INAUGURAL ADDRESS, 
INCLUDING A 
PAPER ON INFANT ASYLUMS. 
BY 
A. JACOBI, M. D., 
PRESIDENT OE THE MEDICAL SOCIETY OF THE COUNTY OF NEW YORK, PROFESSOR OF 
DISEASES OF CHILDREN IN THE COLLEGE OF PHYSICIANS AND 
SURGEONS, NEW YORK. 
{REPRINTED FROM THE N. 7 MEDICAL JOURNAL, JAN., 1872.] 
NEW YORK: 
D. APPLETON & COMPANY, 
549 & 551 BROADWAY. 
18Y2 Published by D. Appleton & Go. 
HAMMOND. 
A Treatise on Diseases of the Nervous 
System. 
WILLIAM A. HAMMOND, M. D., 
Professor of Diseases of the Mind and Nervous System, and of Clinical Medicine, in the Bellevue 
Hospital Medical College; Physician-in-Chief to the New York State Hospital for Diseases 
of the Nervous System, etc., etc. 
With Forty-five Illustrations. 1 vol., 8vo. 750 up. Cloth, $5.00. 
The treatise embraces an introductory chapter, which relates to the 
instruments and apparatus employed in the diagnosis and treatment of 
diseases of the nervous system, and five sections. Of these, the first 
treats of diseases of the brain; the second, diseases of the spinal cord ; 
the third, cerehro-spinal diseases; the fourth, diseases of nerve-cells; 
and the fifth, diseases of the peripheral nerves. One feature which may 
he claimed for the work is, that it rests, to a great extent, upon the per- 
sonal observation and experience of the author, and is therefore no mere 
compilation. 
“ The author’s clear and terse style of diction renders the book exceedingly 
readable, and the cases reported and cited add much to the interest of the text. 
. . . There is so much that is entertaining in the mental and other manifesta- 
tions of nervous disorder, especially when presented as they are here, that a work 
of this kind will find many readers outside the profession; and, it may be hoped, 
will serve not only to interest and amuse, but to induce a closer observance of 
those hygienic laws upon whose violation many of the ailments here treated of 
depend.”—New York Medical Journal. 
“ The work is replete with useful knowledge, and every physician who expects 
to be called on, as an expert, to testify in cases of supposed insanity, after the 
commission of crimes, should give the book a thorough perusal.”—Leavenworth 
Medical Herald. 
“ That a treatise by Prof. Hammond would be one of a high order was what 
we anticipated, and it affords us pleasure to state that our anticipations have 
been realized.”—Cincinnati Medical Repertory. 
“ It affords a vast amount of information, is captivating, and worth reading,” 
—Cincinnati Lancet and Observer. 
“ This is unquestionably the most complete treatise on the diseases to which 
it is devoted that has yet appeared in the English language; and its value is 
much increased by the fact that Dr. Hammond has mainly based it on his own 
experience and practice, which, we need hardly remind our readers, have been 
very extensive.”—London Medical Times and Gazette. 
“Free from useless verbiage and'obscurity, it is evidently the work of a 
man who knows what he is writing about, and knows how to write about it.”— 
Chicago Medical Journal. INAUGURAL ADDRESS, 
INCLUDING A 
PAPER ON INFANT ASYLUMS. 
BY 
A. JACOBI, M. D., 
PRESIDENT OF THE MEDICAL SOCIETY OF THE COUNTY OF NEW YORK, PROFESSOR OF 
DISEASES OF CHILDREN IN THE COLLEGE OP PHYSICIANS AND 
SURGEONS, NEW YORK. 
[REPRINTED FROM THE N. Y. MEDICAL JOURNAL, JAN., 1872.] 
NEW YORK: 
JD. APPLETON & COMPANY, 
549 & 551 BROADWAY. 
1872 INAUGURAL ADDRESS, 
INCLUDING A PAPER ON INFANT ASYLUMS.1 
I hold in my hands the record of the members of this 
Society in the last year. There are names among them of men 
who no longer adorn these seats. There is not one of them 
who has not been, when he had passed away from us, honora- 
bly mentioned by us; there are a few, whose loss all of us 
shall long mourn, and whose memories we shall forever cher- 
ish. The two members to whom I consider it my sacred duty 
to allude were Dr. Bibbins and Dr. Geo. T. Elliot. 
Dr. Bibbins was for many years a member of your comitia 
minora, and your Treasurer. To say that he was a diligent 
and trustworthy officer, although that is saying a great deal, 
is not much when we recollect his untiring industry in behalf 
of the honor and standing of this Society, and of the profession 
in general. There are but few who, with equal erudition, and 
tact, and zeal, and modesty, have untiringly worked for com- 
mon interests as he did, to the hour of his last sickness ; which 
may have found its work of destruction easy in one whose ner- 
vous system was overstrained and exhausted. 
1 Eead at the Stated Meeting, December 4, 1871.  mAUGURAL ADDRESS. 
Dr. Elliot was one of those to whose exertions this Society 
owes a great part of its flourishing condition. It was his am- 
bition and pride to gather large numbers of members, secure 
good papers, and worthy discussions, and to hold extra meet- 
ings. We owe his memory thanks for what he has accom- 
plished in that line. It is true that his predecessors had facili- 
tated his work, for there was no society in the city that had 
shown a better record for many years, when he commenced 
his useful career as onr President in 1868. But it is also true 
that no public man in a public place was ever more diligent, 
zealous, and at the same time gracious. To his other private 
and public virtues I need not allude; they have been recalled 
to your mind from this place before to-night. Whenever 
his name is mentioned, we shall remember a gentleman, a 
man of taste, a refined scholar, and an amiable colleague. I 
have to thank him, personally, for my finding the Medical 
Society of the County of Hew York, when I had the honor of 
being the first time elected to preside over your meetings, a 
year ago, large in numbers, regular in attendance, earnest in 
purpose, and progressive in spirit. 
Fortunately, death has not been the only power that has 
marked its changes among us. The records of last year 
exhibit a rapid increase of our members. Seventy medical 
men have joined our ranks, against eight whom death has 
taken from our midst, and a few who have left the city 
and county. I hail this fact with joyful expectations of fur- 
ther increase. It shows that individualism is not the para 
mount tendency of medical men as a class, and that the 
universal law of centripetal attraction exerts its power. It 
proves that medical men are aware of the existence of com- 
mon interests which can better be served by large bodies than 
by the few or the one. The liberty of the individual is not 
thwarted by a certain amount of centralization. Hundreds 
of private men feel the necessity of closing up into a regiment, 
in order and discipline. Small communities, and states, with 
the same language, customs, and interests, have for centuries, 
up to this very year, sought and found means to abolish artifi- 
cial boundaries and melt into one. Decentralizing State rights INAUGURAL ADDRESS. 
have been wiped out with fire and blood to develop the growth 
and power of a great country, free at last, which is destined to 
be the harbor and fosterer of the civilization of the republican 
world of the future, as it has become the protector and home 
of fugitive republicans of Europe. Thus the tendency to fol- 
low the laws of attraction and gravitation yields its fruits in 
the political, the social, the literary fields. The readiness 
with which new names are added to our lists, proves to what 
extent, consciously or unconsciously, medical men feel the 
necessity of uniting their strength. It will be our duty to 
prove that, even without our legal standing in relation to the 
political administration, we have attractive power enough to 
hold them and to grow; but at the same time it will also be 
our bounden duty to improve the advantages of our legal 
standing in the interest of our members, our Society, the medi- 
cal profession, and the public'at large. I hope to be capable 
within a short time of pointing out the possibilities of availing 
ourselves of our connection with the State and the other county 
medical societies for the benefit of both the profession and the 
community. 
Among the additions to our number during the last year I 
notice dozens of foreign names; the schools and universities of 
Great Britain, Germany, France, Switzerland, Poland, and 
Russia, have sent their pupils to swell our ranks, while our own 
schools have offered their full share as heretofore. Thus our 
Society but repeats the historical and ethnological fact of our 
great Commonwealth, which has been the result of the mixture 
of all the nations of the universe. While, however, the question 
of the beneficial influences of such mixture has, in a political 
point of view, sometimes not been considered as settled to 
universal satisfaction ; while even a dozen years ago there could 
be, as a political issue, a strong party of nativists, there was 
never, to my knowledge, in the liberal profession to which 
we belong, any such party feeling. For, those of us who are 
old enough will remember that, just in those years which en- 
gendered and saw the political efforts of Knownothingism, a 
small number of foreigners, who are still among us, were bid- 
den a hearty welcome in your midst, and have even been pro- INAUGUEAL ADDEESS. 
moted since to tlie highest honors the profession can confer 
upon any member. 
This difference in the reception and appreciation of the 
foreign-born member of the profession from what we notice in 
political life, now and then, is very suggestive. The United 
States, for instance, claims the necessity of a five-years’ residence 
before a new-comer can be admitted to citizenship. Five 
years are considered necessary to acquaint the average immi- 
grant with our Constitution, and the spirit and the habits of our 
republican people; they are considered an apprenticeship for 
those whose lives have been spent under monarchical rule. 
But, as soon as they are considered to be imbued with the 
principles of republicanism and its practical working, they are 
admitted as equal. There is no doubt but that, if the neces- 
sary knowledge and habit should be thought accessible in less 
time, thc*term of five years would be reduced. We have the 
proof of this assertion in the fact that a number of States have 
reduced the term of preparatory residence, as far as their own 
simpler, more uncomplicated affairs are concerned. What, 
then, would be the condition of things, if the newly-imported 
immigrant came, as a rule, not from monarchical communities, 
but from republican states, with institutions, rules, habits, like 
our own ? Can any one think of a legislator wdio would, for an 
average immigration of that kind, consider an apprenticeship of 
five years necessary ? On the contrary, we can safely say that 
when, in future, the monarchies of Europe shall have been 
swept away before republicanism conquering the world ; when 
France shall have the fact and not only the name of a republic, 
when Germany shall have adopted a self-government worthy 
of the character of its people and the high standard of its 
thinkers ; when old England, whose very sap and juice are dry- 
ing up over the old outworn roots of its existence—meaningless 
and powerless as it is nowadays in the councils and destinies 
of nations—shall have been rejuvenated to its original Anglo- 
Saxon freshness and vigor by republicanism ; when in fact all 
Europe shall have stepped over the boundaries between mon- 
archism and republicanism, bondage and freedom, dynastic sway 
and enlightened self-government—there will be no apprentice INAUGURAL ADDRESS. 
ship any more than there is between the States of this one and 
indivisible republic of the United States. Such is the influence 
of equal education, habits, aims, and interests. And such is 
the cause and source of the universal citizenship among the 
members of our liberal profession from whatever geographical 
country they may have arrived. The first minute of your 
acquaintance with a medical man who is born and raised your 
antipode, reveals in him a relative, a brother. The same 
ideas, even the same terminology, render your intercourse 
with him like that of an old friend. For we are fortunate 
enough to live in a time when medical science has the same 
base and foundation, that of Nature and its study. 
It has not always been so, nor could it be so, as long as or 
wherever the standard of science and society was generally 
low. It is a peculiarly instructive fact that these two will 
closely correspond with each other. The science and art of 
old Egypt have no greater accomplishments to boast of than 
hieroglyphs and pyramids, and her physicians were the priests 
of Isis. The Greeks, however, whose art, resulting from their 
enjoyment and close observation of Nature, was in many in- 
stances equal or even superior to our own, produced a Hip- 
pocrates, one of the greatest and truest observers of all times. 
Among the dews, whose one science was the combination and 
union of politics, religion, dietetics, and medicine, the prac- 
tice of the healing art was exclusively in the hands of priests 
and legislators. The Romans sometimes borrowed the cul- 
ture of their neighbors, and some of their medical men were 
Greek ; usually, however, they destroyed it. Their path wras 
marked by the sword, and the blessing they carried along was 
slavery. Accordingly, most of their physicians were slaves ; 
arid Justinian fixed the price at which their persons could 
be bought. The Christian middle ages, which knew no high- 
er scientific authorities than Aristotle and Galen, or his 
Arabian translators or transcribers, and have not succeeded 
in producing a single original mind in medicine before the 
times of Paracelsus, relied on the healing powers of their 
priests and—by way of contrast—of despised Jews. The 
Indian’s medical man is his sorcerer ; for the red man believes INAUGURAL ADDRESS. 
in miracles, in supernatural or rather unnatural powers, just 
as much as the illiterate and credulous white man who fol- 
lows the footsteps of the clairvoyant, the medium, the quack. 
In this manner every age' and every country had its own 
medical science. It required the results of centuries, strug- 
gling for light, to yield a common base; that base being the 
increased knowledge of Nature. But more than some descrip- 
tive knowledge of natural bodies or phenomena was required. 
A universal medicine has been, at last, the result of the genetic 
idea and researches, the idea that there is nothing unalterable 
and unchangeable in Nature; that every thing is incipient, 
growing, and disintegrating; that the same process which had 
been noticed in nations, in the course of centuries, is taking 
place in every being from minute to minute. The researches 
in chemistry, showing rapid or slow transformations, in com- 
parative anatomy pointing out small and trifling differences, 
have been the first to sharpen the senses, and to prepare the 
way for modern medical ideas. To France belong the first 
great names of Lavoisier, Laplace, Bichat, Dupuytren, Laen- 
nec. To Germany the glory of establishing medicine on its solid 
modern foundation. To the world belongs the credit of fully 
appreciating and recognizing the working of the mind, and 
the progress of development, never minding the language or 
nationality of the man who has a claim on priority. Thus, 
the men whose names I have mentioned, and the names of 
Oken, Schwann, Johannes Muller, Bokitansky, Schonlein, 
Yirchow, Hunter, Davy, Faraday, Darwin—are no longer 
national names, any more than in other fields the names of 
Galileo, Copernicus, Newton, or Raphaele Santi and Cor- 
reggio, or Beethoven and Mozart. Those men speak the 
language of the human mind, they are the leading citizens of 
the universal world-republic of science to which wre all, equal, 
free, and fraternal, have sworn allegiance. There is no 
blockade, no fire, no Franco-German War, that will ever dis- 
prove our belonging to the same community. The progress 
of one man, of one country, is at the present day the common 
property of all men, all countries, and an isolated civiliza- 
tion or science belongs to the past. Let us hope, and every 
one at his own wheelwork, that the unity of science may be 
but the precursor of the unity of mankind. INAUGURAL ADDRESS. 
With this view, American physicians have always received 
their foreign brethren friendly and hospitably, no matter wheth- 
er they had come to settle or to visit. With this view I wel- 
come to onr Society those who have lately joined us. Besides, 
the fact of their coming to us proves their agreeing with the 
sentiments I have briefly expressed. There is many a common 
battle we shall have to join in. 
Among our new acquisitions I notice also a large num- 
ber of younger members of the profession, some of whom 
have already drawn the attention of the medical public 
to their labors, and earned golden opinions. I cannot 
but express my satisfaction at their accession to our num- 
bers. If there is a physiological difference between them 
and the older members, it consists in the relation of the 
new-formed young cells entering the organism, the frame- 
work of which is established before. The latter gives the 
necessary firmness, is less changeable, but, it is true, less 
necessary for the performance of the physiological functions. 
The former are the active and enlivening portion of the organ- 
ism. It is the young blood-cells, the young gland-cells, the 
organism is supported by ; their healthy action is the condi- 
tion of healthy and active life ; without them the organs a*nd 
the organism would soon die of atrophy. I hope our young 
cells will not carry this comparison any further. They might 
feel like saying that the old blood-corpuscles cannot do better 
than to get disintegrated as speedily as possible, and disappear 
from the field of action, or that long organized connective 
tissue is but a scar and inert, or that the old pavement epi- 
thelia of the epidermis, with their shrunken nuclei, ought to be 
rubbed off at once, and buried in the bath-tub. They may be 
right sometimes. But the old-established framework might 
have a line of defence; it might retort that young cells might 
overdo their physiological function; that it might happen that 
over-copious proliferation will break down the whole organ, 
young and old, or that the too copious and irregular invasion 
might prove a malignant growth. We shall easily get along, 
though, and all of us, old and young, perform our share of 
the. work, by contributing our best to the general stock of 
knowledge. At all events, our younger brethren, or part of  INAUGURAL ADDRESS. 
them, are conversant with those methods of study and investi- 
gation which have elevated modern medicine to its present 
standard. Therefore, the Society hopes for and requests such 
contributions to the papers and discussions of our meetings as 
will prove their efficiency, and fill our wants. These gentle- 
men will surely not forget that every one has to do his best 
where our aims are the same ; and that, by so doing, they work 
for the future, which ought to be, and necessarily is, theirs. 
While pointing to these wants, and stating my earnest 
request for a diligent and faithful cooperation of such of our 
members as are accustomed to the exact methods of investi- 
gation with the microscope, or chemistry, I still think that 
the papers read and discussed before this Society during the 
last twelvemonth aye of a high order, and creditable to both 
their authors and our Society. Allow me to recall the following 
items: 
November Meeting, 1870.—Paper by the President, on “ Craniotabes,” 
and general introductory remarks. Oases of, and remarks on, “Blepharo- 
plasty,” by Dr. Knapp.' 
December Meeting.—Paper by Dr. Fordtce Barker, on “Blood-letting 
as a Therapeutic Resource in Obstetric Medicine.” 
January Meeting, 1871.—Paper by Dr. II. Knapp, on “Formation of 
Bone in the Eye.” 
February Meeting.—Paper by the Vice-President, Dr. Austin Flint, 
on “ The Pathological Relations of the Gastric and Intestinal Tubules.” 
March Meeting.—Paper by Dr. J. Lewis Smith, on “ Scrofula.” 
April Meeting.—Paper by Dr. Leonard Weber, on “Abscess of the 
Appendix Yermiformis.” 
May Meeting.—Paper by Dr. II. B. Sands, “ On the Use of the Plas- 
ter-of-Paris Bandage, in the Treatment of Simple Fracture, especially Frac- 
ture of the Femur.” “ Case of Abscess of the Appendix Yermiformis,” by 
Dr. Ernst Krackowizer. 
June Meeting.—Paper by Dr. F. N. Otis, on “Syphilitic Infection, 
with Special Reference to the Channels through which the System be- 
comes contaminated, and to the so-called Incubation Period of the Disease.” 
September Meeting.—Nomination of Officers. 
Concerning our recent admissions I have another remark 
to offer. 
It is not a small satisfaction to me that, in this year of my 
presidency, one of the most urgent questions of the day 
should have been quietly and noiselessly answered. The ad- INAUGURAL ADDRESS. 
mission of females into the ranks of the medical profession— 
or, rather, as their obtaining the degree of M. D. is a matter 
belonging to chartering Legislatures, and their obtaining a prac- 
tice depends on the choice or prejudice of the public—into the 
existing medical societies, has been decided by you by a simple 
vote, not attended by either the hisses and clamors of excited 
young men in medical schools, or the confusion and deroga- 
tions of the meetings of a medical association. I think we can 
say that our action has finally settled a question the importance 
of which was recognized by everybody. The vote of the 
largest society of the kind in the Empire State, and I believe- 
in the Union, will have the effect of soothing the passions and 
levelling prejudices in the circles of the army of medical men, 
forty thousand strong, in the United States, and of raising us 
in this respect to the standard of European countries. Even 
the conservative seat of learning, Edinburgh, has admitted 
women to medical studies. Paris has turned out a woman 
doctor of medicine, who will prove, I hope, none of the least 
ornaments of this Society, the profession of this city, and our 
common country. Russia can boast already of her Kaschewa- 
rowa, and will within two years permit any well-educated 
and sufficiently-prepared woman to enter the halls of medi- 
cal learning ; and Switzerland, little but republican Switzer- 
land, enjoys in its University of Zurich the presence of dozens 
of female medical students. I say “ enjoys,” for it has been 
a matter of public congratulation on the part of the profess- 
ors of that institution that, since the admission of the fe- 
males, not only has the university gained a number of hard- 
working and successful students, but that, besides, the general 
bearing of the students of the stronger sex has been more 
quiet, sedate, moral, and studious. 
The question whether females shall be admitted to the study 
of medicine, in the existing medical schools in our country, 
will be solved in time. It appears improbable, for several rea- 
sons, for the present. The standard of many of the young 
men entering upon the study of medicine, as far as prepara- 
tory studies are concerned, is so little elevated, that the schools 
will not lack sufficient numbers of students; for it is true, 
that ours is one of the liberal professions in the Union which INAUGURAL ADDRESS. 
does not consider the previous acquisition of a classical or 
literary education a co7iditio sine qua non. And further, as 
long as new institutions, worthy and unworthy ones, male and 
female, are daily chartered, upon the recommendation of lay 
members of State Legislatures, the increase in number of 
special colleges for females can be continued ad infinitum. 
Thus it may happen that, for some time to come, this question 
of admitting females to our medical schools for male students 
will not be very eagerly ventilated, as its practical necessity 
may, to many of us, not be very obvious. Still, let it not be 
forgotten in the history of this Medical Society of the County 
of New York, that we have opened our doors to worthy mem- 
bers of the medical profession, male or female, white or 
colored, and thus granted reality to the gosj>el of American 
citizenship, the Declaration of Independence, according to 
which we are all free and equal. Let it not be forgotten, 
either, that we, in our circle, have generalized and idealized 
the peculiarly American proverb, “ Help yourself.” Emanci- 
pation, both of color and sex, means nothing else but to uni- 
versalize the postulation of helping one’s self. The future con- 
stitution of an ideal human society will be such that every 
member will take such a place, fill such a position, as is both 
adapted to his or her taste, and adequate to his faculties and 
services. The choice of a calling will depend on the first, the 
recognition by society, position, on the latter. That is the 
meaning of “ help yourself,” which never excludes that every- 
body else should also help himself, nor renders the helping 
each other impossible. On the contrary, the very existence 
of human society in general, and this republic in particular, 
is based on the liberty and independence of one and all. 
Monarchs and oligarchs only claim liberty and self-destination 
for their sole persons and systems. I wish we, in our political 
and social system, and in the institutions of our private and 
scientific circles, might forever bear in mind that we have al- 
ways been the banner-bearers of universal liberty ; and that, if 
the public opinion of Europe, greatly influenced by a mo- 
narchical and antirepublican press and office-holders, has fre- 
quently thrown the “ help yourself ” into our faces as a re- 
proof, we mean and meant to help ourselves and each other, INAUGURAL ADDRESS. 
and tliem also ! We need not sacrifice truth and modesty to 
spread-eagleism, when we point to the facts of our Sanitary 
Commission, our Chicago, or to the hungry of their Ireland, or 
the wounded and starving of their Germany and France. 
And, from this general mode of viewing all questions of great 
importance concerning the requirements of progressive devel- 
opment, we have, all of us, cooperated in solving the woman 
question in our department, no matter whether we have all 
been equally enthusiastic in deciding it, or whether we have 
simply followed the dictates of our longing for justice or 
equity, or resolved upon giving every member of human so- 
ciety a chance to develop his or her faculties, on their own 
responsibility as to failure or success. 
After all I have said, I think I am justified in asserting 
that we have progressed in the right direction, in the ac- 
knowledgment of equal rights and universal solidarity, in a 
truly republican spirit. Besides, there is one progress we have 
made which is too evident to be overlooked. We have done 
our share, we believe, in teaching each other by papers and 
discussions. We have commenced, besides, to stimulate scien- 
tific researches. Hitherto, we must confess, the sun of science 
has risen for us, and mankind, in the far East, in Europe. 
She has the advantage of longer centuries, stored-up knowl- 
edge, hundreds of seats of learning, which are not schools in 
which a special branch of science and art is taught, but uni- 
versities of science. She has her large museums, libraries, 
and collections. She has, which is more important than any 
thing else, a general base of thorough elementary and either 
literary or classical education previous to a special course 
of professional training. She has the advantage of the 
habit of study and thinking. In Europe, the universities, as 
they have the office of finishing the sixteen or twenty years’ 
school education, have also that of advancing science jper se. 
The great works of literature, general and special, the classi- 
cal results of combined observation, learning, and thinking, 
have made their appearance from the laboratories, the cli- 
niques, the libraries of European universities. The solutions 
of many grave questions we owe to the prizes established, 
judged, and crowned by them. If we compare the four hundred INAUGURAL ADDRESS. 
pages of the “ Report on Education, by John W. Hoyt, U. S. 
Commissioner,” as contained in the sixth volume (1870) of the 
“ Reports of the U. S. Commissioners to the Paris Universal 
Exposition, 1867, published under direction of the Secretary 
of State, by authority of the Senate of the United States, 
edited by William P. Blake, Commissioner of the State of 
California,” we shall admit the fact that we have good 
schools, but no European universities. Especially the task of 
advancing medical science, of stimulating strictly scientific 
researches, which our medical schools cannot fulfil, must, with 
us, necessarily fall upon the medical societies. How, from this 
point of view, our Society, in my opinion, has, by approving 
of and authorizing a prize on a strictly scientific subject, 
which will require researches of a laborious and partially 
novel kind, begun a new era in the efficiency of medical so- 
cieties, and proved her earnest appreciation of her position in 
relation to medical science. 
Thus we have commenced to work according to the duties 
of every medical society, and the profession in general, in a 
number of important directions. There are, in fact,, but three 
views which can be taken of the work, the actions, the duties 
of the medical profession—but three different relations. 
The first two I have cursorily spoken of. They are the re- 
lations to the members of the profession itself, that is, to them- 
selves, or each other, and to science. A thorough review was 
not expected this evening, nor was it in my plan to dilate on 
them. The third highly-important question, that of our rela- 
tion to the public and to the political community, I expected 
to discuss this evening. I meant to discuss our responsibility 
to the public, and in connection with that the raising of the 
standing of the average practitioner, in the interest both of the 
profession and the public. 
The relation of medical science to almost every branch of 
civilized life is self-evident. I do not speak of the care of in- 
dividual disease; its importance as a duty of the medical man 
is understood by the lowest degree of intellect. I do speak of 
the whole province of hygiene and social science. Protection 
supervision of the sale of medicines, medical 
and in part also physical care of the poor (sick or well), core- INAUGURAL ADDRESS. 
ners’ department, supervision of dead-houses, public and pri- 
vate institutions for the sick, orphan asylums and foundling- 
houses, the condition of cemeteries, measures % against syphilis, 
sanitary inspection of schools with regulation of hours, subjects 
of teaching, condition of school-benches, supervision of factories, 
of prisons, are duties which form the natural province of a well- 
informed medical profession. I go further. Part of the hu- 
mane jurisdiction of the future will form a portion of the do- 
main of the philosophical physician of the future, -which will 
not leave the plea and the proof of insanity, or total or partial 
responsibility of the accused, in the hands of a shrewd or blus- 
tering solicitor, or to the discriminating minds of twelve men 
whose only claim to sit as jurors sometimes consists in that 
they could find no excuse for staying away. I also meant to 
discuss the difference between a trade and a liberal profession, 
and the relation of both to the public and the political com- 
munity. Also, how it happens that, when a man is out of 
coats, he goes to a tailor; out of shoes, to a shoemaker; -when 
his watch is broken, to the man who knows something about 
watches; when he is out of health, to a seller of nostrums, to a 
clairvoyant, a medium, a grandmother, a neighbor; how it 
happens that, when his horse is sick, he will send for the horse- 
doctor ; when his child is sick, for the priest, the school-madam, 
the auntie, or Mrs. Soothing Syrup. How it comes that, when 
a portion of his money is at stake, he goes to a lawyer whom 
he knows to be informed about the laws of the land; when his 
health is failing, to somebody who knows any thing but the 
laws of his body. How it is that there are laws against coin- 
ing false moneys, coining checks, coining false pretences to 
obtain money, laws protecting your pockets, but no laws pro- 
tecting the health and life of the community, of the very peo- 
ple who make the laws of the land ; how it is that this crimi- 
nal carelessness and ignorance on the part of the public and 
the lawgivers have contributed to demoralize even the ranks 
of a liberal profession, and to impede their progress; how, that 
this profession, usually Upbraided, made light of, neglected, 
has always taken the initiatory steps to protect the health and 
lives of the public, almost Against their wishes and remon- 
strances, enforced the laws of hygiene, diminished mortality,  INAUGURAL ADDRESS. 
lengthened the average duration of life, and improved the 
means of protecting the community, when their services were 
thought by them as superfluous as they were life-saving ? I also 
meant to speak of the mode in which, in my opinion, the con- 
stant cry among our own ranks, for elevation of oyr profession, 
in the interest of the public, could be satisfied. I am sorry I 
have to simply announce this subject of medical education and 
practical reform for some other occasion, as I have felt com- 
pelled to lay a subject before you, which appeared to me so 
urgent that I could not but present it at once. It is of such 
particular urgency because of immediate practical importance; 
and at the same time has claims to the attention, and study, 
and cooperation of every physician. 
A few mornings ago, I learned, through my newspaper, of 
the opening of a new lying-in asylum and foundling hospital. 
The number of such institutions begins to swell; the interest 
of the public is aroused, money is freely forwarded, and the 
lay and professional members of the public are thoroughly 
aware of the necessity of saving infant lives. I shall not here 
discuss the questions whether an effort should be made to save 
abandoned children, or whether the effort to save abandoned 
children will encourage crime. I shall simply try this evening 
to contribute my share to answering a third question of an 
“ appeal in behalf of the ISTew York Infant Asylum,” which 
met my eye but a few days ago—the question, Can these 
children be saved ? I shall also partially answer the question, 
What has been done for them in Yew York City ? How many 
have been saved ? If many, why change the old plans ? If 
few, why not make a radical change ? 
I cannot answer the question to my entire satisfaction; for, 
to do so., the most exact and positive statistics on all institu- 
tions would be required. Yow, part of the necessary informa- 
tion is found in the general literature on the subject. Part ot 
the statistics concerning Yew York, however, I published 
some time ago, but have not taken particular pains to give 
them a wide notoriety. Still, some medical journals have re- 
published part of my statements. The subject, however, is 
too important to be dealt with in a superficial or supercilious 
manner. Therefore, I shall give to-night what I have, and 
for what it is worth. INAUGURAL ADDRESS. 
. About a year and a half ago I read to the medical board of 
the Infant Hospital, Randall’s Island, a report on “ the raising 
and education of abandoned children in Europe, with statistics 
and general remarks on the subject.” It was printed in the 
minutes of the Commissioners of Public Charities and Correc- 
tion. A few hundred copies, which they liberally placed at my 
disposal, I distributed among the medical journals of the coun- 
try, such persons as I knew to take an interest in, or have 
a connection with, foundling or infant institutions, and a num- 
ber of medical gentlemen. I now believe it was a false profes- 
sional pride that induced me to withhold my essay from the 
secular papers and the public on the ground that it was but a 
report to my colleagues of the medical board of the Infant 
Hospital, and because I was, perhaps, too deeply impressed 
with, or wrongly influenced by, the rules laid down in the best 
intended, but in some respects rather naive and unpractical 
law-book, the “ Code of Ethics.” I now believe that the pub- 
lic and the papers had a claim to possess that report, and that, 
if its contents had been thoroughly ventilated in the press, 
public opinion might have been, before this, corrected to a 
certain degree in regard to the best means of raising aban- 
doned infants. For I had enjoyed unusual facilities. Not only 
had I several months to spend on collecting the necessary ma- 
terial, during the summer of 1869, but the authorities, both 
public and professional, of. England, France, Germany, and 
Austria, aided me in my endeavors, and a great many other- 
wise inaccessible, never-printed statistics have been copied by 
or for me; not to speak of a manuscript volume on the found- 
lings of Bohemia, handed over to me by one of the best 
authorities on that subject, Prof. Ritter von Rittershain, of 
Prague. My mistake in not giving the report the publicity it 
ought to have had was, however, in part corrected by some 
medical journals, in part by a paper read before the Social Sci- 
ence Association in Philadelphia, by Dr. Parry, who has de- 
servedly earned the thanks of the public for his dealing with a 
number of questions, both social and physical, of the foundling 
question, in accordance with the statistics and results of my 
little book, to the extracts of which he adds valuable informa- 
tion on the city of Philadelphia. Thus I cannot complain of INAUGURAL ADDRESS. 
my work having been in vain; still, the most important ques- 
tion appears not to he as yet answered sufficiently to the satis- 
faction of the public at large. This question is, Ought chil- 
dren, or rather ought infants, to he raised in public institutions 
or in private families ? In the city or in the country ? By 
wet-nursing or artificial food ? Of this latter I shall not speak, 
because in theory everybody agrees, if it were only on philo- 
sophical or religious principles, that babies ought to be raised 
on breast-milk. 
Thus, the question is practically reduced to this : Is it de- 
sirable to collect infants in an institution, combined or not 
with a lying-in establishment, there to raise them. Is it prefer- 
able to farm them out to private parties ? Is it preferable to 
take the intermediate road, and divide their numbers up in a 
number of country cottages ? 
The first plan, to gather and raise infants in a public in- 
stitution, in a large city, commends itself at first sight. There 
is a large, commodious building, facility of getting the neces- 
sary help, kind-hearted superintendence, the proximity of city 
comforts and medical attendance; there is a large number of 
people whom you expect to call upon for generous contribu- 
tions. The idea suggests itself, also, that a lying-in establish- 
ment ought to be combined with every such institution des- 
tined to receive foundlings ; for the saving must be immense 
when the baby is taken care of, before his birth, by the same 
kind hands that are to fondle him afterward. Let us, how- 
ever, do away with this plan at once. Every medical man 
knows it to be a fact that a lying-in asylum will generate dis- 
eases more than any other hospital, and infect the babies. 
Every man with hospital experience has observed it, and every 
general practitioner has met with puerperal diseases in women, 
and severe affections of the new-born, at the same time or in the 
same houses. It is not long since Lorain published a vol- 
ume on the “Puerperal Fever of Women and Infants.” I 
have myself noticed the fact that when in a public institution, 
of which I shall have to speak, erysipelas appeared among the 
children, one of the houses, which was by far inferior to the 
other from a sanitary point of view, wTas entirely free of the dis- 
ease, while the better house was infected with erysipelas among INAUGURAL ADDRESS. 
the children, only because part of it was used as a lying-in 
establishment. I wish those gentlemen and ladies who think 
of new institutions of the kind, would consult the physicians 
with whom they have the good luck to be connected, and with 
whose recommendations they are always eager to go before 
the public; I also wish the medical gentlemen would forward 
their knowledge, their opinion, their judgment, although not 
asked for, for the benefit of their friends who work, to the best 
of their knowledge, on the impulses of their hearts. These 
friends of theirs cannot, however, ask for advice about spe- 
cial questions, as they know nothing about them. It is impos- 
sible to ask questions without a certain knowledge. This 
knowledge about the absolute danger of combining large lying- 
in hospitals with foundling or child’s institutions they have 
not. Therefore, I urge upon the medical gentlemen to warn 
their friends and the public against a step attended with 
positive danger to the infants whom they mean to benefit. 
The question and its answer is such an old one, and has been 
answered so often and so uniformly, that it ought no longer to 
be necessary either to put or answer it. Even where there 
are large foundling institutions and lying-in establishments in 
the same city, in Europe, they are no longer found under 
the same roof. In this particular department of raising babies 
it appears as if the arts of printing and steam-shipping had 
never been invented. The experience of all Europe, so dearly 
bought, so bitterly complained of, goes for naught here. We 
mean to make our own sacrifices, have our own victims, 
mourn our own losses, do as badly as any by-gone century, 
because we do not take the trouble of profiting by the ex- 
perience of the Old World. A lady at the head of a large 
new institution of the kind in this city has told me herself 
that she knew nothing about the results of the different 
modes of raising babies in Europe. Let, then, the medical 
men in good standing, large practice, and social connections, 
who may be asked for advice, or whose information will be 
thankfully received by the generous planners of new institu- 
tions, protest against the combination of lying-in and found- 
ling hospitals. By so doing, they will counteract the empiri- 
cism which in so many instances has been the curse of our 
political and social institutions.  INAUGURAL ADDRESS. 
Next in order is tlie question whether babies ought to be 
raised in the country or city. 
One reason why infants should be raised in the country, 
even under equal circumstances, is the statistical fact that 
they will thrive better. Of 100 children born alive, there 
died before the fifth year : 
In the cities. 
In the country. 
Difference. 
France 
... 1853-’54 
35.69 
28.56 
7.13 
Holland 
,.. 1850-’54 
36.25 
28.90 
7.35 
Sweden 
... 1851-’66 
38.86 
24.50 
14.36 
Denmark 
... 1850-54 
29.66 
22.68 
6.98 
Sleswic 
,.. 1845-’54 
27.42 
23.42 
4.00 
Holstein 
,.. 1845-’54 
29.92 
25.29 
4.63 
Saxonv 
, .. 1847-’49 
39.88 
36.22 
8.66 
Hanover 
,.. 1854-’55 
28.70 
26.47 
2.23 
Prussia 
.. 1849 
36.02 
29.47 
6.55 
Average... 
.... 33.60 
27.28 
6.32 
Of 100 deaths, of all ages, in England, there were— 
In all England 
Up to the end of 
the second year. 
31.58 
Up to the end of 
the tenth year. 
44.91 
Cities with 100,000 inhabitants or more, 85.12 
51.39 
“ “ less than 20,000 
31.49 
46.79 
Manufacturing country districts... 
35.36 
46.90 
Agricultural districts 
24.33 
35.40 
Mr. Husson urges even the shortening of the preliminary 
stay of the foundlings at the central depot, although a number 
of wet-nurses are kept there, and wants them transferred to 
the country instantly. 
Last in order, not least, is the question where foundlings 
ought to be raised—in institutions, or private families. 
Places inhabited by many can never yield an atmosphere 
as tit for breathing as well-kept private residences. More- 
over, young infants, in consequence of their delicate constitu- 
tion, and their not producing vital warmth by physical exer- 
cise, are confined to the house and room during the greater 
part of the year and day. Besides, offensive admixtures to 
the atmosphere of rooms in which many children are living 
cannot be avoided. Even the institutions in which adults are 
kept, suffer from the same influences, to such an extent that 
not unfrequently the very entrance into such a place is a INAUGURAL ADDRESS. 
guarantee of imminent disease, and portions of hospitals have 
sometimes to he closed. Alvine discharges and urine con- 
taminate the air of infants’ wards to a considerable degree. 
From this source originate the numerous cases of poor sangui- 
fication, and of constitutional diseases, such as rickets, scrofula, 
etc,, even typhoid fever and scurvy; from this source comes 
part of the really immense mortality of foundling hospitals. 
Whenever the attempt is made to correct this cause of disease 
and death, you will find that this attempt is punished at once.. 
Yentilation is never complete except by opening windows. 
To relieve the wards of their unbearable stench—I advise 
you to visit a large, fine-looking, whitewashed, clean ward 
in a foundling hospital, in a Nursery and Child’s Hospital, 
at 6 a. m.—you open the window, and in come the enemies 
of mucous membranes — intestinal catarrh, entero - colitis, 
bronchial catarrh, pneumonia. Of 88 deaths in the Nursery 
and Child’s Hospital which I shall specify to you, more 
than 40 are due exclusively, or partially, to pneumonia. 
These facts have been the causes of the universal changes 
in the rearing of the infants left on the hands of society 
in all Europe. At present, the former foundling institutions 
are nothing but depots for temporary admission, and speedy 
distribution about the country. 
There may be drawbacks also, as far as private boarding 
is concerned. But, where, in such an individual case, or a 
number of individual cases, changes are required, they are 
easier to make than in institutions, which as a rule are more 
than comfortably filled. 
Even if the feeding is the same in private boarding and 
public institutions, the results are more favorable in the former 
category. That a baby should live and thrive on artificial 
food, in a private family, is by no means a rare occurrence. 
Every attentive person, every medical man, has ample op- 
portunities for such observations. That, however, bottle-fed 
babies in a public institution should survive, is a rare excep- 
tion. In the wards of infants’ hospitals everywhere the re- 
ceiving of a baby in the purely bottle-fed department is 
acknowledged by all as amounting to a sentence of slow 
death. Moreover, the only article of food without which a INAUGURAL ADDRESS. 
baby could not be kept alive, viz., milk, can be more readily 
and more regularly procured by the poorest countrywoman 
than by the richest and most circumspect institution. 
Besides, the nurses of institutions having charge of a num- 
ber of infants at once, by day and by night, are very apt to, 
and surely will, lose the self-sacrificing patience and the ever- 
lasting attention which are absolute requisites for the sus- 
tenance of a young human being. 
A task that requires all the holy instincts, the self-immo- 
lating, restless care of maternal love, is left sometimes in the 
hands of corrupt, lazy, whimsical, or malicious women, who 
make it their business to neglect their business, and are 
womanly and motherly only as far as they are so anatomically. 
It is much more probable that the poorest countrywoman 
who takes charge of a society’s child, under the superintend- 
ence of the proper authority, under the eyes of her neigh- 
bors, and with motherly feelings developed in the poorest one 
bound in marriage and family ties, will succeed in saving a 
nursling from certain death. 
I have spoken of superintendence. It is necessary and 
must be close. Of the infants sent out by the “ general 
office of nurse children ” under M. Husson, at Paris, and 
closely watched, the mortality under a year is 17 per cent., 
viz., but one per cent, more than the average mortality of 
the same age in all France. 
Those placed out, on the same conditions, by private 
offices, and not watched, yield a mortality of 42. 
Human nature is the same everywhere. The general re- 
sults of not watching the parties to whom children are 
confided, must be feared, if not expected. We could learn 
from the ladies of Berlin, Germany, how the united efforts 
of the public, especially of the ladies, can be made useful 
under the directing control of the official authorities. 
The latter I prefer as a directing powder. Society itself, 
the State, must be considered responsible for the life of every 
human being that can be saved. It is a duty, not good-will; 
it is good policy, as I have proved in my report, to practise 
charity. Human society has committed both a blunder and 
a crime, when a member that could be saved, physically, INAUGURAL ADDRESS. 
suffers death; when a member whose soul and heart might 
have been kept pure, will sin.1 How is it with us in many 
instances? A party of iadies or gentlemen favor the idea 
of founding some institution. They ask for contributions. 
Sometimes they will contribute themselves, although they 
may not expect to read their names in the newspapers with 
the amounts attached. They erect large buildings, which 
they cannot pay for, or receive patients whom they have no 
1 Of the whole population of the countries of Europe, according to 
Wappaeus, 33.66 per cent, are helow fifteen years of age. Thus one-third 
of the living are consumers only, while they produce nothing at all. Be- 
tween fifteen and twenty years, when most individuals are still unproduc- 
tive, very many still preparing for their vocation or trade, are 9.72 per 
cent. But 48.88 per cent, are between twenty and sixty years, the period 
of activity and work. Between sixty and seventy years, a period of life 
which is almost unproductive, are 4.92 per cent., and beyond that age, 
where unproductiveness is the rule, there are 2.81 per cent, of the whole 
population. At all events, nearly one-half of the population are consumers 
only, before they are able to repay society for the sacrifices the community 
has to bring in order to raise them and render them productive. Thus a 
sound political economy requires the continuation of life until and beyond 
the period of full and unbiassed productivity. "Whatever life is thrown 
aw'ay before, is just as much capital thrown away. Therefore both social, 
moral, and political economy insist upon the protection of the lives of 
the newly-horn and young infant. Humanity requires it, and common 
prudence commands the saving of a product after it has been called into 
existence, and has given rise to a waste of working power. Political 
economy need not be told that a mother who carries a child does less 
work than in normal circumstances. To waste the product after it has 
given rise to expense, which is equal to non-production, is a direct injury 
to national wealth and power. Every new invention in medicine and sur- 
gery, the forceps, vaccination, chloroform, have been so many means of 
increasing the national wealth by saving life. 
But this is not the only consideration of importance. The- lost life is a 
dead loss, but the raising of unhealthy children, or vicious ones, amounts 
to a constant injury to society, a perpetual malignant disease eating the 
marrow of the land. If, therefore, any means are resorted to to save the 
lives of, and providing an education for, the abandoned or orphan children, 
they ought to he sufficient, and amply so. If this duty is neglected, the 
punishment falling upon a community in particular, society in general, is 
but just. Neglect of either physical welfare or moral and mental educa- 
tion is equally dangerous. 
Insufficient physical development, depending upon incompetent nurs- 
ing, scanty or injudicious feeding, results in the raising of a class of persons INAUGURAL ADDRESS. 
sufficient means to support. Then, instead, of paying from 
their own pockets, as they have followed their own hearts and 
imaginations, they ask for further contributions, they make 
people embroider, knit, and sew, and buy their owrn work, they 
make the public buy musical entertainments, for which no- 
body pays, ay, they make them dance. If all that is in- 
whose presence in society is a dead weight and an eating cancer. Feeble 
men, crippled women, raised by insufficient measures for the bringing up 
of children, will require renewed efforts for their support on the part of 
society as long as they live. Thus capital is wasted on their being born, 
nursed, and supported. If they had never been conceived and born, it 
would have been better for society. As they exist, they have a claim on 
humanity. 'When they have facilities to work, society has a claim on them 
and will thrive through them ; not otherwise. Thus raising the poor into 
healthy and robust persons is a direct gain. 
If the moral and mental education of the same class of individuals is 
neglected, there is more than a mere probability of demoralization being 
the result. Public order is destroyed by such a population, and public 
means squandered. Means that were saved in the raising and educating 
of the babies, will be required tenfold to sustain houses of correction and 
state-prisons. In 1853 there were, in the bagnios of France, 5,758 persons. 
Of these 391 had been illegitimate children, and 146 foundlings. In the 
state-prisons, of 18,205 inmates, 880 illegitimate and 361 foundlings. And 
the same proportion holds good for all houses of correction. Of 1,300 
Frenchmen, one was the subject of legal punishment, and among former 
foundlings one of 158. Thus, of the foundlings of France, eight timesjis 
many get punished by law as the average population. 
Thus it appears that the most economical policy consists in raising and 
educating infants and children into physically and mentally healthy men 
and women. Money spent on them is easily saved in hospitals and pris- 
ons. There is but one excuse for a community for neglectiug the obvious 
duties toward the children and itself, viz., extreme poverty. Therefore 
where a special community has but deficient means, the whole people, 
society in general, ought to hold themselves responsible. Society in gen- 
eral is benefited either by or suffering from their constituent parts, and 
therefore the care of the individual is a matter of common concern. If 
there is any meaning in the principle of general solidarity, it includes the 
right of every individual to a healthy body and a sound education. The 
equality preached by early Christianity and the doctrines of modern social 
science agree perfectly on that point, and the shrewdness of political 
economists has arrived at the same conclusion.—{The Raising and Educa- 
tion of Abandoned Children in Europe, with Statistics and General Re- 
marks on that Subject, by Abraham Jacobiy M. D.y Member of the Medical 
Boards, of the Infants'1 Hospital, Randall's Island ; and of the Nursery 
and Child's Hospital, New York, 1870.) INAUGURAL ADDRESS. 
sufficient, tlie common enemy is attacked; tlie common ene- 
my is the treasury, the people’s money, given away less by 
ignorant or injudicious legislators than by unscrupulous lob- 
byists. Thus you will find, in the financial report of the 
“ Seventeenth Annual Report of the Nursery and Child’s Hos- 
pital, in the city of New York, Fifty-first Street, corner of 
Lexington Avenue, March 1, 1871,” the statement that of 
$15,000 dollars spent in one year (rent not included), the 
house inmates paid about $12,000, the treasuries of the State 
and other authorities $21,000, and that private subscriptions 
and donations amounted to little more than $1,700 dollars. 
The balance was made up by the receipts of the great charity 
ball. 
If, on further consideration, you discover that, besides 
subscriptions, donations, payments of inmates, and proceeds 
of charity ball, the treasuries of the people of the State of 
New York pay alone 30 per cent, more than the rate of sus- 
taining tlie infants under the charge of the Commissioners of 
Charities and Correction, you will, I hope, agree with me in 
my conclusion that the State, that society, can work at a cheap- 
er rate, and on a more uniform plan, than the dozens of self- 
constituted authorities. Altogether, you will find that the 
total cost of sustaining the infants of the Nursery and Child’s 
Hospital amounts to more than double the expense of the 
Commissioners for the same purpose. I wish I could say that 
their successes were double as to general care, good food, clean 
wards, and mortality. Unfortunately, the high standards of 
food, wards, and mortality, are undeniable. 
Now, in my opinion, if the expenses are to be borne by 
the State, the State ought to have the credit; for it has the 
moral responsibility toward the indigent and helpless, and the 
tax-paying public, who seldom learn what is being done with 
their money, or to what extent it will be given awray. I re- 
mind you of the fact that the Legislature of last year decreed 
away nearly a million as their contribution to private or even 
sectarian institutions. I know even of instances where large 
sums of money, people’s money, were spent for purposes alto- 
gether different from what they were asked and given for. Let 
me, however, return to another special subject of this paper. INAUGURAL ADDRESS. 
The subject, when brought before an intelligent and know- 
ing public, is so plain that it commands interest at once as 
one of the most urgent questions of the day. Therefore, the 
Medical Society of the State of ISTew York passed, in its 
second meeting in February, 1871, the following resolutions : 
Whereas, Humanity acknowledges the claims of every human being to 
life and to some degree of prosperity, and recognizes in every civilized 
country the right of every new-horu to be protected and supported; and, 
Whereas, Political economy requires the saving of a being which has 
given rise to outlay until and after it can become useful and repay the ex- 
penses incurred in its full development; and 
Whereas, The moral constitution of society requires that every member 
of society should obtain a sufficient training of its intellectual and moral 
powers; and 
Whereas, The mortality of infants, being large from natural causes, is 
three times larger in public institutions destined for the maintaining of in- 
fants than in the general infant population; and 
Whereas, The Board of Commissioners of Charities and Correction, al- 
ways willing to he guided by competent: advice, and desirous of doing their 
best, have already had a report prepared for them suggesting changes and 
improvements in the raising of their infants: 
Therefore, he it resolved by the State Medical Society to appoint a com- 
mittee to investigate and report, in the meeting of 1872, upon the following 
subjects: 
1. The causes of the fearful mortality of abandoned infants in general, 
and those in large public institutions in particular. 
2. The reasons for the giving up of large institutions, and the success 
of the dispersing system for abandoned infants, in every country of Europe, 
where the preservation of lives was an object. 
3. The causes of the unusually large infant mortality in the institu- 
tions in charge of either public or self-constituted authorities in New York 
City and State. 
4. The plans and means for improving the condition of foundlings and 
abandoned children in New York City and State— 
a. During their infancy, when they are most subject to disease and 
death. 
h. During childhood and adolescence, when they require an education 
sufficient to make them useful members, and prevent them from 
becoming enemies of and dangerous to society. 
As I am a member of the chosen committee, I have here- 
with offered a small contribution to the elucidation of the 
subject, and offer another one in studying the statistics of one 
of onr great institutions which has been founded and sup- INAUGURAL ADDRESS. 
ported tor the alleged purpose of saving life. I select the 
Nursery and Child’s Hospital, for the very simple reason 
that I know as much about it as about any other; in fact, my 
knowledge of the minutiae of that institution you will find 
tolerably complete. I consider the statistics I lay to-night 
before you as but preliminary to, and part of, my future 
report to the State Medical Society. By them I mean to 
prove the absolute impossibility of raising infants in a large 
institution, a fact that has been ever so many times proved in 
Europe. The first communication I have to make, I beg per- 
mission to recapitulate from my report on “ The Raising and 
Education of Abandoned Children in Europe,” etc. 
The Nursery and Child’s Hospital, New York, under the 
management of thirty-five estimable ladies of the city, in which 
the infants are fed half on breast-milk, half on well-selected arti- 
ficial food, a mixture so frequently and advantageously used 
in private families, exhibits in the records of 1870 the follow- 
ing facts : I take the liberty of adding at once, that I make 
use of limited statistics only, because up to March, 1870, the 
records have not been well kept. Since that period they have 
been kept regularly, as I, being one of the medical staff of the 
institution, know from personal experience. There have been, 
from March 2d to May 31st, 97 admissions, 20 discharges, 
10 deaths. 
The admitted nurslings were by no mdans new-born ; in 
fact, very few belong to that category. Eighty of these ad- 
mitted children had a total age of 367 months, averaging 4.5 
months for each child at the date of admission. Seventeen 
of the admitted children were 2 years and over, up to 10 ; 
altogether there is a total number of 84 years for 17 children 
over 2 years, that is, an average age of 5 years. Of these 17, 
being of an age where the rates of mortality are always low, 
none died. Thus we have 10 deaths in 80 infants with an 
average age of 4.5 months at the date of admission, within 
a single quarter of a year. Further, of these 80 infants (from 
2 days to 2 years old), admitted during these 90 days, 20 were 
discharged. The shortest stay was 1 day, the longest 68 days. 
The total days of these infants in the institution was 324 days 
for 20 inmates, that is, discharges took place, or were taken, INAUGURAL ADDRESS. 
in 20 cases out of 80, after an average stay of 16.2 days in the 
Nursery. Thus there are 10 deaths in 60 children of an 
average age of 4.5 months at the date of admission, within 
the 3 months following their admission. The average age is 
o c? O 
a little higher, because most of the infants who were dis- 
charged were very young, and have been counted in the grand 
total of ages. Now, if we grant that March and one-half of 
April are unfavorable months, we have to admit that May is 
favorable to health, that the winter months from December to 
February are just as untoward as March, and that the heated 
terra of the summer is surely still more dangerous. Thus we 
may safely assume that the rate of the general yearly mortality 
in,the Nursery is certainly about the same as in the mentioned 
quarter of March, April, and May; therefore the mortality 
through the year would amount to 40 out of the number of 
60, or, if we mean to count the infants that got their dis- 
charges after 16 days’ stay in the institution, out of SO children 
who were admitted at an average age of 4.5 months. I 
prefer this latter figure for the following reasons of both justice 
and charity: The 50 children remaining, having grown a 
quarter of a year older, meanwhile, would, in the second, 
third, and fourth quarters exhibit a smaller rate of mortality, 
while those newly admitted would yield the very same mor- 
tality we figured above. Thus we can afford to count those 
20 discharged ones with the rest. If in future the records are 
kept as fairly as in the last few months, we shall have facts 
instead of estimates. 
Now, then, there are 10 deaths quarterly in 80 children, 
each one 4 to 5 months old at the date of admission. Grand 
total of 50 per cent, deaths yearly of children of 4 to 5 months 
and upward to 2 years. 
Statistics prove that the mortality of the infants born 
alive, from the date of birth to the fifth month, is larger than 
that of infants between that age and 2 years. Of 3 infants 
who die before the termination of their first year, 2 are less 
than 5 months old, and one is between 5 and 12 ; and, of 31 
who die before the end of their second year, 26 have not 
reached the end of the first, and but 5 die between their first 
and second year. Thus, of the above 50 per cent., 8 would INAUGURAL ADDRESS. 
belong to tbe second year, 42 to the first. They were admitted 
at a time of life when mortality is but half of what it is in the 
first months. Thus it appears that the mortality of the Nur- 
sery, if all of the admitted infants were new-born instead of 
being 4 to 5 months old, would be so appalling that I am glad 
I am not required to state its exact figures. The worst figures 
of the European foundling-hells of former centuries are not 
more fearful than ours, and, although being an officer of that 
institution myself, and believing that I and all the rest of us 
have conscientiously tried to do our duty, I cannot but testify 
and bow down to the truth, that, in spite of all the efforts of 
the medical staff, and the painstakings of kind-hearted ladies, 
the probability of the lives of children intrusted to a public 
institution is very slim indeed. The younger the children, 
and the larger the institution, the surer is death. Every story 
added to an edifice which is meant to be a temple of love is 
an additional hecatomb of the innocents. Modern civiliza- 
tion, planning for the best, but mistaken about the means, has 
succeeded in out-Heroding Herod. 
These facts are sufficient to justify the abrogation of large 
institutions designed for the raising of young infants. The 
facts appear to show, besides, that older children (not a single 
death occurring in IT of an average age of 5 years) bear up 
easily under the same circumstances that are a source of death 
to the infants. 
In the same institution, viz., the Nursery and Child’s 
Hospital, there were 41 births from the 1st day of January to 
the last of May. Of the infants, 4 were stillborn, 6 died, 23 
were discharged, 8 remained in the institution to 1st of July. 
Those remaining in the institution on the 1st of July were all 
born in April and May; with a single exception, every one 
born previous to March 31st having left the institution, or 
died. The 23 discharged infants were in the institution 609 
days, each averaging 26.5 days. Those who were born and 
died in the institution, lived altogether 2T4 days, an average 
life of 45.6 in the institution. Those 8 who remained in 
the institution on July 1st had lived, in toto, 340 days, an 
average of 40.25 for each of the 8. Thus, their average 
ages was not yet the average age at which those 6 died, nor INAUGURAL ADDRESS. 
were the agea_of the discharged 23 much more than one-half 
of the average ages of those who died. The naked fact is, 
that of 14 infants (23 having been discharged) 6 died. 
Now, if I add the fact that the women are well kept, the 
food is good and plentiful, medical attendance as efficient as 
the sometimes faulty method of appointing medical attendants 
in our public institutions can make it, and the whole institu- 
tion under the assiduous management of thirty-five ladies 
belonging to the best society of New York City, I believe I 
am justified in concluding that a large institution is the very 
place that nurslings and infants ought to be kept out of. 
For, the poor tenements of our working-classes yield better 
results in their raising of infants than the large institutions 
the city might be proud of. 
From the 1st of June to the 1st of October, 1870, 101 
children were admitted to the Nursery and Child’s Hospital. 
Their average ages were more than 1 year 8 months. There 
were 29 from 2 to 13 years old, and therefore beyond the 
principal ravages of fatal disease; 27 were removed, after 
they had been in the institution an average time of 20.4 
days. Thus there remained 55 hona-jide inmates of less than 
2 years. In that same quarter of a year there are 33 deaths 
recorded in the book of the Nursery and Child’s Hospital. 
It is important to know that, according to a list before me 
containing names, ages, etc., 18 more children, who were 
admitted before October 1, 1870, died after that day. 
This frightful mortality of the inmates of the Nursery and 
Child’s Hospital becomes more apparent by comparing it with 
the following statistics (of Report, p. 38): According to Farr, 
of 392,234 children born in England in 1867, there died before 
the end of their first year 65,464, viz., 16.69 per cent. Accord- 
ing to Prof. Ritter, of Prague, the mortality during the first 
year of legitimate and illegitimate children born alive in 1855- 
1861 was 25.36 per cent, in the Austrian Empire. In Hungary, 
considered separately, in 1862-1865, 24.95 per cent. In Berlin, 
according to Chamisso, the mortality of all the infants born 
alive from 1816 to 1841 was 22.7 per cent, up to the end of 
their first year (33.5 of the third, 36.9 of the fifth). The rate 
was lower in 1842-1860; but in 1861-1866 it was 28.4 per 
cent. IJS'AUGrlTEAL ADDRESS. 
These reports were written and printed, although—I am 
at this day ashamed to acknowledge it—withheld from the 
public at large in consequence of false professional pride— 
when the following newspaper article—one of very many— 
appeared on November 1, 1870: 
The Infants' Home—a Worthy Institution—what it is doing, and how 
it is done.—Among the legion institutions supported by New York 
charity, few appeal with greater force to the promptings of humanity than 
the organization the name of which stands at the head of this article. 
Doubtless, one must watch intelligently its daily workings fully to appre- 
ciate the end it is designed to and does accomplish ; but yet the most casual 
observer can indorse what the managers tell. 
The histories which could make our annual reports intensely interest- 
ing must be as silent as they are sad. They say: “ We often feel that it is 
not alone our prayers which have brought God’s favor on our work, but 
the sighs and prayers of penitent sufferers have been answered by the con- 
stant stream of heavenly blessing.” 
There have been two large additions to the building. The Asylum, 
corner of Fifty-first Street and Lexington Avenue, since its occupation for 
present purposes sixteen years ago, and the last annual report, shows 371 
children in its care, 100 of whom were horn there, and the success of the 
lying-in wards has exceeded the most sanguine hopes of friends. To these 
come women—never without reference—some from poverty, some from 
shame and the world’s cold scorn—for bodily and spiritual comfort and 
sustenance. 
The interest of the State Legislature has been so awakened by repre- 
sentations of the board of officers that power has been accorded to take 
in many who from poverty and despair would have been driven to suicide 
or infanticide. 
The histories and the mysteries of the place may never he written, as 
we have said before; howheit, as an example and epitome of all, the re- 
porter might speculate as best might be on the wan, joyless face of one 
young mother lying there recently, of whom nothing was known save in- 
violably to those in charge, if, indeed, there was a history, but the framed 
Scripture text at the head of her bed seemed a chapter of revelation to 
the visitor, reading, “Whom the Lord loveth he chasteneth, and scourgeth 
every son whom he receiveth.” 
We went to the children’s school, for there is a school for such of the 
children as are large enough to attend, and neat copy-hooks were shown us 
with great pride by sturdy-looking hoys, and little girls with roguish, happy 
faces. Their childish voices united in singing for our entertainment, toof 
and we were shown the first composition that had ever been written in 
the school—the chef-d'ceuvre of little black-eyed Bertha. 
Who could think unmoved of these tender ones, rescued, perhaps, from 
the tyranny of a drunken father, from the breast, earlier, of an intemper- INAUGURAL ADDRESS. 
ate mother, giving thanks that here they were safe and happy? The an- 
nual charity ball, in behalf of the institution, has always met with brill- 
iant success, but its necessities increase with its sphere of usefulness, 
and the provision of a quarantine establishment for contagious diseases 
has wellnigh or quite absorbed the proceeds of the last entertainment, so 
that, if subscriptions and donations should not be forwarded to the rescue, 
the work of charity must be much curtailed. The officers the present year 
are Mrs. Cornelius Dubois, First Directress; Mrs. T. C. Dorernus, Second 
Directress; Mrs. Henry Anthon, Third Directress; Mrs. E. ~W. Stough- 
ton, Treasurer; Mrs, Algernon S. Sullivan, Secretary; Miss R. B. Hunter, 
Assistant Secretary. Among the active managers and honorary mem- 
bers are found the names of many that are “household words” where 
moral and physical want abound. 
This article is but a specimen of many, and none of the 
most brilliant or affecting of its kind. How they are made up, 
on the spur of, and for the moment, we all know who read our 
daily papers, the result of many different brains, hearts, and 
pens. Maybe even those are right who assert that now and 
then lips of honey, cheeks of milk and blood, eyelashes of 
silk, hands of velvet, voices of silver, dollars of gold, and other 
organic and inorganic contrivances have a great influence on 
men, nations, and newspaper articles. At all events, when 
you compare a lengthy article in the same paper (the New 
Yorlc Times of November 12, 1871), you will find that in 
consequence of statistical data contained in my report on “ The 
Raising and Education of Abandoned Children in Europe,” 
and other facts credited to Dr. Parry, of Philadelphia, the 
placing-out system is pronounced the far superior one. 
Let me, however, return to my statistics, or rather go on. 
First, let me direct your attention again to a memorandum 
copied from the records of the Nursery and Child’s Hospital, 
which I here present. It contains the names and ages of 
18 infants and children who had been admitted before, but 
died after, the 1st of October, 1870, that is, after my last 
report was made up. They range from 21 days to one year 
and 10 months. It also contains the ages of these 18 chil- 
dren at the dates of their deaths ; they range from 2 months, 
to 3 years 3 months and 13 days. It further contains the 
causes of their deaths, which one by one read as follows : 
Diarrhoea, tuberculosis, diarrhoea and pneumonia, pneumonia LNAUGUEAL ADDEESS. 
and cholera infantum, diarrhoea and pneumonia, chronic pneu- 
monia, pneumonia, pneumonia, marasmus, pneumonia, mea- 
sles and cancrum oris, measles, diarrhoea and pneumonia, chron- 
ic diarrhoea, capillary bronchitis, pneumonia, entero - colitis, 
chronic diarrhoea, diarrhoea and bronchitis. 
I have read this list to you, because, after hearing the pre- 
ceding reports of mine, you might have been under the im- 
pression that there were not a sufficient number of children left 
in the institution from which it could be recruited. 
Finis coronat opus. Let me continue: 
According to the records of the Nursery and Child’s Hos- 
pital, which appear to have been as well kept as those from 
March 1st to October, 18Y0,11Y babies were born in the lying- 
in department of that institution from October 1, 18Y0, to Oc- 
tober 1, 18Y1. Of this number 69 were discharged within a 
short time after their births; most babies go out with their 
mothers within a few weeks, some remain a little while longer. 
The aggregate stay of the 69 little ones amounted to 108 
months and 5 days. A month is always taken in my accounts 
as averaging 30 days; thus the average stay of each of the 
69 amounts to 1 month and 1Y days. 
My information on one of the rest is not positive. I do 
not know whether James McAlister has been discharged or 
died. I have not counted him among the dead. Of the 
other 4Y babies, who were not so fortunate as to get discharged, 
2Y died. Their aggregate ages at the time of their deaths 
were 69 months, or 2 months and 1Y days per head. We have 
no means of knowing how many of the discharged 69 would 
have succumbed, if they had averaged a stay at the institution 
of 2 months and 1Y days, instead of 1 month and 1Y days. 
Of the 20 who remain alive within the Nursery, 9 have been 
born in the last quarter of the year; 5, viz., 20 per cent., in the 
very last month. They have not yet averaged 2 months and 
1Y days. The future will show whether they are to be counted 
among the living, the dead, or the discharged. The list of the 
18 diagnoses (more or less), confirmed bj post-mortem exami- 
nations which I have read to you before, renders it doubtful 
whether all of them will live. INAUGURAL ADDRESS. 
I wisli every practitioner of medicine present in this liall 
to compare his own experience and statistics among the rich, 
and the poor, with these results obtained in the Nursery and 
Child’s Hospital, where every one of the 47 has had its moth- 
er’s, or, in some cases, nurse’s milk. Of 47 new-born babies, 
27 have died at the average age of 2 months 17 days, and 
half of the rest are not old enough to have reached this 
average. 
You will now be prepared for some more figures: 
Admissions of Inf ants and Children to the Nursery and Child's Hospital, 
October 1, 
1870, to 
October 1, 1871 
between the ages of one 
day and 
nine years one month : 
October, 1870 
.... 25, 
with aggregate ages, 22 
years, 5 months 
23 days. 
November, “ 
.... 22 
44 
35 
44 
11 
U 
27 “ 
December, “ 
.... 21 
44 
27 
u 
7 
LL 
27 “ 
January, 1871 
.... 22 
u 
14 
u 
4 
U 
4 “ 
February, “ 
.... 18 
u 
23 
u 
4 
LL 
26 “ 
March, u 
.... 17 
u 
38 
u 
11 
U 
9 “ 
April, “ 
.... 21 
a 
30 
u 
10 
U 
8 “ 
May, 
.... 17 
44 
24 
Li 
8 
44 
3 “ 
June, “ 
.... 19 
44 
37 
U 
0 
44 
3 “ 
July, “ 
.... 27 
a 
37 
Li 
5 
44 
8 « 
August, “ 
.... 26 
u 
43 
u 
1 
44 
25 “ 
September, “ 
.... 18 
u 
25 
LL 
7 
44 
IB “ 
Total 
... 253 
361 
9 
26 
Thus the average of 253 infants or children admitted in 
good health from October 1, 1870, to October 1, 1871, amount- 
ed to 1 year 5 months 16 days. I naturally lay stress on the 
fact of their health being good when they were admitted ; for 
it is the rule of the institution that it should be so. This much 
is sure, that no child has died this year of a disease contracted 
before it entered the nursery. Still, so great is the liability of 
the inmates to fall sick in the institution, that the secretary of 
the medical board publishes, in the annual report gotten up in 
1870, the unnatural fact that 2,000 serious cases of sickness 
occurred in one year, among 377 admissions; and, in that of 
1871, over 1,400 cases of sickness, in 358 admissions. 
Of the 253 admitted from October 1, 1870, to October 1, 
1871, 128 were discharged within a short time after their ad- 
mission. I will presume they were all in good health when 
they left the institution. INAUGURAL ADDRESS. 
October, 
1870, 
Discharges 
took place. 
12 
Aggregate stay, 
in days, at 
the Institution, 
761 
November, 
U 
10 
755 
December, 
u 
16 
1,049 
January, 
1871, 
12 
393 
February, 
a 
11 
. 800 
March, 
u 
10 
666 
April, 
44 
12 
316 
May, 
u 
8 
274 
June, 
44 
8 
283 
July, 
44 
17 
848 
August, 
a 
7 
804 
September, 
(4 
i 
5 
132 
Total... 
128 
6,581 
Tims, the average residence of each of the 128, inside the 
Nursery, amounts to 1 month 21.1 days. 
If you compare the enumerated discharges and admissions 
in the several months with the deaths, or if you will take the 
trouble to look over the record I have before me, you will 
reach the number ot babies remaining alive in the institution : 
Discharged 
Died 
Eemain 
Admissions. 
since. 
since. 
alive. 
la September, 
1871, .. 
18 
5 
4 
9 
August, 
U 
27 
7 
3 
17 
July, 
U 
27 
17 
4 
6 
June, 
“ 
19 
8 
7 
4 
May, 
u 
17 
8 
4 
5 
April, 
u 
21 
12 
9 
0 
March, 
u 
17 
10 
3 
4 
February, 
a 
18 
11 
3 
4 
January, 
u 
22 
12 
8 
2 
December, 
1870, .. 
19 
16 
2 
1 
November, 
U 
22 
10 ' 
8 
4 
October, 
a 
25 
12 
12 
1 
After all, there were 125 hona-fide inmates, who stayed 
more than the average of 1 month 21.4 days. Of these died: 
October, 1870, 
Years. 
. 12 at aggregate ages 7 
months. 
1 
days. 
8 
November, “ 
8 “ 
6 
6 
20 
December, “ 
. 4 “ 
0 
11 
28 
January, 1871, 
,.8 “ 
8 
10 
0 
— 
—• 
— 
— 
Carried forward... 
.. 32 
16 
28 
56 INAUGURAL ADDRESS. 
Brought forward ... 
. 32 
Years. 
16 
months. 
28 
days. 
56 
February, 1871, 
3 at aggregate ages 1 
8 
1 
March, “ 
. 3 
44 
3 
0 
25 
April, “ 
. 9 
a 
11 
10 
2 
May, “ 
. 4 
a 
2 
6 
4 
June, “ 
. 7 
a 
8 
11 
12 
July, • “ 
4 
u 
3 
1 
19 
August, “ 
. 3 
u 
2 
6 
27 
September, “ 
. 4 
44 
5 
9 
21 
Total 
. 69 
58 
00 
17 
If you remember the meaning of the record of the 18, you 
will expect some more to die. Up to a fortnight ago, one, 
who was admitted at the age of 1 year 3 mohths 21 days, 
died at the age of 1 year 7 months, on November 19th, of 
pneumonia. Thus, up to this date of November 19th, there 
were 70 deaths among 125 healthy children, admitted to the 
Nursery. The average age at the time of death was 10 
months 7 days. 
The causes of death are attributed, in one case each, to 
croup, pleuro-pneumonia, entero-colitis and peritonitis, measles, 
pneumonia and croup, scarlatina and croup, diarrhoea and 
broncho-pneumonia, pleuritis, intussusception, broncho-pneu- 
monia, atelectasis (child of 11 months 4 days), pulmonary tu- 
bercle and pneumonia, measles and pneumonia, diphtheria, 
pulmonary tubercle—in 2 cases each, to marasmus, hypo- 
static pneumonia, measles and croup, cholera infantum, whoop- 
ing-cough—in 3 cases each, to tuberculosis, atrophy, measles 
—in 4 each, to chronic diarrhoea and pneumonia, diarrhoea and 
pneumonia—in 6, diarrhoea, 10 chronic diarrhoea, 13 pneu- 
monia. 
Of these 70 deaths, 18 occurred in children over a year, 52 
in such as were less than a year old. But 3 of the former 
children had been admitted before they were a year old : viz., 
2 were admitted at 10 months; 1 at 11 months 18 days. They 
died when they were 1 year 2 days; 1 year 17 days ; 1 year 
2 months 7 days old. Thus we arrive at a sum of 55 deaths 
among babies, who were admitted before they were 12 months. 
old. A large number of them had reached nearly that age at 
the time of their admission. INAUGURAL ADDRESS. 
But how many babies were admitted under a year, of whom 
55 could die within the short space of time reviewed in this 
retrospect ? 
Of the total of 253 admitted, 42 were over 3 years, 30 be- 
tween 2 and 3, 44 from 1 to 2 years, together 116 over 1 year. 
Of these 116, 76 were discharged in a short time. Of the 
remaining 40, 15 (18 less 3) have died within this limited 
time—a percentage, for the time being, of 37.5 among chil- 
dren over a year, very many of them over 2 and 3 years, and 
all of them intrusted to the Nursery in perfect health. 
Of the 135 admitted at less than a year, 52 were discharged 
after a short period ; 83 were left in the Nursery as bona-fide 
inmates. Of these 83, the number of 55 died within the lim- 
ited period which is the subject of this compilation. The ag- 
gregate ages of these 83 at their admission was 377 months; 
the average, 2 months 23.8 days. 
Thus it results that the mortality of babies intrusted in 
good health to the Nursery, at the age of nearly 3 months, 
within this limited period, is 66.26 per cent. 
The aggregate ages of the 55, at the time of their deaths, 
including those 3 who passed their first birthday while in the 
institution, count up to 26 years 11 months 1 day; the average 
age of each to 5 months 26 days. As their average admission 
took place at 2 months 23.8 days, they lasted 3 months and 
2 days each in the institution. 
Some questions submit themselves very readily: 
1. What will happen to those who have reached, like the 
dead, the end of their sixth month by this time, and will stay 
in the institution to the full end of their first year? For the 
average ages of those 18 above mentioned, who were admitted 
before October 1, 1870, and died after my former report was 
made, amount to 10 months 6 days. 
2. Was it fortunate, or not, for the 128 discharged children 
to stay but 51,4 days in the institution, as the time averaged 
between admission and death is 3 months 2 days? 
3. What is likely to become of the 20 living babies born 
in the place, and remaining at the present time in the institu- 
tion, provided their stay is extended to the end of their first 
year? On the 20th of November their average life was a  mAUGUEAL ADDEESS. 
trifle more than 6 months, and up to that period 27 out of 47 
(57.45 per cent.) had died. 
4. If 66\ per cent, perish among healthy infants admitted, 
as those of the Nursery, at an average age of 2 months 23.8 
days, what would he the percentage if the babies were admit- 
ted at birth, under the same circumstances ? 
To facilitate the answer to this latter question, I beg you 
to compare the statements laid down in a table contained in 
my “Report on the Raising and Education of Abandoned 
Children in Europe,” New York, 1870, p. 29. 
Of 100 newly-born infants died in 
Belgium, 
1840-’50. 
Holland, 
Austria, Sardinia, 
France, 
1848-’53. 
1851. 1833- 37. 
1853. 
0- 1 month 
5.18 
4.70 
10.96 
11.14 
6.60 
1- 2 months 1.76 
2.29 
2.55 
1.87 
2.85 
2- 3 
U 
1.27 
2.09 
1.96 
1.43 
3- 4 
u 
1.08 
1.91 
4- 5 
a 
0.86 
1.48 
3.42 
2.51 
- 2.39 
6- 6 
a 
0.76 
1.19 
6- 7 
7- 8 
u 
u 
0.72 
0.66 
1.7Y ■] 
2.40 
8- 9 
9- 
a 
u 
0.66 
0,65 
1.42 
- 4.89 . 
■ 3.15 
10-11 
11-12 
u 
a 
0.63 
0.80 
1.29 
• 2.78 
J 
0-1 year 
15.03 
18.14 
24.07 
21.84 
14.99 
From this table, which has been taken from official docu- 
ments, it is evident that the mortality of babies who have 
reached the end of their first quarter is but one-third or one- 
sixth, for each following quarter, of what it would be from 
the first hour to the end of the third month of life.—The four 
above questions are herewith submitted to your consideration, 
I think I might go on ad infinitum with the practical con- 
clusions. I want to draw but one conclusion, viz., that the 
attempt to raise babies in great institutions, even with large 
means to aid you, cannot be justified / that these institutions 
must be given up, and reserved for other purposes, and that 
the only system worthy of being sustained is, to place the 
children out with private parties. 
And now let us, for a moment, examine into the expenses 
of large institutions like the Nursery and Child’s Hospital. 
On p. 12 of the Seventeenth Annual Report, under the 
heading of “ Financial Report,” you will find the expenses fAUGUEAL ADDEE3S. 
between March 1, 1870, and March 1, 1871, laid down at a 
little more than $75,000. Of these I deduct at once 
$30,000 for “ temporary investment,” “ part purchase of* 
country hospital,” and “furnishing and support of country 
hospital.” Balance, $15,000. As repairs and insurance are 
counted up with more than $1,000, I estimate the rent of the 
immense buildings at $20,000 only. Thus I take $65,000 
as a fair, or rather low, average estimate of the wdiole sum 
spent for the benefit and support of 253 admitted children, 
and 117 lying-in women with their infants. They are the 
only beneficiaries, for the mothers taken in with, or in behalf 
of, their nurslings, and the wet-nurses, cannot be counted in 
this class, any more than the matron, the ward nurses, or the 
domestics. 
Those beneficiaries did not stay in the institution through 
the whole year, but a very small part of it only. The aggre- 
gate stay of the new-born, who were soon discharged, amounts 
to 8 years; those 27 who died at the average ages of 2 months 
17 days, to 6 years; those 20 who remain after the close of the 
year (October, 1870, to October, 1871), to 8 years. The aggre- 
gate stay of the 128 children who were admitted and soon dis- 
charged, to 18 years; of the 125 who are dead or still alive, to 
60 years. Total, 100 years. The aggregate stay of the 
pregnant women who were confined in the institution may 
be set down at 20 years. Thus $15,000, without rent, or 
$65,000, rent included, are spent on a year’s board of 100 
children (the new-born included) and 20 adults. Said board 
averaging the sum of about $100, rent not included. 
How nearly correct this estimate is, you find corroborated 
by the fact that the sum of about $12,000 is credited as “ house 
income” in this year’s financial report. Our summing up 
would average a yearly board paid by the inmates of $100, or 
a monthly one of about $8.00, which is almost the very figure 
(a little less) of the average board paid to the institution. 
While I remind you of the fact that my figures cover the 
time from October, 1870, to 1871, and the report alluded to the 
time from March, 1870, to March, 1871, and that, therefore, 
trifling differences may be found, you will still find a few of 
the items in the expenses highly interesting. INAUGURAL ADDRESS. 
The 120 animal hoards required in round numbers : $25,000 
for provisions ; wages amounted to $4,000; stationery, print- 
ing, and collecting (of $1,195 “subscriptions,” I suppose), to 
$625; wine, brandy, drugs, and surgical instruments, $1,800. 
Let, however, these figures suffice. He whom they have not 
yet convinced of the truth of my statement, that large institu- 
tions, no matter what their means are, will destroy their infant 
inmates, may, perhaps, change his mind on still further in- 
vestigation. At all events, it will prove a difficult task to 
trace the fearful mortality, of the institution I have spoken of, 
to radical faults in the manner in which it is conducted. I do 
not think there are many shortcomings in the administration of 
that institution, which will not be found in all carried on upon 
the faulty principle of accumulating large numbers of infants 
under one roof. Still, it must be said that institutions under 
dozens of managers labor under unusual difficulties—never 
thrive well. There is always something meddlesome, fidgety, 
inconsistent, incongruous, in large numbers; nor is the trans- 
action of business by a ring, if we are well informed, cheap or 
expedient; nor can we presume that, where less special knowl- 
edge than ambition and theoretical love is brought to bear 
upon a serious task, like that of conducting an infant asylum, 
the results are surprisingly favorable. I say “theoretical 
love; ” for, where aboard of several dozen of managers in Hew 
York City cannot command more than seventeen hundred 
dollars’ worth of “ subscriptions and donations,” I dare say 
that love requires more practical illustration. 
Old Homer says that a government of many heads does 
no good. He wants one master. Perhaps he thought of in- 
fant asylums. The improvements effected in the management 
and mortality of the Infant Hospital (Randall’s Island) by the 
intelligent administration of a single medical officer with his 
subordinates, under the control and in the pay of the Commis- 
sioners of Public Charities and Correction, speak for the ad- 
vantages of special knowledge and a uniform plan. 
Let me, then, again urge the fact that large infant asylums 
will destroy children. 
When this fact became known, many experiments were made 
of distributing infants over a number of places, the so-called INAUGURAL ADDRESS. 
cottage system. Six, ten, twelve, were kept in a small sepa- 
rate institution. The disadvantages are plain. The increased 
number of households raises the expenses, the difficulty of ob- 
taining wet-nurses increases, control and medical attendance 
become more and more difficult. The cottage is, in fact, not 
much, if at all, better than a ward in a public institution. 
What, then, is left but to board out the infants in the coun- 
try ? For, although the experiments of the Catholic foundling 
institution in Waverley Place are by no means so bad as the 
experience of twenty years ago rendered probable, common- 
sense, hygienic principles, and statistics, point to the country 
as the residence of the children of the Commonwealth. When 
this conclusion shall be the conviction of all, the necessary 
steps will be taken, no matter how great the difficulties may 
be. With us, they are not small. 
Our population adjoining the great cities, especially New 
York, is not so large as in Europe, and is not so poor. It is 
is not of such vital importance for a country family to 
avail themselves of the trifling subsidy paid for the infant 
boarder. But there are some considerations which are to be 
taken into account. The first is, that the infants we have to 
care for do not count by six or ten thousands every year; 
and the second, that the sum which is at present spent for 
every infant under the charge of the Commissioners of Chari- 
ties is by no means a trifle, and, under the Managers of the 
Nursery and Child’s Hospital, enormous. It would be found, 
on trying, that the apparent difficulties in procuring proper 
country homes for our infants would by no means be so great 
as they may appear at first sight. Even if there were some in 
the beginning, we should always gain. 
The question whether it would be desirable to leave, if 
possible, the young illegitimate child in charge of its mother, 
cannot be answered in a manner uniformly adapted to every 
case. The facts exhibited by the Munich records, according 
to which the children reared by their own mothers have a 
fearfully larger mortality than those intrusted to strangers, 
do not look encouraging. In our city, I am afraid that many 
of our unmarried mothers would not prove excellent nurses. 
Still, the fact of their being sufficiently supported might 
change the circumstances. INAUGURAL ADDRESS. 
There is another consideration not to be lost sight of. Un- 
favorable though all circumstances be within the walls of an 
institution, mortality can be reduced by procuring paid wet- 
nurses for the same. We know that our nursed infants thrive 
much better than the bottle-fed. But no breast-milk is obtained 
except from those who have no home, the poorest, and most 
miserable. No married woman, as a rule, at least none who 
has the slightest means of escaping the discipline of and sub- 
mission to institution rules, will ever consent to become a wet- 
nurse to any of our children. Thus we have to take either the 
sickly, the profligate, the very poor, or consider ourselves very 
fortunate when we succeed in securing the own mother’s breast 
for the support of the infant. Many mothers, however, who 
have a home in the country, have lost a young baby, or have 
milk enough left, after weaning, to nurse, or enough to nurse 
two, but who would never consent to leave their husbands and 
children, could be induced to take charge of an infant. A 
careful comparison of the direct expenses of the two modes of 
rearing infants, out of, and in asylums, in Europe, has proved 
that even there no pecuniary loss is incurred by the more ad- 
vantageous and humane proceeding. 
Besides, the nurses necessary for the infants in institutions 
are just so many nurses kept out of the service of the 
general public. In Yew York City, wet-nurses are scarce, 
since the humane efforts of the Commissioners of Charity, and 
the Catholic foundling institution, have been directed to the 
task of supplying our foundlings with human milk. Thus it 
is very probable that what society gains on one side, in the 
saving of the destitute and poor, is lost among the public in 
general. At all events, such element of proper food as is 
accessible at its own home only, that is, breast-milk of the 
countrywomen, is left unavailable and unused. 
If not absolutely necessary, no attempts at obtaining breast- 
milk ought to be made within the limits of the city. Besides the 
•other damaging influences of city life and city atmosphere, 
which alone destroy so many infants’ lives, the experience of 
former times, of boarding the city’s infants within the bound- 
aries of the city, has been very unfavorable. 
It is not my intention to go into the particulars of ad- 
ministration, at this moment. Still I beg the privilege of INAUGURAL ADDRESS. 
pointing out a mode of action wliicli in some parts may prove 
faulty, but which under our circumstances will, in my opinion, 
prove sufficiently correct to enlist sympathy or bring out a 
discussion. Before so doing I again refer to my opinion on 
the responsibilities and duties, and the rights, of the State. 
The whole administration of the foundlings ought to he con- 
trolled hy the Commonwealth. Private or sectarian establish- 
ments ought to he under governmental supervision y ought not 
to he supported or aided hy the State, hut not interfered with 
so long as their successes and general management appear 
satisfactory y the department of the foundlings to he centred 
in one office y the necessary appointments of the head, or heads, 
to he made hy the Governor of the State. 
The expense of hoarding the foundlings to he home hy the 
people of the State of New Pork. 
By concentrating the administration, the running expenses 
would be but small in proportion. New York City would 
have a single depot for the abandoned children, from which 
speedy distributions would take place. The large buildings at 
present dedicated to the purpose of raising infants would soon 
be required for those children who would be returned from 
the country, after reaching the age of 3 or 5 years. Some 
might become hospitals—we have no child’s hospital in New 
York City—some schools and asylums for the older children 
of the community, where they would be taught to become use- 
ful citizens of the republic. 
I assume a mortality in the first year, say, of 25- or 30 per 
cent, of infants abandoned in their first year. After that 
time, the mortality will become small. Of 1,000 abandoned 
infants, 750 or 700 must reach in future their twelfth month. 
I assume $150, the amount spent by the Commissioners of 
Charities and Correction, to be a fair average for yearly board. 
Thus 1,000 abandoned infants would cost the State, per an- 
num, say $120,000. The 3,000 lives endangered or thrown 
away every year might cost us $350,000 yearly; but then 
we should certainly succeed in saving most of them, at a 
proportionately small expense, and educating those many who 
have been saved. 
The first steps in this direction would be to awaken the 
interest of the public, particularly in the country. Sympathy INAUGURAL ADDRESS. 
and interest must be stimulated contemporaneously. The 
printed minutes of the Commissioners of Public Charities 
and Correction, of last year, contain a proposition to make 
preparations for boarding out babies, submitted by the Medi- 
cal Board of the Infant Hospital, Randall’s Island. The 
Commissioners have, I believe, deferred further action only 
in consequence of the necessity of keeping up all their num- 
erous charities, and from their fear of not being capable of 
meeting a momentary increase of expenses. But lately a 
paper was prepared, which was intended to be circulated 
over the signatures of the Commissioners, containing similar 
propositions. It is but justice to say that I have been told 
by them, this very day, that they considered the publication im- 
practicable at that moment, but approved of and indorsed all 
its contents. I have requested and obtained the permission 
to read it, and abstain from any remarks or additions. It is 
written in the form of a letter, which was to be distributed 
among such persons as are mentioned in it, and, with its re- 
marks and suggestions, will explain itself. It reads as follows: 
Dear Sir : Your special attention is herewith directed to the claims of 
a class of destitutes who, as they are helpless, are the more deserving of 
the sympathy of the just and benevolent. In their behalf the Commission- 
ers of Charities and Correction have tried to improve the methods of sup- 
porting, raising, and educating, have built costly edifices, and gladly availed 
themselves of any advice their medical hoards could afford them. Still, 
the results of their efforts are far from being satisfactory, and, after care- 
ful consideration of the difficulties to he overcome, and the aims to be 
reached, the undersigned request you to give your attention to the follow- 
ing remarks, and to lend your valuable aid in furthering their endeavors. 
The class of destitutes in question are the foundlings and abandoned 
infants, amounting to the number of about three thousand a year in the 
city of New York. Their claims have been so well acknowledged of late, 
and the public at large have become so conversant with the humane and 
political aspects of their case, that a number of associations have been 
formed for the purpose of either raising them or educating those who 
survive. 
From a report laid before them by the medical board of their Infant 
Hospital, which admits yearly about 1,200 or 1,400 of these destitutes, 
we gather the fearful and embarrassing fact that infants collected in large 
institutions, of the best hygienic designs, with the most careful dietetic and 
medical care, will die in large numbers. This immense mortality is par- 
ticularly great in eaidiest infancy. Of 47 deaths in New York City INAUGURAL ADDRESS. 
under five years, 39 occur under two years, and as many as 30 under one 
year; the mortality of abandoned children under the charge of public or 
private authorities is still larger. The very accumulation of infants under 
one roof, the scarcity of breast-milk obtained, the difficulty of secur- 
ing competent nursing for a large number of infants, the ravages of con- 
tagious diseases, the poisoning by deleterious exhalations and excretions, 
etc., are just as many obstacles to the health and life of the young inmates 
of our public institutions. The difficulties of raising infants in our 
institutions, and of gathering a sufficient amount of breast-milk in them, 
induce the undersigned to try a change with a part of their inmates. A 
number of them are to be given in charge of responsible parties in the 
country surrounding New York. The not unfavorable results of farming 
out even in cities, when compared with the mortality of institutions, en- 
courage us to hope that infants farmed out in the country have a much 
greater certainty of life, and a healthy future. And, with regard to this 
plan', we have herewith taken the liberty of sending you this communica- 
tion. 
We propose to farm a number of babies out until they have reached 
the end of the third year. In particular cases, special arrangements may 
be made beyond that age. 
Babies who have no teeth are expected to be fed on breast-milk ex- 
clusively. Such as have from two to four teeth, on mixed food. After- 
ward they are to be weaned according to such rules, concerning the feed- 
ing of the children, as shall be laid down by the undersigned or their medi- 
cal board. 
A single party is to be intrusted with but one nursling. A medical 
examination only can decide whether, in exceptional cases, a woman is fit 
to nurse two infants. She may, however, obtain an older child in addition 
to the nursling. 
She must either be married, or a widow, or very well recommended. 
She must have plenty of breast-milk for the nursling in charge, no matter 
whether she has lost her own baby, or has sufficient nourishment for two 
(her own and the stranger). She must be healthy, not destitute, not in- 
temperate, and known to be industrious, and not entirely dependent on 
the board paid for the nursling. She has to present a certificate from 
responsible parties—physicians, clergymen, postmasters, town authorities, 
or well-known citizens, concerning the above requirements, stating also 
how many children she has, and how many she has lost. 
The applications of women who offer to take charge of infants are 
made at the office of the Commissioners of Charities and Correction. The 
depot of the babies is at Eandall’s Island. The house-physician notifies an 
applicant to call for her boarder. She has to call personally. Travelling 
expenses are refunded. The board-money is ten dollars a month, to be 
paid semi-monthly, monthly, or bi-monthly. 
Besides, we offer to pay twenty dollars to a party, with whom a boarder 
has been living for sixteen consecutive months, at the end of his second 
year. ENA.UGUEAL ADDEESS. 
These are the outlines of the principal rules which, in all probability, 
will govern the farming out of infants in the country. We now apply to 
you, sir, and your friends, for your opinion and cooperation. You can ad- 
vise us if, in your circle and neighborhood, the men in standing and au- 
thority, as mentioned above, would be found willing to help the cause of 
humanity and an enlightened political economy, by giving such certificates 
as parties would require, by even encouraging a party to serve herself and 
the public by taking charge of an infant, and also by paying a certain 
amount of attention to the little one who has no mother but the com- 
munity. 
The general superintendence will have to rest with the medical board 
of the Infant Hospital. Their house-physician shall be entitled to provide 
for special inspection. Still, it will be of the utmost importance to interest 
the public at large in the welfare of the foundlings, particularly the ladies, 
who, according to localities, might form committees for the purpose of 
watching and superintending the foundlings and their nurses. 
You are respectfully requested to give the foregoing your attention, 
and to communicate to us your opinion as to the feasibility of our plans; 
whether, in your opinion, a certain number of women would be fit and 
willing to charge themselves with bringing up an abandoned infant in 
your neighborhood, and whether yourself or your friends, or their ladies, 
would be found willing, by occasional inspection, etc., to aid our attempts 
in raising infants, whose life is as valuable to society as our duties toward 
them are clear. 
While offering the suggestions of this letter, and my pre- 
vious remarks, to your consideration, I am fully aware of not 
having exhausted the subject. I have already, I know, to beg 
your pardon for keeping you so long. You will, I am sure, ex- 
cuse me, on account of the importance of the subject on which 
I have spoken. 
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