paternalism are mutually exclusive, as are also democracy and love of authority. Democracy might enter our households sooner did we but realize more fully the nature of the problems that lie beneath the surface. We have taken the settlement into the crowded city slums, into the lonely mountain district, into the black belt of the South, but rarely have we become settlement workers in the field that lies nearest-our own homes. Socialism has entered legislative halls, the factory, the office, and the shop, but the social spirit has not always entered every part of the home. Unity of purpose and unity of action in the household can come only as we remember with Kipling, For the strength of the pack is the wolf, And the strength of the wolf is the pack. And if once more we ask, What social and intellectual conditions are conducive to the development of democracy within the household? we come once more to our starting-point, "The Kingdom of God is within you." INFANT WELFARE: METHODS OF ORGANIZATION AND ADMINISTRATION CHARLES RICHMOND HENDERSON II FRANCE The study of protection of nurslings in France is full of interest and instruction. The decrease in birth-rate has brought the growth of population to a standstill. The industrial and military power of the nation is believed by many public men to be endangered. The incentive to colonization is weakened. Since the birth-rate is not subject to legal and administrative control, the next best measure seems to be to reduce the mortality of infants born and save as many as possible. Motives of humanity are added to patriotic calculation. The French medical faculty is famous for its charity as well as for its science and skill.' Some of the facts which have caused alarm were given by Dr. Budin. He cites the statistics of Drs. Balestre and Gilletta of Nice: in the cities of France, of 1,000 persons who die, 167 are infants of o to 1 year. Jacques Bertillon finds 169 deaths of infants in 1,000 deaths in 1889 to 1893, and 161 in 1894 to 1898, the ratio being 1 to 6. The causes of mortality assigned by Drs. Balestre and Gilletta were: 385 died of gastro-enteritis or diarrhea. 145 died of pulmonary difficulties. 177 died of congenital weakness. 50 died of contagious diseases. 25 died of tuberculosis. 223 died of other causes, known or unknown. The writer has spent several months at Paris in 1905, 1909, and in 1911, giving considerable time to this study. It would be impossible to give a complete list here of all the kind and intelligent persons who have assisted him with information and advice. Dr. Pierre Budin, whose noble efforts for infants have been continued by Mme. Budin, gave me in 1905 every facility at the Hôpital Tarnier to observe his famous "Consultation de nourrissons." Senator Paul Strauss and his wife have on various occasions given directions and introductions. Others will be mentioned in connection with special subjects. IV. Cong. Inter. Assist. Pub. e Priv., Vol. IV (1906), 9 ff. In a report for 1910 a French committee declared that in France from 100,000 to 150,000 infants (o to 1 year) die annually; at the end of a year, of 1,000 babies born only 840 survive; the rate of mortality being 20 to 30 per cent. Half these cases of death are avoidable. In a century, 17,000,000 infants of the first year died, of whom 9,000,000 might with proper care have lived.' DWELLINGS The crowded home is known to be dangerous to infant life, and at Paris private associations and public authorities have long sought means of alleviating the situation. There are in Paris about 30,000 families having more than five children and about 75,000 having more than three children. Of 8,669 families having each from 4 to 9 children, almost all occupy rooms which are overcrowded, and all pay less than 625 francs rent per year, all they can afford. The Council has under consideration vast schemes of building houses for such families to be rented at a price which they can pay. LEGAL PROTECTION OF MOTHERS French labor laws have certain provisions for the restriction of the hours of work for women and for securing rest and hygienic surroundings. Thus far there is no general system of obligatory maternity insurance. Some public offices which employ women grant them a vacation for the period of confinement and this is sure to be extended in the future. The women teachers who are under the Ministry of Public Instruction have the right to two months of vacation, while those in the post-office departments have only 35 days.3 Midwives (sages femmes).—The midwives are placed under the regulations of the law of November 30, 1892 (Titre III, Arts. 3 and 4). Every woman who proposes to aid women in confinement must have a certificate, and if she presumes to exercise her profession without it, she is liable to a fine of 100 to 500 francs and to imprisonment one to two months. The certificates are of two classes. The subjects of examination are the same for both, but 1 L'Assistance française, rapport présenté au Congrès int. de Copenhagen, 1910, pp. 50-76. the tests are more severe for candidates of the first class. The midwives of the higher grade are recognized by the physicians and can exercise their calling anywhere in French territory. Those of the lower grade pass examinations before special juries and cannot practice outside of the department. The studies of preparation and qualifications are fixed by decree of government (July 25, 1893, and February 14, 1894). In all the medical schools each year are given lessons of instruction for midwives, generally without fees for tuition. In some hospitals also theoretical and practical instruction is given. The candidates must be 18 years of age, be able to read and write, furnish their family record, and give evidence of good character. There is a school for midwives at the Maternité at Paris which trains women for all parts of France. Here a fee is charged.' ASSISTANCE GIVEN TO MOTHERS AT HOME Numerous agencies exist in Paris and in other French cities for the care of poor mothers at the hour of supreme need. This is an inheritance of mediaeval charity. Aside from the aid given by general public and private benevolence to indigent families in distress, there are numerous associations whose special function it is to assist mothers in their confinement. Only a few illustrations can be given. The Société de charité maternelle was founded in 1784 by Madame de Fougeret. It is administered by a council composed of a lady president, 4 vice-presidents, and 15 members. There are 100 lady administrators, 5 for each arrondissement, whose duty it is to receive applications and supervise the distribution and use of the aid furnished. This society relieves poor married women at the time of confinement, without distinction of origin or religion, if they have resided at Paris five years. It gives in instalments Fr. 59 to those mothers who, besides the new-born, have 3 living children, and Fr. 89 to those who have a greater number or are in special need. In 1910 this society aided about 30,000 mothers and 32,000 children. It has had the patronage of such distinguished 'Ecole d'accouchement de la maternité. Règlement. Administration générale de l'assistance publique à Paris, Journal Officiel, February 15, 1894. women as Queen Marie-Antoinette, the Empress Marie-Louise, Queen Marie-Amélie, and the Empress Eugénie. The Association des mères de famille (of Paris) was founded in 1836. It has as many sections as there are arrondissements. It is governed by a committee composed of the presidents of 20 sections. Its object is to afford relief to indigent women recently confined who, having only 3 children, including the new-born, cannot have the help of the Société de charité maternelle; and it also aids mothers "ashamed to beg," whatever the number of their children. It provides cradles, layettes, bread tickets, meat, sugar, and fuel. Many of the women assisted are given sewing to do at home when they are kept from other employment. On principle, it limits its gifts to married women, but in exceptional cases helps unmarried mothers who wish to marry and escape from an irregular connection. The funds come from the annual dues of members, Fr. 5 a year. INSTITUTIONS WHICH CARE FOR PREGNANT WOMEN L'Assistance publique and certain hospitals have encouraged women to accept refuge, without making known their names and history, even before confinement. This method prevents many injuries to both mother and child. Public funds and institutions are supplemented by such private charities as: L'Asile Michelet, l'Asile ouvroir pour femmes enceintes, l'Asile Sainte-Madelaine, le Refuge ouvroir pour femmes enceintes. L'Asile Michelet was founded in 1890 by the municipality of Paris on the proposition of Senator Paul Strauss. The attendants are laic. The institution receives gratuitously indigent pregnant women who cannot work for wages and who cannot be admitted into the public maternities. The beneficiary must be of French citizenship, with domicile at Paris one year, and about 7 months pregnant. They are not required to furnish life-histories. They are physically examined by midwives. Those having contagious diseases are excluded, and grave cases are sent to a hospital. The women received are employed at housework, sewing, and other light work if they are able, and are paid a little for their service. The layette for the infant is also made by the expectant mother. The confine |