HENRY L. COIT, M. D. 257 



infant morbidity and mortality by gathering statistics, regulating 

 the food supply and making more sanitary the homes of the 

 poor. 



The value of each of these agencies in their influence upon 

 the reduction of sickness and death has been variously estimated 

 by those who are actively engaged in one or another of the many 

 departments of this work with a tendency to over-estimate the 

 influence of the agency in which they are personally interested. 



There is no efficient method at our command for determining 

 the amount of sickness in a community or of analyzing the fig- 

 ures obtained as to the incidence of conditions causing death. 

 Morbidity statistics are difficult or impossible to obtain even 

 through the compelling agencies of municipal or federal ordi- 

 nance. Mortality statistics, for the most part, teach only econo- 

 mic facts in the numerical data furnished, yet these general facts 

 concerning mortality are useful to those dealing with sickness in 

 helping to determine how far their own work has influenced 

 mortality among a similar class under their supervision and 

 treatment. 



The work of infants' hospitals, babies' wards, dispensaries, 

 consultations, and institutions or associations which extend their 

 labors beyond the hospital to the home by giving instruction, 

 assistance, material help, food, clothing and shelter and which 

 are prophylactic rather than remedial, represents powerful influ- 

 ences, the value of which cannot be measured by mortality 

 records. 



All these efforts are directed against the causes of sickness 

 and some reliable method is needed to determine how far the 

 work done influences morbidity as well as mortality. More- 

 over, it is important to follow the work beyond its prophylactic 

 influence and, if possible, measure the progress of the individ- 

 uals benefited toward an improved environment, a normal nutri- 

 tion, immunity to disease and a maximum viability. 



When these various methods of work are combined under the 

 same direction, it would be desirable if some simple system 

 could be formulated for the collection of facts which would 

 show the relative value of the various kinds of work in their 

 influence upon the reduction of infant morbidity and mortality. 



In this way only can it be learned how the many causative 

 factors of mortality are related to one another: Whether pov- 

 erty or ignorance is the most potent; or which method of pro- 

 cedure is the better in our charity work. At present it is a 

 matter of individual opinion and many questions cannot be sat- 

 isfactorily answered. 



The percentage plan of scoring has been employed to deter- 

 mine the status of social, scientific and commercial investiga- 



