"given false addresses" for the purpose of concealing their identity. Swarming as patients thus do, it results that each gets but little attention: a minute being the average for each, sometimes diminished to forty-five seconds. Thus those for whom the gratis advice is intended get but little. Often "the assistance given is merely nominal"; and "is both a deception on the public and a fraud upon the poor." These gratuitous medical benefits, such as they are, "are conferred chiefly by the members of the unpaid professional staffs" of these charities. Some of them prescribe at the rate of three hundred and eighteen patients in three hours and twenty minutes—a process sufficiently exhausting for men already hard-worked in their private practice, and sufficiently disheartening to men with little private practice, who thus give without payment aid which otherwise they would get payment for, very much needed by them. So that the six hundred thousand pounds a year of the metropolitan hospitals, which, if the annual value of the lands and buildings occupied were added would reach very nearly a million, has largely the effect of demoralizing the patients, taking medical care from those it was intended for and giving it to those for whom it was not, and obliging many impecunious doctors and surgeons to work hard for nothing.
These various experiences, then, furnished by societies and institutions supported by voluntary gifts and subscriptions, unite to show that whatever benefits flow from them are accompanied by grave evils—evils sometimes greater than the benefits. They force on us the truth that, be it compulsory or non-compulsory, social machinery wastes power, and works other effects than those intended. In proportion as beneficence operates indirectly instead of directly, it fails in its end.
Alike in the foregoing sections and in the foregoing parts of this work, there has been implied the conclusion that the beneficence which takes the form of giving material aid to those in distress, has the best effects when individually exercised. If, like mercy, it "blesses him that gives and him that takes," it can do this in full measure only when the benefactor and beneficiary stand in direct relation. It is true, however, that individual beneficence often falls far short of the requirements, often runs into excesses, and is often wrongly directed. Let us look at its imperfections and corruptions.
- The evidence here summarized will be found in Medical Charity: Its Abuses, and how to remedy them, by John Chapman, M. D. Some of the sums and numbers given should be greatly increased; for since 1874, when the work was published, much hospital extension has taken place.