512 PEDIATRICS 



Forensic medicine has to guard the interests of all. Nothing in all 

 medicine is more difficult than the discovery of the cause of death. 

 The best knowledge of the advanced practitioner, of the pathologist, 

 of the chemist, of the bacteriologist, of the obstetrician, should be at 

 the service of the people. Every European country understands 

 that and acts on that knowledge. Our own Massachusetts has broken 

 away from the coroner's institution, which was a fit authority for a 

 backwoods municipality, but is so no longer for a cultured people of 

 eighty millions. Now and then, even an expert, or a body of experts 

 do not succeed in discovering the cause of death. What shall we say 

 of a system which now and then does discover the hidden cause of 

 a sudden death? When the New York State Legislature half a year 

 ago passed a bill abolishing the no longer competent office of coroner, 

 our good cultured mayor, a gentleman and author, vetoed it for the 

 reason that the new law was not perfect. It was not pronounced per- 

 fect by anybody, no law is nor ever was. That is why it appears he 

 prefers something that always was and is, and always will be perfect, 

 namely, the absurd incompetency and anachronism of the coroner's 

 office. That is perfect. I have not hesitated to express myself strongly 

 and positively, for I have been called upon to speak to you about the 

 relation of pediatrics to other sciences and arts --politics included, 

 than which there is no more profound practical and indispensable 

 science and art. The greatest historical legislators understood that 

 perfectly well, when they knew how to blend hygiene and religion 

 with their social and political organization. 



One of the greatest questions which concerns at the same time the 

 practical statesman, the humanitarian and the pediatrist,is that of 

 the excessive mortality of the young. The Paris Academy of Medicine 

 enumerated in its discussions of 1870 the following amongst its 

 causes : Poverty and illness of the parents, the large number of ille- 

 gitimate births, inability or unwillingness on the part of mothers to 

 nurse their offspring, artificial feeding with improper material, the 

 ignorance of the parents in regard to the proper food and hygiene, 

 exposure, absence of medical aid, careless selection of nurses, lack of 

 supervision of baby-farms, general neglect and infanticide. // there 

 be anybody who is not quite certain about the relationship of sciences 

 and arts, he will still be convinced of the correlation and cooperation 

 of ignorance, indolence, viciousness, and death, and shocked by the 

 shortcomings of the human society to which we belong. Most of 

 them should be avoided. Forty per cent of the mortality of infants 

 that die before the end of the first year takes place in the first month. 

 That is mostly preventable. A few years ago the mortality of the 

 infants in the Mott Street barracks of New York City was 325 per 

 thousand. Much of it is attributable to faulty diet. 1 



1 Measures taken for the purpose of obtaining wholesome milk are not quite 



