To prevent them from slipping into the void of abandoned history this book describes the institutions-some highly visible and others lesser known in and near Niagara County-that provided some of the earliest organized care for the blind deaf sick disabled insane and destitute. Niagara County a typical rural county of New York State serves as a historical model for study of the various institutions-the poorhouses almshouses sanatoriums asylums orphanages pest houses widows houses hospitals and special schools in the 19th and early 20th centuries. Our predecessors however harsh and out-moded their care seems now labored under and along with societal and cultural attitudes that mandated a sense of responsibility toward the needy in their midst. Their early efforts provided a foundation for many of the programs in New York State that offer progressive services to its citizens today.