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complete toleration, are potent causes ; and to these solvents must be added the disfavour, not to say contempt and ridicule, with which the community is regarded. The majority will become Christians ; but not quite all. For, owing to the energetic steps taken by certain Turkish settlers, who have interested themselves in the matter quite recently, the Lino-bambaki in some places have declared firmly for Islam. Meantime a study of the sect in its present state of absolute liberty to choose its own path is not altogether devoid of interest.

ROLAND L. N. MICHELL.

1908

THE ST. PANCRAS SCHOOL FOR

MOTHERS

Not far from St. Pancras Church, on the left side of a busy street where barrows of fruit and turnips, china and old metal, ply a thriving trade between cheap butchers' and small grocers' shops, gaudy publichouses and secondhand clothes depôts, stands a building conspicuous for the lettering over the large shop windows : The Mothers' and Babies' Welcome.' The plate glass of the windows is whitened and hung with notices of the ‘Baby Consultations and the Winter Classes, while under the huge picture of a pair of crooked infant limbs passing mothers are invited to come and learn how to avoid bow legs.' Inside is a large light room furnished with chairs and benches, big and little, and with cradles made of twopenny banana boxes, and at the fireplace end of the room a table with weighing scales and a large cupboard. The walls are covered with gay charts of the proximate values of food, giving vivid pictorial representations of the amount of nourishment in a chop, a loaf of bread, an egg, a banana, &c., and with impressive pictures illustrating such wise maxims as ' Feed baby by the clock,' and 'Make your baby a teetotaller.'

This is the classroom of the St. Pancras School for Mothers, modelled on the Ghent School for Mothers, described in this Review of December 1906. St. Pancras, though a poor quarter of London and containing a good deal of slum property of a very insanitary character, has not quite the same difficulties as Ghent to deal with in regard to its infant mortality. Wages are rather higher than in Ghent, and married women, as a rule, do not go out to work but are able to stay at home and take care of their babies. Having, however, worked in factories almost universally before marriage, and being, therefore, utterly untrained in the most elementary principles of hygiene and child-nurture, they have not made good mothers, nor have they understood the importance of breast-feeding; and it is not surprising to learn that the infant mortality of St. Pancras compared unfavourably with that of other parts of London. In the summer of 1904—the unhealthiest quarter of the year for infants—St. Pancras came twenty-fifth in the list of the twenty-nine cities and boroughs of

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London, with an infant mortality of 232 (i.e. 232 deaths of infants under twelve months in a thousand births), the rate for the whole of London being 208.

As this was felt to be very unsatisfactory, the active and energetic Medical Officer of Health undertook an investigation with the help of the borough lady sanitary inspectors, and came to the conclusion that attention must be concentrated on the natural feeding of infants as against the municipal distribution of milk, whereby bottle-feeding might appear more easy or more desirable.

To quote from his report :

The measures pursued in St. Pancras have been the discouragement of the artificial feeding of infants of suckling age, and the encouragement of natural or breast feeding, by prompt advice and the personal influence of women inspectors and women voluntary visitors. The efforts tentatively commenced in 1904 were pursued with greater confidence and thoroughness during 1905, and have been extended and elaborated during 1906. It was recognised from the beginning by the borough council that woman's sympathy and influence were essential to success. Your inspectors .. assisted in commencing and elaborating the inquiry and the remedial work, and the numerous ladies (some twenty) kindly acting as voluntary visitors have assisted in extending the work. The members of the medical, midwifery, and nursing professions have fully approved and furthered the principles of the scheme adopted by the borough council.

As a result of the three years' work, in the summer of 1905 St. Pancras rose to the eighteenth place in London, with an infant mortality of 175, all London being 171 ; and in the summer of 1906–0 particularly fatal summer to babies—St. Pancras ranked thirteenth, with an infant mortality of 172, while all London was 187.

To quote again from the report of the Medical Officer of Health :

The interesting point to bear in mind is that the lowering of the infantile mortality has been accomplished without the municipal distribution of milk, the borough council not having established a milk depôt, and no such depôt existing in the borough, and the fall in the mortality rates must be mainly attributed to the diminishod use of cow's milk and other foods for infants, and the increase of breast-feeding.

But while the Medical Officer of Health laid stress entirely on the supreme value of breast-feeding and did not therefore wish to establish a municipal milk depôt, at the same time he found many women whose milk was not sufficiently nourishing for their babies owing to the fact that they themselves were under-nourished, and he found also many mothers who needed a more thorough course in child culture and hygiene than could be given by leaflets and occasional visits from the lady sanitary inspectors and their staff. He and his lady sanitary inspectors were very glad, therefore, to co-operate with a local committee of influential ladies and gentlemen in instituting & school for mothers on the model of the Ghent one, with dinners for nursing mothers on the Chelsea model. Premises were found, and the school was opened in June 1907, and is now under the charge of a highly trained lady superintendent, who supervises the dinners and all classes, herself giving lectures and general advice, who visits the mothers, investigating the cases of special need &c., and by her great tact and wisdom has helped very largely to make the school a

success.

After her round of morning visits, she reaches the 'Welcome' at 1.30 to see applicants for the Provident Maternity Club, and to superintend the dinners. These dinners, which are served at marble tables in a pleasant little room downstairs next to the kitchen, are sold at 11d. each, the actual cost being something over 2d. a dinner for the 685 dinners provided since Christmas. An appetising plateful of meat and vegetables is followed by stewed fruit or a pudding, and the menu is very varied, the six menus for one week consisting of:

1. Stewed beef, suet dumplings, vegetables, potatoes.
2. Boiled hake, parsley sauce, potatoes. Baked apple batter.
3. Fish pie. Stewed fruit.
4. Roast mutton, potatoes, beans. Baked apples.
5. Stewed mutton, with celery, potatoes. Rice pudding.
6. Stowed rabbits, onions, potatoes. Stewed damsons and apples.

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Pregnant mothers during the last three months before confinement, or nursing mothers whose milk is not sufficiently nourishing for their babies, are encouraged by the doctor to come daily (except Sundays) between 1.30 and 3 o'clock, the latter bringing with them the baby and perhaps & young child, when the older children have returned to afternoon school. The baby, of course, is never given ' a taste of anything mother has,' but if the older child is surreptitiously fed with a little bread and gravy, or a spoonful of pudding, the superintendent looks the other way. The day I was dining there myself, I saw a much be-gravied knife go into the mouth of a little twoyear-old girl, while the young mother held the new baby in her left

She had just come out of the maternity hospital and boasted that her new baby had weighed 8 lbs. at birth (after a three months' course of dinners at the Welcome), whereas his older sister had only weighed 5} lbs. at birth. As they pushed away their plates and rested, the mothers chatted over their babies, their confinements, and their holidays. 'When you goes to a convalescent home, that's when your 'usband feels the miss of you,' said one mother. 'I'm sure my 'usband was nearly wild with the three children, and 'e ’adn't a farthing left by Monday morning. 'E had to borrow off my mother. 'E'd always said before I wasn't a good manager, but I told 'im I could lay out a shilling better than anybody.' This led to an animated discussion on the best way of laying out a shilling, and it was finally decided that the items should be as follows :

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After dinner the work of the school begins. On Tuesdays and Friday.s the lady doctor, who generously gives her services without charge, takes her seat beside the weighing scales, and the mothers in turn—any number from six to twenty-bring the babies to be weighed and inspected. While the young assistant, in a big pinafore, is weighing the little naked baby, the doctor is busy with questions to the mother. If it is the first visit, a certain amount of the family history is ascertained and set down, the number of children, causes of deaths of any, history of confinements, &c., and then the baby is carefully examined as to development, skin, feeding, digestion, and habits. The questions are fewer at the subsequent visits, which are supposed to be fortnightly, but the baby's weight is carefully noted and entered on the mother's card, and any improvement in its clothing and habits commented on. The doctor gives special praise when the rubber comforter' has been abandoned, or when longsleeved woollen vests have been substituted for cotton ones. Delicate mothers are also advised about their health, but mothers or babies who are really ill are not treated, being recommended to a local doctor or a hospital. One six months' old baby whom I saw had lost 8 oz. in the three months it had not been brought to be weighed, and was ordered back to the hospital for treatment. The mother admitted that she was not a teetotaller, and she certainly had not the appearance of one. But as a rule the babies who are brought regularly, and whose mothers follow the doctor's advice, gain steadily in weight, and are & credit to the mother and the doctor.

Wednesday afternoon is devoted to the needlework class and provident club. The average attendance at this is thirty-two, and the mothers have been mostly learning to knit little woollen vests (cost of wool for two vests, 9d.) for the baby's winter outfit, also hoods, shawls and socks. When all the mothers are well started, and quiet reigns, the lady superintendent gives a short talk on some health subject, such as 'How to get ready for baby,' and 'How to take care of baby the first month. Meanwhile the babies and the little children who are not old enough for school, are taken downstairs to the dining-room, now converted into a crêche, where they are tended and amused by a staff of voluntary helpers. Old and young, from

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