HENRY L. COIT, M. D. 259 



different factors as based upon the records of the visiting nurse. 

 It is also necessary that the nurse should interpret her records 

 for the statistician who marks the score card. 



The maximum score being one hundred in each line of investi- 

 gation, it is easy to determine the progress due to the influence 

 of the physician's work, nurse's work, or their work combined. 

 The total score for the month, if averaged, will represent the 

 same ratio and this figure with the subsequent monthly scorings 

 will show the improvement in the physical condition of the indi- 

 vidual. 



The total score for the month, expressed in figures and aver- 

 aged, is transferred to the graphic percentage chart designed to 

 show the improvement in the case during the possible period of 

 one year. 



This graphic chart may also be used to express the viability 

 of the individual at the beginning and at the end of the year 

 and the average of the first and last scorings of those who have 

 been under observation during the entire year will show their 

 average viability and the gross advantage of the work of the 

 philanthropy. 



An attempt at simplicity has been made both with respect to 

 the comprehensiveness of the data to be gathered and the method 

 of recording it. Very little writing is required: negative an- 

 swers require no entry; positive answers, except in a few 

 instances, may be indicated by a check or cross and the medical 

 history may be written with very little labor. 



The difficulties in estimating the value of some of the fac- 

 tors in a scheme like this are apparent. Pre-natal causes are 

 not included in the score except as the expectant mother was 

 considered as she came under the influence of the educational 

 system at the consultation, but the baby cannot be scored until 

 it has arrived and is presented to the medical agency for its 

 welfare. 



It seemed necessary to estimate the value of ample money 

 support and its opposite condition poverty; but it was found 

 that these were both indicated in the environment of the home, 

 the facilities for good care available in each case and the ade- 

 quate or inadequate food supply. 



Under management and care, after estimating the values of 

 type in the care-taker, it was found that the number of other 

 children in the family was an important element in lowering 

 the living prospects of the infant. After discovering that a 

 twelve-year-old child would be able to help the mother, it was 

 necessary to carry this cancelling of numbers down to the age 

 when a child could be of no help to the mother which was 

 determined at six years. The problem of numbers begins to be 



