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Charles Richmond Henderson.

Modern methods of charity; an account of the systems of relief, public and private, in the principal countries having modern methods online

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are not allowed to leave the building while wearing the borrowed
clothing. To inmates of long standing and good record clothing may
be given to make them presentable while searching for employment.
Too frequent recourse to the workhouse is disciplined by increasing
the daily task or diminishing the rations, or finally by turning the
offender over to the police. Drinking alcoholic liquors, smoking to-
bacco and games of every sort are prohibited in the workhouse. Un-
willingness to do the work forfeits claim to any other form of aid
and may lead to turning the shirk over to the police. The work done
by the men and women is partly for the market, including the manu-
facture of paper bags and pasteboard boxes, partly for consumption
in municipal institutions, including the making of clothing, under-
wear, shoes, carpenter and cabinet work, painting, locksmithing and
whatever else is required to keep the institution in repair, and all the
whitewashing, scrubbing, etc., required to keep it neat.

At the beginning of the year 1897 there were 430 inmates in the
voluntary workhouse, 397 men and 33 women ; during the year 10,889
were admitted, 10,122 men and 767 women, and at the end of the
year 376 of these men and 36 of the women, 412 in all, were still
in the institution. That year the income from labor done was
29,761.37 flor. The running expenses were 28,577.40 flor. and the
wages paid for extra labor 8,203.34 flor.

H. Medical Relief. — In 1890 there were in Vienna 19 physi-



AUSTRIA-HUNGARY lOl

cians for the poor besides three oculists, an aurist and a dentist. By
the incorporation of surburbs into the city the number of physicians
for the poor was increased, in 1891, to 52, besides the speciaHsts men-
tioned and physicians who conducted dispensaries at each poHce sta-
tion. At the end of 1896 the number, including specialists, had in-
creased to 64 in addition to dispensary physicians and heads of clinics
at hospitals, all of whom are authorized to furnish free medical aid.
According to regulations of 1895 the city physicians are required to
attend all the sick poor in their respective districts, whether legal
residents of the city or not, and the attendance is to be either at the
physician's office or by visit, according to the needs of each case.
They are also required to investigate, and at least twice each year to
report upon the health and sanitary surroundings of all orphans
boarded out by the city. They attend the sick in the poorhouses and
they take part in the conferences of the district poor commissioners.
Each must reside within his district and have on his house a sign
"City Physician for Treatment of the Poor." A monthly report
must be made to the chief city physician. This official, in addition to
the regular duties, upon requisition of the magsistracy, has to in-
vestigate the cases of those who seek the benefit of any fund or pen-
sion or admission to any institution. The prescriptions are filled by
authorized apothecaries upon their presentation accompanied by a
certificate of worthy poverty from the district poor commissioner.
When non-residents receiving free treatment use medicines costing
over 19 gulden a claim for the amount is sent to their legal residence.
Similar arrangements apply to the filling of prescriptions, not only
of medicines, but also of bandages, dressings, glasses for the eyes,
and medicinal baths. In each case the official prescriptions that have
been filled are turned into the city as valid claims against its treasury.
There is a "cure house" for the poor in Baden, where sulphur baths
can be taken with the proper accompaniment of medical treatment.
Board and lodging are furnished and the beneficiaries usually re-
main six weeks. This institution was founded in 1808. There
are 169 beds at the disposal of Vienna and 400 to 500 persons
each season go there cost free from Vienna alone. Admission is
conditioned upon presentation of certificates showing the physician's
prescriptions and the patient's inability to pay for the enjoyment of
the baths, but the degree of poverty need not be so great as is neces-
sary to secure admission to a poorhouse or the grant of a stipend.



102 MODERN AIETHODS OF CHARITY

There are other baths and sanitaria to which the poor of Vienna may-
be sent. With this exception the care of persons in hospitals is not
at the cost of the city but of the province. When hospital patients
are recipients of a stipend payments on the stipends falHng within
the time spent in the hospital are paid over to the hospital manage-
ment and defray, in part, the expense of hospital care. The burial of
the destitute is regarded as an expenditure for sanitation and is not
charged to poor funds.

Not only in Vienna but elsewhere in Austria the number of dis-
pensaries is large. They are either independent or connected with
hospitals. The most completely appointed is the general clinic in
Vienna. It has a building erected in 1893, with special reference to
its uses. The building has a garden and is constructed in 8 sub-
divisions, each with a waiting room, a room for the physicians in
charge, an assistant's room, an auditorium and toilet rooms for men
and for women. The institution has a chemical and bacteriological
laboratory and a Roentgen closet. There is an isolation room where
persons found to have infectious diseases are placed until they can
be taken to hospitals. There are electric lights, central heating, a
ventilating plant which renews the air every thirty minutes, washable
walls, xylolith floors, hot and cold water in every room and all aids
to diagnosis and treatment. There are 20 departments, 20 head
physicians, 37 assistants and 43 "aspirants." The departments are :
two for children's diseases, two for diseases of the eyes, two for sur-
gical cases, two for skin and syphilitic diseases, five for internal mala-
dies, one for throat and nose, one for women's diseases, one for the
ear, one for urinary organs, and one for dentistry. All treatment is
free, persons of means not being received.

Austria has well developed agencies {"Rettungszvcsen") for the
rescue of those whose life is in sudden peril, and restoration of those
who are at the point of death by asphyxia, drowning, strangling,
poisoning, lightning-stroke, etc. Conspicuous notices of the location
of stations are posted. At each of these stations the most necessary
implements are kept packed in a small box that can be hurriedly car-
ried to the place where the endangered person lies. More extensive
apparatus is also provided, including an operating bed and often an
ambulance. Persons who would die before they could be carried to
a hospital are saved at these neighboring stations. This development
is due largely to voluntary private agency, especially to the "Wiener



AUSTRIA-HUNGARY I03

Freiwillige Rettungsgesellschaft." This society founded stations,
provided lectures on the treatment of emergencies, made an agree-
ment with the government sanitary service with respect to rendering
aid, and when the army is mobiHzed places means of rescue at water
courses and prepared to do service in cases of flood, fire and wreck.
The activity of this society has been imitated in Budapest, Prague,
Bruenn, Krakau, Triest, Lemberg, Innsbruck, and elsewhere. Due
to the same initiative, firemen have been instructed in restoring and
in transporting the injured, and also taught to make themselves use-
ful in other emergencies than fire. A full description of the utensils
found desirable for the stations can be found in "Oesterreichs Wohl-
fahrtseinrichtungen," Band III, pp. 458, 462 seq.

Of Austria in general it may be said that hospitals have out-
stripped other forms of beneficence. In 1848 there were 189 Aus-
trian hospitals with 12,701 beds, and in 1896 there were 207 public
and 395 private hospitals, in all 602 with 39,588 beds. In 1848 there
was one hospital bed to every 1,416.9 inhabitants. During this in-
terval the population has increased nearly 7,000,000. In 1848 the
number cared for in hospitals was 116,410, in 1896, 402,904. The
increase is due in part to the opening of hospitals during epidemics
which have been maintained after the passing of the epidemics. The
greatest cause of increase is industrial activity, mining, iron works,
factories, with their armies of laborers to be cared for, with greater
resources. The largest increase has been in Upper and Lower Aus-
tria, Styria and Bohemia, where in 1859 there was one bed to every
1,058 inhabitants and at last report one bed to 630. In provinces
chiefly rural the accommodations are still inadequate ; thus Dalmatia
has one bed to 1,054 of the population, Galicia one bed to 1,559.5, ^"cl
Bukowina, one to 1,576. The general public hospitals have the legal
right to draw on the treasury of the province of which a patient was
a legal resident, for the cost of care and treatment in every case where
the patient is unable to pay and the expense is not met by some
benefaction or by a corporation, labor union or society with which
the hospital stands in relation. There are agreements with some
states outside the Empire by which the latter honor bills sent in for
treating their citizens who fall ill while in Austria. Austria in turn
pays the cost of caring for her own citizens who fall sick and are
taken into the public hospitals of these foreign states. Poor persons
from foreign states that make no such agreement are received in the



I04 MODERN METHODS OF CHARITY

Austrian hospitals and the cost is borne by the province in which the
hospital is located. Though hospitals are provincial institutions,
municipalities have legally defined duties with reference to their main-
tenance. The capacity of single public hospitals varies from 13 to
1,964 beds and floor space per bed from 12 to 893 sq. met. Many
are overcrowded. The 395 private hospitals receive no public aid
and are under no administrative control of city or province. As a
rule they do not have fixed rates, they often care for the sick gratu-
itously, and otherwise upon terms agreed upon in each case. Of the
private hospitals 128 are founded and managed by independent cor-
porations, 61 by mutual benefit societies chiefly of laborers, 56 by
Catholic ecclesiastical bodies, 26 by Protestant and Hebrew bodies,
23 by benevolent societies, 15 by landlords and nobles for the people
of their domains, 13 are private sanitaria existing for purposes of
gain, and there are 73 others. Some are very small, having only 2,
4 or 6 beds. In 1896 there were 71,947 cases treated in the private
hospitals. There are in Austria seven homes for convalescents, so
far as reports show. This kind of aid for the sick is comparatively
little developed. Such homes not only economize the rooms in hos-
pitals but also facilitate recovery. Neither the often crowded wards
of hospitals nor the homes of poverty are fit places for convalescents.
In times of epidemics such homes can be used as hospitals. Aus-
tria has 18 maternity hospitals, most of which were founded in
the eighteenth century. They employ 66 physicians, 53 midwives
and 140 attendants. The number of beds in each institution varies
from 6 to 594 and the total number of beds in the 18 institutions is
1,576. During the years 1848-1877 there were from 11,300 to 14,908
births annually in these hospitals. The number increased to 19,029
in 1896. The administration in most cases is by the provincial au-
thorities. Subordinate to them is usually a superintending board of
physicians, then the resident physician, who often is director of a
larger hospital in which the maternity hospital is a department. In
such cases the head of the maternity department is under a pretty
complicated government, especially when as a teacher he is also under
the dean of the faculty of medicine in the university. In most of
these institutions instruction is given to midwives or to medical
students or both. There is generally lack of sufficient rooms for the
purposes of instruction and research. The greatest maternity hos-
pital in the world is a section of the general public hospital in Vienna.



AUSTRIA-HUNGARY



lOS



The building is half a century old, but during its existence it has
been provided with means of ventilation, a disinfecting house in the
court, extensive baths and tile floors. The worst housed of these
institutions is probably that in Czernowitz, unless the plans for en-
largement and alteration of the building have been recently carried
out. The building was a private house of eight rooms of moderate
size. Here lo or 12 or even 18 women are taken as patients and 20
to 34 midwives receive theoretical and practical instructions. Under
such conditions it is exceedingly difficult to prevent the spread of
contagion. The best equipped was built at Lemberg in 1895, and
is so constructed that 9 separate sections can be shut off, each with
its room for attendant, kitchen, bathroom and sickroom. Cases rec-
ognized as septic when received are taken by a special way to the
second story without touching the corridor, and all washing from
this section goes to the basement by a chute and thence by a special
exit to the disinfecting room and the laundry. The mortality in the
maternity hospitals has greatly diminished, the main point of prog-
ress having been in the antiseptic treatment of birth cases. This prog-
ress is largely due to the Austrian Semmelweiss, who in 1847 rec-
ognized the danger of carrying infection to the women by the hands
of physicians and attendants. The precautions which he intro-
duced resulted in a reduction of mortality, at the clinic with which
he was connected, from nearly 10 per cent, to 3 per cent. By insist-
ing that not the hands only but also instruments, etc., be disinfected,
he caused the death rate to fall further to 1.27 per cent. The teach-
ings of Semmelweiss were not generally followed in Austria till after
they had been reenforced by those of Lister of Edinburgh in 1867.
The carrying of infection by students is particularly to be feared.
No student should be allowed to approach a bearing woman who is
known to have been in the presence of contagion, and researches that
involve contact with contagion should not be allowed in the same
semester with instruction in these institutions. Safety requires that,
on the average, women should be at least three weeks in the establish-
ment, of which at least 10 to 14 days should be spent in bed. But
from lack of room this is impossible except in a few institutions. In
most the women are crowded out by newcomers as soon as they have
spent 7 or 8 days in bed and 9 or 10 days in the house. The mortality
of women in Austrian maternity hospitals and its relation to the
length of stay is as follows : In the 1 1 hospitals mentioned the



Io6 MODERN METHODS OF CHARITY

women are allowed to keep the bed 7 to 9 days. In Ragusa though
in bed but 9 days they regularly remain in the house 14 days and the
mortality is o.i to each 100 births; in Zara, a very small house, the
mortality is 0.2 per cent.; in Czernowitz, i.i per cent.; in Laibach,
where they remain in the institution 10 to 14 days and may remain
four weeks, i.i per cent.; in Triest, 1.4; in Klagenfurt, 1.6; in Vi-
enna, 1.7 ; in Bruenn, 2.0 ; in Prague, 2.1 ; in Krakau, 2.8 ; in Linz, 3.2,
In six other establishments where the women remain in bed 10 days
or more the mortality is as follows: Lemberg, 1.7; Lebenico, i.i;
Salzburg, 0.2 ; Olmutz, 0.3 ; Graz, 0.3, and in Spalato, a small house,
0.07. The highest average was in 1854, 4.8 per cent. In 1880 it was
I per cent, and has never since been greater than that ; during recent
years it has been .05 to .06. One of the seven homes for convales-
cents is for poor women who have just given birth.

The care of consumption is in a backward state. But for several
years it has been a subject of agitation, and in 1897 there was one
hospital for consumptives which the year preceding had 100 patients.
In 1898 an institution for those suffering with diseased lungs was
opened at Alland, near Baden. This equipment cost 600,000 flor.
There is a similar institution for Hebrews at Kierling, but with im-
perfect arrangements.

Regular provision for free vaccination is offered at many of the
Austrian dispensaries. In 1894 there was one vaccination to every
19, and in 1895 one to every 19.5 of the population. Vaccination
is not so nearly universal as in Germany, where it is compulsory. In
1886-1895 seventeen Bohemian cities lost 4,078 by smallpox, while
the disease was little known just across the border in Germany. To
make the example more specific, in the town of Warnsdorf and its
immediate vicinity in northern Bohemia 539 persons died of small-
pox in the years 1876-1899. Intercourse across the boundary is very
active, scarcely any separation at all being made by the national line,
and in the whole of the adjoining district on the German side, during
the statistical period 1883-1893 there was not a single death from
smallpox.

J. Defectives. — Though of course much has been done for the
care of defectives the provisions remain very inadequate. It has
been said that there are 10,000 defectives in the relatively advanced
province of Lower Austria alone who require institutional care but
for whom it is not provided. The first institution in Austria for the



AUSTRIA-HUNGARY 107

instruction of the blind was founded in Vienna in 1806, and the
teacher was Klein, whose ingenuity and devotion have caused him to
be regarded as the greatest teacher of the blind among the German
peoples. It was in 1816 that Klein's school became a permanent state
institution. According to the latest available report it had yi pupils,
44 boys and 27 girls. The largest number that has ever been in the
institution at one time was 82. This school gives a regular eight
years' course, including besides subjects always taught to the seeing,
practical and theoretical instruction in music and trades. In music
instruction is given upon the organ, piano, and string, reed and brass
instruments. The institution has its own orchestra, writing of scores
in prick-note is diligently practiced, many learn piano-tuning, and
all learn to sing. The trade instruction aims at thorough prepara-
tion to practice some trade suited to the blind. The trades taught
include brush-making, chair-bottoming, machine-knitting, rug-mak-
ing, and all feminine handiwork. The hand is strengthened and the
sense of form developed by means of hand and finger gymnastics,
Froebel work, modelling, drawing, wood work, work at the lathe and
the potter's wheel. Great heed is paid to the physical health and de-
velopment, which are promoted by gymnastics, baths, walks and a
vacation colony, belonging to the school. A physician visits the insti-
tution daily, and a dentist examines the pupils every two months.
There are three hospital rooms for pupils suffering with light ail-
ments, those seriously ill are sent to the hospital. The instruction
at this institution is highly successful. A large number of those who
have enjoyed its courses become entirely self-supporting, and most
largely so, yet many require aid and receive it in a variety of ways.
There is in Vienna a home for blind single women and another for
blind men, and an additional institution to afford home and occupa-
tion to the blind.

The second institution for the blind in Austria was founded in
Prague in 1807. This establishment carries on two kinds of work,
the instruction of poor blind children, and also the free treatment of
blind children whose sight may be wholly or partially restored by
medication or by operations. Because of limited funds as late as
1880 only 31 could be received. To supplement the small regular
staff of teachers benevolent persons have given gratuitous instruction
in music and in mechanical occupations. At present the house has the
necessary school rooms, shops, dormitories, etc., to accommodate 80.



Io8 MODERN METHODS OF CHARITY

Children are admitted between the ages of eight and twelve, who are
incurably blind, poor and residents of Bohemia. Beside usual school
studies, music, gymnastics and trades are taught. A competent
and adequately large corps of teachers is now employed. The care
of health is similar to that in the institution at Vienna. Among
the trades taught is basket making. Since the foundation of the
school 1,374 blind children have been educated here, 796 boys and
578 girls. The attendance never falls below the full capacity. An-
other school for the blind exists in Linz. It was founded in 1824
and has capacity for 54 inmates. It receives children between the
ages of seven and fourteen if they are blind, able to learn, and not
afflicted with any other incurable malady. Poor children of other
provinces than Upper Austria are received, but for such a fee of
50 flor. a year is required. In Bruenn there is a school for the
blind of the provinces of Moravia and Silesia, founded in 1822. It
provides for 116 pupils. Among the trades taught are the making
of straw coverings for bottles, reed mats, table covers, trunks, and
the use of the sewing machine. The occupations by which the larg-
est numbers of graduates of this school have made themselves self-
supporting are those of musician, piano tuner, basket weaver, brush
maker, and feminine handwork. The institution has a fund of
128,201 flor. for the aid of its graduates ; this is annually increased
by about 2,500 flor. An essential part of the work of such an insti-
tution is to have a paternal care for those who have gone out from
its instruction, and the ways in which it can aid them are many. An-
other school for the blind is in Lemberg, Galicia. It accommodates
about 40, and the admirable handiwork of its girls is an object of
remark. In Vienna there is a school for blind Hebrew children,
with between 50 and 60 pupils. It has a large collection of models
for use with its beginners in extended exercises for the development
of the sense of touch.

At Purkersdorf in Lower Austria a school for the blind was
founded in 1873. Its new edifice was built in 1879 with a model
equipment. It has capacity for 100 pupils, and has 15 teachers in
addition to the director and one male and one female nurse. At
Graz there is a school for the blind with 62 pupils. Another at
Klagenfurt was opened in 1898. In one of the public schools at
Vienna there is a department for the blind. They live at home and
are conducted to and from school by relatives. But a noon meal is



AUSTRIA-HUNGARY



109



furnished free, and street car fare is free to blind pupils. The num-
ber in this public school division for the blind is between 15 and 20.
The work, like that at regular institutions for the blind, is in three
departments, literary, musical and manual, though the two latter are
not in so great variety. After five or six years' attendance the pupils
are usually transferred to a regular school for the blind.

A benevolent society founded at Vienna in 1885 an asylum for
blind children under school age. It is a boarding home and kinder-
garten. The kindergarten methods are modified to meet the require-
ments of blind children and much of the attention is devoted to exer-
cises in touch, hearing and orientation, finger-play, hand gymnastics,
marching and motion plays. The kindergarten poems and songs and
most of the kindergarten occupations are successfully used. The in-
mates number 25 and the expenses are 5,300 flor. a year.

There is an institution in Vienna for those who have become
blind late in life. The aim is to restore courage to live and the joy
of activity by fitting these unfortunate persons either to return to
their former callings or to take up new ones. All are required to
learn to read and write the characters for the blind and to learn to
read the musical notation for the blind. Among the occupations
taught are those of typewriter, organist, piano tuner, and teacher of
foreign languages. Those who have received instruction here are
expected to become self-supporting.

Among those sightless from childhood and educated in an ordi-
nary school for the blind are many who but partially support them-
selves and who must be aided. Klein — that father of the blind —
felt this necessity and there is an institution in Vienna, grown from
the seed he planted, which affords home and occupation to the blind
who are no longer in school. Here none are admitted under 15 years
of age; there are about 100 inmates, slightly more women than men,
and there are many applicants for admission. Those who live to-
gether here carry on all the trades usually taught the blind and their



Online LibraryCharles Richmond HendersonModern methods of charity; an account of the systems of relief, public and private, in the principal countries having modern methods → online text (page 12 of 73)