174 THE AMERICAN JOURNAL OF SOCIOLOGY
tically confined to cities of the larger size; it is often administered in a way to injure the patients of certain hospitals; it is almost always administered to the disadvantage of the depots de mendicite; in all circumstances it is insuffi- cient, and we should be in a position much more miserable if private charity did not support a great number of aged people.
The effects of the optional law on hospitals are very grave. It is claimed that many old, infirm, and incurable persons are retained in hospitals designed for the treatment of curable maladies persons who could be more economically supported in their homes, or boarded in families and asylums; while many persons suffering from acute disease are denied the help of hospi- tals because the wards are already crowded with the feeble and incurable. The law of 1893 (gratuitous medical relief) does not provide for chronic cases; but the local authorities, when they see that an invalid has no sheltering asylum, will retain him in the hospital in spite of the law, rather than turn him out to perish. But this act of humanity deprives many curable cases of the relief which the law intends to give them. In the hospitals for the insane, also, many senile demented are kept who should be placed in colonies or asylums, or boarded out. The depots de mendicite were designed for places of correction, but they have often become mere asylums for the decrepit. Even prisons and houses of cor- rection are crowded with the helpless and incurable for whom the law provides no means of support.
The present incomplete system involves much financial waste. In the case of hospitals the need of central control and direction is obvious. Under optional relief, with local initiative, there were, in 1886, 39,248 beds in hospitals, of which 15,709 were not used; and in hospices (asylums) 10,772 beds out of 67,964 were unoccupied. In 1892, a census taken in summer showed that out of a total of 165,694 beds, only 125,534 were occupied on June 30, or 75.76 per cent. On February 28, 1901, a census showed that out of a total of 183,883 beds, 144,743 (78.81 per cent.) were occupied. The figures indicate that after medical relief was made obligatory, national in scope, and placed under central con- trol, the resources were more fully and economically used.
The extent of private relief of the aged and infirm is shown
