many. That girl was a very repulsive creature, a girl that no one in this large assembly would for one moment have thought of marrying ; yet we had her own testimony and the testimony of her parents that she had had four children. It will be interesting to see what will be the mental capacity of those children.

Another case that I investigated recently was of a woman who came to me, and said that her husband had died and she had seven children, four boys and three girls. All four boys were feebleminded. Her husband would not let her part with them while he lived, but he had died and left no property. I investigated the matter, and found that these four boys were perfectly helpless. She was colored, and three or four of her children were in our institution. Her sister had two children with us, and she had two cousins in the institution.

The PRESIDENT.- The only way to get rid of such imbeciles is to stop raising them.

Adjourned at 10 P.M.

EIGHTH GENERAL SESSION.

Sunday afternoon, June 1.

The members of the Conference assembled in a body at 2.45 P.M., and went in procession to the Light Guard Armory, where the Conference sermon was preached by the Rt. Rev. John Lancaster Spalding, of Peoria, Ill. (page 13).

The music was under the direction of Mrs. Elmer E. Liggett.

NINTH GENERAL SESSION.

Sunday night, June 1.

Many meetings were held Sunday night throughout the city, addressed by different members of the Conference; but the only one on the official programme was that held in the Central Methodist Church, where addresses were to have been made by the Rev. John F. Mulany, of Syracuse, N.Y. (page 338), and Mr. James L. Blair, of St. Louis, Mo. These gentlemen were not present. Mr. Mullany's paper was read by Mr. T. P. Pennyman, and Mr. Blair's was read by title (page 328). A letter from Hon. William Dudley Foulke, United States Civil Service Commissioner, was read (page 324), by the President.

The PRESIDENT.- The change in our state has been marvellous. The condition described was the condition fifteen years ago, and was one of the things that led to the creation of the State Board of Charities. That board took up the matter at once, and determined that all this political management should cease. It required several years before we succeeded; but now, with one exception, the prison, every state institution in Indiana has been taken out of politics. Civil service has been introduced. The head of an institution cannot be removed by his board except for incompetency. He cannot be removed on account of politics, and the head of an institution cannot remove any subordinate on account of politics.

The President then introduced Dr. Runge, of Missouri.

Dr. EDWARD C. RUNGE, Superintendent St. Louis Asylum for the Insane. After hearing this paper, I would say that under those conditions in Indiana a man like myself would never have been a superintendent of an asylum for the insane, or, if I had been appointed, I would have resigned. It is almost impossible to conceive that men would work under those conditions, where their authority over their patients is taken away from them. These people are put away because society does not want them. They are peculiarly constituted: they may be dangerous. They are entirely different from penitentiary inmates; for a prisoner's complaints would be listened to, while the poor insane man is not listened to.

I do not know if any state is as bad as Indiana was fifteen years ago. The Far Western states I do not know anything about: we hardly ever see the men at our meetings. We get their annual reports, but that is as far as our knowledge goes. But here you are on a soil which every American, working on these lines, should be proud of. We always quote Michigan and New York as the two states to which we look up with pride. Michigan has no political system of any kind. Civil service is there, as far as I know; but there are other states where things are not quite so glorious, where political influence interferes with the management of the insane. No business men among you, if you were to give the construction of an important bridge, would dream of intrusting it to any one but a competent engineer. You would not take men entirely unfitted for any special work, and give them that work to do. But we do not find that care in selecting men to be at the head of an institution. A great many of my professional brethren, who are first-class men in general practice, are unfit to be at the head of an institution, because it takes study of a peculiar nature, and not only study, but a peculiar composition of a man to take charge of an institution of that kind properly. This is so simple that, if you will show me your superintendent and let me talk with him three hours, I can tell you what kind of an institution he has back of him. It is so with the feeble

minded. It is the man at the head who will show what kind of an institution he has, under favorable conditions. But, when the conditions are not so favorable and the superintendent must stand abuse, it is not fair to judge the institution by him. He may be willing and capable, but he may not have that philanthropic nature which would make him unwilling to submit to other authorities and feed his patients with bad meat or with pork with trichina or butter with maggots. He would get out and make an ado. If I were put in such a place, I would get out to-morrow, and you would hear something about it. Where the political system is carried out, it goes all the way down. Imagine a capable man in charge of an institution walking round his wards and having to deal with a lot of men and women who are there because of political influence, or of having friends on the board, not because of fitness for their positions. A superintendent has no power, if he has such a board at his side. And the contractors who deal with the boards! A contractor who will sell such things to an institution as are mentioned in that letter, while I do not believe in capital punishment, if there is ever an instance when we should hang a man, it is the man who sells such things to insane asylums; for it is wholesale murder to give such things to people who have absolutely nothing to eat but what is set before them. They must eat it or starve, and we cannot let them starve. If they will not eat, we often have to feed them with a stomach-tube. We feed them against their will, because such patients must be nourished. Their life depends upon it at times. The man who will furnish such food is a contemptible maggot himself, and I have no use for him; and there is no language strong enough to express what I think should be done with such people. And they are ubiquitous. They are not in one city or state. My experience has been that men who stand high in the community and who are rated by Bradstreet as "A 1," who would not injure you as an individual, will do any damage they can to a state institution. They manage to justify themselves: it is remarkable. There must be something strange about them: they must divide their consciences into two separate divisions, one for public and one for private dealings, which seem never to clash. In fact, they never do clash. And yet I doubt if such contractors are worse than the men in the legislature who, when they want to reward men for political service, make them appointees, and put them into institutions to care for the insane when they are not fit for the work. One thing is sure: attendants should be trained for the care of the insane, or these hundreds of helpless inmates of our institutions are at the mercy of people who have no qualifications for the work. You will see a great many people give up their time to take care of delinquent children, and properly so; but, when it comes to the insane, there is the old superstition that the insane are something entirely apart. But the insane man is just like any other sick person, except that

he is more difficult to deal with. The training school is not the most vital thing, either: the character, the temper, of the individual is even more important than the training.

Rev. Geo. Elliott closed the discussion.

Adjourned at 9.30 P.M.

TENTH GENERAL SESSION.

Monday morning, June 2.

The Conference was called to order by the President at 9.30 A.M. Prayer was offered by the Rev. R. W. Clark, of St. Paul's Episcopal Church.

The report of the Committee on Time and Place was made by the chairman. Invitations had been received from Denver, Col., Richmond, Va., Dallas, Tex., Atlanta, Ga., and Portland, Me. The committee voted unanimously to recommend that the next meeting should be held in the month of May in Atlanta, Ga.

On motion of Mr. Hart the report was accepted.

After some discussion the following resolution, offered by Mr. Hart, was adopted:

Resolved, That the invitation of the city of Atlanta be accepted, provided the local authorities shall make arrangements satisfactory to the President and General Secretary; but, in case they should be unable to do so, that those officers be authorized to accept the invitation of Portland, Me.

On motion it was voted that the time should be left with the Executive Committee.

On motion of Mr. Hart it was voted that the thanks of the Conference should be sent to all those cities from which invitations had been received. Taken by rising vote.

The report of the Committee on Hospitals, Dispensaries, and Nursing, was next in order, Mr. Byers, chairman; but the papers and discussion were devoted to the subject of tuberculosis.

Mr. J. P. BYERS.- For some years I have been very much interested in the lack of proper provision for crippled and deformed children. I have had it in mind that the state should have, either under state supervision and control and management or, preferably, under private management and control, a hospital that should give the best surgical and medical treatment to crippled children, whose

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defects can so often be altogether removed or greatly modified by early treatment; that we should also have in connection with such a hospital a system of trade or manual training schools; and that the hospital and the trade school, working together, should make these otherwise hopeless little ones as fit as possible to meet the world. This, to me, ideal arrangement has not been perfected in any state. I would have in that hospital provision for children who are in county infirmaries and county homes, where usually little attention is paid to their deformities. I would have provision for those in private homes whose parents cannot afford the means to treat them, and I would have the whole thing of so high a grade that the children of the well-to-do would be sent there for treatment and training. As for the trade schools, they should be no less perfect than the hospital. I would have them afford an opportunity for every child to acquire the trade best fitted to his or her condition, physical or mental. This is a subject of great importance, and I hope to see it taken up at some future Conference.

I have the consent of my committee to make no formal report. You will agree with me before the morning is over that they were wise in agreeing to give the time usually devoted to committee reports to the consideration of the topic to be presented in the next paper. The Committee on Hospitals, Dispensaries, and Nursing, feels singularly fortunate in being able to present to the National Conference a paper on "What shall we do with the Consumptive Poor?" by an eminent authority and writer upon and the chairman takes pleasure in introducing to you the author of "Tuberculosis "; that paper, Dr. S. A. Knopf, of New York City.

Dr. Knopf read a paper on "The Consumptive Poor " (page 218).

DISCUSSION ON TUBERCULOSIS.

Professor VICTOR C. VAUGHAN, Dean of the University of Michigan.- Dr. Knopf says that tuberculosis is not a dangerous communicable disease, because it is easily avoided. that understanding, and say that a disease is dangerous in proIf we are to accept portion to the difficulty with which we avoid it, then death by lightning is the most dangerous, because we have least control over it. Consumption is a disease dangerous to the public health, and it kills more people than any other; and the proper way to estimate danger is by the amount of injury done. I know that Dr. Knopf and I hold exactly the same view, but we use words differently. When he says it is a disease that is not dangerous to the public health, he is placing in the hands of certain people a weapon by which they will fight every measure to overcome consumption. everything else he has said. I also wish to honor the rich philanI heartily agree with thropists who have given so much for private charities; but I would