Charles A. (Charles Abram) Ellwood.

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LIBRARY



UNIVERSITY OF CALIFORNIA.



Gl FT OF



Class






A BULLETIN



ON THE



CONDITION OF THE COUNTY
ALMSHOUSES OF MISSOURI



CHARLKS A. KLLWOOD, Ph. D.,

Professor of Sociol-



I'l HI 1SHKD BY l r OGY

UNIVERSITY OF MISSOURI
May, 1904.



A BULLETIN



ON THE



CONDITION OF THE COUNTY
ALMSHOUSES OF MISSOURI



BY



CHARLES A. ELLWOOD, Ph. D.,

Professor of Sociology




OP THE

UNIVERSITY



PUBLISHED BY THE DEPARTMENT OF SOCIOLOGY

UNIVERSITY OF MISSOURI
May, 1904.




A BULLETIN ON THE CONDITION OF THE
COUNTY ALMSHOUSES OF MISSOURI



i.



THE CONDITION or THE COUNTY ALMSHOUSES OF MIS-
SOURI.

Statistics. There is but .one method of collecting
accurate statistics concerning social conditions ; and that
is to send experts into the field to gather the informa-
tion upon the spot. Unfortunately this method was not
open to the department of sociology when it undertook
to investigate the condition of the county almshouses of
Missouri. The desired information had to be obtained
by other and less accurate means. Wherever possible
a student or alumnus of the University was sent to
visit the almshouse about which information was
sought; but it was found possible to do this in only
about thirty per cent, of the cases. In the remaining
cases question blanks were sent to the superintendents
of the almshouses with the request that they be filled
out and returned to the department. In this way infor-
mation was received concerning fifty per cent, more of
the almshouses. But when no response from the super-
intendent could be elicited, the information was usually
obtained through the county clerk, although in the case



1 59882



of three county almshouses all efforts of every sort
failed to secure the desired information. Nevertheless,
in spite of the relatively crude methods employed in
gathering the statistics, there can be no doubt that they
present a fairly accurate picture of the actual condi-
tions of Missouri almshouses to-day. Small details,
both good and bad, may lie concealed, but the main out-
lines of the system stand out in clear relief.

The statistics here presented concern ninety of the
ninety-three county almshouses of Missouri. Twenty-
one counties of Missouri have no almshouses, but still
follow the primitive practice of boarding out their pau-
pers (usually very few in number) with farmers. These
counties are Benton, Camden, Carter, Dent, Douglass,
Dunklin, Gasconade, Hickory, Laclede, McDonald,
Madison, Maries, Miller, Oregon, Ozark, Pemiscot, Eip-
ley, Shannon, Taney, Worth, and Wright. St. Louis
county also has no almshouse, but sends its paupers to
the St. Louis City Poorhouse.

The chief statistics for each almshouse of the ninety
concerning which information could be obtained are
herewith presented in tabular form, beginning on the
following page.



Religious
services...



Employm't
of able-
bodied...



Cells for
the insane



By lease
system . .



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week per
inmate

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w Cost of 8?*fl : oBS

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,5 Acres of
land
Paralytic.. '* ^-<~ '^->e*

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minded..

Insane..

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2 and 14.

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services. ..



Empl'ym't
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the insane.



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per annum









Cost of
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Acres of
land ...



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Paralytic .






Crippled,



Blind



Epileptic.



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Feeble-
minded . .



Insane



CO -SOiO cOCOOifS
SM -i-i CC



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Above 60.



Is

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Male..



Total










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The total number of inmates in the ninety alms-
houses was 3,348, of whom nearly one-half were found
in a single institution, the City of St. Louis Poorhouse.
The usual preponderance of males, due undoubtedly to
the fact that dependent women are less likely to be sent
to the poorhouse than dependent men, is exhibited in
the Missouri almshouse population, over 54 per cent., or
1819, being males, and a little less than -46 per cent., or
1529, being females. As regards race, 3056 of the in-
mates are white, while 292 are colored. This makes the
proportion of almshouse inmates who are colored a lit-
tle less than nine per cent, while the colored element in
the total population of the State constitutes but a little
over five per cent. Classified as regards age, 1262, or
37.7 per cent, of Missouri 's almshouse inmates are above
sixty years of age; 1932, or 57.7 per cent., are be-
tween eighteen and sixty years ; and 154, or 4.6 per cent,
are under eighteen. It is evident from these figures
that in Missouri as elsewhere an undue proportion of
the aged end their days in the poorhouse. While per-
sons above sixty years of age constitute but a little over
six per cent, of the population of the entire country, they
form over thirty-seven per cent, of the population of
Missouri's almshouses. The proportion of children and
young persons in Missouri's almshouses is not great,
although it is much higher than it should be. Of the
154 inmates under eighteen years of age, ninety-two are
between two and fourteen years.

If classified according to physical condition, it is
evident that very few of the inmates of Missouri's aims-
houses are able-bodied. Five hundred and nine, or fif-
teen per cent, were reported as able to do some work,
but probably not more than one-third of these might be
considered in any proper sense able-bodied. One thous-
and nine hundred and nine of the inmates, or fifty-seven
per cent., are mental defectives, being either insane,
feeble-minded, or epileptic. Four hundred and seventy-

8



five more are reported as blind, crippled, or paralytic.
Bearing in mind the large proportion of the aged among
the inmates, it seems reasonable to conclude that Mis-
souri 's poorhouses are not to any extent places of re- f
sort for able-bodied persons who are too lazy or shift-
less to support themselves.

The Condition of the Insane. There are 1177 in-
sane persons in Missouri's poorhouses; and of this
number three-fourths, or 884, are in the St. Louis City
Poorhouse. All but thirty-two of the ninety almshouses
reporting have insane inmates. The largest number
of these insane are not found in the poorer counties
which have poorly equipped almshouses, but in the
prosperous counties which have large and relatively
costly institutions. There seems to be a movement in
the State toward increased almshouse care of the indi-
gent insane. Indeed, the most effective argument for
building a new poorhouse often seems to be that the
county may "care for its insane at home," and thus
save the expense of treatment at a State hospital.
Hence it comes about that many of the counties with
good almshouses have turned their institutions to a
great extent into local insane asylums. The following
item which went the rounds of the press of the State in
the summer of 1903 illustrates the tendency spoken of :

"The Ray county court, at its June session, made an order that
all of its insane patients should be removed July 1st from the asylum
at St. Joseph to the Ray county poor farm. The court figures that
the amount paid the asylum for keeping of the patients will more
than provide for them at their county farm."

That this movement is a mistake no one at all ac-
quainted with the history of almshouse care of the in-
sane can doubt. The inevitable result of such care
everywhere is various degrees of inadequate and brutal
treatment ranging downward to the sheerest cruelty.
That this is the result of almshouse care of the indigent



insane in Missouri, there is abundant evidence to show.
However, in this bulletin we shall confine ourselves to
the evidence furnished by student investigators or by
the almshouse superintendents themselves. In the first
place, we have to note that fifty-four out of the ninety
almshouses reporting have ce]ls for the incarceration
of the violent insane. Some even have a cell-house
which they go so far as to call a "jail." Again, the
question was asked whether any sort of mechanical re-
straint was used to control the insane. Of the forty-
eight who answered this question, thirty-seven admitted
that mechanical restraint was used. That is, seventy-
five per cent, of the almshouses which have insane in-
mates use mechanical restraint of some sort. And yet
it is supposed by some that the insane in our almshouses
are never violent! Of course, mechanical restraint
employed by a skilled physician may be sometimes of
great benefit to the insane ; but who would argue that it
would be so when used by an average almshouse of-
ficial?

A third line of evidence as to the condition of the
insane in Missouri's almshouses may be furnished by
certain quotations taken from the reports of investiga-
tors and even of the superintendents themselves. Thus
one superintendent says : i i Sometimes they are chained
to the wall till they are quiet ; if too bad they are kept
in a room and locked up." An investigator says:
"When the insane are violent, they are put in cells,
handcuffed, and tied with ropes." Another investiga-
tor reports: "One female has to be tied by block and
chain. ' ' Still another reports : l ' The insane are locked
in cells and at times have been manacled. Their condi-
tion is too filthy for adequate description. They are
locked in small cells, a stool in each cell, excrement cov-
ers all about the stool, building filthy, persons unclean;
enough to drive a sane man mad. ' ' Finally, in line with
the above the following may be quoted from the report

10



of the Greene county grand jury on the condition of
the insane in the Greene county almshouse (December,

1903) :

"We found twenty-three insane persons confined in cells, of
which there are at least three, two men and one woman, violently
insane, that should be consigned to and kept in the asylum, as their
condition here requires them to be kept in dark blind cells, and their
constant and continual ravings, day and night, are a constant irri-
tation to the other inmates, preventing them from getting the sleep
so necessary to people in their condition."

Of course, the almshouse superintendents are not to
be blamed for the condition of the insane in the alms-
houses. They have to manage as best they can the per-
sons who are turned over to them by the county authori-
ties ; and usually they are conscientious in the perform-
ance of their duties. The blame ultimately rests with
the people of the whole State who permit by law the
commitment of the indigent insane to amishouses; and
the only remedy is legislation prohibiting such commit-
ments and providing for the gradual enlargement of
our State Hospital facilities, so that in time all insane
may be cared for in State institutions.

The Condition of Other Defectives. In addition
to the insane there are 551 feeble-minded persons and
181 epileptics in the almshouses of Missouri. These
numbers probably understate rather than overstate the
proportion of the almshouse population which belongs
to these classes, as many cases of feeble-mindedness
would not be recognized except by experts. From ten
to fifteen per cent, of the feeble-minded are helpless
idiots. The condition of these, of course, is equally as
bad as the condition of the insane. As for the higher
grades of the feeble-minded it may not be so evident
that their presence in the almshouses is to be condemned.
But from the social point of view they need, equally
with the insane, separate treatment in special institu-

11



tions. Their presence in the almshouses is a menace to
society because their affliction is hereditary. The in-
vestigation revealed at least two instances in which fee-
ble-minded women had become mothers of illegitimate
children while inmates of almshouses.

As for the epileptics, it need only be said that their
presence in the almshouses is a hardship to them and to
the other inmates. The almshouse surroundings are
such as to aggravate their disease and to preclude all
possibility of their cure ; again, they are often danger-
ous and their presence is necessarily unpleasant to other
inmates. The epileptics in our almshouses should
therefore, be sent to a State hospital or colony especially
provided for them.

There are in addition to these mental defectives a
large number of physical defectives in our almshouses.
The reports show 263 cripples, 114 blind persons, and
98 paralytics. Under the existing differentiation of our
chairitable institutions these persons are where they be-
long. But if the almshouse is to be made a comfortable
home for these infirm classes and for the aged worthy
poor, it must be freed from the classes which it can not
properly care for. Furthermore, it must have special
provisions for the care of the sick and the infirm both
in its construction and management. Only two aims-
houses in the State have nurses for the care of the sick
(Jackson county and St. Louis city), and these are not
trained nurses. The superintendent's wife is usually
matron, and is supposed to look after the sick; but on
account of her other duties she can do little or no nurs-
ing. Practically, then, the only nursing which is done
in our almshouses, both in the urban and in the rural
counties, is that which is done by the paupers them-
selves.

The Condition of Children. Statistics already
quoted show that there are 154 persons under eighteen

12



years of age in the almshouses of Missouri, ninety-two
of these being between the ages of two and fourteen.
The chief reason why there are not more children in Mis-
souri 's poorhouses is that the Missouri Children's
Home Society is extremely active in taking children
from the poorhouses and placing them in good families.
Probably not more than one-half of the children be-
tween two and fourteen years which remain in the alms-
houses of the State are healthy children, the remaining
half being feeble-minded, epileptic, physically deformed
or diseased children who can not be placed in private
families. Again, the few healthy children to be found
in the almshouses are usually there in company with one
or both their parents, in which case it is difficult for the
Children's Home Society to get possession of the chil-
dren. Of course, the defective children should be sent
to the special institutions which exist for them, the fee-
ble-minded and the epileptic to the State Colony for the
Feeble-Minded and Epileptic at Marshall, and the blind
to the State School for the Blind at St. Louis. The
county authorities should understand that these institu-
tions exist especially for the care of defective children
of these classes ; and that they are there cared for and
educated at the expense of the State if they are indi-
gent. The problem of disposing of the deformed and
diseased children in our almshouses is not so easy, see-
ing that there exists no public institution especially for
them. But it would seem that the county authorities
should if possible commit them to private hospitals, or
else send them to the hospital of the medical school of
the University of Missouri, for treatment. The only
effective remedy for the evil of allowing children to re-
main in our almshouses, however, is legislation which
shall prohibit their detention in almshouses for a period
longer than one month.

Buildings and Grounds. Only twelve counties in

13



Missouri have almshouse buildings costing $10,000 or
more, viz.: Boone, Buchanan, Clinton, Cole, Greene,
Harrison, Jackson, Linn, Macon, St. Charles, Sullivan,
and St. Louis city. Eleven other counties report build-
ings costing between $5,000 and $10,000. In all the
other counties reporting the almshouse buildings cost
less than $5,000 ; and in twenty-one out of the sixty the
cost of the building used as an almshous^e was less than
$1,500. In other words, it is probable that at least one-
third of the county almshouses have cost to build them
less than $1,500 !

The "cottage plan" of construction is supposed to
be the best for almshouses. There is only one aims-
house in Missouri built consistently upon this plan, and
that is the Pike county almshouse. Unfortunately,
however, in this case the cottages are built of wood
and are without modern improvements. Pettis, Daviess,
and one or two other counties have almshouses ap-
proaching this type. Fifteen counties have aims-
houses of the "institutional" type one or more large
buildings several stories in height. Practically all the
other almshouses of the State are old farmhouses in
different stages of repair.

The actual fitness of almshouse buildings for their
work may perhaps better be judged by their sanitary
arrangements than in any other way, since sanitary ar-
rangements are so important in dealing with the infirm
and helpless classes found in the almshouses. Only five
almshouses in the State may be said to have fully mod-
ern arrangements for heating lighting, ventilation, bath-
ing facilities, closets and sewerage, viz. : Buchanan,
Jackson, Macon, Putnam and St. Louis city. Seven
other counties have almshouses with nearly or partly
modern sanitary arrangements; viz.: Boone, Clinton,
Greene, Harrison, Linn, Livingston, Pettis, St. Charles,
and Sullivan. The remaining almshouses of the State
have only such sanitary arrangements as are found at

14



:R3ITY

an ordinary farmhouse. Such primitive arrangements
may, of course, answer very well, where the number in
the almshouse is small, not larger than an ordinary fam-
ily ; but it is manifest that where a large number of sick
and infirm people are brought together the best sanitary
arrangements are needed.

The superintendents of the almshouses in their re-
ports to the department often show consciousness of the
inadequacy of their facilities. One writes: "This
county has very poor accommodations for its inmates ;
while there are not many still they are human." An-
other writes: "The equipments of the house are not
what they should be * not convenient for keep-

ing the class of people who go to poor farms." An-
other says, regarding the farm connected with the alms-
house : ' ' My opinion of the county farm is that it is a
poor farm, sure enough. ' '

This brings us to a consideration of the amount
of land which should be associated with the almshouse.
The prevalent idea in Missouri of what a county aims-
house should be is expressed in its most common name,
"county poor farm." The idea is, not only that a
farm should be associated with the almshouse, but that
the institution should be made as nearly self-supporting
as possible through the labor of the paupers. Hence,
we find many county almshouses with large farms at-
tached. Of the eighty-five which reported the amount
of their land, twenty-eight had over 160 acres, forty-five
had between fifty and 160 acres, and twelve had under
fifty acres. It is. doubtful whether a large amount of
land should be associated with an almshouse. As was
shown above, only a few of the poorhouse inmates are
able-bodied ; therefore, the idea that the institution may
be rendered self-supporting through the labor of its in-
mates is fallacious. Again, if the amount of land is
large the superintendent has to spend nearly all of his
time in managing the farm to the neglect of the inmates.

15



Further, the economy of a large farm in connection
with the almshouse is now questionable on account of
the cheapness with which supplies may be purchased. It
has, at any rate, been demonstrated that an institution,
with a small amount of land can be run as cheaply as
one with a much larger amount. Finally, the weightiest
argument against the large farm in connection with the
almshouse is that it usually necessitates locating the
almshouse far in the country where it and its inmates
can be but seldom visited. A small farm near the
county seat is, therefore, preferable to a large one sev-
eral miles in the country. Probably the proper size of
farm for an average Missouri almshouse would be about
fifty acres, though, of course, the size should vary ac-
cording to the number of inmates and other circum-
stances. In any case it should be large enough to fur-
nish labor for all able-bodied inmates and to supply the
acreage needed for gardening and grounds.

Management. The most striking, and at the same
time the most regrettable, feature of almshouse manage-
ment in Missouri is that most of the almshouses are
managed by what may be called the " lease system."
That is, the management of the almshouse is let out to
the lowest bidder, or, as it is usually reported, "to the
lowest and best bidder. ' ' If the county court, which in
Missouri is the legal board of managers of all county
institutions, does not openly advertise for bids, it never-
theless usually lets out the care of the almshouse and
its inmates at so much per inmate per week. Only in
thirty-five counties of the State is the almshouse super-
intendent paid a fixed salary. In the remaining coun-
ties the lease system, under one form or another, pre-
vails.

This ' ' lease system, ' ' making, as it does, the wages
of the superintendent dependent upon what he can save
from the inmates, is doubtless responsible for many of

16



the worst conditions in our almshouses. Many of the
superintendents working under it express their disap-
proval of it. Thus one writes: "The plan used in
this county does not meet my approval. ' ' Another can-
didly details the workings of the system as follows : " A
few years ago the poor were let at $38.00 per head per
year. Under that treatment there were nine out of nine-
teen that died, and the county had to pay doctor's bill
and burial expenses which cost more than board and
clothes. They now pay $72.00 a head per year, and see
that it is cheaper and more humane. " This is truly a
record of progress under the "lease system; " we wish
that we could record that that particular county had
progressed so far as to pay its superintendent a fixed
salary.

As regards the relative cheapness of the two sys-
tems, there can be no doubt that the poor can be cared
for quite as cheaply with humane and modern methods
under officials at fixed salaries as under the lease sys-
tem. There are many counties paying as high as two
dollars per week for each pauper under the lease system
and getting poor service ; while there are other counties
which have modern buildings and pay their superin-


1 3

Online LibraryCharles A. (Charles Abram) EllwoodA bulletin on the condition of the county Almshouses of Missouri → online text (page 1 of 3)