218 MEDICAL SCHOOLS AND INFANT MORTALITY 



virtue of its relative importance in the welfare of the commun- 

 ity the study of the prevention of infant mortality demands a 

 commensurate attention at the hands of medical schools. 



The crime of omission becomes more noteworthy when one 

 pauses to realize that fully one-half of the infantile death rate 

 is from preventable causes. Are the best schools of this country 

 to be regarded as overlooking their responsibility in the matter 

 of preventing disease ? 



The cry throughout this land has been for prevention first and 

 cure when prevention fails. The backbone of preventive work 

 lies in widespread education. Unfortunately, the physicians just 

 graduated are not equipped to enter the field of education either 

 in infant feeding or general infant hygiene. The Council on 

 Medical Education suggested that 180 hours be devoted to pedi- 

 atrics, and 120 hours to hygiene and medical jurisprudence. No 

 schools have begun to reach this standard. 



Holt in his investigations of 44,226 deaths under one year of 

 age found 28 per cent, to be from gastro-intestinal diseases. In 

 New York City 85 per cent, of the infantile deaths occurred 

 among the artificially fed children. In Great Britain 75 per cent, 

 of the infant mortality is among the bottle-fed children. How 

 harsh these figures seem in the face of opinions such as that 

 expressed by Holt: "It is my belief that ignorance in feeding 

 causes quite as many deaths as bad milk." And our medical 

 schools do not place sufficient stress upon infant feeding. I do 

 not believe that I am guilty of exaggeration in stating that 90 

 per cent, of the graduates of medical schools during 1909 received 

 too little instruction in infant feeding to allow them to take up 

 the work of feeding infants without recourse to the widely adver- 

 tised prepared infant foods. 



In an address before the Association of American Colleges, 

 Hoxie stated "our schools of medicine are designed primarily for 

 the education of practitioners of medicine/' There are today 

 one of these practitioners of medicine to over 113 families in the 

 United States. It is generally admitted that the schools are 

 turning out graduates more rapidly than the increase of the popu- 

 lation and the death of physicians warrant. In the light of the 

 lack of efficient training the schools are giving the public might 

 well become aroused and seek to call a halt of this poorly drilled 

 procession. It is time to think of the better preparation of the 

 student with a view of eliminating some of the unfit. The first 

 problem lies, not in raising the entrance requirements, but in 

 raising the standard of teaching for the students at present 

 enrolled. The teaching of pediatrics must be strengthened. Few 

 colleges have specially prepared teachers in this subject. The 

 pediatrist must give more attention to the hygiene of infancy in 



