DISCUSSION 215 



DISCUSSION 



Dr. Samuel Amberg, Baltimore: I cannot leave this paper with- 

 out saying a few words in connection with it. I think Dr. Schwarz 

 has been extremely modest in giving us an outline of the work which 

 he has organized in New York. Anybody who has had occasion to see 

 the way in which the pediatric department of the Maternity Polyclinic is 

 conducted, the thorough way in which the infants are followed, and the 

 care which is allotted to them must give very high credit to Dr. Schwarz, 

 who has organized this service. Particularly important, to my mind, are 

 the figures which Dr. Schwarz has obtained with regard to the ability 

 of women to nurse. This agrees very closely with the statement which 

 Dr. Williams made yesterday evening on this platform. Dr. Williams 

 stated that in a practice of twenty years, only once was he unable in 

 private practice to induce the woman to nurse her own infant, and in 

 that particular case, they parted company. It is unfortunate that the 

 attitude has gained ground rapidly that the women of today are less 

 able to nurse their infants than they were generations ago, and I think, 

 to a certain extent, the fault lies with physicians because we have not 

 paid the necessary attention to the technique of nursing. The fact that 

 the great majority of physicians of today are not sufficiently acquainted 

 with the technique of breast feeding is due to the fact that the subject 

 has not received the attention it deserves in the medical curriculum. 

 These figures that Dr. Schwarz has presented should make us more 

 enthusiastic, not only to use the knowledge acquired in our practice, in 

 the dispensary and hospital work, but also to impart it to our students 

 that they may go out into the world and spread this very useful and 

 important knowledge. 



Dr. J. H. Mason Knox, Baltimore: Dr. Schwarz' s results have 

 been an inspiration to many of us for a long time. In his work he is 

 having practical results which we hope .will be obtained by prompt noti- 

 fication of births. If we had the knowledge in this city of the birth of 

 every baby within twenty-four or thirty-six hours, and also a sufficient 

 corps of nurses and physicians to look after the baby and the house- 

 hold conditions and encourage maternal nursing of the baby we would 

 reduce our infant mortality in Baltimore tremendously. What he has 

 said is in verification of the need of vital statistics, particularly of birth 

 registration; he has simply acted promptly on the knowledge of the fact 

 of birth. 



Dr. Schwarz (closing): Of these 1,500 women, 6 had character- 

 istics that prevented them from nursing and 4, as far as I could find out, 

 had no milk at all, so really of the 1,500 women, 4 were not physically 

 able to nurse for sometime. It is important that we should tell them 

 that one week of nursing is valuable, two weeks is of use, once or 

 twice a day for three or four weeks is of great importance to the child 

 in helping it to prevent contagious diseases and to keep in good health. 



