One might enlarge upon the fact, were it necessary, that in every form of public service whose aim is to uplift, the benefits are reciprocal. And when any state makes its public service so inviting as to cause the best and ablest to rally to it, as is evidenced by this Conference, then it is indeed an honor to serve the state in any capacity. And I think I can speak for all the managers of all our institutions, when I say that we expect that, with the keener insight and wider wisdom that time and experience will bring, far more and greater things will be accomplished than have yet been wrought.

DR. HOWARD:

subject?

Will there be a general discussion of this

It seems to me that the subject has been so skilfully and so well. presented that we can well accept it and adjourn for the forenoon.

PRESIDENT WILLIAMS: Is there any further business? we stand adjourned until this afternoon at 2:30.

If not,

THIRD SESSION.

WEDNESDAY AFTERNOON, NOVEMBER 17, 1909.

The Conference convened in the Senate chamber at 2:30 P. M. THE PRESIDENT: Will the Conference kindly come to order? Is there any business? If not, I shall introduce the chairman of the Committee on "The Care and Relief of the Poor in their Homes," Mr. Morris E. Waldman, Manager of the United Hebrew Charities of the City of New York.

REPORT OF COMMITTEE ON THE CARE AND RELIEF OF THE POOR IN THEIR HOMES.

MORRIS E. WALDMAN.

Among a number of movements which have been vitalized as directly or indirectly affecting the poor in their homes, passing mention may be made of the International Congress on Tuberculosis, with its accompanying exhibit which aroused tremendous public interest. Another is the National Labor Exchange, which, with a fund of $100,000, and with the active support of some of the wisest philanthropists in the state, has been established in the city of New York to remedy the social and economic maladjustment called unemployment. The other is the National Conference on Child-Caring, held in Washington, where the note that was struck reverberated throughout the country and evoked a chorus of sympathy for the child. It is in consonance with that awakened interest in the welfare of the child that both the topics of the day have been selected.

It is cause for deep thankfulness that the commercial depression which came upon our country in 1907 has fairly run its course. The shriek of the factory whistle is again heard throughout the land, and the smoke from mill and smelter signals the restoration of the full dinner pail. The relief agencies which were severely taxed during the past two years have now relaxed their tension. Among the dependent, the able-bodied are hardly to be seen. We still have with us the sick, the maimed, the blind, the widowed and the orphaned; indeed, as pestilence often follows war, so have evils succeeded the panic of 1907. The heroic suffering of the masses who crowded together to prevent eviction, and who fasted to avert starvation, must be translated into bodies diseased, spirits discouraged and ambitions undermined.

It is at such times as this that the white plague reaps its greatest harvest. There is little doubt that mortality figures for years to come will reflect the hard times of the past two years. In spite of the great and laudable activity on the part of tuberculosis committees and sanatoria, tuberculosios claims as many victims as ever. The capacity of our sanatoria is inadequate to check its ravages, and their discharged patients usually return to their vocations frequently only to suffer relapses and again become foci of infection. It is for us to consider whether the state shall not be called upon to render additional aid in the struggle. For the state to shield the children against the death-dealing tubercle bacillus is in accord with that spirit of English law which has for centuries supported a special court of equity for their protection, and which so recently created a new court in many states in this country - the juvenile court to help such children as have fallen under evil influences. That tuberculosis is fast laying its horrible grasp upon masses of innocent children is becoming more apparent every day. An examination by Dr. Theodore B. Sachs in Chicago, of 322 children one or both of whose parents were suffering from tuberculosis, disclosed the fact that 171, or fifty-three per cent. were infected with the disease. Of 150 such children examined by Doctors James Alexander Miller and I. Ogden Woodruff in New York, 76, or fifty-one per cent. were found to be positively tuberculous. The weight of medical authority points to human infection as the means of transmitting the disease. Of 1,000 children examined in Boston by Doctors Floyd and Bowditch, 360 of whom were tuberculous, there seemed to be little doubt that direct transmission from parent to child was the means of infection. Comby says: "Our clinical investigations have shown that tuberculous children are found only in families in which there are tubercular members. Among 1,430 autopsies on children in Paris hospitals, 529, or thirty-seven per cent., were found to have the disease, and among these were young infants, with whom, as is well known, tuberculosis is not so common."

On the other hand, we have the remarkable experience that children of tuberculous parents, who have been placed in orphan asylums and boarded out, do not develop tuberculosis. Cornet says: "A careful investigation of the actual conditions reveals many contradictions to the theory of heredity. I need only refer to the fact that children who are hereditarily tainted are apt to remain healthy when brought up in orphan or foundling asylums, unless their new environment subjects them to fresh 'dangers. In the orphan

asylum at Nuremberg, with an average capacity of 100 children, many of them with a pronounced tuberculosis taint, Stich saw only a single case of tuberculosis in eight years. Furthermore, he succeeded in tracing only one case among those dismissed from the institution, in spite of the fact that many were already twenty years of age."

According to Schnitzlein, in forty-one per cent. of the children at the orphan asylum at Munich, both parents had died of tuberculosis, and in forty-three per cent. either the father or the mother. In spite of this fact, he observed only two cases of tuberculosis among 620 children. Dr. Ludwig B. Bernstein, Superintendent of the Hebrew Sheltering Guardian Society of the City of New York, states that though in thirty per cent. of the 1,500 children admitted to his institution and through him in boarding homes, during the past six years, where one or both of the parents suffered or died from tuberculosis, only five cases of the disease developed. This testimony is overwhelming. To segregate consumptives, which would indeed be a radical ineasure, is impossible in the face of the people's jealous defence of personal liberty, or at best, their ignorance and indifference. Though the tendency at the present time is to look askance upon the value of the orphanage, in the face of these remarkable facts has the last word been said on the subject? Does not all this experience point rather to the wisdom of removing the children of the sufferers and placing them under proper care elsewhere, in private homes, if you will, at least the children in those families for whom proper living conditions cannot be secured, or where the necessary precautions are not taken? Educating consumptives in personal hygiene, though highly important, is a slow and tedious process. Is such education not a science in itself? Is there not such a thing as the psychology of the consumptive, the effect of his discase upon his ethical conceptions, upon his social attitude? Have not some of us been shocked at the selfishness of the consumptive, who, placed upon limited rations, has satiated himself while his little ones stood by hungry? Is it convicting one's self of phthisiophobia to say that this phase of the subject deserves the most earnest consideration? The topic "What Steps Shall be Taken to Guard Children Against Tuberculosis" presents different aspects.

No general scheme of prevention of tuberculosis in children can be radical, thorough and comprehensive unless it be part of a larger scheme of the prevention of tuberculosis in adults. This larger scheme, to be effective, must be fundamental. We charity

workers are the first, I take it, to confess the inadequacy of remedial measures and the first to advocate those of prevention. Tuberculosis has well been called a social, or better still, an antisocial disease. If its cause does not lie in underpay and overwork, surely these are its strongest allies, and charity workers are the first to admit that the most sweeping preventive program would be a social and industrial upheaval or shall I say a social and industrial atonement?-higher wages, shorter hours, sanitary workshops, and the things that follow: Proper housing conditions and good food and clothing. But while hoping and striving for these things, patiently and persistently, much can be done and will be done in the several ways to be suggested to-day.

CHAIRMAN WALDMAN: The first paper will deal with the problem of child desertion and will point out the experience of social workers in New York City, under the law which makes child abandonment a felony. Those who have been confronted with the task of checking this evil in New York City cannot but feel that making child abandonment an extraditable offense, with a severe penalty, has not only not solved the problem there, but has thus far had no palpable effect in the decrease of such cases. If this is due, as Mr. Sobel will show, to the fact that the officers of the court are out of sympathy with the enactment, then proper pressure must be brought to bear upon them or the law should be modified. But to secure the cooperation of the prosecuting officers only by the elimination of the probationary feature of the law is to make the law punitive in motive, which was not the primary object in its enactment. The human element in the solution of the problem would have to be injected in some other form.

The suggestion has been made that a separate court be established to try all cases of desértion and non-support, in which justice shall be meted out more paternally, and where the degrading influences now present in magistrates' and other inferior criminal courts shall not be felt an institution somewhat analogous to the children's court. The Commission to Inquire into the Courts of Inferior Criminal Jurisdiction in the Cities of the First Class has given the matter consideration, and, as the approval of responsible organizations has ben secured to the plan in a modified form, it is possible that without creating a new court, provision will be made for the trial of such cases in separate parts. Such court would regard the punishment of the offender