THE HOSPITAL SUPERINTENDENT

It is well known that the majority of hospital superintendents when appointed have not had sufficient training to enable them to competently discharge the duties of office, said Dr. Thomas Howell at the recent meeting of the American Hospital Asociation.

A hospital superintendent does not need intellectual brilliance, but he does need practical experience. He should have at least a superficial knowledge of a great number of things, such as engineering, laundering, carpentering, painting, plumbing, bookkeeping, the purchasing, preparing and serving of foods, the admitting, assigning and discharging of patients, etc.

He must also have had training as an organizer and as an executive. These can be learned only by hard, patient work. If he has no knowledge of these things his officers and employees will show him little respect, and he will have an uphill fight to maintain dis cipline and order, and without discipline and order a hospital cannot be efficient.

The hospitals are training doctors and nurses who leave the institution just about the time they become useful. Why shouldn't they also train superintendents?

PROSTITUTES PROVIDE $3,934 TOWARDS SALT LAKE CITY TAXES.

During 1912 fines and forfeitures aggregating $9,870 were collected by the criminal division of the city court. More than one-third of this amount was contributed by women. of the halfworld, the exact figure of their contribution under charges of keeping disorderly houses-resorting to disorderly house and vagrancy being $3,934. The total receipts from the same sources for 1911 were $4,365.

Of this amount not one cent has been spent directly for the benefit of these unfortunates. Some one of them perchance the loved daughter of a friend whom we fondled as a child only a few short years ago. Felons are received into our pentitentaries and sent to the prison hospital for treatment of their

diseases, including venereals caugt from these very women who have contributed during the past year nearly $4,000 to the city treasury. These women are foully diseased and capable of spreading the most horrible and loathsome of contagious diseases amongst, not only their patrons, but indirectly innocent women and children, as well as the public at large. No attempt, however, is made to protect the public health by their quarantine or cure, as is done in the case of convicted felons. The only object of the city fathers seems to be to collect fines, etc., for the benefit of the city treasury and to make things so unpleasant that they perforce migrate to other cities or towns in this state or to other states, regardless of the danger of conveying infection to others. Thus gonorrhea and syphilis is spread from city to city, and state to state, from bakery to cook-shop and candy kitchen to drug store. Moses appointed three cities of refuge, but for the unfortune prostitute and her pimp every city or town is a city of refuge, as long as she earns enough money to pay their police fines. Has not the time arrived for our legislators to appropri ate the moneys received from these fines and forfeitures for the benefit of the unfortunates who pay them by at least attempting to render them noninfectious before inviting them "hike" to the next city or state?

ENDORSEMENT OF SOCIOLOGICAL LAWS.

The legislative committee of the Utah Federation of Women's Clubs met at the Hotel Utah on the 9th of January to consider the four bills prepared by Dr. Clift to carry out the resolutions passed by the State Medical Association at Ogden in September last. Dr. Clift, by invitation of the committee, explained the purpose of each bill and the

existing conditions calling for such laws, which would be met by their adoption. An abstract of the principal points in his argument appears in this issue of the Journal. Judge McMasters of the Salt Lake Juvenile Court was

also present and urged the necessity for the proposed laws in connection. with his work. The legislative committee of the Federation will actively support these bills in the house and sen

ate.

The annual meeting of the Municipal League of Utah, comprising the mayors and officers of all cities of the second and third class, was held at American Fork, on the 10th and 11th of January. Dr. Noyes of that city being president. The question of the conservation of the public health was dealt with by Dr. W. R. Calderwood, of Salt Lake, and after a lengthy discussion, a resolution was adopted, endorsing the four bills carrying out the resolution of the State Medical Asociation at Ogden in September last.

Governor Spry in his message to the Utah legislature has endorsed the sterilization law.

"The protection of life, property and the conservation and promotion of Public Health are the fundamental duties of Government."-President Taft.

The greatest scourge to the public health and well-being of the state is venereal disease-the result not alone of public prostitution, but of clandes

tine prostitution as practiced by both men and women. Let us consider:

(1) Gonorrhea and syphilis undermine the health of at least 50 per cent of our young men the fathers of the During the past next generation. twenty years these diseases have in this state increased from almost nil to alarming proportions as can be shown by the records of the Juvenile Courts, the State Mental Hospital, the State Industrial School and the State Prison.

(2) Of these boys who have been infected-and who are not cut off in their prime-seven out of ten will suffer from the latent effects of these diseases in the declining years of their lives. Paresis, locomotor ataxia, arterio-sclerosis are the resultant products of "wild oats" in the guise of syphilis -syphilis in itself is curable, but the "wild oat" seed once sown is never eliminated so far as latent results are concerned. So, too, gonorrhea sets up latent inflammation of the prostate gland and subsequent bladder troubles. -the curse of the declining years of most of our older men. These troubles are only too often the direct product and result of an uncured or only partially cured gonorrhea, and all this largely the result of the familiar but monstrously dangerous assertion of the corner druggist or barber that "he would just as soon have 'clap,' as a bad

cold.

(3) Of the unfortunate girls who marry these at some prior time infected boys, only too many find their way to the operating table for removal of diseased ovaries, pus tubes, etc., and are permanently rendered sterile and incapable of bearing children-not a few actually losing their lives within a few months or years of their marriage. The parents often wonder why their strong and hitherto healthy daughter should suddenly become an invalid and die so soon after her marriage, with suave an handsome John, little dreaming that it

was caused by the sowing of John's "wild oats" in their daughter's body. A certificate of John's health before marriage would have saved her life.

(4) Of the children which are born to these boys and girls who have at some time been infected, the majority of those who come into the world alive will be of a defective type-some degenerate both physically and mentally, other epileptic or degenerate in lesser degree. All these "weaklings" if not absolutely dependent upon the charity of the state during the greater part of their lives are acknowledged to be not "fit" for the battle of life.

(5) "I will visit the sins of the fathers upon the children unto the third and fourth generation." This is absolutely true, for the children, if allowed to procreate will produce others like unto themselves, until in the "n"th generation they have become physically impotent or potentially so by confinement in our state insane or other asylums for degenerates.

(6) Our palatial homes for the insane, the feeble-minded, the epileptic, the deaf, dumb and blind, the state prison for our criminals and the reform or industrial school are all growing larger and larger every year; the percentage of our degenerates being greatly in excess of the natural increase in our population.

(7) These homes, prisons and schools cost money to build and every legislature is called upon every two years or so to add extra wards, cottages or accommodations for the increasing number of these defectives. Their maintenance is a perpetual drain upon the state and this drain will increase year by year as long as these degenerates and defectives are allowed to procreate without restraint and contrary to the laws of nature. A sick dog or animal is an outcast from its mates and sexual gratification, but the "human" is selfish and whether well or sick usually cares only for its own comfort and the

gratification of its desires. One author says: "Man is born without a conscience. He has no moral sense or will. These he must acquire."

Dr. Goddard in his book, "The Kallikak Family" demonstrates most forcibly that the feebleminded in our midst constitute a distinct menace to our social life. From their ranks are recruited most of the criminals, prostitutes, paupers and the worthless members of every community. Decent citizens pay a heavy price for these hereditary perpetuations. Men sit calmly by and allow the criminal to procreate his own kind, the idiot to beget the idiot and the harlot to give birth to the illegitimate seeds of concubinage. While the degenerate classes multiply, the tax rates continue to increase.

Our taxes are 40 per cent. higher than they would be if this problem were met rationally and scientifically.

In all the material things of life the financial end is considered and improvement, including the elimination of the useless, is the ultima thule.

The problem of dealing with mental defectives as a matter of fact touches the pocket of every citizen, for be he property owner or renter, every man directly or indirectly contributes his proportion of city, county, state and federal taxes. Every man in every community is paying his mite-and no inconsiderable mite it is to support prisons, jails, insane hospitals, alms houses and the special institutions made necesary for the care of our great herd of mental deficients.

Decent normal citizens are being continually robbed of hard earned. money; feeble suffering children are being brought into the world every year, little rickety, syphilitic, blind bundles of festering humanity, a burden on themselves and society, all because the public is calloused to the knowledge and sight of misery, or because it does not think, or know or care. It objects to highway robbery, but

condones this insidious form of robbery, accompanied by suffering.

The public conscience should be aroused to the evils attendant upon feeblemindedness, so that the subject could be treated fearlessly and firmly. We are positive in the belief that sterilization of criminals and mental defectives of all classes is logical, sensible and effective. The operation is trivial and harmless and absolutely prevents procreation. If this were to be carried out many of our institutions could be closed, our criminal classes would be diminished, epileptics, inebriates and the various types of persons of deficient mentality would be startlingly less and society would eventually be raised to a higher plane.

A united effort on the part of medical societies and civic organizations could do much to bring about sterilization laws. Eight states, or one-sixth of those in the Union, have wearied of the increasing burdens put upon them by these unfortunate classes and have enacted laws calling for the sterilization of certain prescribed persons. These laws are admirable as far as they go, but they are not sufficiently sweeping.

When a man suffers from a gangrenous leg, his surgeon does not amputate his toes. He goes to the bottom of things and the leg is taken off.

It is not enough to sterilize a man who has been convicted of certain serious offenses against the state. Any person guilty of a felony showing premeditation is not worthy of procreating his kind and he should be sterilized

As a standard for sterilization we would take the individual who shows tangible evidences of defectiveness. We would separate the sheep from the goats and see to it that the unfortunate ones be for ever prevented from encumbering the earth with their offspring.

Doctor Bruce Smith of Toronto well states the question: "What avails the continuous increase of hospitals, asy

lums, and similar institutions if the number to occupy these grows faster than the accommodations? How can we possibly leave the world better for our work if we do not at least begin some action to stop this vicious stream at its fountain head?" It seems to be the opinion of the majority that restriction of propagation is the only solution for the relief of this downward tendency, but the question is how to bring this restriction about in the proper manner. The education of public opinion has been suggested, so that those from defective parentage will, in the face of public opinion, abstain from marriage; this seems absurd, for even if marriage might be limited, which is to be questioned, it is well known that marriage is not necessary to propagation in this class. Segregation is out Segregation is out of the question, first from an economical standpoint, and secondly because many of these individuals would be fairly valuable citizens and be able to care for themselves if it could be so arranged that they were unable to propagate their kind. Under present conditions the state cannot take charge of those of defective mentality who have committed no crime, or who have not been committed to its care unless the same has been requested by proper authorities; but it certainly has the right to take those who have been legally committed to its charge and deal with them so that they will not be a menace to this or future generations. Indiana, Connecticut, Delaware, and Michigan have passed laws preventing marriage among defectives.

Indiana, Oregon, Washington, New Jersey, New York and Connecticut have also laws providing for the sterilization of defectives. Dr. II. C. Sharp of Indianapolis, who has performed the oper ation known vasectomy several hundred times, states "he has never seen any bad results; on the contrary, the patient becomes more pleasant, of brighter intellect, ceases

his bad habits, and frequently advises his fellows to submit to the operation for their comfort and good. As you know, this is a simple operation occupying only a few minutes of time and a local anesthetic. It consists of ligating and resecting a small part of the vas deferens in the male; the corresponding procedure in the female, the removal of a small part of each Fallopian tube, is more difficult. "These states that have taken a step forward are to be commended for their enlightened action in this direction. Pearson says: "Today we feed our criminals up, and we feed up our insane, we let both out of the prison or asylum reformed or cured, as the case may be, only after a few months to return to state supervision, leaving behind them the germs of a new generation of deteriorants.'

In conclusion it seems that the only solution of this peril is a broader dissemination of knowledge, and legislation regulating marriage and permitting

sterilization of the defective classes. Let us hope that our next legislature will see the need of these laws. Selection of parentage is the only effective process known to science by which a race can continuously progress.

Prostitution and the procreation of defectives must be regarded as a disease of society's morals and remedial measures must be twofold. (1) Elimination of the "social evil" the fons et origo of venereal disease by education. This must be begun at once. (2) Control of the existing disease by the state, county and city authorities. Of course, the ideal solution is abolution, total and absolute. This is not possible of sudden accomplishment. We can only arrive at the ideal by patient, persistent, perpetual effort and by a long process of activity and education. Dr. C. E. Smith of St. Paul in part says, "Suppression does not suppress, it merely turns an open evil into a secret one causing clandestine vice to increase. All attempts