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105
measures adopted and applied by local and other authorities during
that period. Such as the improvement of drainage and water
supplies; the improved system of removal and disposal of house
refuse; the improved sanitary condition of dwellings and their
neighbourhood; the notification and isolation of infectious diseases,
Ac., in addition to other improvements provided for in the various
Public Health Acts passed during the period in question.
While these measures have profoundly affected, in a beneficial
manner, the general mortality and the sick rate, they appear to bave
had very little or no effect for good upon the infant mortality, and
the reason for this is not difficult to discover. It may safely be said
that the health of the community at large, especially that of adults,
depends upon many factors, some of which have been beneficially
influenced by Public Health legislation; but the health of the infant
population depends chiefly upon home and maternal influences, i.e.,
upon the mode of feeding, clothing, &c., which Public Health
legislation has only slightly touched. The general mortality reacts
most quickly to sanitary measures of a municipal character, the
infant mortality to domestic hygiene, and this, in my opinion, is the
explanation of the different behaviour of the general death rate and
the infantile death rate during the last half century.
The fact is that personal and domestic hygiene, and in this I
include all that relates to the proper care of infants, has been
neglected in the past; it may be said in this respect we are very
little better on the whole than a quarter of a century ago. With the
exception, perhaps, of a nebulous idea that when an individual is
known to be suffering from an infectious disease, such person should
be separated from those who are healthy, the public, especially in
crowded localities, may be said to possess no ideas on domestic
hygiene, with the result that the community at large still suffer from
an unnecessarily and preventably high infant death and sick rate.
It appears, therefore, as if the time has arrived when those to whom
the Public Health has been entrusted, as well as those interested in
its maintenance and improvement, should make some effort, outside