222 MEDICAL SCHOOLS AND INFANT MORTALITY 



Ditman has made a splendid plea for the establishment of a 

 school of public health. There should at least be obligatory 

 courses in the many parts of this question in every medical 

 school. Pending the institution of such obligatory courses cov- 

 ering the subject of public hygiene, the responsibility for ade- 

 quate training in the hygienic aspects of the various portions of 

 the curriculum must rest upon the heads of the departments. The 

 necessity for instruction in hygiene falls particularly heavily upon 

 the teachers of the diseases of children. At the present time 

 they have not given any evidence of their intention of living up 

 to their responsibility in this regard. Many of these teachers are 

 the first to criticise the ignorance of the young graduate in the 

 matter of the hygiene of infancy. Proper education in the medical 

 school should be the strongest factor in the prevention of infant 

 morbidity. 



The fundamental causes of infantile mortality may be summed 

 up as poverty and ignorance. The physician may not be able to 

 cure poverty, but he can correct the ignorance and its stepchild, 

 neglect. The social aspects of this question are largely of a 

 medical character, and the teaching of prevention has to take 

 into account the social conditions that underlie, or the teaching 

 must be inadequate and but half done. Pediatric medicine should 

 be taught in its relation to community life in order to present 

 the preventive phases to the students in the true relative impor- 

 tance. The relation of the infant death rate to the occupation 

 of mothers before labor and after labor is such a topic ever 

 mentioned in the pediatric lecture room? The value of home 

 nursing as opposed to babies' hospitals is thought ever given to 

 the types of diseases that are best treated in the hospital ? Eighty- 

 five per cent, of the infant mortality occurs among children 

 receiving artificial foods what stress is placed upon municipal 

 milk supplies or milk sanitation? There is insufficient teaching 

 of the value of breast milk. Practically no instruction is given 

 regarding the care of the breasts in preparation for their func- 

 tion. Little is taught regarding the milk supply during the first 

 few weeks after labor, the time when many women are told that 

 they have insufficient milk. How scant is the information as to 

 the best foods to be given to the mother for the purpose of increas- 

 ing the flow of her milk? These are sins of omission that must 

 be corrected in order to lessen the number of children that are 

 to be unnecessarily weaned. The problem of the proprietary 

 infant foods demands careful attention that students may receive 

 unbiased information in regard to their constituents and their 

 proper place in pediatrics. The recent graduate must not be left 

 at the mercy of the representations of the retail men, whose 

 information is largely confined to the printed information that is 



