merits description. The city has a "Municipal Sanitary Commis-
sion" which directs the sanitary corps. It is composed of 12
members, chosen by the City Council for four years, one from
each ward. These name curators for the quarters of the city.
There is also a consulting council of physicians from different
medical institutions, and a physician-in-chief of the prefecture.
The commission directs the sanitary inspectors, the city physi-
cians, the medical school inspectors, the city maternity hos-
pitals, the municipal laboratory, the disinfecting plant, the in-
spection of cemeteries and night work. The city physicians,
24 in number, are each in charge of a district and give free
service to the poor with orders on the city pharmacy. Fourteen
of these physicians are women, as are many of the medical
inspectors of schools.
Private medical relief is given by almost every charitable so-
ciety, especially by the Institutions of the Empress Marie and the
Red Cross. Like those in the public service the physicians have
the reputation of being very well trained. Medical colleges are
all connected with universities except the Medical Academy in
St. Petersburg, which is a separate institution. Nurses, in public
and private service, come chiefly from the Red Cross classes.
These form a semi-religious body, not bound by life vows, and
they are of both sexes.
Both public and private hospitals are divided into general and
special hospitals. There are maternity hospitals, children's,
orthopaedic, ophthalmic, as well as hospitals for infectious dis-
eases, but the most common form is the general. There are
numerous maternity hospitals in charge of private societies, the
Institutions of the Empress Marie, and of cities and Zemstvos.
The children's hospital of Prince Oldenburg is over 30 years old.
It is described as being finely equipped and administered in the
most perfect manner.
Payment in the hospitals is usually graded according to the
patient's means, the very poor being admitted free. In large
towns a hospital tax is levied upon working people and servants
who are entitled to free treatment. Out-patients pay unless
they present certificates proving their poverty.
In 1892 there were 3,969 hospitals under the Ministry of the
Interior, 62,453 beds in general hospitals, 11,790 in special hos-
pitals and 21,924 for special classes of people, as factory em-
Like the rest of Europe Russia suffers severely from tuber-
culosis and her physicians are constantly studying methods of
cure and prevention. The royal family has led the way in prac-
tical efforts to combat the evil. In 1891, through the suggestion
and with the support of Alexander III the first sanitarium was
built at Halida near St. Petersburg. It is considered in every
way a model. There are two wards, one of which ("Section
Marie") holds 50 beds, the other ("Section Nicholas") has 32
beds. Dr. Gabrilowitch is its director. The success of this hos-
pital led Nicholas II to found another in 1895 which was, how-
ever, not opened until 1900. It is situated at Taectzi. It con-
tains 50 beds, 20 of which are free. A third sanitarium with 30
beds was located at Massandra on the Crimea and a fourth is
under construction by Prince Oldenburg at Gagry on the Black
The work of the Red Cross Society in sending sanitary mis-
sions among the peasants in time of epidemics and its efforts to
prepare girls to become nurses are the only form of educational
work among the people to which reference could be found. The
sanitary inspection practiced in St. Petersburg with a view to
preventing epidemics, and the visits of physicians to schools,
constitutes all that can fairly be called preventive medical service,
except the use of vaccination which is somewhat general. Pre-
ventive medicine is, however, the subject of study and discussion
J. With rare exceptions all care of defectives is private and
is very limited in extent. The blind were the first to receive any
attention and this by the formation, in 1881, of a special society
which was later made one of the "Institutions of the Empress
Marie." This has charge of 23 schools for children in some
dozen cities, with over 600 pupils, of trade schools for adults, of
3 refuges, 7 hospitals and 33 m.issions of oculists for country dis-
tricts. It publishes two periodicals and expends 203,000 rubles
a year, funds obtained from its own members and from gifts.
The total number of blind is to-day estimated at some 200,000,
so that the pitiful inadequacy of the relief offered is very evident.
There is not even an estimate of the number of deaf and dumb.
546 MODERN METHODS OF CHARITY
and until very recently there was no care taken of them. There
is now a society similar to that which cares for the blind. This
has a school with 230 pupils, 137 boys and 93 girls, both boarders
and day scholars. They are taught by the oral method as well
as by sign and manual, reading, arithmetic, religion and trades.
According to the report of the Commissioner of Education
(U. S.) for 1890-91 there were then 13 schools in all for deaf
mutes and one for idiots.^
The feeble-minded are carefully distinguished in legal defini-
tions from the insane, but they are kept in the same public insti-
tutions. The only separate asylums are private. There are
two of these in St. Petersburg and there are also special wards
in the Alexander Hospital and in one in Moscow. Yolsk on the
Volga has a school for backward children of the military schools.
No further details are obtainable, and we can only infer that these
unfortunate ones are practically neglected. It is known that they
are found in the great army of beggars.
Epileptics also receive little care. They are frequently found
in insane asylums, but the rule is to receive only those who are
mentally diseased. The treatment of the insane has followed
much the same course as in the rest of Europe. During the
Middle Ages if they were cared for at all it was in the monas-
teries. They were thought to be possessed by evil spirits as they
still are among the peasants. In 1677 a law was passed guard-
ing the property of the insane, and Peter the Great announced
others on the same subject, including regulations for the exami-
nation of the supposed lunatic. Catherine II had special wards
or houses provided for the insane and these were placed in charge
of the bureaus of charity. Now, like other hospitals, they are
under the general direction of the Minister of the Interior and
the Medical Department. Private hospitals must be sanctioned
by the Minister of the Interior. This minister names a medical
' From another source we learn (1903) that it has been estimated that there are
200,000 deaf mutes in the empire, of whom about 40,000 to 50,000 are of school
age. In 1901 there were 885 pupils in the schools. There are 20 schools for the
deaf; St. Petersburg has 162 pupils, Warsaw 170, Moscow 158. The imperial
institute at St. Petersburg lays great emphasis on industrial training. In Moscow
there is an asylum for deaf girls after school years, and a benevolent society to
care for adults. Warsaw has a Sunday school for the instruction of deaf hand-
director. Each Zemstvo has a permanent commission on asy-
lums composed of the president and two or three other members,
and also a medical director named by the commission. The City
Council names the city director. Outside of the Zemstvos gov-
ernments there are but three separate insane hospitals. The
Zemstvos have 10,000 beds, some in general hospitals, some in
those which separate chronic and acute cases. The hospitals
are classified as state, departmental, municipal and military. In
some places the insane are simply kept in separate wards of or-
dinary hospitals, and the country hospitals are very few and
small. According to law the hospital for the insane is a walled-
in building and has a military guard, but the latter provision is
often a dead letter. The physicians are trained alienists and their
aids are good, but the attendants, chiefly peasants, are very poor.
They are quite illiterate and untrained, receive wretched wages
and have bad living arrangements, so that the service they render
is necessarily very unsatisfactory.
The estimates of the total number of the insane are of doubt-
ful value. There are said to be 64.4 men to 38.6 women and some
18,000 are reported in hospitals.
In 1886 Dr. Bajenofif first introduced family care of mild,
chronic cases. His plan, which is being gradually adopted in
different parts of the country, is to place about ten patients in a
village either near a large hospital or so located that a small
hospital could be erected as center for several colonies. There
is not room enough in the hospitals for all cases and he believes
the patients are happier where they can see and share in home
occupations. He hopes to thus colonize 20 per cent, of the
patients. Admission to hospitals is gained by direct application
through parents or the police to the physician in charge. In
the country parents apply to the medical director of the district
and he makes the arrangements with the director of the asylum.
Examinations of the supposed insane are held in the presence of
the officials under whose jurisdiction the patient is, the Gov-
ernor, the president of the district court of law or judges, and,
if he is a noble, of the marshal of the nobility of the district.
The examination may be held at his house if the patient cannot
well be moved. It is conducted by the medical director or
his representative. The governing senate passes on the find-
648 MODERN METHODS OF CHARITY
ings of the examination in order to appoint guardians of the
property, except in the case of the peasants for whom the
district authorities act. The heirs usually have charge of
the property until the person is cured or dies. Property is re-
stored upon order of the senate or in the case of a peasant, when
he has been two years without a relapse. Release from the hos-
pital is obtained upon cure or at the demand of parents or re-
Criminal lunatics must be confined in asylums of the prison.
They are examined by the medical inspector or assistant and two
physicians in the district court while the judges are in session.
Most of the treatment in hospitals for the insane is free, as
is made necessary by the fact that 80 per cent, are needy peas-
ants, 15 per cent, bourgeois and only 5 per cent. rich.
Cripples receive no special attention and their numbers have
never been estimated. There are said to be great numbers of
them among the beggars, some of them the victims of accidental
injuries, others purposely mutilated in order to excite pity. The
cripple children of the poor are sometimes given to beggars to
be brought up in what seems for him the most profitable pro-
fession. The Foundlings' Hospital of Moscow, which gives pen-
sions to its cripples, finds that they often become beggars in
order to add to their incomes.
K. The Council of Guardians, formed to extend the work
of the cabinet which administers the "Institutions of the Empress
Marie," has under the Minister of the Interior the most extended
oversight of the "work of protecting and educating poor chil-
dren." The state does not assume to stand in loco parentis to
dependent children nor has it passed any general legislation in
regard to them. There is no children's court, but a law of 1897
declares that children under ten years of age are not subject to
judicial procedure. If arrested the judge sends them home to
their parents or places them with responsible people.
The real social care of the child begins long before this. The
oldest institutions for children are the Great Foundlings' Hos-
pitals of St. Petersburg and Moscow, established by Catherine II.
In 1899 the former cared for 33,366 children, the latter for 39,033.
The Moscow hospital ir. the more famous. It is intended for
illegitimate children, but a few others are admitted if the mother
is dead or too sick to care for the child. For the illegitimate,
certificates of birth are required. The mother is asked to come
in and nurse her child, receiving 75^ rubles a month if she does.
Otherwise well children are kept in the hospital but two weeks in
summer, three in winter and are then put out to nurse in a peas-
ant's family in the neighborhood. The weak and sick are also
boarded out if places can be found for them, but many remain
permanently in the hospital. The nursing staff in 1891 included
60 superintendents, 150 nurses and 950 wet nurses. The latter
were apt to leave at the time of festivals and then the mortality
among the babies sometimes rose as high as 60 per cent., but
recent changes are said to have removed these evils.
The children placed out are paid for at the rate of 3 rubles
per month for a year; the amount is then gradually lessened until
for a girl of from 10 to 15 years and a boy from 10 to 17, only I
ruble is paid. There is a system of inspection for these children
and Moscow has 41 districts, each with an inspector, usually a
physician who pays at least six visits a year to the children. The
hospital has over 100 primary schools and offers prizes to the
peasants for the child that passes the best examination.
The department of children's asylums, also among the Institu-
tions of the Empress Marie, has for its primary object that of
feeding and caring for the children whose parents are at work
all day. It has under its charge 146 infant schools, 11 baby
homes and a children's library in Moscow.
Under the same institutions are a number of orphanages in
Moscow, St. Petersburg and Gatchina for girls alone and for
girls and boys. There is also a home for half orphans. There
are of course schools in connection with these asylums and con-
siderable attention is apparently given to health. Open air ex-
ercise is required and a system of medical gymnastics is em-
ployed in at least one place.
Creches are a common form of aid in large cities. They are
supported by the cities, by Zemstvos, by the curators of indus-
trial homes, by the Red Cross and by other private associations.
Day nurseries for slightly older children have also been opened
in some places.
Elementary charity schools which usually have manual train-
ing in some form are supported by many different societies, some
650 MODERN METHODS OF CHARITY
of which, like the Elizabeth Society, aid the child with food and
clothing. The Zemstvos in their endeavor to make the primary-
schools available for children in sparsely settled regions have
opened night shelters and lodging houses.
For sick children there is the medical inspection in St. Peters-
burg schools, the Foundlings' Hospitals, the general hospitals
and one or two devoted especially to them. Two special sana-
toriums and a ward in another have been opened for the use of
L. Children between lo and 17 years of age when arrested
are adjudged either with or without discernment. If the latter
they are sent back to their parents or to responsible people, in
extreme cases, to a correctional home. Those with discernment
are sentenced either to a correctional home or to prison.
The older children under the care of the Foundlings' Hos-
pitals are selected for higher teaching. In 1898 there were 1,500
in Moscow learning trades. The girls generally remain in the
country and learn housework.
Nearly all assistance offered to youths is educational. There
were 596 societies at the close of the nineteenth century which
aided scholars, usually by means of purses or prizes and there
are many schools for special classes of youths, soldiers' orphans
and those of members of the civil service and children of railway
employes, which are wholly or partly free. The curators of in-
dustrial homes support workshops for apprentices which are
trade schools as well as shops.
M. Preventive. Educational institutions are to be classed as
most important preventive agencies in the country where ignorance
and poverty are so closely connected. So, too, are the ordinary
schools. Most of these are under the jurisdiction of the Minister of
Instruction, but all the other ministers as well as the Holy Synod
have also organized schools. Those of the Holy Synod are peas-
ant schools and aim to develop good citizens and orthodox
Christians. They teach religion, reading of Church Slavonic and
Russian, writing and arithmetic. They number some 40,000.
There are 84,544 public schools, out of which number 40,131
are under the jurisdiction of the Ministry of Public Education,
42,588 under the jurisdiction of the Holy Synod, and the
remainder under other departments. Of the pupils, 73,167
were adults, 3,291,694 boys, and 1,203,902 girls. The teachers
number 72,000. The maintenance of all these schools costs more
than $25,000,000. The average school tax for city schools is $9.50
and for village schools $5 per pupil. ^
The Zemstvos have some elementary trade schools and in
nearly all of the schools conducted by private societies manual
training is taught. Thus the school for the children of railway
employes teaches woodwork, domestic science, nursing and the
care of children. The schools of the St. Petersburg Ladies' Pa-
triotic Society give instruction in sewing, embroidery, lace mak-
ing, porcelain painting, embossing on leather and other semi-
One of the most interesting illustrations of this tendency
to make the schools practical in the true sense and adapted to
the needs of the people and country is found in the agricultural
schools of all grades which numbered 107 and had 5,996 pupils
in 1896. In 1898 there were no lower schools. The instruc-
tion covers all branches of agriculture, horticulture, sericulture,
dairying, etc. School gardens have also been introduced to a
limited extent and serve for considerable elementary instruction.
Along the line of more specific preventive work we find some
social and factory legislation. Marriage with an imbecile or an
insane person is forbidden, but how the law is enforced is not
Factory acts have sprung up ready made and compare favor-
ably with those of countries much older industrially. Those af-
fecting child labor date back to 1882 and 1885. No child under 12
years of age can be employed in factories or industrial establish-
ments. Between 12 and 15 they can be employed only 8 hours
a day, exclusive of meals and only four hours continuously.
They must not be employed in any dangerous or exhausting oc-
cupation. In textile factories night work is forbidden to youths
between 15 and 17 and to women, and underground work is for-
bidden to the same classes. Any child who has no certificate of
primary studies is to be given the opportunity to attend school
18 hours a week. For railways, steamboats and factories there
are employer's liability acts and in government works there are
* Samuel Smith, Consul at Moscow; Mon. Con. Rep., 1904, p. 847.
652 MODERN METHODS OF CHARITY
relief funds formed by taking 2 to 3 per cent, of wages and by
The industrial regions are divided into districts, each of which
has inspectors and a labor board. There are laws governing
contracts between employers and employes, which aim to guard
the workmen against injustice and loss, as, e. g., payments must
be in money and once a month if the engagement is for more
than that time, once in two weeks if it is indefinite. Medical
aid is to be furnished the workman and he may Ijreak his con-
tract if the work affects his health. The employer of agricultural
labor is likewise bound to pay in money to provide food equal to
that used by the peasants of the neighborhood and to care for
the sick at home or in the hospital.
The Peasants' Banks, established in 1882, have done good
service in enabling the peasants to redeem and stock their land.
The original rate of interest proved too high and it was reduced
in 1894 to 73/2-6j>< per cent, for terms of from 13-15 years.
There also exist many Mutual Loan and Savings Banks. In
1893 there were 764 in all; 662 of these had 211,400 members,
capital of 9,118,000 rubles, and borrowed capital of 12,343,000
rubles, and made loans of 18,271,000 rubles.
Rural banks loan up to 200 rubles a year to their peasant
founders and are allowed to do a commission business for them.
Somewhat similar assistance is rendered by the curators of
industrial homes, who provide funds for buying cattle and tools.
Another very necessary and characteristic aid is fire insurance.
The "red cock" crows so frequently in the wooden, straw-
thatched villages that special legislation has become necessary,
prescribing the distance between houses and requiring that all
peasants' buildings be insured.
The Zemstvos try to protect the peasants in another way by
providing public granaries, filled by levying a tax in grain upon
the farmers. Unfortunately the supply is never sufficient in
times of widespread want.
Employment bureaus have been opened by the curators of
industrial homes, by the Imperial Society of Charity and by a
The industrial homes and workshops serve to a limited degree
the needs of discharged prisoners, but only in a few localities.
Care of Discharged Prisoners. вАФ At Moscow there is a society
of patronage for female prisoners. When a woman is arrested the
authorities give all necessary information to the society. The
president of the society secures the cooperation of members in
her behalf; some of them visit her, learn from her whether she
will accept their assistance, the kind of work which she can do,
her needs in respect to clothing, passports, etc., discover whether
she has a family at home in need of their help, and seek to per-
suade her to behave well while in prison. Before the day for dis-
charge the society provides a place for her to work or a temporary-
asylum. In this asylum the women are sheltered and maintained
and required to work. If the discharged prisoner continues to
reside in Moscow she is placed under the care of a friendly visitor
in the district where she lives, and these friendly visitors are
organized something after the method of the German "Elberfeld"
system, and they give such advice and material help as the person
The dwellings of the poor have not received much attention
as yet, but it is understood that the general sanitary condition
in the average towns is bad. As we have seen, sanitary matters
are in the hands of special departments in cities and Zemstvos.
General measures looking to the prevention of epidemics
throughout the empire are the care of the State Medical Depart-
ment. Local outbreaks are looked after by local bodies. The
organization in St. Petersburg is the most complete. Its com-
mission has a plant for disinfecting clothing, etc., oversees vac-
cination, analyses in the city laboratory milk, water, meat, but-
ter and other foods, and has a considerable force of inspectors
to report on unhealthful conditions.
Probably the greatest social evil in Russia next to the habits
of begging is drunkenness and the government has recognized
this by taking measures to suppress it somewhat similar to those
used in Sweden. Beginning in 1894, a system of government
monopoly of the sale of spirits has been gradually introduced
into the provinces of European Russia. There are Guardians of
Temperance organized by the Minister of Finance to see that the
sale is according to law, to educate the public to understand the
dangers of abuse of drinking, to open asylums for drunkards, to
*Riv. Ben. Pubb., 1902, p. 841, N. Tabanelli.
6S4 MODERN METHODS OF CHARITY
cooperate with temperance societies and interested individuals
and to provide amusements for the people. According to the
lavv^ pure spirits rectified by the government are sold in sealed
bottles having labels stating the price, and are not to be drunk on
the premises. Liquor is sold for half a day on Sundays and fes-
tivals, not at all on Easter Sunday and Christmas ; on other days
from 7 A. M. to 8 P. M. in the country, from 7 A. M. to 10 P. M.
in cities. The sales are never on credit nor to children or
Special committees on temperance are authorized by the Min-
ister of Finance. That of St. Petersburg provides popular illus-
trated lectures on history, libraries, restaurants, children's gar-
dens, concert halls, theaters, night-lodging houses and hospitals.
The Minister of Finance provides in the Polytechnic Institute