156 A CITY'S DUTY IN THE PREVENTION' OF INFANT MORTALITY 



The municipality should provide proper pavements; keep them 

 clean and free of dust; should thoroughly and effectively dis- 

 pose of all waste and should establish milk stations, which, how- 

 ever, would fail in their purpose unless receptacles and ice were 

 provided to preserve and keep milk wholesome in the home ; 

 should enforce by legislation, the restriction of the practice of 

 medicine and mid-wifery to those receiving diplomas or certifi- 

 cates after satisfactory examination; should instruct employers 

 of female labor in the laws of industrial hygiene; and last and 

 most important of all, should furnish professional municipal 

 nurses for educational purposes in the home. 



Such are ideal conditions, but as the ideal is impossible of 

 accomplishment, what can be done where such laws and prac- 

 tices are not in existence? To the education of the people in 

 rational hygiene the health officer looks as the final solution of 

 the problem. The ignorant should be led, not driven. Force 

 should seldom be used, and only against criminal acts. 



I will cite what has been accomplished in the city of Phila- 

 delphia, not that the work therein performed is all that could 

 be done, or better than elsewhere, but with the sole thought 

 that the experience here related may suggest something to 

 others that will be of advantage in furthering the purposes for 

 which this Association was organized: 



Up to the spring of 1908 no special work had been done in this 

 line; then the newspapers were employed in general educational 

 work, to which much credit must be given in creating public 

 interest, which has made latter results possible. Free circular- 

 ization was used and volunteer visitors were requested through 

 the ministers of the city. Although good was accomplished, the 

 movement was ephemeral and general interest was not main- 

 tained. Mortality during that summer, in infants under one 

 year of age was 5 per cent, less than the preceding year. 



In the early spring of 1909 a movement was started by hold- 

 ing a public conference, interest in which was created by a 

 systematic series of newspaper articles, by the co-operation of 

 the Bureau of Animal Industry of Washington, and other na- 

 tional and State organizations already engaged in this work, 

 all of whom sent representatives to the public meeting. This 

 was largely attended by representatives from nearly all the pri- 

 vate and charitable associations and hospitals in the city, the 

 result of which was the organization of 1 a "Babies Alliance, 

 under the auspices of the Department of Public Health and 

 Charities, the Board of Public Education, the Mothers' Congress, 

 the Home and School League, and allied associations." The pub- 

 lic schools were used as assembly halls for lecture purposes to 

 audiences obtained largely through the school children and their 



