the number of the pauper insane who are confined therein at the public expense. The man selected for this arduous and delicate task was the secretary of the Board of Health, Dr. C. W. Chancellor, and he seems to have performed his duties thoroughly and fearlessly. His report revealed a state of things in the almshouses which appalled the very county supervisors. Most of his pages cannot be quoted. I shall try only to give a feeble notion of what he saw, leaving the rest to the readers imagination. He saw everywhere men and women handcuffed, bound, and chained to the floor; he saw rooms filled with lunatics, weeping, howling, and dancing, unrestrained; he saw the sane and insane men and women all crowded together in the same noisome den; he saw their children deformed in mind and body; he saw, by the light of a candle which, in the broad daylight, he was obliged to use in order to see at all, a haggard, half-clothed woman crouching in the corner of a room so filthy that when the door was opened he staggered back, half fainting. Speaking of the almshouses as a whole, Dr. Chancellor said, In most of these places cleanliness is an unknown luxury; all is filth and misery, and the most degrading, unrelieved suffering. The inmates, sane and insane, were found, in many instances, huddled together without discrimination of age, sex, or condition, . . . with results shocking to all sense of humanity. And he thus described the condition of the insane: “There are now within the almshouses and jails of our State five hundred insane and idiotic people, who are utterly cast down, neglected, half fed, and ghastly in their wretchedness. A few figures will speak more plainly than words. Maryland has twenty almshouses. Only six of these, in 1877, appeared to be kept with any regard to cleanliness; and two of the six had colored departments, in disgraceful order. More than three fourths of the almshouses were old, dilapidated, and so constructed that any classification of the inmates was out of the question. Thirteen houses kept children whose parents were insane, and whose birth was directly owing to the States neglect; indeed, there were only three almshouses quite free from abuses of this shameful character.”
The publication of this report was attended with marked results. The supervisors tore down some of their worst almshouses, and built new ones; they repaired and cleaned the others; they turned away the old keepers, and gave the new ones stringent instructions; in short, the almshouses, to use Dr. Chancellor’s own words in his last report, became as good as those of any other State where the same unregenerate system prevails. In a few houses the insane are still subject to the same shame and torment; in none can they receive adequate care. What the Maryland almshouses were there is reason to fear most Southern almshouses are. Nor is this unfortunate state of things without great excuse in the poverty of the South, and in the more pressing social problems thrust upon her by the war. North and South alike, our treatment of our pauper insane is open to grave condemnation, quite as much upon economical grounds as any. Even the States having the best public insane asylums send many of their acute cases to the almshouses. The consequence is that they have these patients to support through their lives; for the vast majority of almshouses have no facilities for curing insanity. Furthermore, only a few almshouses make any account of insane labor, except in the West, and there only during the summer months, and among the milder chronic lunatics. English and French experience shows that insane labor may be used to a much greater extent than most almshouse keepers dream. The difference between the amount of labor which we might and which we do get out of our insane paupers is just so much wasted. The expense of keeping a pauper lunatic is commonly reckoned at a dollar and a half a week, or seventy-eight dollars a year; it is not a high estimate to call the properly directed labor of a lunatic worth half this sum, and the States not getting this labor lose thirty-nine dollars a year for every lunatic not employed, yet capable of employment. Assume, for instance, that three thousand of New York’s six thousand paupers of impaired intellect can work if they may; the State then pays $117,000 every year which is worse than thrown away, since it is paid for the deliberate and well-meaning torture of the most miserable class of human beings. A general survey of the whole field makes it appear that our system of caring for the insane is equally cruel, senseless, and wasteful.
Another class of paupers was noticeable in the almshouse which I described in the beginning of my article, I mean the children. They suffer as deeply as the insane, although in a different way. The best institution is a poor home for a child, and most candid men admit that almshouses are among the worst institutions which we have. Rude and blurred as are the foregoing portrayals of almshouse life, I think they show its entire unfitness for any child. None speak more strongly on this subject than the almshouse keepers themselves; and the very mothers of almshouse children realize its degrading influence. I remember the language of a matron of an Iowa almshouse. We were standing together before a feeble-minded girl with her baby in her arms. “Seven of ’em has been born in this house since I come,” said the matron. “I thank God they was all born dead but this one and one other, and I pray God this one may die, too.” Then she spoke of a proposed law to take the children out of the almshouses. The girl interrupted her with an eager inquiry: “Will they take my baby away?” “You would not want him brought up here, yourself, would you?” I asked. She looked up, with a sharp change of expression. “I? she repeated, passionately. God knows I would not! Anywhere else!”
I have thus roughly indicated the general character of the various classes of indoor paupers, and the way in which we treat them. To paint this sorrowful picture in detail would require a wider canvas than I have taken.