“The public health is the foundation on which reposes the happiness of the people and the power of a country. The care of the public health is the first duty of a statesman.” Such was Lord Beaconsfield’s standard of public values, and it is that of a veritable army of women health workers in the United States, who not only share his vision but are rapidly learning the processes by which the foundation of general happiness and power may be firmly established on American soil. It has been through conferences, conventions and publications that women have gained an appreciation of the manifold activities that must be included in any comprehensive public health program, but they have been led up to the point of effective participation in health conferences through their own practical experiences. In the first place, the self-preservative interest or the mere instinct for a proper environment has forced women into public health activities; in the second place, they have done their health work well considering their own indirect influences, the opposition of interests, and popular indifference; in the third place, they have sought to avoid duplication of effort by establishing clearing houses for information and guidance for themselves and for the public; in the fourth place, they have moved step by step into the municipal government itself, pushing in their activities through demonstrations of their value to the community and often going with their creations into municipal office; and This does not mean that even in fundamental matters of physical well-being the accomplishment of the means to that end have been simple in any case. There has had to be a strong organization of the women in a given community who were interested in its health problems. These women have had to study the most intricate mechanical problems like municipal engineering. They have had to understand city taxation and budget making. They have had to educate those less interested to something approaching their own enthusiasm. Moreover they have had to work for the most part without political influence, which has meant that they have had to overcome the reluctance of public officials to take women seriously; they have had to understand and combat the political influence of contractors and business men of all kinds; they have had to enter political contests in order to place in office the kind of officials who had the wider vision; and they have had to watch without ceasing those very officials whom they have helped to elect to see that they carried out their campaign pledges. Sometimes it has happened that women have campaigned for a non-partisan ticket pledged to put through certain municipal health reforms and the ticket has been defeated at the polls. Under such circumstances they have had to renew their courage, maintain their organization, raise more funds and keep up the fight. Women who have experienced these All these educational methods which women have used for their own development and for the instruction of voters, the political machinations with which they have had to deal, the necessity they have been under of “nagging” without mercy until they achieved their desired results, the sympathy and encouragement on the part of men, the coÖperation of progressive officials, their ways of raising money, their means of perfecting organization, and their publicity enterprises will be illustrated in the pages that follow. Some of their failures to obtain the municipalization of certain proposals will also be recorded. In spite of all the handicaps under which they have had to labor, women have steadily forged ahead in medical knowledge and skill. It was the munificent gift of a woman to Johns Hopkins on the condition that it admit women as medical students that forced open the doors of that institution to them. Now Dr. Louise Pearce of that university has been appointed assistant to Dr. Simon Flexner at the Rockefeller Institute for Medical Research in New York. Women moreover hold high executive positions in the leading medical societies of the country today. Only within the last few years, however, have women been accepted anywhere as internes in hospitals and yet some municipalities, Jersey City for instance, have women physicians on the staffs of their city hospitals. Failing to get experience in other hospitals as internes, women have often established their own and they serve as superintendents, internes, consulting physicians in many such institutions. Large contributions have been made by women for the founding of various types of hospitals, both private and public. In instance after instance, the first hospital to make Free dental clinics, dispensaries and women’s clinics for the dissemination of knowledge of sex hygiene are some of the more recent results of women’s interest and effort. The first hospital ambulance in Chicago was bought by a woman’s club. A long list could be given of the efforts of women to establish adequate public provision for the sick. In 1910 it was reported at the Biennial of Women’s Clubs that 546 individual clubs had aided in the establishment of camps, sanatoria, tuberculosis clinics and hospitals; 452 had conducted open-air meetings for the improvement of health conditions; and 246 had placed wall cards in public places to convey information about public health ordinances. The sale of Red Cross Christmas seals alone has produced marvelous results in increased hospital provision, the work of tuberculosis clinics, open-air schools, camps and sanatoria. Hundreds of women in various states act as agents for the sale of these stamps and they sit at their little tables in shops, post-offices and elsewhere day after day during Christmas week, raising money for health work. Emily Bissell of Delaware is responsible for the recent use of these stamps. As president of the Anti-Tuberculosis Society of Delaware, she writes: “All our work on tuberculosis has been done by women and men working together, and while the women’s clubs have done their part, the men, in their benefit societies, labor unions, Catholic and Jewish associations, etc., have all had their part, and it will be difficult to disentangle their activities from ours. All this is as it should be, but it makes data more difficult when restricted to either sex.” Another example of effective and direct tuberculosis work is afforded by the Association of Tuberculosis Clinics of New York City which includes women on its board of directors and has, for its executive secretary, Miss F. Elizabeth Crowell. The importance of an association like this In various ways, women have sought to control the spread of this dread disease. They did much to abolish the common drinking cup and have worked for the establishment of sanitary drinking fountains in public squares and sanitary faucets in public schools and public buildings. They have agitated against spitting in public places, and have seen their agitations rewarded with anti-spitting ordinances; and they have organized junior and other leagues to help with their enforcement. They have pressed upon the attention of the authorities the necessity for medical inspection in the schools and for open-air schools; and Mrs. Vanderbilt of New York has built some splendid open-air homes for tuberculous patients, which have served as models for later attempts to deal with the housing requirements for the permanent cure of tuberculosis. Testimonials to the initiation and pressure by women along these lines, all of which are of the utmost importance in checking the ravages of tuberculosis, come from all quarters. The Buffalo Federation of Clubs, the organized women of Minneapolis, the Women’s Municipal League of Boston, and the Civic Club of Allegheny County, Pennsylvania, are among the groups that have insisted upon open-air schools for children either infected with the germs of tuberculosis Mrs. Ella Flagg Young, superintendent of schools in Chicago, brought the open-air idea into the ordinary schools by seeing that properly devised window boards were installed so that school children might regularly study with open windows. This makes possible the wide extension of preventive health work, and her scheme is being extended to other cities. In addition to the communicable diseases there are occupational diseases some of which, like tuberculosis, are communicable, while others are not. Women were behind the agitation for the abolition of poisonous matches—matches which produced sulphur poisoning for those who made them. In the official organ of the Federation of Clubs was found zealous advocacy of the Esch-Hughes law until its passage. Occupational diseases are ills which are quite distinct in causation from fevers and other epidemics due to germs. Relatively little has been done in the United States toward the study and prevention of such diseases, however, and the recent quickening of consciences and interest in that direction is true of women as well as of men. The reports of Dr. Alice Hamilton on lead-poisoning and of Mrs. Lindon Bates on mercury poisoning are excellent contributions to the subject and are among the rare studies of occupational hygiene in this country. The widespread interest in industrial accidents may well extend to the more subtle industrial diseases which may not be as sensational as cataclysmic events but are not the less sure in their depletion of vigor and in the hardships they bring into the lives of the workers and thousands of families. The activity of the Women’s Municipal League of Boston affords us an example of the way in which women are awakening to their own and the public responsibility for As in other branches of social endeavor, we see public health work tending more and more toward prevention. The ideal now is not merely to provide more ambulances, but rather to reduce the necessity for so many ambulances. This need early became apparent as hospitals discharged patients only to find them soon fallen into sickness again. In all varieties of hospitals where the poor are admitted as patients, the follow-up treatment is often as vital as the immediate prescription and nursing. This involves family visitation and advice and is called by Miss Katherine Tucker, president of the New York Association of Hospital Social Service Workers, “a new profession.” Miss Ida M. Cannon, headworker of the Social Service Department of the Massachusetts General Hospital, puts these pertinent questions about the social work of hospitals: OF WHAT USE IS IT— If a patient for whom the surgeon orders a back brace starves herself to pay the bill? If a workman, cured of rheumatism, goes back to his job in the damp cellar which caused it? If a clerk, fitted to glasses, returns to the dim desk which crippled her sight? If an unmarried girl, delivered of her child, goes from Medicine and surgery, supplemented by social service, not only cure disease but restore to full health and working capacity. The theory and practice of this youngest handmaiden of medical science are fully, simply and interestingly told in the latest Russell Sage Foundation Publication. Dr. Richard Cabot, of Boston, was one of the first physicians to emphasize the social background of health; but it is admitted on all sides that women are proper persons to treat the family and discover its needs. They are social physicians in a very real sense and their knowledge must be industrial, economic, psychological, as well as medical. At the fifteenth annual convention of the American Hospital Association held in Boston last summer (1914), Dr. Frederick Washburn, president of the association, insisted that the function of the hospital is not merely to treat patients acutely sick, but to aid in the prevention of disease, and to undertake social service and coÖperation with community agencies. Other speakers dwelt on the necessity of better care of the “out-patient,” the social service side of health work. The Survey had this to say: “A new note was struck by Elizabeth V. H. Richards, headworker of the social service department of the Boston Dispensary, who showed that the social service department is not only of assistance to individual patients, but that the medical social worker can be of value to the managing authorities of the institution as a whole, in studying the efficiency of its clinical work, and in planning the broader relations which its work may bear to other welfare resources in the community.” The home situation clearly has to be considered as well as the physical ailment in almost every case requiring medical care. Thus the task is a coÖperative one between the social worker and the medical scientist. Every attempt to After-care is especially imperative in cases of mental disorder. Patients may be discharged from insane hospitals in some cases if the physician can trust in the home environment. The social worker is his aid in these cases and thus helps to keep families together. The prevention of insanity and the after-care of patients is the object of the National Committee for Mental Hygiene which numbers Julia Lathrop, Jane Addams, Mrs. Philip Moore and several other women among its members. Dr. Thomas Salmon, a leader in this work, writes: “Women are active in this committee and I can say that we rely very much upon the wise counsel of these members of the committee.” Care of the sick in hospitals, as everyone knows, depends almost as much upon efficient nursing as upon the skill of the physician—in many cases, far more. Of the labors of nurses for humanity, it is not necessary to speak here. But in our present public health campaign, a new type of nurse has appeared, “the visiting nurse,” who watches homes to guard against disease as well as to cure, and she is now regarded by competent observers as the strategic point in the battle for improved health in our cities and towns. Ysabella Waters in her examination into the system of visiting nursing in the United States shows that in 1913 “50 health departments employed 867 visiting nurses, including 345 school nurses, 350 tuberculosis nurses, 107 infant An excellent system of district nursing is that developed by Miss Lillian Wald from her Nurses Settlement in New York City, and, according to Professor Winslow, it was due to her far-sightedness and organizing ability that the application of the educational force of district nursing was made to the problem of tuberculosis. Miss Wald’s belief that the hospitals can never cope with disease and that home treatment is better and more practicable is borne out by the figures given for the total number of patients treated last year by the district nurses which indicates that the number visited and cared for was larger than the number treated by three large city hospitals in the same space of time. Ten per cent. is the proportion usually cited as the ratio of the sick taken to hospitals. Miss Wald contends that the treatment of patients in their homes, especially where children are concerned, is preferable to hospital care in most cases, and can be carried on in a way that compares favorably with the treatment accorded in hospitals and by the private nurse in the homes of the well-to-do. Miss Wald began her work for public nursing twenty-four years ago and has steadily pushed its importance into public recognition and changed the official attitude, as well as the attitude of doctors and laymen, from that of indifference or contempt to that of sympathy and understanding and public support. In other cities, the idea has been taken up and developed in many ways. The Visiting Nurses’ Society of Philadelphia wants to increase its force to enter industrial nursing and here as elsewhere in the various aspects of nursing, the demand for training far exceeds the equipment. Here, too, just as the hospital nurse soon sees the necessity of economic Los Angeles was the first city to municipalize the district nurse, and this bold step was taken at the instigation of Mrs. Maude Foster Weston and the College Settlement workers who furnished statistics and reports, which they themselves had gleaned from their own observations with private district nursing, to prove that such a step was municipally advantageous. The first school nurse was also secured in that city through the efforts of the same women. In 1909 a practical demonstration was given of the value of the district nurse in daily coÖperation with the city physician in controlling an epidemic of measles. Mrs. Weston thus explains the woman’s point of view about this work: “Someone has said that infant mortality is the most sensitive index we possess of social welfare. It may be that in our fair climate we need never reach the appalling records of our eastern cities, but we who know the true state of things in Los Angeles believe that if there is not more care of our newly-born, that, while the death list may not compare with the East, we shall produce a sickly, ailing set of children who will be unable, at maturity, to cope with disease. We are accused of standing for a sort of social service which has to do with the effects only and not with the causes which create them.... We approach however our problems in a modern and scientific manner and we always seek for causes.” The Women’s Municipal League of Boston has made a thorough study of public nursing and has adopted a scheme whereby the nurse and houseworker are combined. This system is called Household Nursing and its aim is to be self-supporting. The nurses are called “attendants” and the problem of their training has had to be worked out by patient experimentation. Women are developing largely for themselves the whole science of training for public nursing. The National Organization for Public Health Nursing has a broad social point of view, realizing that upon the district nurse rests the responsibility of applying in a very practical way among the people the results of scientific thought and research. In this social battle to arrest and prevent disease, the campaign against infant mortality assumes an ever larger proportion, and as we should naturally expect, women are also in the front ranks here. More or less quietly for a long period women have studied and worked on the problem of infant mortality. In addition to their private efforts to reduce its amount, they have served in official capacities. In 1908, for example, a division of Child Hygiene was created in the New York City Health Department, after careful study of the organization of such an enterprise; and a competent woman physician, Dr. S. Josephine Baker, was placed at the head of it. It is believed to be the pioneer—the first bureau established under municipal control to deal exclusively with children’s health. There had previously been diverse or scattered activities in that direction but under the new plan all these were coÖrdinated. In Milwaukee, baby-saving on a “hundred per cent. basis” was being worked out by Mr. and Mrs. Wilbur Phillips when the defeat of the Socialists brought their labors there to an end. Their experiment was made possible largely The combination of private and official activities in behalf of Child Welfare led to the agitation of women for a Federal Children’s Bureau to study infant mortality and nutrition. The scheme was proposed by the National Child Labor Committee and supported by the club women. Julia Lathrop was made Chief of the Bureau. She was given a very small appropriation however. Furthermore she was handicapped from the outset by her lack of satisfactory records as a basis of work. “What do we know of infant mortality when not a single state or city in the United States has the data for a correct statement?” was her first query. While pursuing the Bureau’s first study therefore, that of infant mortality, Miss Lathrop emphasized the need of better birth and death registration laws and methods. It was soon recognized that women’s clubs in the various states were the most hopeful agencies for bringing about better statistical records. “The plan [of the Bureau] is to have the actual investigating done by committees of women—in most instances members of the General Federation of Women’s Clubs—who will take small areas in which they have an acquaintance and, selecting the names of a certain number of babies born in the year 1913, will learn by inquiry of the local authorities whether the births have been recorded, sending the reports to this bureau. An investigation dealing with about 5 per cent. of the reported number of births will probably constitute a sufficient test. The women’s clubs are responding well and the work is progressing satisfactorily.” The recent Kentucky vital statistics law is due in a large measure to the women’s clubs of the state, and the Chicago Woman’s Club was also instrumental in getting a state bill for the registration of births. The first monograph of the Federal Bureau was that on Birth Registration and this was requested by the General Federation of Women’s Clubs. Other bulletins issued by While women in official positions are working to educate the public in child saving, women physicians and social workers are constantly emphasizing the value of baby conservation at conferences of one kind and another. An instance of this among the many that might be cited is the participation of women in the meetings of the American Association for the Study and Prevention of Infant Mortality. Dr. Mary Sherwood of Baltimore, speaking at the last annual meeting, said: “Communities and individuals must be made to realize the fact that the babies of today will be the fathers and mothers of tomorrow. Make the babies well, prevent mortality, and we have strengthened a great weakness. No community is stronger than its weakest point.” Dr. Sherwood is chairman of the Association’s committee on prenatal care, instruction of mothers and adequate obstetrical care; Harriet L. Lee, superintendent of nurses of the Cleveland Babies’ Hospital and Dispensary, is chairman of the committee on standards of training for infant welfare nursing and problems that confront the city and rural nurses engaged in baby-saving campaigns; and Dr. Helen Putnam, of Providence, is chairman of the committee on continuation schools of home-making and training for mothers’ helpers, and for agents of the board of health, such as visiting nurses, sanitary inspectors, visiting housekeepers, and One of the most effective ways of stimulating the interest of mothers in educating themselves in the care and feeding of young children is through baby contests or shows or “derbies” as they are called in some places. One of the pioneers of this movement was Mrs. Frank De Garmo, of Louisiana, who organized a contest at a state fair there, and later, one in Missouri. It was Mary L. Watts who so forced the better baby movement upon the attention of Iowa, through a contest for prize babies held at the state fair a few years ago, that farmers and their wives began to ask the question: “If a hog is worth saving, why not a baby?” Baby exhibits with their attendant instructions to mothers, whose pride and interest are aroused by the public admiration of fine infants, are now held from coast to coast. In the education of public opinion on the question of reducing infant mortality, it is inevitable that great attention should be given to the matter of pure milk. One cannot think of a baby without thinking of milk, so that the effort to provide pure milk is directly associated with every effort to reduce infant mortality and make children strong. The problem of milk is twofold: to supply the best possible grade for bottle-fed babies, on the one hand, and on the other to provide the mother of the breast-fed baby with necessary conditions for nursing her infant properly. There is no dispute as to the greater importance of the latter phase of the problem. The milk station to supply pure milk to the poor at low Dr. S. Josephine Baker of the Bureau of Child Hygiene of the New York Health Department also has a large perspective in dealing with this problem. She says: “The evolution of the infants’ milk station is essential. Pure milk, however desirable, will never alone solve the infant mortality problem. Under our system of home visiting to instruct mothers in the care of babies we have demonstrated Here, as in medical prescriptions, it is futile to insist that a mother who is physically able shall nurse her baby if she is so poor that she must work under conditions that weaken her and thus reduce the grade and quality of her milk or that preclude leisure in which to nourish the infant. The question of poverty, that skeleton in every social closet, looms up here with an insistency that nothing will banish. No kind of philanthropy will solve the requirements of infant welfare when poverty or labor conditions are the root of the problem. Babies’ milk thus becomes essentially a social-economic problem. It is so recognized by many women and is becoming more and more recognized as such by those who work along baby-saving lines. No one sees this fact more clearly perhaps than Miss Lathrop who joins in the ever-growing cry for a “war on poverty.” Mothers’ pensions, and every attempt to increase the wage of the husband or of the wife before the child-bearing experience has entered into her life, that she may lay by a sum for that function, reaches infant mortality more fundamentally and directly than do milk stations. In spite of this truth, milk stations are a useful supplementary social service and the value of pure In most cases women now recognize the milk station not as a private but as a public responsibility. They first demonstrated the wisdom and practicability of the enterprise as direct health activity, then urged the municipalities to incorporate the plans into their regular health department program. Cities have accepted the lesson readily, although there are still places like our national capital, where the death rate among infants is disgracefully high and where no provision is made by the commissioners, during even the hot summer months, to care for babies in this way. The superiority of breast feeding is so well-known that the provision of wet-nurses is recognized as a social advantage. The examination, registration, pay and care of wet-nurses are matters of increasing interest to women health workers and the Women’s Municipal League of Boston is attempting to deal seriously with this social mother. No more interesting story of women’s help on the problem of general milk supply is to be found than comes from the Oranges, although it is fairly typical of the way women have viewed their responsibility elsewhere. In the spring of 1913, the Civic Committee of the Woman’s Club of Orange, New Jersey, offered, for the summer, the services of its secretary to the Orange Board of Health in order that a more thorough study of the milk supply might be made than was possible with the limited official staff alone. “Through the courtesy of the Board, Miss Hall was made a temporary special milk inspector in June, 1913, and has enjoyed the use of the department’s laboratory in assisting in the test of over 600 samples on which conclusions are based as to the quality of the milk furnished in the Oranges.” The joint effort of the Woman’s Club and of the Department of Health led to their common support of certain proposals dealing with the milk situation in the four Oranges. In this case, after a careful and detailed study of all the elements that enter into the provision of milk for these communities, the women determined upon a citizen support of the health officers that, among other proposals, they might obtain better appropriations for the work of inspection. Their publications and general agitation have been marked by exact information. From New York on the eastern seaboard to Portland on the western come countless reports of the activities of organized groups of women in behalf of pure milk. The “Portland Pure Milk War” was graphically described by Stella Walker Durham in a recent number of Good Housekeeping. The struggle to secure the kind of milk they wanted meant a year’s fight for the women who knew and proved that they knew the true conditions of their city’s milk supply. Dr. Harriet Belcher, formerly bacteriologist in the Rockefeller Institute in New York, in her campaign for clean milk, made a close study of dealers, delivery, refrigeration, balanced rations for cows, care of cows, process of milking, soils in relation to cost of production, and many other phases of the problem. She did field work as well as laboratory work, and is justly entitled to the name of expert. While the advisability of mothers learning to care properly for milk and other food in their own homes instead of relying solely upon public care, is evident and is urged even at the milk stations in their educational capacities, such right care in the home necessitates the ability to secure ice easily and cheaply. IceA tragic story of the scarcity and cost of ice in summer has come from more than one large city and the machinations of ice trusts have been among the most scandalous of business revelations. Here and there in the United States sporadic attempts have been made to establish municipal ice plants. Women have been prominent in the agitation for cheaper and more plentiful ice. An instance of this agitation is afforded by the following clipping from the New York Times, May, 1914: More than one hundred mothers attended a meeting yesterday afternoon in the offices of the East Side Protective Association, No. 1 Avenue B, and discussed plans for the establishment on the east side of a municipal ice plant whereby ice could be distributed to mothers during the coming summer for their infants. At the conclusion of the meeting a letter was forwarded to Mayor Mitchel, signed by Harry A. Schlacht, Superintendent of the Association, asking the Mayor to do all in his power to aid the project, pointing out that through it lives of hundreds of infants would be saved. A report on Municipal and Government Ice Plants in the United States and Other Countries was prepared last winter by Mrs. Jeanie W. Wentworth, who has been assisting Mr. McAneny, president of the New York City Board of Aldermen, to study the question of ice. The reduction of infant mortality is only one phase of child welfare. However imperative it is to save little babies, unless they are watched over and safeguarded physically during the after years of growth and nutrition, the earlier work is wasted. It is this conception of the unity of health The General Federation of Women’s Clubs voted several years ago to work for the following five universal needs of the American child: 1. For better equipped, better ventilated and cleaner school buildings. 2. For more numerous, larger and better supervised playgrounds. 3. For medical school inspection and school nurses. 4. For physical education and instruction in personal hygiene. 5. For instruction in normal schools in wise methods of presenting the essentials of personal and sex hygiene. Every medical inspection of the poor children in the public schools of large cities reveals a state of anÆmia from undernourishment. A hungry child cannot learn rapidly, if at all. Teachers are the ones to see the connection between hunger and mentality, and the first school lunch in Cleveland was therefore started by teachers in a neighborhood where many of the mothers of the children were forced to go out of the home each day to earn all or part of the family income. Everywhere women have been largely instrumental in initiating and defending the school lunch. Promoters of the school lunch often have as competitors the candy vender, the ice cream man and sellers of adulterated and low dietary wares of various kinds who stand even at the school gates to wean the children away from less exciting but more nutritious food. School lunches cannot be compulsory, or are not compulsory, and the child must be led to realize that good nutrition is fundamental and desirable. Then he can be led on to an interest in pure food laws and their enforcement, and kindred civic matters. The school lunch is therefore of high social utility and an invaluable adjunct to the work of the school medical inspector or nurse. Yet it has its critics. Mrs. George B. Twitchell of Cincinnati gave a spirited defense of the school lunch in a letter to The Survey: I want to ask Mr. Lee how it is possible to disrupt a family when our social conditions are such that the mother has to go out to help make a living. Isn’t that family already disrupted? We are all working to bring about social conditions when it will be possible to have a home for all the people, when father will be able to earn enough to make it possible for mother to remain at home; but until such time the children must be given some good, substantial food, not candy, pickles and such trash as they can buy at the candy store.... The teachers of Cleveland proved that their pupils could not work on a diet of candy and pickles. The school lunch has proved so helpful that ten have been established in Boston, all but one in the poor districts. The one in the Mt. Auburn school was started by the Mothers’ Club because they wished to give their children better food than they could get at the candy store at recess time. The mothers report that since they have opened the lunch room and the children get good food at recess time they have better appetites and eat more than they did before. Many times children do not eat because they are too hungry and tired after the walk home and really have lost their appetites on account of that. Children often eat a very light breakfast and need a lunch at recess. They are like little chicks, they thrive best if fed every three hours. We believe there should be a lunch room in every school which should supply the children with good food, rather than depend on commercialism, as in that case we know the only interest is to make money. Undaunted by those who fear that the school lunch may pauperize the poor, some of its defenders would go further. Miss Mabel Parker, of New York, proposes to unite with the school lunch a “pre-natal restaurant” in certain districts where poor women in a pregnant condition can get for five Not only must mothers be taught better care of their infants but the “little mothers” and “little fathers” upon whose young shoulders devolves the burden of taking mother’s place, while she goes out to earn or help earn the family living, must receive the education which will enable them to preserve the lives intrusted to their care until such time as the real mothers and fathers can be placed in an economic situation whereby they themselves are able to assume that burden which is rightfully theirs alone. Dr. S. Josephine Baker appreciates the value of this work and through the organization of groups of young guardians of children, this information is being imparted. Mrs. Clarence Burns of New York has been among the women who have sought to make the burdens of the “little mothers” lighter and her “Little Mothers’ Aid Society” is one of the well-known institutions of that city. Recently the little fathers have begun to feel that their position of responsibility was ignored too much in the greater efforts made to smooth the way of girls who have parental tasks, and their protest has served to call attention again to the extent to which the oldest child whether boy or girl is the real person charged with the task of prolonging infant life and keeping or making baby brothers and sisters well and strong. Children Born Out of WedlockIn leaving the matter of women’s interest in the reduction of infant mortality and the proper preparation of women for motherhood, mention should be made of the growing recognition of the right of the child to be well born. Realizing the responsibility of the father, as well as the mother, for the physical and mental vigor of children, women in many states are discussing in their associations the proposition for requiring health certificates for those who seek the marriage license. In some states such laws have been already passed. The right of the woman (as well as of the man) to know that her children are to have a proper physical heritage is now included in the new Declaration of Independence. Mothers there are with no legal husbands and for these and their children the problem is difficult indeed. Mrs. Weston of Los Angeles states that the care of such children and their mothers presents a large and serious question economically and that the ratio of these children and their mothers is very high among the patients visited by the nurses. The infant mortality among children born out of wedlock has been suspected of a high ratio but it remained for the Juvenile Protective Association of Chicago, of which Mrs. Bowen is president, to undertake an investigation into child mortality among this group. In its summary of the investigation which was carefully made, the Association states that: “From the facts obtained it is evident that three main causes lie at the bottom of the prodigious child mortality among the illegitimate. “First: The lack of method in recording vital statistics, some being kept at the city health department, the logical repository for such records, and others by the county clerk, who has no special interest in the matter. “Second: The laxity of institutions and individuals in “Third: The inadequate provision for disposing of children who cannot be kept by the mothers. This last is perhaps the greatest factor. “In conclusion, the truth is that thousands of children are lost in Chicago. Physicians and hospitals are careless in reporting demanded facts. Some hospitals give children away indiscriminately. Doctors, midwives and maternity homes do likewise. There is absolutely no check upon such disposition of babies; many hospitals and doctors and others do not want any safe supervision.” Mrs. Stanley King, of Boston, the Secretary of the Conference on Illegitimacy, is one of the women who insist that the unmarried mother and her child must receive equal consideration with other mothers and children in any sincere plans for the reduction of infant mortality. As for the rest of the Conference, Mrs. King states that “A committee has been appointed to make an investigation of the causes other than feeble-mindedness that are at the root of illegitimacy. This committee has already done valuable work as a by-product of its main purpose in suggesting important points which agencies are apt to omit in their histories and in aiding in a greater standardization of work. A full report of this committee is expected next year. “Study groups are being organized to take up the questions of legislation, venereal disease, the efficiency and range The definite proposals of the Juvenile Protective Association and of the Society for the Study and Prevention of Infant Mortality for proper care of children born out of wedlock include: better systems of records, a better system for the legal adoption of infants, provision for well-organized infants’ homes, better bastardy laws, and a system of probation for the mother of an illegitimate child during the first year of its life in order to secure proper nursing and care of the child. The district nurse becomes again the most important agent in the real nurture of infants of this group through her supervision of all young mothers among the poor. Owing to the fact that the deserted mother must assume the burden of her own support and that of her child and therefore finds nursing the child extremely difficult if not, in fact, impossible, the whole question of mothers’ pensions comes to the fore in the discussion as to whether widows alone should be the recipients or whether any needy mother should share their benefits. While women do not stand as a unit for recognition of the unmarried mother where they do support home pensions, there is evidence of strong advocacy among women of her inclusion in the benefits of this legislation. At all events women are opening their eyes to the problem. Being principally responsible for the food of the family as well as the children, women have joined with spirit in what is known as the pure food movement. In many a city, large and small, women’s associations have taken up the question of the proper food supply and by concerted efforts wrought marvelous results. An illustration of an active municipal campaign for pure food carried on by women is described in the American City for June, 1914, What has been accomplished by the Pure Food Committee of the Civic League of Grand Forks may be equaled or surpassed by any group of determined women in any small city. To be sure, it is somewhat easier to keep clean in a climate which has no excessive heat and moisture and with a population made up for the most part of Americans and Scandinavians. However, vigilance and education will more than make up for differences in climate, but efforts must be ceaseless if results are to be forthcoming. When this committee was organized under the able leadership of Dr. May Sanders, chairman, the work was new to all, and methods had to be devised. The first step was a consultation with Prof. E. F. Ladd, State Pure Food Commissioner, who was of great assistance in suggesting just and reasonable methods of dealing with the subject of sanitary inspection of foods so that the interests of both merchant and consumer might be safeguarded. A general educational campaign was inaugurated. The state pure food and drugs act was printed in folder form, and a copy, together with a personal letter calling attention to the provisions of the law and asking coÖperation in its enforcement, was mailed to each of the 128 food merchants then doing business in the city. The portion of the law applying to a special class of stores or goods was red-lined when sent to a man selling that article. For example, sections relating to bakeries were red-lined when sent to bakers; those applying to groceries were marked for grocers. Ten days were given the merchants in which to clean house and prepare for state inspection. The state inspection continued five days, of eight hours each, and the inspector was accompanied by Mrs. R. A. Sprague, who later became local officer. Each merchant was rated on a score card provided by the state commissioner for the purpose. It became evident that the only way to secure sanitary inspection of food at intervals frequent enough to make the city food supply reasonably clean was to have a regular city Since her appointment as local food inspector, Mrs. Sprague has also been made resident food inspector by the state pure food commissioner. The work of the food inspector showed conclusively that the education of the public had only begun and that in order to make her labors most efficient the pure food committee must devise means of keeping the subject before the people. The greatest menace during the late summer and autumn is the house fly, and no work along the line of sanitary food supply can be effective that does not emphasize the necessity of doing away entirely with the breeding places of this deadly pest. Grand Forks has a garbage ordinance which, if strictly enforced, would go far toward accomplishing this end. However, no matter how good the law, public opinion must be back of it to make it effective, and education must be administered in large and frequent doses. The newspaper and motion-picture theater are excellent teachers, since they reach the largest audience, and the one most difficult to interest. Through the courtesy of the Grand Forks Herald, a fly-page was edited by the pure food committee in August, when the fly season is at its height and the dread of typhoid is strong with the parents of the less fortunate classes. Yellow journalism of the most lurid type was resorted to, and so black was the little pest painted in both prose and verse that the public seemed roused to the situation. Closely following the press exposÉ of the fly came the climax of the season’s campaign for pure food and sanitary conditions. The public-spirited proprietor of one of the motion-picture theaters gave the pure food committee the use of the theater with all proceeds for one day for the presentation of the fly-pest film.... As a result of complaints from dairymen and confectioners The subject of a municipal slaughter house was brought before various organizations and committees were appointed to coÖperate in a city-wide effort to solve the problem. The subject of a city incinerator for the disposal of garbage was also agitated. The pure food committee, through the courtesy of the Minnesota food commission, secured the pure food exhibit of the commission, placing it in a conspicuous place on the grounds during the state fair, with a lecturer in charge. This proved a great attraction, and the space in front of the exhibit was crowded with people from the rural districts who had heard little of the new gospel of pure food. The local food inspector visited each food concession as it was being placed, and explained the pure food law, with a hint that it was to be enforced on the grounds during the fair. Several later visits were made to the concessions, and suggestions were made and many bad practices discovered and stopped. For example, lemonade must be made from lemons rather than from acid powder was one order enforced. It was noticeable that the eating places having screens were the most popular. The second season of pure food education is naturally less strenuous for the committee, but not so for the inspector, who, if she be the woman for the place, continually finds new problems to be solved. No small part of her time must be devoted to receiving complaints and assisting merchants in planning ways of complying more completely with the law. She should be kind, tactful, firm and resourceful, with a touch of the Sherlock Holmes quality. It is well to invite the members of the city council and board of health to take an early spring drive to the city dumping grounds and slaughter houses—early enough to find conditions at their worst. No one factor can make for the health of a community more surely than a strict enforcement of the pure food laws. This enforcement by a special officer makes it possible for bad practices of all kinds to be traced and eliminated, either by persuasion or fine. It makes it possible for the poor to be In response to an inquiry the following report comes later from Mrs. Leonard: The municipal abattoir was built in Grand Forks, and, by dint of all the pressure the Civic League could bring to bear, it was put in working order after being carelessly constructed. After working for years to get the abattoir and telling the Council what features were necessary to make it efficient and sanitary, not one of the women was put on the advisory committee, even, when it was being built. It is still far from perfect and yet scarcely a week passes that the food inspector does not receive inquiries for plans and advice from towns all over the West, such is the interest in the smaller Western cities in doing things for themselves. With all the bad management, the abattoir has some months paid expenses, which is an excellent showing for so new an institution. The activity of Indiana women was a large factor in the establishment of a state laboratory of hygiene under the Board of Health charged with the examination of food and drugs and assistance in the enforcement of health laws. The chief of the food research laboratory in Philadelphia is a woman—Dr. Mary Pennington. Missouri women pledged their efforts to a pure food crusade some time ago, while the excellent laws in Texas reflect the interest of the women of that state. In 1906 the women of Iowa drafted a pure food bill which they presented In Kansas State Food Commissioner Fricke appealed to the club women to aid him in enforcing food regulations of that state by acting as volunteer inspectors. Where they have not been asked by city and state officials to act, women have often proceeded to act on their own initiative. An official inspection and report on dairy products were recently undertaken by Chicago Club women during the session of the National Dairy Show. Women in Louisiana are active in the inspection of bakeries, meat markets and dairies. It is largely due to the work of women that fruit stands and markets are screened in New Orleans, a city in utmost need of such care. This is true of many other cities. Louisiana has a woman as state health inspector—Agnes Morris. In Wheeling, West Virginia, the club women have been asking for a woman food inspector. Tacoma, Washington, is one of those cities which already have a woman serving in that capacity. Such a clean food supply is reported from that city that other communities in the state are imitating its example. The women of Seattle, Washington, transformed some old plants into five large modern sanitary bakeries. Mrs. Sarah Evans was in 1909 Inspector of Markets in Portland, Oregon, and her publication of clean market requirements was the inspiration of more than one organization of women for better civic conditions. The Housewives’ League, organized and directed by Mrs. Julian Heath of New York, has the twofold aim of securing pure food uncontaminated by dust and flies and of securing it at a lower cost. In the general pure food war, Mrs. Heath and her assistant, Miss M. E. McOuat, have, among other things, sought to interest girls in their teens in the purity and cleanliness of the candy and soda water they buy. Open-air meetings in the poorer districts of New York City, where cheap and dangerous wares are on every hand, have been held to warn young children against poisons The Women’s Health Protective Association of Philadelphia had a Bakeshop Committee which visited bakeries and consulted with the bakers themselves over conditions. The state of affairs that was revealed to the women led to a public agitation and legislation controlling the most unsanitary features of these places. A new bakeshop code secured by the women of Cleveland requires absolute cleanliness and a ten-hour day for employees. A “White List” is published showing those bakers who best observe the code. Mrs. E. E. McKibber, chairman of the Food Sanitation Committee of the General Federation of Clubs, has sent a letter to the clubs of each state to this effect: “Do you as club women keep yourselves informed and discriminate against poor food as you do against poor clothing? “Have you helped pass an ordinance looking to a better food supply, to the better handling of food? “Have you any organization in your town that looks after the food supply?” This pressure by the chairman of the Food Sanitation Committee of the clubs indicates that hundreds of committees representing thousands of women are instituting a constructive campaign for better and cleaner food. The Women’s Municipal League of Boston has been very active. “The cleanliness and hygienic condition of markets seems to me to belong peculiarly to woman’s province,” writes the chairman of its market committee, “and I confess it gives me a certain feeling of shame that a comparatively small and new city like Portland should be more civilized in this respect than Boston. It is, however, encouraging to think that Portland has been brought to this standard The Boston League in connection with its market work made a study of oysters last year in their relation to the transmission of infectious diseases, and cold storage. For an investigation of provision shops, twenty-four Radcliff students were used who conducted the investigations “with enthusiasm and success, bringing to the committee papers of decided ability. Could this plan, modified perhaps in some details, be extended successfully over the whole city there would result from it such a mass of information respecting the small shops as would cast a very strong light upon the whole problem of the proper marketing of the food supply in a big city. As far as we know no such investigation has been undertaken before.” The Boston League has very positive ideas about legislation and enforcement, as the analysis in its 1913 report indicates. Sometimes despairing of securing the sanitary conditions that they deem essential in the handling of food, women seek to establish public markets under stricter surveillance. In Pasadena, California, for instance, the Shakespeare Club sought to persuade the City Fathers to establish a free public market under conditions satisfactory to intelligent housewives. The City Fathers ignored the plea and the women are raising money with which to finance the enterprise themselves. The Pasadena Elks have donated a lot and the women will pay an overseer and make rules for the sale of foodstuffs. Market conditions in New Orleans are being closely studied by a committee of housewives, headed by that very able woman, Mrs. J. C. Matthews. Among the recommendations are: The repeal of all restricting ordinances which militate against healthy competition in the handling of produce—game, fruits, fish and meats. That a market commission composed of men and women be appointed to coÖperate with the commissioner in charge of the markets, so as to secure the best possible sanitary and distributing conditions. In connection with this battle for pure food and drugs, it is interesting to see open credit given, in a conservative and anti-feminist paper in New York like The Times, to a woman for securing the new drug law in 1914. Mrs. William K. Vanderbilt led the fight for this new legislation which goes further than any other in stopping the sale of habit-forming drugs in that it provides a simple and effective way of discovering and punishing the sellers of such drugs as cocaine and opium. Chloral, morphine and opium and any compounds and preparations derived therefrom can no longer be sold except on the prescription of a regularly licensed medical practitioner or dentist or veterinarian. Prosecutions have already taken place under the new law. While the new drug law was due to Mrs. Vanderbilt, according to the newspaper headlines and the discussion of its passage in the above mentioned paper, influential men and women were her active aiders and abettors. Among these were judges of the New York courts, men and women probation officers, representatives of both sexes from reformatory institutions, the prison associations, and others. Dr. Katharine B. Davis, the city commissioner of corrections, worked for the success of the measure. Pure water as well as pure food and drugs has been the starting-point of many a woman’s organization formed for National recognition was won by the women of New Orleans, members of the Era Club, in their successful efforts for a municipal sewerage, water and drainage system. The yellow fever epidemic that raged in that city a few years ago and its attendant sacrifice of life aroused the women even more than the men to the imperative need of a pure water supply and a scientific drainage system adapted to the peculiar conditions of that city. The women seem to have felt the need; the men to have appreciated the difficulties in the way of securing the system. The Era Club believed that, where there is a need, there is a way and the men finally agreed. Practically every house in the city at the time of the epidemic had a cesspool. “The drainage system was incomplete and inadequate, dependent upon a few drainage machines which paddled the water through troughs into the canals and eventually into Lake Ponchartrain. After a heavy rainfall the streets were flooded; in some sections the water would stand for days.” Still the men hesitated to undertake the kind of an enterprise that local conditions demanded. For the first and only time the women of New Orleans, who were qualified, voted, instigated and led by that splendid Southern woman, Kate Gordon. The Survey thus describes the attitude taken by the women: Under the Louisiana Constitution women property-holders may vote at elections for authorizing municipal bond issues, and any woman who objects to going to the polls may send a proxy, provided that the proxy be given in the presence of two witnesses, which witnesses, by a strange mingling of the old and the new order of things, must be men. The work undertaken by the Era Club was to get the signature of one-third of the taxpayers to a petition praying for a special election; to arouse sufficient interest among both men and women The area that had to be drained and properly supplied with sewers comprised 37½ square miles and 700 miles of streets, and it is claimed even by outsiders that this undertaking was the largest public work of this character ever put through at one time in the United States. That the women of New Orleans have not voted since that occasion is no evidence of their discouragement at their first vote. Municipal bonds are not issued at every election and these alone entitle any of them to vote. Suffrage conferences are held in New Orleans and the agitation for a wider suffrage in Louisiana is being carried on by the same women who so ably fought to secure pure water for New Orleans. This would seem like the most direct kind of health work, for we learn that “the death rate has been reduced 20 per cent., business confidence has been restored and New Orleans is today one of the healthiest and most delightful cities of the country,” according to one of the lovers of the city. One of the papers on the Pacific Coast, the Pasadena Star, recently reported that: [United States] Surgeon-General Blue pays a handsome, but deserved, tribute to the efficiency of women in practical aid in making cities sanitary, referring particularly to the excellent work of women in San Francisco, in their invaluable assistance in eradicating the plague from the bay city, a few years ago. In Woonsocket in the dry region of South Dakota the women of a club requested the Town Fathers to supply them with pure and more abundant water. Regret was expressed by the fathers that they could not comply with the request. The women, nothing daunted, organized an Improvement Association, collected money and hired an expert to drill an artesian well. When plenty of pure water gushed forth, the town officials consented to lay mains through the streets and allow the people to receive water from this excellent source. The women were then successful also in persuading the fathers to plan a beautiful park, or accept their own plans for the same, with a charming artificial lake as the crowning pleasure. In New Mexico the Woman’s Club of Roswell behaved in much the same way. It was irrigation that seemed the crying need of that region. The club had a well dug and erected a tank which holds several thousands of gallons of water. As the women had previously planted some hundreds of trees in their town, they were thus able to maintain them also in a healthy condition. One who reads the following somewhat casual report of a victory in a fight for better water might have no appreciation of the fact that it was the women of New Canaan who did the fighting, and hard fighting it was, for the filtration plant in their vicinity: Agitation by the local Civic League for an improved water supply for New Canaan, Connecticut, recently won, through the Public Utilities Commission, a victory which may lead to important results throughout the state. The League, aided by an engineer and a sanitary expert, after a three-day hearing at Hartford, secured an order directing the private water The lawyer for the water company in his brief declared that if the request of the petitioners were granted the previous railroad work of the Commission would be small in comparison with what was ahead in adjudicating similar appeals relating to water supply in other towns. “The Commission,” said one of the petitioners after the verdict had been handed down, “has rendered this decision, so let us hope that good days are ahead for Connecticut in regard to water supply, and that it may lead to an efficient system of state inspection.” It was the women who refused to accept the findings of the male authorities with reference to the purity of the water and proposed methods for its control. Experts were engaged by them and their activity at the hearings at Hartford made their determination to have better water so clear that the men yielded and now New Canaan is proud of its achievement—so proud that notices of the same necessitate an inquiry into the personnel of the Civic League for a complete story. Women were instrumental in establishing public baths in several cities; notably in Pittsburgh, where The Civic Club of Allegheny County led in the agitation. The Woman’s Institute of Yonkers campaigned for baths in that community and some were secured. In cases where women have been directly interested in having baths arranged for the people, better sanitary conditions seem sometimes to have prevailed than in cases where they just passively approved and the city established the baths. In Newark, New Jersey, for example, a few women made an examination of the conditions of the public baths which had been established in that city for some time. To their horror they found them in a positively infected condition and their task There is more foundation for the arguments in favor of public wash houses than for the arguments in favor of public baths. Whatever the equipment in individual homes for bathing, and however excellent the individual water service, there are health considerations of a very different character to be met in connection with the family laundry work. In large towns and even in small towns in congested areas there are no facilities for drying the clothes and the sanitary conditions which result from indoor home drying are deplorable and dangerous. In addition to health considerations, the mental effect of sitting in rooms filled with damp clothes is so depressing that many a man and many a boy or girl has fled from home to the saloon and dance hall as a more cheerful place to spend the evening. The poor mother who has done the washing must bear its company in solitary submission. In an effort to alter this pathetic condition of affairs, some attempt has been made to establish public laundries with drying rooms attached and every facility for rapid and sanitary disposal of the weekly laundry. There are economic features which add reasonableness to the agitation for public laundries, for the waste of fuel and energy involved in individual fires for washing and ironing is incalculable and useless, for the most part. The Civic Club of Allegheny County has laundries in connection with its bath houses, but their use is a matter of gradual education as the masses are slow to give up cherished customs, however harmful and wasteful. Where day Woman’s historic function having been along the line of cleanliness, her instinct when she looks forth from her own clean windows is toward public cleanliness. Her indoor battle has been against the dirt that blew in from outside, against the dust and ashes of the streets, and the particles of germ-laden matter carried in from neglected refuse piles. Ultimately she begins to take an interest in that portion of municipal dusting and sweeping assigned to men; namely, street cleaning. A volume itself could be written on the activities of women for clean streets and public places. Little towns have needed and received the treatment even as the great cities—not every little town nor every large city but countless numbers of them. Lack of space prevents the recounting here of many significant or typical cases of women’s work for public cleanliness as an aid to general health. The Women’s Civic League of Baltimore originated in that city the idea of a “Clean City Crusade,” and its application was acknowledged by city officials to have been of great assistance to various departments: street cleaning, fire and health. Chief Engineer August Emrich of the Fire Department said, in 1913, that the fire losses for 1912 were less than they had been for the previous 34 years, and he gave much of the credit for this result to the Clean City Crusade which led to the removal of rubbish and other inflammable materials. That Pennsylvania women generally are alert to the The Civic Club of Harrisburg, Pennsylvania, says: “It is no longer necessary for us to maintain at our own cost the practical experiment we began in street cleaning or to advocate the paving of a single principal street as a test of the value of improved city highways, nor is it necessary longer to strive for a pure water supply, a healthier sewerage system, or the construction of playgrounds for the pleasure of our fellow-citizens. This work is now being done by city councils or the Board of Public Works and by the Park Commission.” That was in 1906 and it proves that, after one or two demonstrations of the possibilities and practical advantages of cleanings, the city proves ready to assume the responsibility for them. The next great problem is how to keep the city clean, for real health protective work is not a matter of annual and sensational hauling away of miscellaneous rubbish, but an every-day-in-the-year campaign for the elimination of disease-breeding germs and dust provokers. As they volunteered to show the wisdom of better disposal of rubbish and of street flushing and oiling, so women are volunteering to educate the people to desire permanent cleanliness. The inherited instincts of the cleanly housekeeper thus become a valuable municipal asset. In Philadelphia, Mrs. Edith Pearce, a club woman, is a city inspector of street cleaning. The Woman’s Home Companion thus described the way she goes about her work: First she planned for making the children her aids, teaching them not only to refrain from throwing fruit skins, paper The American Journal of Hygiene recently printed a paper by Mrs. Ellen H. Richards of Boston on “Instructive Inspection,” elucidating the advantages to be derived from the Board of Health’s appointment of a teacher to be sent with power like any other inspection officer “wherever ignorance, usually diagnosed as stubbornness,” is found. Detroit club women are asking to be appointed as instructive inspectors to do this kind of work while women in the Municipal League of Boston are already performing a somewhat similar service, clothed with official authority. Fifty St. Louis club women have volunteered and been accepted as city inspectors “to help make St. Louis the healthiest city in the country.” In the sphere of municipal housekeeping, which forms such an easy transition from domestic housekeeping, women have proved themselves interested and efficient in suggesting reforms and helping to see them completed to the minutest detail. The sanitary survey of a municipality has had to precede, of course, any large constructive proposals for improvement. One of our leading experts in this field is Mrs. Caroline The organization of junior leagues for guarding the streets has seemed to some persons, women included, as a very trivial public activity. They have had an impression that budget-making or public accounting were far more intellectual operations and of more social value. Are they? One of the most expensive of public departments is the street cleaning one. Shall any sum demanded by the present incumbent in the office of chief of that department be granted lightly and the books be well kept and the affair end? Or shall causes of dirty streets be investigated to the full and the problem of heavy expense for cleaning be tackled perhaps by some measure for the prevention of dust and refuse? The education of the people so that they may Children, through ignorance, are habitual misusers of city streets, but they are also the most enthusiastic clean-up crusaders and rubbish preventers when they are once aroused. All sections of the country announce the formation of these children’s leagues to assist the women and the city officials in cleaning-up enterprises, and in carrying home the messages of prevention and the feeling of public interest which they have acquired at school or at their little meetings. In New York, circulars were printed recently in Yiddish, Italian, and English and distributed to children by women’s clubs, teachers, churches, and civic organizations, to aid the Health Department in its annual clean-up program. Junior leagues may greatly reduce the cost of the street cleaning department and the work of the courts in enforcing city ordinances and thus materially assist in the city budget-making; but it requires tact and patience and more than a mere bookkeeper’s mind to make them effective. Jane Addams and other members of the Woman’s Club of Chicago on their own initiative gave a practical demonstration of their ability to keep hitherto neglected streets clean and of the wisdom of the municipal exercise of such a function. Two members of the Club later were appointed on the Municipal Garbage Commission which helped to solve Chicago’s problem in an expert and comprehensive way. Miss Mary McDowell of the University of Chicago Settlement made effective contributions to this work through a personal study of refuse disposal systems in Europe. The story of the efforts of Chicago for a proper refuse disposal system here reprinted from The Survey is well worth study: During most of the time prior to this crisis the issue had been mainly a plaything of politicians. But it began to assume a new aspect when the vote was given to women and they thus came to have a voice in municipal housekeeping. The care of the city’s waste had been a serious matter to the Woman’s City Club, whose committee on the subject had been for three years urging the wisdom of preparing for the day, September 1, 1913, when the contract with the reduction plant would end. For nineteen years the University of Chicago Settlement had protested against making the twenty-ninth ward the city’s dumping ground, but without avail. In the midst of the intense political fight over the garbage question there seemed to be no one with courage to lead toward any constructive plan. The administration and the aldermen played battledore and shuttlecock with the question of responsibility. At this crisis—when the summer’s heat was intense and no definite plans were in sight for caring for the daily six hundred tons of garbage—the Woman’s City Club’s Waste Committee sent a series of pointed questions to the city officials whom they held responsible for this situation. The press published these questions and, as the questioners had secured the vote, the city officials were much disturbed. They then brought the matter before the city’s Health Committee, making an adequate and scientific city-wide plan for the collection and disposal of the city’s refuse. The chairman of the Health Committee, Alderman Nance, backed by Alderman Merriam, from that moment became the leader of the movement to secure a scientific report and plan. The members of the City Council, glad to have a definite thing to do to save themselves politically, created a City Waste Commission with an appropriation of $10,000. Two The Woman’s City Club has issued bulletins to educate a public that will demand the best collection and disposal system known, one that will not be an unpleasant industry in any community, and a collection system that will make short hauls, with frequent collections in wagons that are closed tight and fly-proof. This is possible to any people who demand sanitation first and economy second, who take municipal housekeeping out of the hands of politicians, put at the head of “the cleansing department” a sanitary engineer and give the city the right to collect all garbage from hotels and restaurants as well as households. According to the data shown by the Woman’s Club, the city can in this way make enough money to pay for the whole system of collection and disposal. The movies which are being utilized all along the line have been brought into play in several places for sanitary education. In Boston one of the theaters is coÖperating with the Women’s Municipal League “by giving an eight-minute picture act showing striking facts about children playing on top of sheds, in dark alleys and in the refuse from overturned garbage cans; about dirty and unsanitary streets and unsightly and obnoxious dumping at sea and on land; showing, also, better ways of doing things and better places to play, and giving the theater-goers something interesting and worth while to think about.” SmokePerhaps the position taken by the Civic League of St. Paul in demanding the enforcement of the Smoke ordinance illustrate very well the attitude of the women toward this nuisance. Its campaign is thus described: This occurred quite early in our career and kicked up quite a dust, really making the atmosphere almost as murky as the smoke had done. We succeeded in doing what no power in the city had hitherto been able to do; that is, in getting the ordinance actually enforced—for about a week. The mayor’s orders were positive and not to be ignored. Several arrests were made, prosecutions by the city were conducted with vigor and judgments rendered against several offenders. It was proved to most people’s satisfaction that there were smoke consumers which consumed and smoke preventers which prevented smoke. But on an evil day it fell out that an officer “on the force” said unto himself, “Go to, this is my day for arresting somebody.” He put his telescope to his eye and, turning his back upon the wicked city where burglars and gamblers and such like birds of night disport themselves and a forest of chimneys was belching furiously, he espied a flying plume of smoke outlined upon the horizon of the Sixth Ward. “Ah,” said he, “there is my man,” and he went forth and laid rough hands upon him and fetched him into court. Now, it happens in this city that there is one whose cry strikes terror to all hearts—it is the manufacturer. When the manufacturer doesn’t like anything, he says: “If you interfere with me I won’t play on your cellar door any more, but I’ll go over and play in Minneapolis.” That settles it. It mattered not that in this case he bought two smoke consumers on his way home, which people in his employ testify not only materially decreased the smoke, but saved fuel as well. The mischief was done. The newspapers went into spasms and told how there was “money in the smoke,” as the current saying runs in Pittsburgh. Far be it from the loyal women of the Civic League to But is there? Is it not true that 99 per cent. of the smoke which pollutes the atmosphere we breathe is belched forth, not from the chimneys of factories, not from the smokestacks of producers in any capacity, but is the direct result of the carelessness, selfishness and indifference of the owners of office buildings, apartment houses and—more shame to us—the public buildings of the city. If citizens are to be required to put up patiently and peaceably with the smoke, it behooves the men of the city who profess to like it so much to make their boast good. Let them develop manufactures; let them found new industries; let them turn the energy and creative force of our people to making things which the world wants to buy—let them put “money in the smoke.” Then at least will there be some compensation for the inconvenience, the filth and the waste which the people are called upon to endure. The women of Baltimore have been educating their city to see the folly of smoking chimneys, with considerable success. From every section of the country come reports of antismoke committees in women’s organizations and it all points to the fact that women are just housecleaning as usual. Flies, mosquitoes, and rats as spreaders of disease have been attacked with avidity by women. “The anti-fly campaigning is a movement of more far-reaching importance and more promising of prolonged life The leader in the effort for a “flyless city of Cleveland” has been Jean Dawson, professor of civic biology at the Normal School. In her work emphasis was as usual these days laid on prevention, and breeding places were attacked. As it had been estimated that a single pair of flies is capable of reproducing two million young flies, the necessity of such a movement was evident. Owners of stables throughout Cleveland were compelled to clean-up, and keep clean, their premises. The schools were utilized in an educational campaign and various civic bodies together with the health officials eagerly coÖperated. The interesting thing about this campaign in Cleveland is that it started before the flies hatched; in fact, it was directed against the winter flies before they could lay their eggs. Miss Dawson issued a “fly-catechism” which helped to win the coÖperation of the women of the city in her effort to eliminate the pest. The occasional threat of bubonic plague and its actual appearance now and then in port cities draws the serious attention of the public to the necessity for the elimination of the rat. “Starve the rat and let him go” is the war cry of women in New Orleans as well as in other cities, especially as it becomes recognized that it is not merely the rat but the fleas which live upon it which are carriers of disease. The excessive noise in urban communities adds to the nervous tension under which city dwellers must live. Effort has been made with some success to reduce the “yelling peril” as it has been called; namely, the nervous peril that results from trying to study, to sleep, to convalesce, or to work in the midst of constant uproar. Mr. Edward A. Abbott, of Chattanooga, Tennessee, who has also worked for a quieter home city, says of the anti-noise crusade initiated by Mrs. Rice: “The unfortunates in the hospitals and the babies in the cradles of the great city, if they knew their benefactress, would canonize her.” In Chattanooga the campaign was planned to show “by argument and testimony that noise injures health, disturbs the right development of infants, destroys the value of property, hinders the growth of cities, promotes hate and resentment and is useless and silly.” The ringing of railroad and other bells, crowing roosters, barking dogs and church chimes were attacked in that southern city. That many women are not unmindful of the fact that the anti-noise movement must not be purely a middle-class movement is indicated by their activity against prolonged hours of work amid the whir of factory machinery. Noiseless machinery has not yet been a possibility, whatever the future may hold in store for us in that respect; but any attempt to limit one’s interest in health to a particular group is short-sighted, to say the least. Jaded nerves are to be found in large numbers among the factory men and women Among other miscellaneous health activities of value may be mentioned the American Posture League, which has been incorporated in New York to start an organized campaign to secure “correct posture or carriage of the body as of fundamental importance for health and efficiency.” The points of immediate attack are to be: school furniture, and seats in cars, theaters and other public places. Men and women in medical and educational professions are on the committee. While women are working in their localities and through their clubs for improved health conditions, they are also affiliated in large numbers with general associations interested in the advancement of public and private hygiene. The National First Aid Association of America, an inspiration of Clara Barton, is a life-saving agency of incalculable worth. Young and old are taught methods by its members to bring quick and proper relief to the injured, which may preserve their lives until a physician can give them better care. Policemen and firemen are taught this lesson and Boy Scouts are becoming adepts in first aid. A Central Council of Public Health was lately formed by the Academy of Medicine, in New York, to act “as a medium for concerted action by various health agencies, when need should arise.” While not distinctly a woman’s council, it is composed both of women and men representing women’s and men’s organizations. 1. To provide for conferences of private health organizations, 2. To act as a clearing house for the exchange of ideas and information in reference to the public health of the city, 3. To coÖrdinate and prevent duplication of the various public health activities of the city, 4. To promote coÖperation in the investigation and study of health problems, 5. To study the city budget in its relation to public health, 6. To take an active interest in the administration of all such branches of the city government as have a direct bearing on public health, and 7. To provide for a combined expression of opinion on matters relating to public health. At the first of their conferences on the city’s health, members of the Council discussed the problem with the police commissioner and the health commissioner and there was an exchange of viewpoints that was of inestimable value. At the great Hygienic Congress held at Buffalo in 1914 women were prominent during the sessions and they helped largely to awaken public interest in the meeting. Report had it that 7,000 representatives of women’s clubs coÖperated to secure the participation of school and civic authorities in the Congress. At the Fifteenth International Congress of Hygiene and Demography which was held in Washington, D. C., last year, women not only participated but furnished one of the most interesting features of the event—a notable health exhibit. If Lord Beaconsfield’s test of statesmanship were applied today, women would be seen to qualify. |