The institutions that receive foundlings are too few and too poorly equipped. One day Mr. J. Pierpont Morgan saw in the street, within a block of his home, a poor woman hugging despairingly to her breast a new-born infant. In consequence, he caused to be built the million-dollar lying-in hospital on Stuyvesant Square, which has already been the means of saving many an innocent life. But that superb hospital, large as it is, has not the facilities for taking care of more than a small number of the infants that require such an institution.
The material agencies, efficient and marvelous as they have become, have not been the chief aid in the reduction of the death-rate, especially among children. Public education has really had more to do with it. Even those in direct charge of the work in infant mortality do not assert that the entire credit for the satisfactory progress should be given to the milk stations, the dispensaries, and the hospitals. Pamphlets, lectures, newspaper articles, and school-room instruction are at the base of the advance. Publicity has proved to be a greater force than milk inspection. Certain popular newspapers in New York have the power to achieve definite radical reforms in modes of living whenever they choose to prosecute a vigorous campaign. Just as the newspapers can expose corruption in any of the city’s departments, so almost as readily they can uproot or at least substantially lessen certain sanitary evils. A case in point is their campaign against the fly last summer. By means of wide-spread and vigorous news articles and editorials they succeeded in so rousing the mass of the people that the fly pest was visibly reduced. Health Department officials testify readily to this.
The work of the social settlements, of the mothers’ clubs, of the neighborhood nursing associations, of the diet-kitchens, all contribute to the general education that is bringing about a condition of excellent public sanitation. This work is necessarily of slow growth. Its effect is not nearly so evident as that of vaccination, of smallpox segregation, or of typhoid diagnosis. It is not so simple as establishing proper sewers or purifying the water-supply; but it is no less important.
THE STUDY OF SEX HYGIENE
IN all this tremendous volume of public sanitary education, no one feature stands out more clearly than the work being done in sex hygiene. Prudery is passing; there can be no doubt of that. Within the last five years every public school in New York has introduced a course of teaching in its physiology or biology department the aim of which is to acquaint the growing boy and girl with the essential facts of sex life, to open their eyes to sexual evils, and to prepare them to treat with sexual diseases intelligently. Ignorant mothers, both foreign-born and native, or those whose false modesty is worse than their ignorance, are day by day being taught by their daughters of twelve and fourteen, who have learned their lessons in school or in neighborhood classes, certain essential facts of sex life, ignorance of which has brought about pitiful conditions of disease and death.
The effect of this is not yet fully apparent in a decreased death-rate, but there can be little doubt that within a very few years it will have its result. For instance, one third of the infant mortality is due to prenatal conditions, congenital diseases which afflict the child at birth, and which mean either speedy death or a lingering, crippled life. The larger part of these untoward prenatal conditions are due to sexual diseases. To eliminate them will require two sustained efforts: the further abolishing of prudery, with consequent rigorous sex hygiene, and the enactment and enforcement of laws that will require proper medical examination before marriage.
A physician told me recently that in his opinion within a decade laws will be enacted providing that every man and woman desiring to marry can do so only with a doctor’s certificate that shall carry with it a clean bill of health. Once that is done, it is confidently believed that the death-rate among infants will fall off perhaps by a quarter, and surely by a fifth or a sixth. The educational work in this field is being done for the future. With present adults there is little hope; but the fathers and mothers of the next generation will be much better equipped.
THE FIGHT AGAINST TYPHOID GERMS
IN one more campaign the immediate future seems likely to yield great results perhaps almost as important as those resulting from the discovery of antitoxin. This will be from the use of the new anti-typhoid serum, which the Department of Health in December, 1912, decided to use as extensively as possible in New York. This decision followed close on the War Department’s public declaration that the anti-typhoid serum had proved a success, virtually eliminating the disease from the army. In 1909 there were more cases of typhoid in the United States than of the plague in India, despite the fact that India’s population is two and a half times that of the United States. In 1907 there were more cases of typhoid in New York than of pellagra in Italy, though Italy’s population is six times that of New York. In this work, as in children’s diseases and in tuberculosis, New York is a pioneer, and yet New York is better off regarding typhoid than many other American cities, for it has a lower typhoid death-rate than Boston, Chicago, Washington, or Philadelphia; yet its typhoid death-rate is higher than that of London, Paris, Berlin, or Hamburg.
Last spring when Wilbur Wright, the aviator, died of typhoid fever at the age of forty-five, several newspapers were honest enough to speak of it as a murder—a murder by the American people, through neglect and ignorance, of a genius who, had he been allowed, might have lived to be of still more distinguished service to the world.