what the suffering of a little baby's death means, and realize that the tragedy has come to more than one in ten of all the households gladdened by birth during the year. Yet nothing is more certain than that nearly half of these infant deaths are preventable, and by simple and definite procedures. The establishment of infant welfare stations for the instruction of mothers in breast feeding and the other essentials of maternal care is a measure that never fails to bring results. In New York City the infant death rate has been reduced one third by this means in a period of seven years, and a state-wide campaign along similar lines inaugurated last summer by the New York State Department of Health resulted during the first four months in a saving of 700 infant lives.
Many of us, I suppose, have felt that there must have been a strange lack, either of responsibility or of humanity, or of imagination, in the chancelleries of Europe when the bronze doors of Janus were unlocked. Is there not the same lack nearer home while this slaughter of the innocents goes on unchecked?
The children who escape the perils of infancy are next exposed to the attack of such communicable diseases as diphtheria, scarlet fever, measles and whooping cough. These enemies are less easy to control, but they may be held in check by measures for prompt diagnosis and intelligent isolation, and by the cultivation of habits of personal cleanliness. Against diphtheria, in particular, we have a practically certain defense in antitoxin, yet we lose 20,000 children every year from this disease because some of our trusted guardians, the physicians, neglect or postpone the use of this simple and specific weapon.
When the army of civil life is actually mustered in for active service, the enemies, typhoid fever and tuberculosis, make their great frontal attacks. Typhoid fever has been reduced to an almost negligible quantity in many communities, and those which lag behind pay their own penalty for special and conspicuous neglect. Against tuberculosis, on the other hand, we are all over the country doing little more than fight a drawn battle. The great wave of enthusiasm which swept over the United States ten years ago has not yet achieved all the results anticipated. There are still 150,000 deaths a year from this disease, of which three fourths should be prevented. The theory of the anti-tuberculosis campaign has been well thought out, but in few places has the practical machinery for carrying it out been adequately supplied in the shape of hospitals for the isolation of advanced, and the cure of early cases, and of visiting nurses to secure the proper care of patients in the home. Yet it is of little value to preach hygienic living without providing the means for practicing what we teach. Nowhere has the enemy been vigorously pursued into the insanitary tenements, and the dusty, unventilated factories where he gains his first foothold. The work of our tenement departments and state labor bureau is only a
