IRA S. WIIvK, M. S., M. D. 217 



for one-quarter of the total mortality? I do not mean to be too 

 harsh in my criticisms, but no one can deny that at the present 

 time there are not over one-half dozen medical colleges in this 

 country that are properly and fully equipped to give the medical 

 student the education humanity has a right to demand of a phy- 

 sician along the lines of caring for normal infants, not merely the 

 sick ones. When the question of preventing infant mortality is 

 considered, the conclusion must be that the colleges have hardly 

 begun to think of this part of the problem. There are today no 

 medical schools that give adequate instruction in the prevention 

 of infant mortality, and in this failure to give the merited train- 

 ing they are negligent of the best interests of the humanity they 

 profess to serve. Let us be honest with ourselves. Our medical 

 institutions as a whole turn out men and women who are seriously 

 minded and anxious to give the best that is in them for the 

 benefit of their patients. They are in possession of the knowl- 

 edge that has been imparted to them a feeling of confidence, a 

 commendable ambition and high ideals. At the end of the first 

 year of practice the shortcomings o ; f their teaching become 

 manifest in the mere field of therapeutics, and in the work of 

 prophylaxis they are amazed at their own ignorance. The col- 

 leges have not enabled them to live up to their ideals, and society 

 has to suffer the consequences. 



At the majority of medical schools pediatrics is made a part of 

 the general course in medicine. In a few schools there are some 

 didactic lectures without any clinics ; in others there are a 

 few or moderate number of clinics and without any or a few 

 didactic lectures. Some few colleges make the subject a 

 required subject, while others class it as an elective. Pediatrics 

 presents problems that are not to be included in the subject of 

 internal medicine nor in general medicine. Infant feeding is a 

 subject as peculiar to pediatrics as is menstruation to gynecology. 

 The possibility of reducing the infant death rate is retarded as 

 long as preventive work remains untaught in a special depart- 

 ment of pediatrics. There must be didactic lectures, clinics and 

 ward class work, so that each student may be brought into 

 intimate relations with the patients for the purpose of history 

 taking, physical examination and giving the advice to the mother 

 herself who needs the education. The institution that places 

 pediatrics among the elective studies is minimizing the impor- 

 tance of the subject and thus does an injustice to the student, 

 who depends for his course upon the superior intelligence of 

 the faculty directing his work. The Report of the Carnegie 

 Foundation entirely overlooked this phase of the question of 

 medical instruction, though emphasizing the disproportionate 

 attention given to various subjects as at present taught. By 



