SAVING THE CHILDREN.*

BY SAMUEL W. ABBOTT, M. D., Secretary of the State Board of Health.

Speaking of the service of official health bodies, he said: "The most important work of local boards of health, beyond question, is the management and control of infectious and preventable diseases or causes of death. In those municipalities where this branch of sanitary work has been efficiently and thoroughly carried out, the sanitary authorities have had the satisfaction of witnessing a very decided fall in the death rate from infectious diseases, and a consequent saving of human life, a saving which is worthy of commendation as much as is the heroic act of the life-saving crew which breasts the storm and rescues a shipwrecked and dying company from some unfortunate craft upon our storm-beaten New England coast. 'Tis true that the life-saving crew have imperilled their own lives, but the grand result is the same in either case, the humanitarian result of saving human life.

"That this saving of human life has actually resulted, and that too in a very large degree as a consequence of the well directed efforts of sanitary authorities, cannot admit of a reasonable doubt. "But, while these evidences of the great advantage of sanitary measures are clearly demonstrated, it still remains a fact that the general mortality of the State has not materially changed in a period of forty years or more, since, while the death-rate from certain diseases has diminished, that of others has increased in a corresponding degree. How, then, may the balance of mortality be so influenced that there may be a decided fall in the general death rate (as has actually happened in England).

"I have carefully examined the list of diseases in which an increased death rate has occurred in Massachusetts, and have no hesitation in stating that boards of health in our large cities will find a fruitful field of work in the study of the question of infant

"Abstract of a paper read at the quarterly meeting of the Massachusetts Association of Boards of Health, at Lawrence, Oct. 27, 1898.

mortality, its causes and the prevention of its excessive prevalence.

"Another reason for encouragement in this special direction is the fact that many lives saved in infancy are saved for a long and useful life, and are, in fact, so much added wealth to the community at large. Dr. Schlossmann says: "The death of every child constitutes a definite loss of national wealth.' On the other hand, energy expended in saving the lives of the aged from the inroads of disease at the later years of life only saves this class at a period when they are most likely to be a burden to the community."

Dr. Abbott spoke in detail on the prevalence of infant mortality in this State, its causes and conditions and methods of prevention. Our statistics of infant mortality are seriously defective.

Statistics for the forty years from 1856 to 1895, inclusive, show that the death rate of children under one year of age per one thousand births has varied from 202.7 in 1872 to 119.2 in 1857 and 1858 each. The average for the first twenty years was 150.3, and for the second twenty was 161.2, and the average for the forty years was 156.3. The infantile mortality of the cities of the State, from 1881 to 1890, inclusive, varied from 239.7 in Fall River to 111.9 in Newton. The figures for Boston were 188.2. Lowell and Lawrence only were above Boston, with Fall River, the former being 222.5 and the latter 213.9. In the cities the average infant mortality for this period was 174.9, whereas for the rural portions it was only 129.5. Figures were given of foreign countries, showing that from 1884 to 1888 in Ireland the rate was only 94 per 1,000 births. This was the lowest figure, and the rate increased in different countries till it reached 287 in Bavaria from 1879 to 1888. In England it was 144 from 1885 to 1891. In France it was 165 from 1885 to 1890. In Massachusetts, from 1892 to 1896, of the 54,867 deaths under one year, 11,708 were due to cholera infantum, and the nearest cause to that was atrophy and general debility, which carried off 5,493.

The deaths from diphtheria, whooping-cough, cholera infantum and other diarrhoeal diseases, and violence, are more or less preventable, and, in a measure, those from tubercular causes may be reckoned in the same category. These together constituted 45 per cent. of the whole number of deaths of infants under two years of age.

In the case of diphtheria, thanks to the efficient co-operation of local boards of health with the State board in the matter of anti-toxin distribution and gratuitous culture work, the death rate is already diminishing. Speaking of preventable causes and conditions, Dr. Abbott said in regard to density of population, that the aggregation of inhabitants in cities and large towns (other things being equal) coincides with an increase in the general death rate of those communities, but when we analyze the factors of this general death rate, the principal increase appears in the mortality among infants. This principle involving the effect of density of population upon the death rate was established a half century ago by Dr. Farr, who showed that within certain limits there was a definite relation between density and mortality. He showed, moreover, so far as age periods are concerned, that children under five years of age are the greatest sufferers from this condition. But, in Massachusetts, notwithstanding an increase in the density of population from 136 per square mile in 1855 to 300 per square mile in 1895, the general death rate remained practically stationary (about 19.5 per 1,000), "a fact that may be taken to show that improved sanitary conditions have nearly counterbalanced the unfavorable influence of increasing density."

It is hardly necessary to assert that intemperance is a direct cause of infant mortality. The records of every country and every city give ample proof of the assertion. The poverty, the neglect, the cruelty, which are the inevitable result of a system of licensed saloons, are all handmaids of intemperance. Cities in which intoxicating liquors are sold freely under local option laws have a higher infant mortality than those in which license is forbidden by the popular vote. In the census year 1895 the infant mortality in the seventeen cities in which licenses were granted was 174 per 1,000 births. In those cities where no licenses were permitted the infant mortality was only 12 per 1,000, or but little more than two-thirds as great. In this estimate no account is taken of those few cities in which the sentiment was divided, so that a change from license to no-license, or vice versa, took place during the year in question. The records of the societies established for the prevention of cruelty to children confirm the foregoing statements both in this country and in England.

In conclusion, then, said Dr. Abbott, while very marked improvement has taken place in this State, in most directions as a result of direct sanitary work on the part of the health authorities.

of cities and towns, very little progress appears to have been made in limiting the death rate of infants. That an open door in this direction presents itself to boards of health for earnest sanitary work, an opening, too, which presents an encouraging outlook, I have not the least doubt. Beyond all question the one factor in diminishing the infantile death rate lies in the direction of the food supply of this helpless class. Further improvement of the milk supply of our cities is still needed, the co-operation of women's sanitary associations, whose organization should be encouraged, the intimate control of boards of health of the methods of feeding among the laboring classes, the establishement of day nurseries of creches in manufacturing cities under careful sanitary control, and the circulation of literature generally aimed at improvement in this line of sanitary work.

NEW METHOD OF PRESERVING MEAT.

A new method of preserving freshly killed meats has been discovered by the Danish zoologist, August Fjelstrup, already well known through his method of condensing milk without the use of sugar. The system (according to the printed reports) has stood a remarkably hard three months' test at the Odense (Danish) Company's slaughterhouses, in a very satisfactory manner.

The method in itself is extremely simple, and might be of great service for the troops in the tropics (the writer having had considerable experience in trying to keep meat fresh in Cuba).

The animal to be used is first shot or stunned by a shot from a revolver (loaded with small slugs) in the forehead, in such a way as not to injure the brain proper. As the animal drops senseless, an assistant cuts down over the heart, opens a ventricle, and allows all the blood to flow out, the theory of this being that the decomposing of the blood is almost entirely responsible for the quick putrefaction of fresh meats. Immediately thereafter a briny solution (made of coarse or fine salt, more or less strong, according to length of time meat is to be kept) is injected by means of a powerful syringe through the other ventricle into the veins of the body.

The whole process takes only a few minutes, and the beef is ready for use and can be cut up at once. This method has been examined and very favorably reported on by the general councils at Odense and Aarhaus, and also by many experts.

OLIVER J. D. HUGHES, Consul.

WHERE OUR DAUGHTERS GROW VIGOROUS.

THE DURANT GYMNASIUM.

The difference between this system and that in use in European gymnasia or in the German public schools is interesting because it so well illustrates the differences of American and European social evolution. In Europe the individual per se is of small account. People are thought of in masses-as belonging to this or the other class of life, and they are treated according to rule. So thoroughly rooted is this idea that it makes itself felt as well in all branches of education as in social customs. Some doctor of anatomy and physiology poring over his books evolves a theory in regard to a certain exercise; he has watched its effects, perhaps, and known it to cure dyspepsia or to relieve over-much adipose tissue. Well, then, it is a good thing. Use it for the entire classes throughout the school, for fat and lean, for dyspeptics and those with hearty digestion; what is good for one must be good for all.

But, coming to the American system as taught by the Young Women's Christian Association shows us something different. Develop the individual to his best possibility, and the community is the better for it, exclaims the American. Therefore, no sooner does a pupil enroll herself here than she is sent to the measuring room, and there, through Dr. Sargent's system of measurement, any over or under development is discovered. Incipient curvature of the spine and similar conditions which have escaped the attention of the family physician are often detected by this means. Then, in the office of the medical director, herself a woman, the new pupil is carefully tested as to the condition of heart and lungs and general health, and finally is given a prescription of exercises based upon all these data and thus adapted to her especial needs. When she enters her class, therefore, she is not only prepared to spend her time to the best advantage, but she has begun to realize something about the possible influence of exercise upon the health.