The purpose of this volume is to state the problem of poverty as it affects childhood. Years of careful study and investigation have convinced me that the evils inflicted upon children by poverty are responsible for many of the worst features of that hideous phantasmagoria of hunger, disease, vice, crime, and despair which we call the Social Problem. I have tried to visualize some of the principal phases of the problem—the measure in which poverty is responsible for the excessive infantile disease and mortality; the tragedy and folly of attempting to educate the hungry, ill-fed school child; the terrible burdens borne by the working child in our modern industrial system.

In the main the book is frankly based upon personal experience and observation. It is essentially a record of what I have myself felt and seen. But I have freely availed myself of the experience and writings of others, as reference to the book itself will show. I have tried to be impartial and unbiassed in my researches, and have not “winnowed the facts till only the pleasing ones remained.” At times, indeed, I have found it necessary, while writing this book, to abandon ideas which I had held and promulgated for years. That is an experience not uncommon to those who submit opinions formed as a result of general observation to strict scientific scrutiny. I had long believed and had promulgated the opinion that the great mass of the children of the poor were blighted before they were born. The evidence given before the British Interdepartmental Committee, by recognized leaders of the medical profession in England, pointed to a fundamentally different view. According to that evidence, the number of children born healthy and strong is not greater among the well-to-do classes than among the very poorest. The testimony seemed so conclusive, and the corroboration received from many obstetrical experts in this country was so general, that I was forced to abandon as untenable the theory of antenatal degeneration.

In view of the foregoing, I need hardly say that I do not claim any originality for the view that Nature starts all her children, rich and poor, physically equal, and that each generation gets practically a fresh start, unhampered by the diseased and degenerate past.^[A] The tremendous sociological significance of this truth—if truth it be—will, I think, be generally recognized. Readers of Ruskin’s Fors Clavigera will remember the story of the dressmaker with a broken thigh, who was told by the doctors in St. Thomas’s Hospital, London, that her bones were in all probability brittle because her mother’s grandfather had been employed in the manufacture of sulphur. If this theory of antenatal degeneration is wrong, and we have not to reckon with grandfathers and great-grandfathers, the solution of the problem of arresting and repairing the deterioration of the race is made so much easier. It may be thought by some readers that I have accepted the brighter, more hopeful view too readily, and with too much confidence. I can only say that I have read all the available evidence upon the other side, and found myself at last obliged to accept the brighter view. I cannot but feel that the actual experience of obstetricians dealing with thousands of natural human births every year is far more valuable and conclusive than any number of artificial experiments upon guinea pigs, mice, or other animals.

The part of the book devoted to the discussion of remedial measures will probably attract more criticism than any other. I expect, and am prepared for, criticism from those, on the one hand, who will accuse me of being too radical and revolutionary, and, on the other hand, those who will say I have ignored almost all radical measures. I have purposely refrained from considering any of the far-reaching speculations of the “schools,” and confined myself entirely to those measures which have been tried in various places with sufficient success to warrant their general adoption, and which do not involve any revolutionary change in our social system. I have tried, in other words, to formulate a programme of practical measures, all of which have been subjected to the test of experience.

A word of personal explanation may not be out of place here. I have been privileged to know something of the leisure and luxury of wealth, and more of the toil and hardship of poverty. When I write of hunger I write of what I have experienced—not the enviable hunger of health, but the sickening hunger of destitution. So, too, when I write of child labor. I know that nothing I have written of the toil of little boys and girls, terrible as it may seem to some readers, approaches the real truth in its horror. I have not tried to write a sensational book, but to present a careful and candid statement of facts which seem to me to be of vital social significance.

As far as possible, I have freely acknowledged my indebtedness to other writers, either in the text or in the list of authorities at the end of the book. It was, however, impossible thus to acknowledge all the help received from so many willing friends in this and other countries. Hundreds of school principals and teachers, physicians, nurses, settlement workers, public officials, and others, in this country and in Europe, have aided me. It is impossible to name them all, and I can only hope that they will find themselves rewarded, in a measure, by the work to which they have contributed so much.

I take this opportunity, however, of expressing my sincere thanks to Mr. Robert Hunter; to Mr. Owen R. Lovejoy, of the National Child Labor Committee; to Dr. George W. Goler, of Rochester, N.Y.; to Dr. S. E. Getty, of St. John’s Riverside Hospital, Yonkers, N.Y.; to Dr. Louis Lichtschein, of New York City; to Dr. George W. Galvin, of Boston, Mass.; and to Professor G. Stanley Hall, of Clark University, for many valuable suggestions and criticisms. To Mr. Fernando Linderberg, of Copenhagen; to his Excellency, Baron Mayor des Planches, the Italian Ambassador at Washington; and to Professor Emile Vinck, of Brussels, I am indebted for assistance in securing valuable reports which would otherwise have been inaccessible. I am also indebted to my colleague, Miss C. E. A. Carman, of Prospect House; and especially to Mr. W. J. Ghent for his expert assistance in preparing the book for the press. Finally, I am indebted to my wife, whose practical knowledge of factory conditions, especially as they relate to women and children, has been of immense service to me.