COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64074471 R A609 R34 is Rhode Island a th ^'^"""■'■^'^•-"" Columbia (BnitJer^ttp intlieCitpotlrttJgtirk Cottege of ^fjpfiSitiang anb ^urgeonfi! Hibrarp Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/isrhodeislandthoOOrhod Is Rhode Island A Thoughtful Father TO ITS Little Children ? CHILD WELFARE DIVISION STATE BOARD OF HEALTH Columbia ®mtjers;itj> COLLEGE OF PHYSICIANS AND SURGEONS Reference Library Given by IS RHODE ISLAND A THOLoxiTFUL FATHER TO ITS LITTLE CHILDREN ? A TENTATIVE SURVEY COMPILED UNDEB THE DIRECTION 09 ELIZABETH M. GARDINER, M. D. (Director R, I. Division of Child Welfare.) M. B. Still WELL, A. B., and Habold a. Andrews, LL. B. PROVIDENCE 1920 THE following sketch is the first of a series of publications regarding certain things which Rhode Island is doing, and ought to do, to safeguard the health of its children — a study which was authorized by the Rhode Island Legis- lature in April, 1919. This sketch relates to the health of babies and of children under school age. It has been issued for the purpose of carrying to Rhode Island homes a knowledge of this phase of Child Welfare work. It has, in addition, another purpose. It is intended as a starting point for a comparative study between laws and conditions in Rhode Island and those in other states. And it is hoped that this survey will lead to public support and the legislation which may be necessary for the further development of the work. Elizabeth M. Gardiner, M. D., Director. Division of Child Welfare, R. I. State Board of Health. December 15, 1919. 3 IS RHODE ISLAND A THOUGHTFUL FATHER TO ITS LITTLE CHILDREN ? The. answer to this question is not wholly satis- factory. In some of its provisions, Rhode Island is a kindly father. In others, it is strangely negligent. In the wake of the War lies a trail of problems, national as well as international. Their solution is unknown. Their final outcome no one can predict. Of one thing only are we certain. The future of this country — possibly its existence as a nation — depends upon the care, or lack of care, which is given to the present genera- tion of young Americans. As Dr. Crane has written, "Vast problems press upon us. The world is upturned. The masses seethe in the ferment of untried theories. Yet the way is so simple! It lies through the child." Therefore, back of the Americanization move- ment; back of all schemes for political and social betterment; more fundamental even than Educa- tion itself is the question of the health and moral welfare of the children. "WTiolesome morals do not develop from unwholesome conditions. A normal body is the first step toward a sound mind and sound principles. Here is Rhode Island an industrial community. Our mills and shops are full of workers. Many of our streets swarm with little children. In their hands lies the future of the State, and the part which the State will play in national affairs. Are we making necessary provision for the children's health and welfare? If not, have we the will to make whatever additional provision may be necessary? It is in the answer to questions such as these that we find a key to the fate which lies before us. This is a time for thought and for serious con- sideration. It is a time for a survey of ourselves as we are. Investigation only is of small avail. It is action, based upon consideration, that will bring results. First then, what is Rhode Island doing to safe- guard the health of its little children? Secondly, what should Rhode Island do? 6 When a new citizen is bom to us, the State at once attends to two matters of importance — first, that the child's eyesight may not be impaired from lack of proper care; and secondly, that the child shall be officially registered and received to citizen- ship. The State Board of Health provides the silver nitrate to be dropped in the baby's eyes, as a preventive to blindness, and the State law makes this preventive measure the duty of the physician, midwife, or nurse. But the law does not require the birth to be registered promptly enough to aid the agencies engaged in preventing infant mortality. The little children, who for one reason or an- other are boarded in homes other than those of relatives or legal guardians, are given fatherly supervision by the State in the licensing and in- specting of boarding homes for infants. Accord- ing to the framing of the law, this supervision does not extend to such philanthropic homes as have been incorporated. Doubtless, these homes by their very nature are well run and in them, un- doubtedly, everything possible is being done for the welfare of the little children committed to their care. It is evident that the State feels justified in taking this for granted and thinks it quite unnecessary to make sure that this is so. Only the slightest protection is afforded the unborn children who, from disregard on the part of the State, may come into the world mentally deficient. The chapter of Marriage Laws makes only a feeble attempt to safeguard the child, and State, against this handicap. In laws apparently contemporary with Moses, it is provided that no man shall be permitted to marry his "mother," his "grandmother," his "son's daughter," his "father's sister," or similar relatives. But aside from persons in the care of institutions, nothing is done to prevent marriage or procreation by persons who in themselves are feeble-minded! However if, when a child is bom, it prove to be an imbecile, then it may be accepted by the State as a beneficiary and assigned to a suitable institu- tion or school — provided that, as at the present time, our State school is not already overcrowded. And if, in spite of precautions after birth, a little child should lose its sight, maintenance and educa- tion are provided by the State, if such aid is necessary. 8 Thus does the State aim to prevent the afflic- tions from becoming so heavy a drain upon the family income that its standards of home life may be lowered and its members a possible future public charge. It has not as yet taken measures to prevent the cause of the affliction. Rhode Island laws do nothing to prevent the marriage of persons who are feeble-minded or of persons who have a venereal disease. Yet, according to the digest of "American Marriage Laws" just issued by the Russell Sage Foundation, there are 23 states in which the marriage of imbeciles is prohibited, and 11 states in which the statutes forbid the marriage of persons afflicted with the diseases of immorality. It is not the function of any State to usurp the rights of the people. It is not its function to dictate to them their manner of life. But it is the duty of the State, for its own protection and for the welfare of the community and its members, to guide and to protect the development of the home whenever its members are unable to do so for themselves. It has long been considered proper for the State to give financial aid to persons who are in want. And in connection with such aid, the State, through its various boards and com- missions, sometimes takes occasion to give advice or guidance in practical affairs. It is not the poor alone who are in need of guidance in questions relating to the health of children and to personal hygiene. Unfortunately there are many, many homes in which, from lack of knowledge, the proper kind of care is not given to prospective mothers or to new-born children. Ignorance in such matters is criminal, in the unnecessary suffering which it inflicts upon the helpless. In Massachusetts, a bill is being prepared for the next Legislature seeking to provide that in- struction, nursing and medical care shall be given for a reasonable time before and after childbirth to any woman who has been a resident of the Commonwealth for the two preceding years. This is declared a public health measure. Its benefits are free to all persons regardless of financial condition. The mother has only to agree to carry out such instructions in hygiene and 10 medical care aa are given her by the State Board of Health, before and after confinement. By this clever bit of moral suasion, the Legislators seek, for the good of the State, to provide it with healthy citizens for the future, and to safeguard the integrity of its homes from the loss of the mother. It would be well if Rhode Island also were to make some such provision. It would constitute the most valuable measure known, for the prevention of maternal and infant mortality. In Rhode Island, the aid given young mothers is left to local officials and to philanthropic agen- cies — if any exist. And the work of these ofiicials and agencies is more from the point of view of charity than of public health. How about the industrial towns lying between Ashton and Woon- socket, or the districts around Scituate, Foster, Green, Little Compton, Portsmouth and other sections of the State in which there is not a single District Nursing Association to give the young mother help or advice? To be sure, in Providence when charity-cases come to the notice of the local Board of Health, if the mother remains at home, a physician paid 11 by the city is sent to attend her; or a midwife licensed by the State and trained by the Provi- dence Board of Health may remain with the mother a week. The family then comes under the supervision of one of the two "baby nurses" employed by the local Board of Health. This nurse instructs the mother in the care and feeding of the baby and keeps an eye upon affairs at the home for the first month. On the other hand, if the mother applies for admission as a free patient at the Lying-in-Hospital, her name is simulta- neously put on file with the Providence District Nursing Association who "follow up" the case immediately after the mother is discharged from the hospital. For the benefit of these mothers, and also for any of its young mothers who may request them, the Providence Board of Health has issued a series of leaflets which give suggestions for proper feeding, the regulation of sleep, and even recipes for the preparing of food. These leaflets are pub- lished in English, Yiddish, Italian, Portuguese, and Polish. Also, prenatal clinics for young mothers are held at Federal Hill House, and 12 ^'baby clinics" are held weekly at the Providence Day Nursery, Federal Hill House, and the Point Street School. All this is excellent, so far as it goes — and a remarkable bit of community cooperation. But after all, it relates mainly to work among the poor, and it is purely local! The Massachusetts bill is not aimed at poverty. It is aimed at lack of proper knowledge. It is as it says, "a, public health measure." Its object is to secure healthy babies among all classes of persons. Its aim is to secure healthy citizens, for its own welfare in the future. Rhode Island, also, has a future for which it should provide.* Another means which a farsighted state may employ for its own welfare is through laws for the inspection of milk and for the purity of foods. Especial care must be exercised over the foods which nourish growing children. In Rhode Island, the State milk laws are not adequate to safeguard the health of all its children. Tuberculin tests of cattle, for instance, are made by the Board of Agriculture only upon request. *See also: Appendix C. 13 The Pure Food and Drug Commission has legal power to inspect dairies if it wishes, but it has no means of coercing unlicensed producers. In the chapter of Milk Laws, it is required that, in the cities, milk dealers must be licensed and trade milk must be inspected. But it is left for the towns to decide for themselves as to whether or not they shall adopt these regulations. And their decision, naturally, is affected by considera- tion of the expense involved. As a matter of fact, a good proportion of our mill workers live in towns; northern Rhode Island is a chain of "mill-villages." And, so far as milk is concerned, the State neglects to provide for the welfare of the children living outside of the few Rhode Island cities. The law forbids the adulteration of milk, yet in the towns, the State requires no inspection of trade milk. It is left for the consumer "to complain" if he has reason to think that the milk may be adulterated and that — in spite of the willingness of the Pure Food and Drug Commission to test whatever samples a consumer may submit — is at best only a hit or miss method of securing pure milk for the public 14 as a whole. If New York city with its millions of persons to serve can, daj'- after day, provide its citizens with certified or guaranteed milk, the task cannot be impracticable. As always, it rests with the people. Their will is the State's will. And in spite of the fact that Rhode Island's standard for butter fats in milk, 23^^%, is among the lowest in the country, there is agitation at the present moment to have the standard in this State reduced still lower. Are we deUberately about to give legal sanction to the undernourishing of Rhode Island's children? The cost of milk is another aspect of the ques- tion to be considered: In order to help the sick babies of the poorer families of Providence, milk is sold below trade price at the Milk Stations which are run under the kindly auspices of the Housewives' League. These stations are located at the Providence Day Nursery in Olneyville and at the Federal Hill House in the Italian district. Through them milk of a good grade (whose bacterial count and contents of solids and fats are carefully watched) is sold, in bottles, at the rate of 15 cents a quart. It is sold, however, only to 15 families which, because of their extreme need, have been granted a milk ticket by a physician, a representative of the District Nursing Associa- tion, or of the Providence Society for Organizing Charity. Only relatively few families therefore, and those the acknowledged "poor," are allowed this privilege. This, then, is a consideration for those who should bestir themselves to reduce the cost of living. In Providence, by the aid of philan- throphy, milk is sold to the most needy households at the reduced rate of 15 cents a quart! How about those who are poor but do not ask for aid? How about the physique of children in the average family, brought up at a time when milk costs from 15 to 20 cents a quart, sugar 20 cents a pound, and all other food stuffs are pro- portionately high? Every bowl of oatmeal and milk has become an item in the household budget. Malnutrition is a shadow. It is absolutely in- separable from the High Cost of Living — and the community pays in the end. The undernourished child can not be expected to become the ideal citizen, sound in mind and body. He is irritable 16 in disposition, mentally dull, and invariably stunted in physical development. According to a recent statement by Dr. Emer- son, over one third of the school children in the United States are habitually under-nourished. And in a recent report. Dr. Carpenter states that of 25,000,000 children in our country, at least 15,000,000 are underweight, and of these 6,000,000 are so far below weight that they cannot become healthy adults. This is not a record to be proud of. The question for us to answer is — How many of these undernourished children are in the rural and the overcrowded industrial section of Rhode Island? Unfortunately not a small per cent.* And another point brought to light by the report recently issued by the Providence Milk Inspector is the fact that 42.3% of the milk for pasteurization which was brought to Providence dairies from unlicensed producers exceeded the bacterial maximum of 500,000 per cubic centi- meter. In some cases, especially in milk brought from Connecticut, the bacteria equalled 2,000,000- 10,000,000, or even 20,000,000 per cu. cm. The * The survey of schools just started by the Providence Board of Health, already proves this to be true. 17 bacteria, to be sure, are supposed to be killed by the process of pasteurization. But, since it is true that certain disease producing organisms in- crease in number along with the growth of general bacteria and are not killed by pasteurization — the question arises, should not there be a regula- tion to prohibit the pasteurization of milk having bacteria in excess of a given number, i. e., milk that is too old. This is a question not only for the chemists to answer but for every purchaser of pasteurized milk. The inspectors cannot exceed the powers accorded by the statutes of the State. As a matter of fact, the chapter of Milk Laws entirely omits all consideration of bacteria. In addition to its climes, the Providence Day Nursery has an average enrollment of 70 children who may be left there each day by mothers on their way to work. The Carter Day Nursery, St. Anne's, St. Raphael's and the Salvation Army Day Nursery have an enrollment of 154, 150, 60, and 35 children, respectively, who are given similar care while their mothers are employed. Providence is fortunate indeed — but these nurse- 18 ries are philanthropic and, like those elsewhere in the State, they are purely local. There are many places where there are none. The pitiful part of it is that, splendid and necessary as their work is, it can after all reach only relatively few of the many children who need such care. And even so, a nursery is a substitute for the child's own home life. It is a kindly effort to give the child something of what it is deprived. It is charity's way of making the best of un- fortunate circumstances and of doing its best to relieve distress. If the State believes in home life and not in communism, it should strike at the root of the matter. It should consider what should be done to preserve the home itself. For instance, Rhode Island gives no pensions to aid the many widowed mothers who are forced to support their children. It is physically im- possible to work all day and to care for a home efficiently at night. One task or the other must be slighted. If the father is dead, insane, or incapacitated, the mother must take his place. Money must be earned. Her work must be well done or her job is lost. A tired mother goes 19 home at night. Her household tasks await her. It is surprising that her children receive as much motherly attention as they often do. It is only inborn Mother-love which makes a women so often try to be superhuman. And her struggle is full of pathos. Would it be charity for the State to help her, at least until her children are of school age, if her need and worth were proved? No. Not charity — merely common sense, a "public health meas- ure," "a prophylaxis against physical degeneracy and moral delinquency." In the family pocket- book of the State, "an ounce of prevention is worth a pound of cure." It is as unwise for the State as for an individual to ignore the morrow, in order to obtain more comfort for today. As it is, one of two fates usually awaits the little children of working mothers. Either they are well cared for by some philanthropic agency, outside the natural home; or, as is more fre- quently the case, they are left during the day to the questionable care of older children, the "little mothers" of America. In fact, so im- 20 portant are these little mothers in the life of all foreign communities, that New York city gives annually in all public schools a lecture on the ABC of baby care — cleanliness, fresh air, proper food, and sleep. And in many schools, the girls over twelve years of age are given a systematic course in baby care. It is these young girls who will be the mothers of our future citizens. Of the feasibility of such a scheme of instruc- tion much may be said, for and against. It is true, it adds one more topic to a full school schedule. It runs the danger, through criticism of home methods, of possibly widening the gulf which exists between some foreign-born parents and their American-educated children. Yet the future must be reckoned with. The State believes in the home. The theories of home life so far maintained by its institutions are a development of the ideals established by our forefathers. It is essential for us to look facts squarely in the face. We now have in our midst a horde of unassimilated Americans. Many are still foreign-speaking. Worse than that, the majority are foreign-thinking! That is where the gravest danger lies. 21 If our institutions are in the future to continue of the same complexion as in the past, the "young- Americans" must be taught to think from the purely American point of view. The problem is many sided. For example — and to name one side only — from the standpoint of public health, they must be taught to live according to the American code of hygiene and of sanitation. To narrow this down to the case in hand, they must be taught to bring up their families according to American methods and ideals. Is there any better way to see to it that, in the future, the State's little children shall ^be cared for in the approved way than by deliberately teaching the mothers of the coming generation how to care for little children? As Dr. Crane has so wisely said, " The road to the Golden Age lies through the school house." If, under the State's fatherly protection, our new-born citizens may be ushered into the world without preventable physical defect or handicap; if, through the State's laws and guidance, the 22 food and care of these little children may be safeguarded within the bounds of reason; and if some way may be adopted to instruct the mothers of the future, in the approved way of caring for their own little children — then, at least, we shall have started on "the road." (In the second paper of the Series it is proposed to discuss the "School Laws" which relate to the health of children. Acknowledgments are due Mr. Herbert O. Brigham and Miss Grace M. Sherwood of the Rhode Island State Library, and the personnel of the various Boards and philanthropic societies whose courtesy in answering ques- tions has made possible the compilation of the present paper.) 23 APPENDIX A RHODE ISLAND LAWS RELATING TO THE HEALTH OF INFANTS 26 RHODE ISLAND LAWS Chap. 1769, Public Laws of Rhode Island, 1919. Sec. 18. The state board of health shall establish and maintain a division of child welfare for the study and application of measures for the prevention of maternal and infant mortality; for the preparation and issuance of child health literature, the suppression of diseases of young children, and the organizing of child welfare work; and for the institution of such other measures for the protection of the lives and the improvement of the health of young children as the state board of health shall direct. CARE OF THE ETB8 27 Chapter 343 of the General Laws, Amended by Chapter 1641, P. L. op Rhode Island, 1918. "Section 25. That any diseased condition of the eye or eyes of any infant in which there is inflammation, redness, sweUing or any unnatural discharge at any time within two weeks after birth, shall for the purpose of this act be deemed to be ophthalmia neonatonmi. It shall be the duty of any physician, midwije, nurse, 'parent or any other person or persons assisting any woman in childbirth or assisting in the care of any infant to report within twelve hours after noting the same, any such case of ophthalmia neonatorum coming to his or her attention, to the local health officer of the city or town within which the mother of such infant shall have been at the time of confinement. It shall be the duty of the attending physician, midwife, nurse, or other person in attendance on a confinement case ■ to use such prophylactic treatment for the prevention of blindness among new-bom children in accordance with the rules and regulations prescribed by the state board of health. It shall be the duty of physicians, midwives, and such other persons as may be lawfully engaged in the practice of obstetrics or assisting at childbirths to inform parents or guardians of the serious nature and consequences of this disease and to advise the use of prophylactic measures designated by the state board of health. Inflammation within two weeks after birth. Preventative measures. 28 RHODE ISI^ND LAWS Diity of health officer. Duty of state board of health. Penalty. For the purpose of this act, midwives, who, previously have not been permitted to use medicinal agents under any conditions may employ the approved prophylactic of the state board of health, with the consent of the parent or guardian." "Sec. 26. It shall be the duty of the local health officer to investigate each case of ophthalmia neonatorum and the health officer shall be required to report all such cases and their results to the state board of health. It shall be the duty of the state board of health to enforce the provisions of this act; to provide a prophylactic agent for free distribution, together with proper directions' for the use of the same; to publish and distribute in- formation concerning the dangers and prevention of ophthalmia neonatorum; and to bring all violations of the law to the attention of the attorney-general." "Sec. 27. The failure of any person mentioned in Section 25 of this chapter to report any and aU cases of ophthalmia neonatorum, as herein directed, or the failure or refusal of any person or institution herein mentioned, to obey any rule or regulation* adopted by the state board ^Ophthalmia Neonatoeum. — To be reported to the local health oflBcer and also to the Secretary of the State Board of Health. 1. Infectious Agent. — The gonococcus or some member of a group of pyogenic organisms, including the hemoglobinophilic bacilli. 2. Source of Infection. — Discharges from conjunctivse, or adnexa, or genital mucous membranes of infected persons. 3. Modes jf Transmission. — Contact with an infected person or with articles freshly soiled with discharges of such person. BIRTH REGISTRATION 29 of health under this act, shall constitute a misdemeanor, and upon conviction thereof, shall be fined not less than ten nor more than one hundred doUars." CHAPTER 121. Section 1. The town clerks of the several towns, or Registration of any person whom the board of aldermen of any city, or '""* ^' ®*°" the town councU of any town, may appoint for that pur- pose, shall obtain, chronologically record and index, as 4. Incubation Period. — Irregular, but usually 36 to 48 hours. 5. Period of Communicability. — During the course of the disease and until the discharges from the infected mucous membranes have ceased. 6. Method of Control: (A) The infected individual and his environment — 1. — Recognition of the disease. — Clinical symptoms, con- firmed where possible by bacteriological examination. 2. — Isolation. — None, provided the patient ia under adequate medical supervision. 3. — Immunization. — None. 4. — Qiiarantine. — None. 5. — Concurrent disinfection. — Disinfection or burning of conjunctival discharges and articles soiled therewith. 6. — Terminal disinfection. — Thorough cleansing. (B) General measures — 1. — ^Enforcement of regulations forbidding the use of common towels and toilet articles. Education as to personal cleanliness. 2. — Use of silver nitrate or some similar solution in the eyes of the new born which ia furnished free by the State Board of Health. 30 RHODE ISLAND LAWS required by the forms prescribed by section three of this chapter, all information concerning births, marriages and deaths occurring among the inhabitants of their respective towns; and on or before the first Monday in March, an- nually, shall make duly certified returns thereof to the secretary of the state board of health for the year ending on the thirty-first day of December next preceding, ac- companying the same with a list of the persons required by law to make returns to them who have neglected to do so, and with such remarks relating to the object of this chapter as they may deem important to commimicate. Sec. 2 As amended by Ch. 1239, G. L. of Rhode Island, 1915, reads: State board of ' 'The secretary of the state board of health shall receive health Bhall , :; . ... receive returns, the retxuTis made m pursuance of the preceding section, and annually make a general abstract and report thereof, in form as prescribed by section 3 of this chapter, and pub- lish and print not exceeding one thousand copies thereof; and for preparing, tabulating and pubKshing said annual report, including all clerical assistance needed therefor and the printing and binding of said report, the sum of seven- teen hundred dollars is hereby annually appropriated to be paid to the state registrar. Said returns, after such report is prepared, shall be deposited in the ofl&ce of the secretary of state, who shall cause the same to be arranged, full alphabetical indices of all the names to be made, and the whole to be boimd in volumes of convenient size and carefully preserved in his office." BIRTH REGI8TBATION 31 Sec. 3. As amended by Ch. 575, G. L. of Rhode Island, 1910, reads: ' 'The blank forms required to carry out the provisions Questions to be of this chapter shall, on appUcation, be furnished by the recorded, secretary of the state board of health to clergymen, phy- sicians, undertakers, town clerks, clerks of meetings of the Society of Friends, and other persons requiring them, sub- stantially as follows: The record of a birth shall state the date and place of birth, name of the child, if it has any, the sex and color of the child, number of child of the mother, whether born alive or still-born, the name and surname, age, color, residence, and birthplace of the parents, and the occupation of the father, and the time of recording, so far as the same can be ascertained. . « . The record of deaths shall state the date of death, name and surname of deceased, the sex, color, and condition, whether single or married, age, occupation, place of death, place of birth, names and birthplace of parents, disease or cause of death, the name and relation to the deceased of the person fiimishing such information, place of burial and the time of recording, so far as can be ascertained: Pro- vided, however, that still-births shall be recorded both as births and deaths, but separately from the records of both births or deaths." Sec. 5. The town clerk of every town shall annually, in the month of January, collect the information required by this chapter in relation to aU children bom in the town during the year ending on the thirty-first day of December next preceding. Duty of town clerk. 32 EHODE ISLAND LAWS Duty of phy- sicians and mid wives. Penalties. Sec. 6. Physicians andjjinidwives shall, on or before the fifth day of each month, report to the clerk of each city or town a correct hst of all children bom therein during the month next preceding, at whose birth they were present, stating the date and place of each birth, the name of the child if it has any, the sex and color of the child, the name, place of birth and residence of the parents, and the occupation of the father. The fee of the physician or mid- wife shall be twenty-five cents for each birth so reported, and shall be paid by the city or town in which the report is made. Sec. 7. As amended by Ch. 575, G. L. of Rhode Island, 1910, reads: ' 'Whenever any person shall die, or any still-bom child be brought forth, in this state, the imdertaker or em- balmer who has charge of the body shall obtain and return to the town clerk or registrar a certificate of death, prepared in accordance with section 3 of this chapter, and upon a blank to be furnished by the secretary of the state board of health. The statement of facts relating to the disposi- tion of the body shall be signed by the undertaker or person acting as such. . . ." Sec. 13. Every clergyman, physician, midwife, under- taker, town clerk, clerk of any meeting of the Society of Friends or other person, who shall wilfully or vmreasonably neglect or refuse to perform any of the duties imposed on or required of him by this chapter, shall be fined not ex- ceeding twenty dollars nor less than two dollars for each BIRTH REGISTRATION 33 offence, one-half thereof to the use of the town in which the offence shall occur and one-half thereof to the use of the person who shall complain of the same. Sec. 17. As amended by Ch. 575, P. L. of Rhode Island, 1910, reads: "Births, marriages, and deaths of the residents of a town or city which occur outside of such town or city shall be recorded separately from those occurring in such town or city." Sec. 18. The secretary of the state board of health may, from time to time, vary forms of returns and require such additional information as he may consider necessary to accompUsh the object of this chapter. Sec. 20. The clerk or registrar of each town and city shall, on the first day of each and every month, make a certified copy of all births, marriages and deaths recorded in the books of said town or city during the previous month, whenever the parents of the child bom, or the bride or groom, or the deceased person, were resident in any other town or city in this state, or in any other state, at the time of said birth, marriage or death; and shall transmit such certified copies to the clerk or registrar of the town, city or state in which such parents of the child born, the bride or groom, or the deceased, were resident at the time of said birth, marriage or death, stating, in case of a birth, the name of the street and number of the house, if any, where such parents resided, the place of birth of such parents and the maiden name of the mother, whenever the 34 RHODE ISLAND LAWS same can be ascertained; and the clerk or registrar so receiving such certified copies shall record the same in the books kept for recording births, marriages and deaths. Such certified copies shall be made upon blanks to be furnished for that purpose by the secretary of the state board of health. Sfomation. Sec. 25. If it shaU come to the knowledge of a town clerk, or any person, appointed under the provisions of section one of this chapter, that any birth, marriage, or death which has occurred in his town or city has not been returned to him as required by this chapter, or has not been recorded, such town clerk or person shall record the facts called for by section three of this chapter, to the extent he shall receive in any way any credible information of the same. If any error shall be made in the return of any birth, marriage or death, or shall be discovered in the records of births, marriages or deaths, such error shall be corrected without erasure. In each case the source of information, from which the addition or correction is made, and the date of making the same shall be noted on the face of the record, and such town clerk or person shall attest the same by his signature thereon. Such town clerk or person shall annually, on or before the first Monday in March, make duly certified returns to the secretary of the state board of health of aU such additions and corrections made during the year ending on the thirty-first day of December next preceding. Such town clerk or person shaU receive for each such additional record and return of a death, DEAF, BLIND AND IMBECILE CHILDREN 35 marriage or birth made by him the same fees specified in sections twelve and nineteen of this chapter for recording and returning deaths, marriages, and births respectively. CHAPTER 100. State beneficiaries. Section 1. The governor, on recommendation of the state board of education, upon application of the parent or guardian, may appoint any deaf, bhnd or imbecile child, being a legal resident of this state, who shall appear to said board to be a fit subject for education, as a state beneficiary at any suitable institution or school now established, or that may be estabUshed, either within or without the state, for such period as he may determine, within the limit of ten years: Provided, that he may, upon the special recom- mendation of the state board of education, extend the period and that he shall have the power to revoke any appointment at any time for cause. Sec. 2. The board of education are hereby clothed with Supervision. the duty and responsibiUty of supervising the education of aU such beneficiaries, and no child appointed as above shall be withdrawn from any institution or school except with their consent, or the consent of the governor; and said board shall annually report to the general assembly their doings under this chapter, with such further information in relation to the several institutions at which these bene- ficiaries have been placed as may be deemed desirable. Sec. 3. The board of education may expend in the pur- chase of necessary clothing for such beneficiaries a sum not 36 RHODE ISLAND LAWS exceeding twenty dollars, in any calendar year, for a single child. Sec. 4. As added by Ch. 945, Public Laws of Rhode Island, 1913, reads: Blind babies. ' 'The state board of education shall have power to pro- vide for the suitable care, maintenance and instruction of babies and children under school age residing in this state who may be born bhnd or become blind, in any case where by reason of lack of means or other cause the parent or parents of such children may be unable to properly care for, maintain and educate such children." Sec. 5. As added by Ch. 945, General Laws of Rhode Island, 1913, reads: "For the purpose of providing such care, maintenance and education the said board of education shall have power to contract with any institution having or furnishing faciUties for such care, maintenance and education in this or any other state at a contract price to be agreed upon, not exceeding one dollar per day : Provided, that such con- tract shall be made by and with the written consent of the parents or the surviving parent of any such child." Sec. 6. (Section 4, Ch. 100, G. L. of R. I., 1909, re- numbered Section 6, by P. L. of R. I. Ch. 945, Sec. 2, 1913.) All bills arising under this chapter shall be examined and approved by the board of education, and the state auditor is hereby authorized to draw his orders on the general treasurer for the payment thereof when properly LICENSING OF MIBWIVES 37 certified by the secretary of the board and approved by the governor; and a sum not to exceed seventeen thousand dollars, or so much thereof as may be needed, is hereby annually appropriated therefor out of any money in the treasury not otherwise appropriated. Chap. 1634, Public Laws of Rhode Island, 1918: Sec. 16. The state board of health is hereby author- ized and directed to make rules for the regulation of the practice of midwifery and for the licensing of midwives. On and after July 1, 1918, no person not a licensed midwife or a physician registered under the provisions of Chapter 193 of the General Laws, shall practice midwifery, or shall make a practice of attending women in childbirth for hire, or use the name or title of midwife. Any person who violates the provisions of this section or who violates any of the rules of the state board of health made in pursuance hereof shall be fined not more than one hundred dollars, or imprisoned not more than six months, or both, and the state board of health may revoke the license issued to any person when, in the opinion of the state board of health said person is guilty of unprofessional conduct. Licensing of midwives. Penalty for violation. 38 RHODE ISLAND LAWS Boarding homes to be licensed. Incorporated institutions exempt. Penalty for violation. Regulations. CHAPTER 141. Section 1. As amended by Ch. 548, General Laws of Rhode Island, 1910, reads: ' 'No person (other than the managers of any state insti- tution, the corporations and societies enimaerated in Sec- tion 3 of Chapter 139 of the General Laws, any charitable institution incorporated by an act of the general assembly of this state, with authority to aid, support, or care for infants, or any duly authorized officers or agents of any of the same), shaU receive, board, or keep for hire, gain, or reward, any infant under the age of seven years not related by blood or marriage to, or not legally adopted by, or not legally committed by order of any court to, such person, unless licensed in writing by the board of state charities and corrections. Every person violating any of the provisions of this section shaU, for each such offence, be punished by a fine not exceeding one hundred dollars, or by imprisonment not exceeding one year, or by both such fine and imprison- ment: Provided, that if in any prosecution under this chapter the defendant reUes upon his relationship to, or right to the legal custody of such infant in defence, the burden shall be upon the defendant to prove such relation- ship or right to legal custody." Sec. 2. The board of state charities and corrections may grant licenses to receive, board and keep infants, and may revoke such license in its discretion. No such hcense shall be granted until the application therefor shall be BOABDING HOMES FOR INFANTS 39 approved in writing by the board of health of the city or town in which such licensee proposes to receive, board and keep such infants. The board of state charities and corrections, the Rhode Island Society for the Prevention of Cruelty to Children, and boards of health of cities and towns, shall annually, and may at all times, visit and inspect premises so Ucensed, and may at any time designate any person to visit and inspect said premises. Sec. 3. Such licenses shall be granted for a term not exceeding one year and a record thereof shall be kept by the board of state charities and corrections, which board shall forthwith notify the Rhode Island Society for the Preven- * tion of Cruelty to Children, and the board of health of the city or town ia which the Ucensee resides, that such Ucense has been granted, with the terms thereof. Every such license shall set forth the name of the licensee, the par- ticular premises in which the business may be carried on, and the nimiber of infants permitted to be boarded at one time in such premises; and shall, if so required by said board, be posted hi a conspicuous place in such premises, and the niunber of infants specified in such Ucense shall in no case be exceeded. No Ucense issued as aforesaid shaU authorize the holder thereof to keep an iafant in any building or place other than that designated in the Ucense. Sec. 4. Every Ucensee as aforesaid shall keep a true and particular record in such form as may be prescribed by the board of state charities and corrections, of every infant received, which record shall include the name and age of 40 RHODE ISLAND LAWS such infant, the date of the receiving of such iafant, the name and address of the person or institution from whom such infant is received, the date of its discharge, and the name and address of the person or institution to whom it is delivered. Sec. 5. When such license is revoked the board of state charities and corrections shall note the revocation upon the face of the record of the Ucense, and shaU give written notice of such revocation to the holder of the license, by deUvering the same to him in person or leaving it at the place of business designated in the license. Sec. 6. As amended by Ch. 548, Public Laws of Rhode Island, 1910, reads: "Every person, hcensed as aforesaid, receiving under his care or control, for hire, gain, or reward, or placing under the care or control of another, any infant under seven years of age not related by blood or marriage to, or not legally adopted by, such other person, to be kept under the care and control of such other person for hire, gain, or reward, shall, within two days after such reception or placing, give notice to the board of state charities and corrections of such reception or placing under control and its terms, with the names, ages, and residences of such infant and of its parents, so far as known to the person giving such notice." Sec. 7. As amended by Ch. 548, Public Laws of Rhode Island, 1910, reads : PenaltieB. ' 'Every person violating any of the provisions of section four or section six of this chapter shall, for each such 41 offence, be punished by a fine not exceeding one hundred dollars, or by imprisonment not exceeding one year, or by both such fine and imprisonment." Sec. 8. As added by Ch. 548, Public Laws of Rhode Island, 1910, read: ' 'The provisions of this chapter shall not in any manner affect or impair the rights, powers, and duties conferred and imposed, by Chapter 93 of the General Laws, upon overseers of the poor, relative to the settled poor within their respective cities and towns." CHAPTER 173. Of Milk. Section 1. AU nulk, cream, and skimmed-milk shall be ^jgasurea sold only by standard wine measure, and by or in measures, cans, jars, bottles, or other vessels or receptacles which shall, prior to being used in such sale, be sealed by the sealer of weights and measures of the town where the person so using the same shall usually reside in this state, or of the town where such milk shall be sold for use; and every person selling any of the same contrary to this sec- tion, or deUvering any of the same sold contrary hereto, shall be fined for the first offence not less than fifty doUars and not exceeding one hundred dollars, and for any sub- sequent offence not less than one himdred dollars or im- prisonment not to exceed ninety days, or both such fine 42 RHODE ISLAND LAWS and imprisonment. Any purchaser of milk, cream, or ekimmed-milk having reason to believe that any measure, can, jar, bottle, or other vessel or receptacle in which milk, cream, or skimmed-milk is sold and deUvered to him is not of sufficient size or capacity to contain, by standard wine- measiu-e, the amount thereof purchased may apply to the sealer of weights and measures of the town in which such ndlk, cream, or skimmed-milk is dehvered to him, which sealer shall, upon the receipt of a fee of twenty-five cents therefor, test the capacity of the same and issue to such purchaser his certificate stating the capacity thereof; and if such capacity according to such certificate shall be less than the amount purchased, such purchaser may make complaint and dehver such certificate to any officer of such town authorized to make complaints for the violation of this chapter, who thereupon shall duly make complaint against and prosecute the person or persons selling or deUvering the same for violation of this section. Regulations for Sec. 2. No person, firm, or corporation, as principal, servant, or agent, shall sell, exchange, or dehver, or have in his or its possession, care, custody, or control with intent to sell, exchange, or dehver, in any manner whatsoever, mUk, cream, or skimmed-milk, urithin any city, unless such person, firm, or corporation shall have first obtained and have in force a hcense therefor from the board of aldermen of such city. Sec. 3. The board of aldermen of such city may grant licenses to any person, firm, or corporation making written 43 application therefor at the office of the iospector of milk of such city on printed form or forms provided for that purpose by such inspector of milk. Such application shall state the name, residence, and location of the business place or places of the applicant, the number and the description of each and every wagon, carriage, or other vehicle used by the apphcant in the milk, cream, or skimmed-milk business, and the names and residences of all persons from whom such apphcant purchases any nulk, cream, or skimmed- milk. Any hcensee hereunder shall at any time, on request of said inspector, give said inspector such informa- tion. All apphcations shall be signed by the applicant, and in case of corporations so applying the apphcation shall be made by the treasurer or other duly authorized officer thereof, and the names of the officers of any corporation so applying, or to which such Ucense is granted, shall be fur- nished in writing by such corporation to such inspector at any time on his request. The inspector of milk shall promptly present to said board of aldermen each such apphcation, with his recommendations thereon in writing. All hcenses issued shall expire on the first Monday of February next following the date of such hcense. Sec. 4. The inspector of mUk shall keep a record of all such hcenses issued, including the name, residence, and place of business of each and every person to whom such license is issued and the date of issue and the date of license, and so much of section twelve of this chapter as requires milk dealers to register their names and places of business 44 RHODE ISLAND LAWS in the inBpector's book shall not apply to such licensees. No person, firm, or corporation holding such license shall have power to transfer, sell or assign such Ucense. Such Ucense shall not be required for a person acting as the servant or agent of a person, firm or corporation having a license, but they shall record the names and residences of such servants and agents in the oflBce of the inspector of milk. Any person, firm, or corporation Ucensed under the , provisions of this chapter shall immediately cause to be and remain posted such license upon some conspicuous part of the room, place, or office in which the business is carried on. Sec. 5. The board of aldermen of such city shall have the power at any time in their discretion, upon the com- plaint of the inspector of milk or of any other person, to revoke or suspend any such license for any violation of the provisions of this chapter, or for any other good and sufficient cause, or when the interest of the pubhc health demands it: Provided, however, that no such license shall be revoked or suspended imtil after said board of aldermen shall give the Ucensee five days' previous notice and an opportimity to be heard in person or by counsel. Sec. 6. Any person violating any provision of section two of this chapter shall, upon conviction, be fined for the first offence not less than fifteen doUars and not exceeding one hundred doUars, and for any subsequent offence not less than one hundred dollars or imprisonment not to exceed ninety days, or both such fine and imprisonment. 45 Sec. 7. Any town may at any time accept the pro- Towns, visions of sections two to seven inclusive of this chapter by vote of the town council thereof and by filing in the office of the secretary of state a copy of such vote of acceptance duly certified by the town clerk thereof; whereupon the foregoing provisions of this chapter shall apply to such town for the purpose of granting and issuing such Ucenses, and at the expiration of thirty days from such filing shall wholly apply to such town for all purposes therein, and the town council thereof shall have all the powers conferred thereby upon the board of aldermen of any such city. Sec. 8. As amended by Chapter 863, Public Laws of R. I., 1912, reads: "The mayor and aldermen of any city and the town ingpectora. coimcil of any town, may annually elect one or more per- sons to be inspectors of milk therein, except in the city of Newport, where such inspector shall be elected by the board of health of said city, who shall be engaged to the faithful discharge of the duties of their ofiBce. Every such inspector shall give notice of his election by publishing notice thereof, for two weeks in some newspaper published in the city or town for which he shall be elected; or, if no newspaper be published therein, by posting up such notice in two or more public places in such city or town: Pro- vided, that the mayor and aldermen of the city of Provi- dence shall on the first Monday of January, biennially, commencing A. D. 1913, elect such person or persons to be inspectors of milk, and may, at any time during the term EHODE ISLAND LAWS Collectors of Bamples. Duties of inspectors. thereafter fill by election any vacancy occurring by reason of death, resignation, absence from the city, or inabihty to act." Sec. 9. Any inspector of milk of any town or city may appoint, subject to the approval of the town council or the mayor and aldermen, one person as collector of sam- ples, except in the city of Providence, where two may be appointed, who shall have the same powers and be subject to the same duties and KabiUties provided by law relative to the taking of specimens or samples, as an inspector of nuLk. AU specimens or samples taken and retained by any such collector shall be dehvered to such inspector, who shaU have the same powers and duties relative to the same as in case of specimens or samples taken by himself. Such inspector at any time may revoke the appointment of any such collector and, subject to the approval afore- said, appoint another person in his stead. Such collector upon being appointed shall be duly engaged to the faithful discharge of his duties before the city or town clerk, who shall keep a record thereof; and shall receive such salary as the mayor and aldermen or town coimcil shall determine. Sec. 10 Every inspector of milk shall have an office and a book for the purpose of recording the names and places of business of aU persons engaged in the sale of milk within the limits of his town. He may enter any place where milk is stored or kept for sale and examine all carriages used in the conveyance of milk, and whenever he has reason to beUeve any milk found by him is adul- 47 terated, lie shall take specimens thereof and cause the same to be analyzed or otherwise satisfactorily tested, the result of which he shall record and preserve as evidence; and a certificate of such result, sworn to by the analyzer, shall be admissible in evidence in all prosecutions under ' this chapter. Such inspector shall receive such compensa- tion as the mayor and aldermen or town coimcil shall determine. Sec. 11. Whenever the inspector of milk shall have reason to believe that adulterated produce or food is being sold or kept for sale contrary to law, he shall take at least two specimens, from the same package or bidk as samples thereof, such specimens, if soUd, not to exceed in weight one pound each, and if liquid, not to exceed in measure one pint each. He shall take said samples in the presence of the owner or his agent, and shall seal and label the same in the presence of such owner or agent, said labels to state the kind of provisions or food and the name of the seller, and shall then and there deliver one of said samples to such owner or agent. Sec. 12. Whoever, engaging in or being engaged in the business of selling milk and conveying the same for sale, tradesmen. neglects to cause his name and place of business to be recorded in the inspector's book and his name to be legibly and conspicuously placed and constantly kept upon aU carriages and vehicles used by him in the conveyance of milk or in the sale thereof, and whoever, being engaged in the business of selling milk and conveying the same for sale, shall neglect to renew such record annually between 48 RHODE ISLAND LAWS Adulteration. Butter-fats. Adulteration. Definition. the first day of February and the first day of March, shall be fined twenty doUars for the first offence and fifty dollars for the second and each subsequent offence; and whoever offers for sale milk produced from cows fed upon the refuse of distillers or any substance deleterious to the quaUty of the milk, and whoever offers for sale milk produced from sick or diseased cows, shall be fined twenty dollars for the first offence and fifty dollars for every subsequent offence; and whoever, in the employment of another, violates any provision of this section shall be held equally guilty with the principal and shall suffer the same penalty. Sec. 13. No person shall sell or exchange or have in his possession with intent to sell or exchange, or offer for sale or exchange, adulterated milk or milk to which water or any foreign substance has been added. Sec. 14. Every person who shall sell, exchange or deUver, or shall have in his custody or possession with the intent to sell or exchange or dehver, for himself or as the employee of any other person, milk from which the cream or any part thereof has been removed, or which shall not contain two and one-half per centum of milk-fats, shall dis- tinctly mark, in letters not less than one inch in length, in a conspicuous place above the centre, upon the outside of every vessel, can or package containing such milk, the words SKIMMED-MILK, and such nulk shall only be sold in or retailed out of a can, vessel or package so marked. Sec. 15. In all prosecutions under sections thirteen and fourteen of this chapter, if the milk shall be shown upon 49 Penalties for adulteration. analysis to contain more than eighty-eight per centum of watery fluids, or to contain less than twelve per centum of milk-soUds, or less than two and one-half per centum of milk-fats, it shall be deemed for the purpose of said sections to be adulterated. Sec. 16. Every person who shall be found guilty be- fore a district court of violating any of the provisions of the three sections next preceding, upon the first conviction shall be fined twenty dollars; and upon the second, and every subsequent conviction, shall be fined twenty dollars and be imprisoned in the county jail for ten days. Sec. 17. Whoever by himself or by his servant or agent, Care of jars. or as the servant or agent of any other person, firm, or cor- poration having custody of a can, jar, bottle, measure, or other vessel used as a container for milk destined for sale, places or causes or permits to be placed therein any offal, swill, kerosene, vegetable matter, or any article other than milk, skimmed-milk, buttermilk, cream, or water or other agent used for cleansing said can, jar, bottle, measure, or other vessel, shall be punished by a fine of ten dollars for each vessel so misused. Sec. 18. Whoever, by himself or by his servant or Penalty, agent, or as the servant or agent of any other person, firm, or corporation, sends, ships, returns, or deUvers, or causes or permits to be sent, shipped, returned or delivered, to any producer of milk any can, jar, bottle, measure, or other vessel used as a container for milk containing any offal, swill, kerosene, vegetable matter, rotten or putrid milk, 50 RHODE ISLAND LAWS Penalty. Complaints. Public notices. or any other offensive material, shall be punished by a fine of ten dollars for each said vessel so misused. Sec. 19. Whoever by himself or by his servant or agent, or as the servant or agent of any other person, firm, or corporation, sends, ships, returns, or delivers, or causes or permits to be sent, shipped, returned, or delivered, to any producer, dealer in, or consumer of milk any can, jar, bottle, measure, or other vessel used as a container for milk with- out first thoroughly cleaning and cleansing, by the use of boihng water, steam, or other proper agent, such can, jar, bottle, measure, or other vessel used as a container for milk, shall be punished by a fine of ten dollars for each said vessel so misused. Sec. 20. Every inspector of milk shall institute com- plaints on the information of any person who shall lay before him satisfactory evidence by which to sustain the same. Sec. 21. Every inspector of milk shall cause the pro- visions of this chapter to be published in his town at least three times in some newspaper published in said town or some newspaper in the county in which the town is situated. Sec. 22. Every inspector of milk shall cause the name and place of business of all persons convicted under this chapter to be published in two newspapers pubUshed in the town or county where the offence shall have been committed. EUGENICS 51 Sec. 23. Any chief of police and any inspector of milk, Prosecutions. and such special constables as the town council of any town, or the board of aldermen of any city, may appoint for that purpose, may make complaints and prosecute for all \aolations within the city or town wherein they are appointed or elected, of any of the provisions of this chapter; and they each shall be exempt from giving surety for costs on any complaint made as aforesaid. CHAPTER 243. SECTio>f 1. No man shall marry his mother, grand- mother, daughter, son's daughter, daughter's daughter, stepmother, grandfather's wife, son's wife, son's son's wife, daughter's son's wife, wife's mother, wife's grandmother, wife's daughter, wife's son's daughter, wife's daughter's daughter, sister, brother's daughter, sister's daughter, father's sister, mother's sister. Sec 2. No woman shall marry her father, grand- father, son, son's son, daughter's son, stepfather, grand- mother's husband, daughter's husband, son's daughter's husband, daughter's daughter's husband, husband's father, husband's grandfather, husband's son, husband's son's son, husband's daughter's son, brother, brother's son, sister's son, father's brother, mother's brother. Sec. 3. If any man or woman shall intermarrj' ■within the degrees aforesaid, every such marriage shall be null and Marriage Laws. 52 RHODE ISLAND LAWS void, and the issue thereof shall be deemed and adjudged illegitimate and be subject to all the disabilities of such issue. Sec. 4. The provisions of the preceding sections shall not extend to, or in any way affect, any marriage which shall be solemnized among the Jews, within the degrees of aflBnity or consanguinity allowed by their rehgion. Sec. 5. AU marriages when either of the parties has a former wife or husband living at the time of such marriage, or where either of them shall be an idiot or lunatic at the time of such marriage, shall be absolutely void; and no dower shall be assigned to any widow in consequence of such marriage, and the issue shall be deemed illegitimate and be subject to all the disabiUties of such issue. Sec. 18. If any person shall have any lawful objection to the marriage of any two persons he may state the same in writing, under his hand, to the minister, elder, justice, or warden about to solemnize the same, whereupon such minister, elder, justice, or warden shall proceed no further in such marriage imtil such lawful objection be removed. (In some cases, certain words have been italicized in the laws, in order to emphasize points bearing especially upon the health of infants.) APPENDIX 53 ca X Q a. a. < w EH O P5 n 1 ««-« ^.^ a) ^" /-^ _g o iri ^ ^2 ^ *3 .-S fc 73 0} ^ •— H OS d S3 i .3 S-g to 1 § ^ a 02 d i ■ts J3 g'S'S § O > 3 aj o 1^ C mm 8^ Oh 1 o W * * IS d g a CO ^ H • is p:< uo &0 « a> § (H "B a M .a 03 .*^ .£a O § m « fa u 00 a § 1 00 E< s ^ a 1 1 5 a vh o s . fS >.« Q S3 <: O Ph APPENDIX C. Since this went to press, an official report by Mr. Henry J. Harris, Ph. D., has been issued by the U. S. Department of Labor, Children's Bureau, in which it is shown that practically aU of the leading countries of the world, ex- cepting our own, have well-estabhshed Maternity Benefit systems. A Bill, recently read twice before the U. S. Senate and now under consideration (S 3259), seeks to provide proper care for maternity and infancy throughout oiu- country. In this it is proposed that the Federal Government pay annually to each State a sum based upon its population (plus $10,000 for administration) providing the State shall appropriate annually for maternity instruction and care a sum equal to the first named Federal appropriation — that is, the Federal Government would cooperate with each State according to its size, on a 50-50 basis. Thus the matter has now become a question for definite consideration. The recent official compilation of "Laws relating to Mothers' Pensions in the United States," just issued by Miss Laura A. Thompson of the Children's Bureau, proves that Rhode Island is the only northern State which gives no aid to working mothers. APPENDIX 55 Only eight other States, all southern, were without "mothers' pension" laws at the close of the legislative session of 1919, and at least five of these had had Bills under consideration. The compilation gives, therefore, the "mothers' pension" laws which are now in force in 39 States — and in the territories of Alaska and Hawaii. INDEX. Page Americanization 21-22 Birth registration 7, 29-35 Blindness : Preventive measures 7, 27-29 Care of bUnd 8, 35-37 Boarding homes 7-8, 38-41 Cattle, Diseased 13, 48 Deafness 35-37 Eugenics 7, 9 Eyes, Care of 7, 27-29 ImbecUes 8-9, 35-37 Infants : Infant mortality 11 Care at birth 7, 27-29 Clinics (Providence) 12-13 Day nurseries (Providence) 18-19 Instruction in care 12, 21-22, 54 Malnutrition 15-17 58 INDEX Marriage Laws: Page In Rhode Island 8, 9, 51-52 Elsewhere 9 Maternity benefits 10-11, 13, 54 Midwives : Duties 7, 27-29, 32 License 37 Training in Providence 12 Milk 13-18, 41-51 Licensing: In cities 14, 42-44 In towns 14, 45 Duties, of inspectors 45-47, 50-51 " " chief of police 51 " " tradesmen 47 Measures 41-42 Adulteration 48-49 Pastem-ization 17-18 Care of jars 49-50 Milk stations (Providence) 15-16 Bacteria 18 Mothers: Prospective: Local aid 11-13 Maternity benefits 10-11, 54 INDEX 59 Mothers : — Concluded. Page Instruction 12, 21-22, 54 Working mothers: Local aid 18-19 Mothers' pensions 19-20, 54 Nurses, Duties of 27-29 Ophthalmia neonatorum 27-28 Physicians, Duties of 7, 27-29, 32 Venereal disease 7, 9 E. L. Freeman Company, Central Falls, Rhode Island, December 15, 1919. i provided by the library rules or Dy the Librarian in charge. DATE BO RROWED DATE DUE RA609 R54 Ra t, ^1 ^.<^^^w-*^^^ R3^ IWPP' ins!^ r