DR. J. M. MUNRO KERR'S PAPER 421 



medical man knows that if pregnant women in the 

 poorer classes were looked afjer properly an enormous 

 number of maternal and infantile lives might be saved 

 from the dangers of toxaemia and other complications 

 of pregnancy. Many of these complications I might 

 refer to, such as malpositions of the child, haemor- 

 rhages, tumours, malformations of the parturient or 

 birth canal, all of which, if recognized early in preg- 

 nancy or early in labour, would result in an enormous 

 saving of maternal and infantile lives. 



It must not be imagined we are doing nothing for 

 such cases. As a matter of fact we do everything 

 we can to encourage prospective mothers to consult 

 us at our maternity hospitals, but except when the 

 complications have become specially serious we seldom 

 see these women. 



If we admit, and every one must admit it who 

 knows anything about the matter, that a great number 

 of mothers and infants are lost who need not have 

 perished, the question naturally arises, who is to 

 remedy this and how is it to be done ? 



As regards those who are to be made responsible 

 for bringing about a more satisfactory state of affairs, 

 I can readily understand you members of this Asso- 

 ciation and the Public Health Authorities saying 

 that this matter of the care of pregnant women the 

 prospective mothers does not belong to your spheres 

 of influence ; that it is a matter that concerns us 

 obstetricians, and that we should take it up and deal 

 with it. Now I entirely disagree with such a view. 

 Unless the Public Health Department comes to our 

 aid, we can accomplish very little. As illustrating 

 how little can be done in connection with preven- 

 tive medicine, unless the Public Health Authorities 

 take it up, let me mention two problems which might 

 very naturally be considered as belonging to the 

 province of obstetrics, but which were only satisfac- 

 torily dealt with when the Public Health Department 



