A. JACOBI, M. D. 49 



year. Their babies rarely survive when the mothers die. That 

 makes 400. Two hundred cases, however, are not the exact 

 number. I know that this very day, as ever before, the diag- 

 nosis of acute Bright, of peritonitis, of pneumonia, is inscribed 

 on the certificates received by the health departments when it 

 should be puerperal fever. And puerperal fever is avoidable ; its 

 occurence is a scandal and a shame in the community like small- 

 pox or typhoid fever ; and no actual precaution is taken to avoid 

 it. Poor agricultural Prussia had its well-informed and trained 

 and supervised and responsible midwives a century ago. There 

 was and is no village in that country without one. We, how- 

 ever, have none that can compare with them. We cling to our 

 prejudices and our indolence. Forty years ago the midwife 

 question was discussed in a large New York Medical Society. 

 One per cent, of the members present voted for instructing, 

 and licensing and supervising them. And this very day the 

 system under which they practice is slovenly and shiftless ; no 

 instruction is held out, no examination enforced, and the babies 

 swell what you are bound to combat infant mortality of all 

 classes. You do not question where the baby was born ; it is 

 a human baby; you do not consider the usefulness or uselessness 

 of a baby after it will have grown up. We never question the 

 right of an individual, though one may be the offspring of the 

 poor, who will struggle and work and add to the wealth of the 

 nation; and the other that of the idle rich that will never learn 

 to work and create, but only to consume. In the roll of humanity 

 the latter is the inferior creature, but before our forum here, and 

 statistically, they are equal. Still, I plead mainly for the millions 

 of the babies of the poor who are excluded from the benefit of a 

 scientific hygiene. 



The women of the nation must be healthy else the young will 

 be feeble and sickly. But the vast majority of the confined women 

 in the large cities have no time to recover. Under the law in 

 Prussia, working women are not readmitted to factories within 

 six weeks after their confinement. Then they may allow their 

 forsaken babies to shift for themselves. Those who do not work 

 in the factories work at home, here and there. Tens of thousands 

 get up after their confinement on the third or fourth day to do 

 the washing and the rest. Instead of the two months which is the 

 shortest period in which the organs can become normal, a few 

 days are allowed, with scanty food and no attention, and a 

 household to care for. A woman that has not sufficient time to 

 recover will start and retain her pelvic inflammation and decrepi- 

 tude. Her present child suffers, and dwindles, and dies; the 



Mi 



