JOSEPH S. NEFF, M. D. 155 



cared for in institutions, this class is increasing at an alarming 

 rate ; therefore, from an economic standpoint there is no better 

 investment for a municipality or a commonwealth than the per- 

 formance of its obligation to care properly for these unfortu- 

 nates, whose cost to the public is increasing in almost geometric 

 ratio. One of the first duties is to provide proper institutional 

 care for feeble-minded women during the child-bearing period, 

 and another to prevent the illegitimate propagation of the species 

 of the criminal and defective classes by so-called sterilization 

 laws, that are already effective in several states. 



A "Division of Child Hygiene," with a thoroughly trained 

 corps of physicians and competent nurses necessary for the 

 education of the parents in the feeding and care of their chil- 

 dren, in the maintenance of health and the medical care of the 

 sick, is valueless unless the authorities insure pure water, pure 

 food, pure air. and general sanitation, the lack of which, coupled 

 with ignorance, is the cause today, of nearly all of the pre- 

 ventable deaths of infants. Legislation and a competent corps 

 of inspectors are necessary to secure pure food, especially milk, 

 which, in this connection, is the most important and most per- 

 ishable of our food supplies. The greatest difficulty here will 

 be found in the large cities dependent for their supply upon ter- 

 ritory far distant. Inspection and education of all those con- 

 nected with the handling of milk is necessary, from the dairyman 

 to the transportation companies, the receiving platforms of the 

 city, the milk depots, the delivery wagons and the consumer; 

 the most important of which are the first and last named, for, 

 if milk starts from the farm bad it can never be made good, and if 

 milk is received into the home in good condition, unless properly 

 cared for by the housewife, it will soon deteriorate and be unfit 

 for human consumption. 



It is the duty of a city to furnish pure water, and with our 

 present knowledge of filtration there can exist no excuse for its 

 failure to do so. The procurement of pure air is somewhat 

 more difficult of accomplishment. The factory, the railroad, the 

 steamboat, so important for the commercial prosperity of a com- 

 munity, should be compelled to so conduct their business as to 

 prevent what is commonly known in American cities as the 

 "smoke nuisance;" overcrowding can be overcome by statute; 

 ventilation of public places of assemblage and public conveyance, 

 can be enforced ; but it will be almost impossible to overcome 

 the prejudice, especially in the foreign population of large cities, 

 against admitting fresh air into the home, particularly during 

 cold weather and at night, night air, especially among the 

 Italian population, being still resolutely maintained as dangerous. 

 Education alone can overcome ignorance, superstition and pre- 

 judice. 



