the diarrhoeal diseases, is excessive. A limited investigation in Chicago among the families of immigrants indicates a higher death rate in the larger than in the smaller families. Since ignorance as well as spent energies contributes to this result, the public schools must face this problem and train our children for the varied duties of life. Our young men and young women must learn more about the requirements and needs of the home and of home life. Domestic science, the art of housekeeping, proper uses of food, the importance of cleanliness, hygiene, sanitation, infant care and management, and other items of value should become part of the instruction of every young woman. Such instruction is so fundamental that it should rank as a most important preventive measure.

Domestic science must soon form part of the curriculum in every elementary school. It should be made compulsory for every girl in the seventh and eighth grades, and the amount of ground covered during these two grades ought to be sufficient to enable a young woman to learn all the rudiments necessary to begin a home on an intelligent basis. A very large percentage of public school pupils leave school before they reach these grades, many going at the end of the fifth year, while the loss during the sixth year is also very heavy. Provision of some kind for these children is also imperative, for it is precisely this class that swells the aggregate of undesirable elements in our large cities. Compulsory education will reach all who are not over-aged, but the latter form a special problem and cannot be neglected. Either they must be given the training in special classes, or they must be held at school until they have had the needed training. The group of girls most in need of the training afforded by domestic science and household economy are least liable to be reached by the present halting methods of instruction. The majority of cities have done little for the cause of domestic science, and therefore the chief cause of ignorance of household economy still remains. Domestic science in the high school should be encouraged, and it will be a source of pleasure and of profit to the high school girl. Instruction in this branch, however, does not benefit the children of the poor,

because they do not reach the high school; and effective preventive work for the child of the coming generation can be performed only by educating the girl and boy who are most in need of the training which these branches will yield. The introduction of such courses into the secondary schools will only touch the better classes and will affect less than 10 per cent of all the people. Our schools are strangely lacking in their provisions for instruction in household economy, and the need of reform is urgent and immediate.

In the larger cities many babies are really cared for a large share of the time by their older sisters. These "little mothers " are usually ignorant of the principles of baby care and are therefore quite precarious caretakers. In New York City the Department of Health, realizing that for many years this practice would continue, decided to instruct the children. Accordingly a lecture on baby care is given in every public school in the city in May of each year, and little mothers' leagues are formed among girls over twelve years of age. These leagues continue the study of child care, and in 1911 239 such leagues were organized, with a membership of 17,050 girls. The leagues met weekly for twelve weeks, during which time they covered an entire course on the principles of baby care. Valuable as this work is in guiding the little mother in her daily task, it will have still more value when she becomes a real mother. We can well afford to utilize school buildings for this purpose.

Boys likewise need additional training, especially in home hygiene and sanitation. The value of nature's curative forces and regenerative agencies must be taught in order to give the boy a proper appreciation of the danger and injury incident to unsanitary housing conditions. The uses of fresh air, the germ-destroying power of sunlight, the effects of contamination of air, the influence of gases, standards in regard to sufficient air space, and other necessary knowledge relating to proper housing conditions must be effectually taught to all young boys. The meager knowledge of these subjects gained at present in the study of physiology is entirely insufficient, and an extension along the lines indicated is necessary; otherwise the instruction

must be given as a separate branch of the work of the school. Whatever be the course followed, it must be judged from the standpoint of efficiency. The knowledge which makes for better homes and more sanitary houses, and which will accordingly save the lives of thousands of babies, must be acquired before the homes are formed and before babies are born. If this is not done, children will always be the victims of ignorance and neglect.

The evening school, with its classes in appropriate subjects for both young men and young women, and the classes formed in settlements and other institutions which strive to meet this deficiency in the education of the child, reach a small number of persons only and cannot adequately meet the situation. Furthermore, this work is or should be considered a mere temporary expedient, to be abandoned when the elementary schools expand their functions so as to include home science among the subjects taught. A temporary expansion of the work of these classes should be cordially welcomed, because the public school does not now meet the needs of a large bulk of our growing youth, and many anticipated reforms are not yet being realized. 6. Prevention of Overcrowding.

Fatalities among children depend in part on the bad housing conditions of a city. Overcrowding may take one of the following forms: first, an enormous number of persons may live on a single acre; again, many families may live in a single house or tenement; third, a large number of persons may be crowded into a single flat or group of rooms, this latter form being by far the most dangerous one. It is an appalling fact that the threeroom apartment is the most common form of housing for the large families of the poor, while two-room apartments are also amazingly frequent. In England an average of more than two persons per room is considered overcrowding, but in New York City the informal standard is 1 persons per room. Owing to the small rooms in its tenements this standard is not entirely adapted to other cities, but if the sexes are to be separated, it will hold. A tremendous amount of overcrowding does exist in American cities.

The density per acre may be very heavy, yet the conditions under which the individual families live accord with all the demands of sanitation and cleanliness. Tenement houses well cared for and well inspected by the city authorities may house a dense population without special injury or excessive suffering to the indwellers. This is particularly true if houses are built according to the best modern models. In actual practice, however, a heavy per acre density is usually associated with tenement house conditions of the worst type, the size of the families of the better classes being uniformly smaller and the families themselves refusing to submit to such crowding. Congestion invariably means poor conditions and inadequate equipment. Investigations have made quite plain the following proposition in regard to the effects of crowding: first, the mortality of a population increases as the density per acre is increased, and is considerably higher when a very heavy density obtains: second, mortality is much less if single tenements only are built upon the lots than if front and rear tenements exist. Statistics for New York City (old) and for St. Louis show that the mortality of children under five was nearly twice as high in the latter type of buildings. Third, mortality varies inversely according to the number of rooms per apartment. English figures have shown that the one-room apartment is nearly twice as fatal as the four-room apartment. This form of overcrowding is by far the most dangerous to life and health, as it is directly related to the problem of adequate air space, especially for sleeping purposes. It also prevents the enjoyment of sufficient sunlight and ventilation. It is especially under such conditions that a large infant mortality ensues, because it becomes impossible to provide the child with a sufficient amount of nature's curative forces and properties. It has been shown that in Vienna, Austria, when 8 per cent of the population was overcrowded, the mortality increased more than 100 per cent above the normal, and that all overcrowding was accompanied by a high rate of mortality.1

The noxious influence of overcrowding upon the life and health 1 Bailey, W. B., Modern Social Conditions, p. 323.

of the young child is well known. There remains only the problem of ascertaining the precise influence of this factor in order that our cities may become more resolute in providing and demanding sufficient air and room. Reform in housing conditions, including the building of wholesome tenements, is urgently needed, as well as insistence upon better conditions in and about the two-family houses, especially in regard to plumbing, sewage, garbage disposal, closets, etc.

7. Prevention of Employment of Married Women.

An additional method of lessening our infant mortality consists in reducing the number of married women employed in factories, offices, and mercantile establishments. In 1900 the total number of married women in the United States engaged in the gainful occupations was 769,477 or 5.6 per cent of the entire number of married women. Although a small number, it represented an increase of 1 per cent in the proportion of married women at work when compared with the census of 1890. Our recent immigration from Europe has probably increased this proportion, although statistics for 1910 have not yet been tabulated. Many Italian, Polish, Bohemian, and French Canadian mothers are at present employed in our factories and workshops, and therefore are compelled to neglect their children. They are found in canning factories, in clothing establishments, in the candy, meat-packing, and cotton and wool industries, and thousands are engaged in laundry work, or clean offices and stores. In several cities women have asked for a night nursery where babies might be kept during the early part of the night, so as to make it possible to work until 10 or 11 o'clock. In Fall River, where a large percentage of the married women are at work in the cotton mills, the infant mortality is not only very high, but it exceeds that of every American city having a population of 100,000 or more, while the rates for diarrhoea and enteritis are also disproportionately high. There can be no doubt of the causal relation between this high mortality and the presence of mothers in the factories.

In some European countries women are forbidden by law to work in industrial establishments for a period of from four to