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But overcrowding is not the only factor in the production of a
high infantile mortality in these particular areas and in the smaller
houses. Overcrowding, in the sense now used, is inseparably connected
with other evils. Both overcrowding and one of its resultants
—high infantile mortality—are merely symptoms; the malady lies
deeper and involves educational, moral, social and industrial problems
which only remotely touch medicine. These questions will
not be entered into, except as far as the figures at our disposal may
serve to illustrate their effect upon the infantile mortality.
In a district, such as ours, instruction in domestic subjects is
especially necessary. Young women enter upon the responsibilities
of motherhood in utter ignorance of the requisites of feeding, clothing
and tending of infants. It is not possible to put back the hand
of time, and to say that prior to wedlock the woman must be engaged
in domestic work. The girl who enters some industry, such as
laundry work, has her energies well occupied with her daily task,
and when she becomes a mother, enters on her new life with hardly
any conception of what its duties consist. It is hardly possible, perhaps,
to teach domestic subjects in an elementary school, but the
machinery whereby these subjects may be taught should not be beyond
the ability of the combined action of the education and health
authorities. To imagine that nature can be trusted in these matters
is folly. A mother has not an instinctive knowledge of what is necessary
for a child's welfare, no more than the child has an instinctive
knowledge of its own requirements.
The mortality of first-born children should indicate that a modern
woman carries no instinctive system of baby management with her