FOOD OF INFANTS AT TEWKSBURY.

ate Document No. 294, 1868,) as to the food given them at the Tewksbury Almshouse; nor did the remedy for the existing state of things proposed by the Committee agree with the judgment of your Board. Accordingly I was instructed to ascertain and set forth more fully the facts to which the Committee refer. In making inquiries for this purpose I became satisfied that among motherless infants the great mortality at Tewksbury had very little to do with the original quality of the food given them; that this was never "skim milk," in the common acceptation of the term, and only for a short period was there any ground for saying that their milk had been skimmed. But, on the other hand, the health of these infants was considerably affected by the want of care in preparing the food, and in otherwise attending to their wants. The means for providing them with better care are set forth in the following recommendations of the Foundling Committee of your Board, which were approved by the Board and submitted to the Almshouse authorities early in May last. They were at once adopted by those authorities, though they may not have been carried out in all their strictness since.

Recommendations of the Foundling Committee.

First. That the milk given to motherless children should be,as we understand it is now, and long has been,-the unseparated milk of the cow; but that also, so far as possible, the milk of the same cow should be given to the same infant continuously, and that it should always be warm when prepared and given.

Second. That the napkins and other baby clothes should always be carefully dried before being put on, and that a sufficiently large stock should be kept to allow of frequent changes at night, as well as in the daytime, since great harm may be done to an infant by neglecting these things.

Third. That the whole washing of the infants' department should be put in charge of a responsible person, and kept separate from the general washing of the clothes of the Almshouse; and that she should be held responsible for the restoration of every article given into her hands to be washed, and for its being thoroughly dried and left in readiness for the nurse.

PART II.]

SECRETARY'S REPORT.

[CHAP. II.

Fourth. That special nurses should be employed in the care of these infants, and should be retained as long as possible, and allowed to devote all their time to that work.

Fifth. That the milk should be kept warm in the same room where the children are; but that the clothes should not, under any consideration, be dried there.

Such regulations as these, properly enforced, and accompanied by the oversight of a judicious Matron, will do something to diminish the mortality of motherless infants at the State Almshouses. But at the best, these great establishments are no places for them. After a period of success in their treatment, they are at the mercy of any epidemic, which in such establishments may occur at any time; such, for instance, as the measles at Bridgewater in the last spring, by which so many infants perished who seemed otherwise likely to survive, that of all admitted under one year, both with mothers and without them, at least half died from October to May; and this in spite of great skill and care on the part of the physician of the Almshouse. The true course is, not to allow motherless infants to enter these great establishments, if any smaller family can be found to receive them; and if possible, to board them out where they will have kind nursing, and the nearest possible approach to maternal treatment.

A State Foundling Hospital Needless.

The recommendation of the Charitable Committee of the last Legislature, that a Foundling Hospital should be maintained by the State in connection with one of the Almshouses, was based upon a superficial acquaintance with the matter, and proposed a hasty and wholly inadequate remedy for a long-existing wrong. It was brought to the notice of that Committee that the Infant Asylum, already mentioned, had been incorporated the year before, and had already opened a home, to which many of the deserted infants would be sent; that the methods adopted by the Directors were those shown by experience and the highest medical authority to be the best for preserving infant life; that the number of these infants not thus provided for was too small to justify a new State institution, with all its machinery of

THE PRESERVATION OF INFANT LIFE.

trustees, physician, etc.; that to connect such a hospital with a great Almshouse exposed it to most of the risks of the old system, which everybody censured; and finally, that a regular Foundling Hospital, if successfully established, was quite as likely to prove an injury as a benefit. These facts and suggestions did not have weight with the Committee; nor did the other fact which your Secretary laid before them, that the mortality of infants at Bridgewater, where they proposed to open the new Foundling Hospital, had been greater during the session of the Legislature than it ever was at Tewksbury, whence it was proposed to remove the infants. But they seemed to your Board conclusive against the proposition of the Committee; and in this view the Legislature coincided.

PROPOSITIONS TO BE CONSIDERED.

I may be permitted here to observe that the evils complained of in regard to motherless infants, were first brought to the attention of the medical profession, the Legislature and the public, in Massachusetts, by myself. The Massachusetts Medical Society, in their memorial, cite my reports as authority for the facts, and the same is done by the Charitable Committee. In point of fact, until, by much insisting, in season and out of season, upon the wrong and shame of allowing these infants so to perish, your Secretary had forced the facts under the eyes of physicians and legislators, no step was taken to correct the existing wrong. This being so, I would ask your Board and the Legislature and the public, to consider the following statements, giving only such heed to them as they shall be found to deserve. They are made after a four years' study of the question under discussion.

1. Much of the mortality among infants of all classes is easily preventable, and is actually prevented, even with delicate children, in families where they are carefully nursed.

2. Among motherless infants the amount of preventable mortality is relatively greater than in any other class; it being now more largely beyond the minimum rate than in any other class of infants.

PART II.]

SECRETARY'S REPORT.

[CHAP. II.

Fourth. That special nurses should be employed in the care of these infants, and should be retained as long as possible, and allowed to devote all their time to that work.

Fifth. That the milk should be kept warm in the same room where the children are; but that the clothes should not, under any consideration, be dried there.

Such regulations as these, properly enforced, and accompa nied by the oversight of a judicious Matron, will do somethin to diminish the mortality of motherless infants at the St Almshouses. But at the best, these great establishments are places for them. After a period of success in their treatme they are at the mercy of any epidemic, which in such establi ments may occur at any time; such, for instance, as the mea at Bridgewater in the last spring, by which so many inf perished who seemed otherwise likely to survive, that o admitted under one year, both with mothers and without t at least half died from October to May; and this in spit great skill and care on the part of the physician of the A house. The true course is, not to allow motherless infant enter these great establishments, if any smaller family ca found to receive them; and if possible, to board them out they will have kind nursing, and the nearest possible app to maternal treatment. tom of mario Him ay m