from two hours to two days to get the history, and to formulate it, to be sent on to the superintendents of the poor of the State, and to have these cases returned, when they come before us, and not sure, as they may pass to the next county and drift around .to each state until they become a fixed charity. They seem to me, as they come before me in increasing numbers, all the time, to have an aggravating sort of attitude, a good deal like one who carried papers to me once. Christmas morning came around: "Good morning; wish you a Merry Christmas. What are you going to give me?" We should run them back to the superintendents of the state poor. We have a good many cases in Monroe county sent back. One case of an Italian epileptic-put in the Italian insane asylum. In one of his epileptic attacks, he knocked a woman down and bit her. It was immediately reported, and inside of two weeks that case was on the ocean going back to the country responsible for it. I just want to emphasize the point we should take special pains to hold these cases, make out their history, send them in to the proper officers, and have them returned.

President Redmond then introduced Mrs. Jennie E. House, of Erie County Hospital, who in the absence of Emma J. Keating, read the following paper:

COUNTY HOSPITALS AND THE CARE OF THE SICK IN THE ALMSHOUSE.

NURSING IN COUNTY HOSPITALS.

When the request for something on "Nursing in County Hospitals" came, I was asked to open a discussion on the subject, and later learned that some one else was to discuss this paper, so was forced at a rather late date to prepare something on this broad subject.

Every county in our State has an almshouse to care for the elderly unfortunates-but very few of them have a regular hospital department. Two, Kings and Erie counties, have large hospital buildings and a training school for nurses in connection. In the Erie county hospital, one of the eight resident house-physicians is regularly appointed to visit the almshouse daily, when those who are in need of liniments, catharties and such simple remedies report to him and are at once supplied from the store kept in stock there. But if anything serious occurs (which very often

does) he has them at once transferred to the hospital, and to the department, medical or surgical, which their treatment demands. As most of these inmates are more than sixty years of age, they are often in a serious condition when they come under our care. By far the larger number of these people are alcoholics or addicte to the use of some drug, and their recovery, if possible, is slow and often attended by relapses. In the hospital, we have all departments, medical and surgical, (men's and women's) nervous, genito-urinary, nursery and maternity, contagious and tubercular or consumption. Our hospital is located on high ground, one hundred and fifty acres, on the outskirts of the city, and has all conveniences of water, electric lighting, natural gas for cooking and the purest and best of fresh air and sunshine.

The poor of our county, who have not funds to be cared for in a hospital, where rates are high, make application to the superintendent of the poor and receive an order for treatment and care in the county hospital for one year or as long as their necessities demand, and we often have them for the remainder - of their lives. We have one woman who has been in the hospital for seventeen years and she is but forty-six years old now.

Tuberculosis or consumption, which is aptly called the "white man's scourge," is one of the most hopeless and pitiable diseases with which we have to deal in our changeable, uneven Northern climate, and it is a noticeable fact that we always have fully three times as many men as women afflicted with it in our tubercular buildings. All these cases, unless they have been here before, are entered as any medical case, to the main hospital, medical wards, but are very carefully examined as soon as possible after entrance..

If they are coughing and expectorating, some of the expectorated material is thoroughly examined with the microscope, and if the tubercular bacilli or germs are found, the patient is at once transferred to the building specially for that purpose. The danger of these patients being with others is that they usually expectorate a great deal and anywhere convenient, and when this material, which is reeking with germs, dries it is whirled up in the air in the form of dust, by the breezes, our feet, skirts, brooms, etc., and is breathed into the lungs, which, if weak, prove fertile soil, in which these germs develop and produce the dread disease. These tubercular subjects, on the streets of our cities and towns, in our street cars and everywhere, are a menace to all classes of

people, and if possible should not be in families or boarding houses, but in institutions specially constructed for the care of the disease.

Our tubercular or consumption hospital is but two years old (a frame structure, on the same site, was burned five years ago) and is a solid, grey stone building, with excellent arrangements for most thorough ventilation and sunrooms for the morning and afternoon.

We encourage the patients to be out of bed every day, if it is necessary to get them out in a wheel chair, to a cot in the sunroom or on the porch. They have all the milk and eggs they can eat, besides all other articles of diet, which we can procure and they desire. The medicines prescribed by the physicians (attending and house) are very carefully given, day and night, and every effort made to make them comfortable and contented.

The unfortunate side of our care of them is that when we have a hopeful case and really get them started on the road to recovery they are very apt to become ambitious to get to work and leave the hospital, against our wishes, usually to return in a few short weeks or months in such a state that all we can do is to comfort and alleviate their last days.

After more than eight years of experience in a large hospitai of this kind, I can heartily say that it is a most excellent field of study for the pupil nurse, and also a field, which gives great scope, for more advanced workers.

EMMA J. KEATING,

Supt. of Nurses, Erie County Hospital,

Buffalo, N. Y.

Miss Martha M. O'Neill, who was to discuss the above paper, being absent, there was no discussion.

Motion to adjourn until 9:30 a. m. Wednesday, June 29.

WEDNESDAY MORNING SESSION.

Convention called to order at 10 o'clock by President Redmond, who called upon Mr. L. L. Long, of Erie county, to read the following paper:

EVILS OF "PASSING ALONG.”

The evils of passing along are so familiar to those persoas having experience in the administration of charity, that for them.

this topic presents little that is new by way of suggestion. However, for those whose labors and experience in the field of charity have been limited, the topic has attractions, especially when seeking information. It is for this purpose in part that the committee have assigned it for treatment.

It is but a few years since those administering charity, alarmed at the growth of their bills for transportation furnished as temporary relief, began to seek out the reasons for what seemed an overwhelming demand for this form of relief; as they passed on applicant after applicant they found new applicants arriving by the next train, bound in the opposite direction. The ranks of the assisted tourists ever growing in numbers by the addition of persons ostensibly seeking to better their condition, handed along from county to county, old offenders and new, the aged and the young, becoming familiarized with the degrees of pauperism and graduating finally into the poor houses and penitentiaries. Many of them started in pauperism by the first gift of transportation, and association with the ways of the traveling poor.

The improper giving and acceptance of the poor ticket is a burning iron branding the soul with a black brand. It destroys manhood and womanhood; it kills the spirit of independence. It makes the act of seeking the transportation put the seeker on à par with the beggar on the street, and the repeated applications from county to county sink the soul deeper and deeper into the "slough of despond" until arriving at the journey's end the traveler is ready, in too many cases, to embrace a professional career having for its landmarks the asylum, the almshouse and the prison.

Harsh as this above statement of the case may appear, could we have before us ten years' records preceding the awakening of five years ago they would prove it none too harsh. In many cases it is the thoughtless or careless detachment of the tree from its precarious hold upon the bank of the stream to float along with the driftwood, when careful treatment might save and preserve.

On a former occasion, and at a previous convention of the Superintendents of the Poor, the "Passing Along System" was discussed and there was outlined a proposed remedial agency, copying the main idea from the National Associated Hebrew Charities. A committee was appointed to formulate a plan, system and method, in accordance with the sense of the convention

as there expressed. So soon was merit recognized by the National Conference of Charities and Correction in the same year that it also appointed a committee which has so faithfully performed its work that the plan and system have been adopted by very libera! applications for membership in the voluntary association, called into existence by the action of such committee, determining it as the proper remedial agency.

This was the foundation of a great work. There was formed a voluntary, unincorporated association of the various charity departments, private and public corporations and persons engaged in administering charity, wide as the nation and comprehensive in its purposes. Such was its scope and purpose, and so promising were and are its projects, that your committee hailed it as the correct solution and abided with confidence the practical demonstration of its usefulness. Universal coöperation, and the adoption of correct rules of judgment and satisfactory means and methods of procedure were the elementary subjects taken up by this association. Recommended by the National Conference, operating under the constructive talent of wise and experienced directors, it has come to stay, to perform the work expected of it, and as the membership increases it will come to occupy the whole field designed for it by its architects.

Its growth, as testimony of its importance and necessity jus tifies the labor of the committee, and in their report upon the work accomplished we see the application for the first time of a national method, and just and adequate conception of the true function of transportation as temporary relief, and we behold the country over what was once the most indiscriminate and poorly administered temporary relief becoming reduced in volume. enormously, satisfying the true aim of charity and mutual cooperation everywhere in the investigation of cases.

Certain fundamental principles are laid down which are quoted,

viz:

1. Before any charitable transportation shall be granted, the organization or official having the matter under consideration must be satisfied by reliable and adequate evidenceFirst. That the applicant is unable to pay the regular fare. Second. That the applicant's condition and prospects will be substantially improved by sending him to the place in question. Third. That the applicant will have such resources for main