IRA S. WILE, M. S., M. D. 223 



upon the wrapper around the infallible food. The relation of 

 poor ventilation, room congestion, baby farming, overdressing, 

 vital statistics, and the countless other aspects of public hygiene 

 merit consideration in the course that is designed to turn out men 

 trained in the prevention of infant mortality. Illegitimacy, 

 alcoholism, milk stations and their consultations and their 

 work are special problems that are bound up in the lessening of 

 the infantile death rate, and stress should be placed upon them. 

 Nursery hygiene, boarding-out systems, convalescent houses, 

 preventoria are worthy at least a lecture to students who later 

 will be the teachers of the public. 



To adequately teach the prevention of infant mortality the 

 medical schools must be socialized in spirit. A proper considera- 

 tion of the social origin of much of the infantile disease marks 

 a new era in etiology. Physicians cannot escape the responsi- 

 bility of having information upon this subject. The medical 

 schools must revise their teaching of pediatrics so as to supply 

 what is most necessary for the protection of the community from 

 the plague of preventable disease. Students should have lectures 

 upon social questions as related to the cause of infantile mor- 

 bidity, and also training in the value of various types of the 

 institutions for the cure of the diseases. 



Obstetrics, pediatrics and hygiene should be taught in the 

 light of the social basis of disease. At the present time medical 

 schools do not prepare students for the work of preventing infant 

 mortality. If physicians are to be leaders in the preventive medi- 

 cal work that is now the present ideal in medicine, the medical 

 schools must awaken to their responsibility and duty in the matter 

 of affording the adequate training to the students who go to them 

 for the purpose of being trained in all that makes for the highest 

 type of efficient, conscientious, humanitarian physician. In short, 

 preventive pediatrics must be taught. This becomes possible only 

 when it is a required course based upon the present-day needs 

 of the community. To be successful the preventive work in 

 pediatrics must have a foundation in the knowledge that the 

 faulty social structure is at the basis of many of the ills that are 

 thrust upon infant flesh. 



Dr. Wm. H. Welch, Baltimore: There are so many papers to follow 

 that it seems hardly justifiable to occupy much time in discussion. I 

 think everyone, as evidenced by the reception of Dr. Wile's paper, must 

 agree with the general trend of his argument. I certainly am in entire 

 sympathy. There is no question but that the great need of medical 

 schools in this country is the establishment of satisfactory training in 

 preventive medicine and public hygiene. There are one or two points I 

 wish to speak of, which I do not intend in the least by way of criticism, 

 but to be borne in mind. We hear equally urgent pleas for almost every 

 subject in medicine. I recall a plea for the teaching of electro-therapeutics 



