\
"Remarks of Assistant Surgeon General Walter L. Treadway
‘of the United States Public Health Service, on the
Occasion of Dedicating the Federal Hospital at
Springfield, Missouri, September 22, 1933.

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Mr. Chairman, Mr. Director, Distinguished Guests, and
Friends and Neighbors of this Institution:

We have gathered here today for the significant and serious purpose
of dedicating an enterprise having humanitarian, and, practical and scientific
objectives. Surgeon General Cumming of the Public Health Service has asked
me to express his sincere regrets for his inability to attend these ceremonies

'. in person. I am glad of this opportunity, however, both personally and offi-
cially, to join you in these exercises. Under such circumstances it is appro-
priate that we indulge those who have been instrumental in bringing this
institution to its present state, and we hail with expectation the func tions
it is designed to perform. As an institution it occupies a significant place
in the evolution of public policies affecting the treatment and amelioration
of disease and illness, and also in the development of a eoordiinte system of
correctional prosedive. It has been designed primarily for the care and treat-
ment of the sick who have conmitted offenses against the United States, including
those who are mentally ill and those who are afflicted with chronic and pro-
tracted physical disease. Specially designed facilities were, and still are
contemplated for the tuberculous.

The peophe of Missouri, and of Springfield in particular, are to be
commended for their interest and attitude toward the establishment of this
hospital. It illustrates a spirit of cooperation characteristic of the
American people. Aside from the United States, perhaps, there is no other
country’ in the world where men and an have exhibited, in more striking form, -

that sympathy and helpfulness for alleviating suffering, for rectifying wrong,
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and for dattibe the weak in the way of strength and hope. Such a spirit has
built up @ great system of government, standing in many respects as a model
for those who seek to set liberty upon a firm foundation.

There is, however, more in the conception of this hospital than the

mere housing or domicilary care of prisoners. It represents a medical center

with all those diversified facilities which the broad activities and interest

of modern medical science and the treatment of the sick entails. It represents
even more than individual services for those admitted, for it is an aspect of
specialization aiming at the solution of a special social problem confronting
organized society. The role this institution occupies in the scheme of our
social order has behind it a continuous evolutionary growth of more than three
centuries. During that period civilizetion has endeavored to set up coordinate
public policies directed toward solving the problems of those who cannot meet
adversity, illness, or cope with the liberal standards of conduct maintained .
by society.

To understand this long and tedious erowth, it must be appreciated
that betterment in the social, moral, economic, or commercial conduct of a
self-governing people springs, not from the mind of any One person, but from
congregate opinions and crystallized wishes of generations. Notwithstanding
the sudden emergence of so-called reform movements, they are always based
upon a framework that is deeply rooted in a background of tradition and
custom, and flavored, perhaps, by the spirit of the times.

As populations increased and our communities grew older, their
isolation gradually eave way, and with it there = no escape from the constant

increase in the number of those who for various reasons became charges upon the
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general public. At first communities endeavored to dispose of them as cheaply
as possible through indenture or by allowing the public to offer terms for their
support. The practice of auctioning these public charges to the lowest bidder |
gradually lost ground, and out of it arose the policy of indoor relief. For
many decades almshouses and jails were the only public institutions housing
people who could not provide against adversi ty or cope with the customs of
society.

The almshouses, originally built and maintained to shelter and care
for the poor and helpless, gathered together under a single roof all manner of
persons. There was the widowed and the aged who were incapable of self-support;
Shs Little children left orphans or sired by incompetents; the idiot, the epi-
lleptic, and the feebleminded; the deaf and the dumb, who were the grinning butt
of public riducule; the "maniacs" and "harmless insane"; the lame, the crippled,
the chronically diseased, and the blind. All were gathered together under the
same inclosure.

Admissions to such almshouses did not stop. with the helpless and
worthy ones. Among these were thrown the vagabond, the tramp, the petty
thieves, and other delinguents and criminals, the vagrant class, the svonbt tube
brought to her lying-in, the drunkard and drug addict, the venereally diseased,
the tuberculous, and others with aomtidnideble diseases. —

Public interest was focused on this situation, partly because of its
inhumane aspect, but more especially because of the increasing drain on the
public treasury. It became obvious from public demands, that some means must
be found to decrease or at any rate, to stem the tide of this drain on public
coffers. Thus there began a period of specialization from which evolved various
systems, schemes, and eventually public policies and facilities to meet the

needs, or assumed needs, of these various groups as special problems.
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The first attempt at epecielization was stimulated by an insistent
demand that the able bodied poor, the sturdy vagabond, and the delinquent or
criminal should be put to work and made to contribute something to his self-
support. In consequence, there developed, on the one hand, special facilities
and policies to meet the assumed needs of the helpless and the sick poor, and
on the other hand, facilities for the more able bodied who could not conform
to the standards of conduct maintained by society. Thus the evolution of
facilities and public policies governing aid from the public treasuries of
American communities had their beginnings in what appeared to be two distinct
groups, first, the helpless poor or almshouse group, and second, the sturdy
delinquent or workhouse group.

These two problems are the nuclei out of which has grown those
public policies and obligations broadly designated as Public Health and
Public Welfare. With the growth of the many diversified institutional
facilities now available, and with the development of every public policy
for relief suppor ted from the public treasuries of American communities,
the physically and mentally diseased, disordered, and defective person has
arisen as a dominant complicating factor in administration, and sincere

endeavors have been made to meet this special medico-social problem. Among

- such efforts there has graduelly come the realization that physical and mental

defects and physical and mental diseases are complicating factors in crime and
in correctional procedure. It is this realization that led to setting up these
special facilities at Springfield. They have for their object the safety and
protection of civil communities; the application of +ehabiiitetion measures

in existing correctional institutions uncomplicated by the presence of these

special medical problems; the humane care, cure, or amelioration of adverse
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physical and mental states; and scientific stadien for doatributing to the

sum of our knowledge concerning physical and mental disease and defect as
motivating factors in crime, and the application of these results to future
policies which a social order may adopt in meeting this special phase of the
crime problem. These dedication ceremonies, therefore, represent a significant
change in Federal approach to the crime situation. Looking beyond the scenes
of the present hour, our prophetic fancy depicts an institution dedicated to
the noble purpose of providing humane care and scientific interest for those
who cannot, because of mental illness, meet the liberal standards of conduct
maintained by our social organization.

It is fitting, in connection with these exercises, that I embrace
this opportunity, on behalf of the Surgeon General and the United States Public
Health Service, to express appreciation for the sympathetic understanding and
interest which the people of Missouri, and the City of Springfield, especially
the medical fraternity, have shown toward the purposes and objectives of this
new sntagorice. It is our every hope and wish that this same helpful coopera-

tion will continue toward the activities and aims of this hospital.