22 The Philippine Journal of Science 1920 
double mission imposed upon him, to save the life of the mother 
and that of the fetus, he must familiarize himself with the se- 
crets of puericulture in its relation to obstetrics. On the other 
hand, we must also admit that for the very reason that it is 
inconceivable to conduct any effective campaign against infant 
mortality without the help of puericulture, puericulture cannot 
be effective without the aid of obstetrics. For this reason, if 
it is desired to carry on a thorough campaign against infant 
mortality in this country, and at the same time establish pueri- 
culture centers, it is necessary to establish also well-organized 
maternity services which will serve as obstetrical centers, and 
centers for prenatal, intranatal, and even neonatal puericulture. 
Such maternity services could be established in our towns in 
two different ways: one through visiting nurses and qualified 
midwives who shall be under a physician’s supervision, in order 
that the patients will be cared for entirely at their homes; the 
other way would be by establishing hospital maternity depart- 
ments with their corresponding out-patient service for certain 
cases. It is evident that the former plan would be cheaper but 
at the-same time less effective and more exposed to failure. 
Cases of abnormal labor which might be encountered cannot of 
course be so well attended at the homes of the patients as at 
the hospital, especially when the conditions surrounding the 
homes of the patients, for the majority of whom the service is 
intended, are taken into consideration. 
It goes without saying that in default of a hospital maternity 
service, with its out-patient service, the first plan should be 
tried, even if, on account of lack of proper personnel who could 
be trusted with the work, it could not be made at present as 
extensive as is necessary. Be 
Imbued with these ideas and in my sincere desire to work 
for the benefit of the people, I took it upon myself to address 
an official communication to the Honorable the Secretary of the 
Interior on September 30, 1919, urging that, as a valuable con- 
tribution to the solution of the great problem of infant mortality 
in this country, steps be taken to carry out the provisions of 
Act 2801 whereby the construction of eight provincial hospitals 
is authorized, either simultaneously or one at a time, additional 
hospitals to be constructed and organized as fast as the resources 
of the Insular Treasury would permit it. These hospitals, which 
are an every-day need, should be provided with their corre- 
sponding maternity services, both hospital and outside. They 
are to be built of reénforced concrete and first-class timber, and 
