tional factor. At the beginning of our attempts in New Haven to furnish babies a clean, wholesome milk, I was absolutely convinced of the necessity of station-made modifications and mixtures. It did not seem possible to me that the class of mothers we met could ever be taught the cleanliness necessary to meet the requirements of successful artificial feeding. It also seemed to me that the cost of the educational campaign would be all out of proportion to the expense of the distributing stations. As a matter of fact, the cost has been materially lower; and, under the guidance of Miss Gilbert and her able, enthusiastic assistants, a clean milk has been made possible in a tenement where the only thing clean was the milk and the utensils used in its preparation.

THE PRESIDENT: Is there any further discussion of this paper?

DR. KATE C. MEAD (Middletown): I want to say that, in a way, I represent the work done in Middletown; and we have cut down the price there for caring for milk-station babies from two dollars and a half to forty-nine cents each. As a matter of fact, our nurses are not graduate nurses. We have practical nurses that do some of our baby work; and then we have untrained people that just weigh the babies and do similar things. We have been able to get only money enough to run the milk station for three months of the year; but even so, we have cut the death rate down one-half. Middletown milk is said to be "good." The State Laboratory is located there, and the milk is under constant inspection and examination.

One thing that we have had to struggle with is that some of the babies saved in the summer die in the winter of pneumonia, because we cannot yet afford to have the nurses keep track of them during the winter. We have a District Nurses' Association, but these nurses are not employed to look after well babies. The sick babies are not sent to a doctor soon enough, because they are not seen by someone who is able to detect early signs of disease. I am anxious to know how frequently the New Haven doctors have found pneumonia in the winter among these station babies.

DR. FRANK W. WRIGHT (New Haven): The Health Department has been doing a good deal of work in New Haven. We have been examining the milk as to its quality, and have had a very good quality of milk; but five or six years ago we found that our milk was dirty. Then we started farm inspection and laboratory examination of the milk. The first year, the death rate was reduced thirty-four per cent. below the average for the three previous years. Now, for several years, our death rate has been approximately fifty per cent. less than that. We believe that we have the milk producers and the milk dealers pretty well educated; and that it is the consumer that needs education,-the mother

that feeds the baby. We have appropriations for five months' work during the summer. We have engaged nurses, and propose to start them to teach the consumers how to care for the milk, and let them know that they are responsible for the milk from the time it is delivered to them. In addition, the nurses will teach the mothers how to prepare milk for their babies. We have decided not to attempt to treat the sick babies. We shall refer them to the Welfare Station and have Dr. Linde attend to them. I think that we shall accomplish a great deal of good in that way, and I hope to have enough money to put on a good corps of nurses all during the summer.

DR. ARTHUR S. BRACKETT (Bristol): It seems to me that we should enlist all the agencies possible in such a movement as this. I think, also, that the same people who look after the Welfare Associations of different places are connected with associations in the different churches, etc. They are all right, but what are the school authorities doing? It seems to me that the best thing to do would be to put it to the school authorities, and say that the reason that the babies are dying so frequently is that their mothers are ignorant. The school authorities are not fulfilling their scope. There is no one so easy to teach about babies as the eight to twelve years old girl. There is no one who cares for babies so much, except the mother, as the child of this age; and these girls will take a very active interest in the subject, if instructed with regard to it. Then, too, the schools ought to be used at night for lectures along these lines. It is not now either necessary or right that a few persons should stand the expense of all this. It should be put to the State that the schools ought to be used as teaching

centers.

THE PRESIDENT: Is there any further discussion? If not, I will call on Dr. Linde for some closing remarks.

DR. JOSEPH I. LINDE (New Haven): Regarding pneumonia during the winter among these babies, I would say that we have had some. I do not know the exact figures, but if you wish to know them, I will find out exactly how many cases there were. I should like to show the charts that I have brought in connection with my paper.

This is the kind of chart that the physicians use, and this is the diet list for older children. This is the prenatal chart. This chart shows the map of the city. The dots indicate where we have cases. They are scattered from Foxon to West Haven. This is the literature that is put into the homes and displayed in conspicuous places. This pamphlet urges the importance of breast-feeding, daily care of the bottles, fresh air, etc. These are a few snap charts taken from the nurses at the Lowell House Station.

Dr. Eli Todd and the Early Days of the

Hartford Retreat.

CHARLES W. PAGE, M.D., HARTFORD.

Among Connecticut's medical worthies, that have been long neglected and almost forgotten, Eli Todd, the first Superintendent of Hartford Retreat, deserves high rank, if indeed, in respect of character, ability and deeds, his record is not the most illustrious of them all.

In the year 1715 the General Assembly of the State of Connecticut revised its Public Statutes, one act of which reads as follows, viz.:

"When and so often as it shall happen to any person to be naturally wanting of understanding, so as to be incapable to provide for him, or her, self; or by the Providence of God, shall fall into distraction and become non compos mentis, and no relative appear that will undertake the care of providing for them, or that stands in so near a degree as that by law they may be compelled thereto; in such cases the selectmen or overseers of the poor of the town, or Peculiar where such person was born, or is by law an inhabitant, be and hereby are empowered and required to take effectual care, and make necessary provision for the relief, support and safety of such impotent or distracted person," etc., etc.

For the next century, in the State of Connecticut, no more direct or specific laws regarding the insane were enacted. Meantime any surroundings, however unfitted, cramped and forbidding, any devices, however galling and cruel, deemed by ignorant or inexperienced relatives as proper measures for confining or restricting the insane were adopted without exciting public protest, or more than passing interest, with those exceptional instances where attending physicians had had their sympathies engaged by observing the unnecessary hardships frequently imposed upon neglected or abused cases.

In 1812 Dr. Nathan Dwight of Colchester wrote a paper reciting existing conditions and suggesting the need of a public hospital for the insane.

His paper was read at the State Medical Convention and, as a result, a committee, with Dr. M. F. Coggswell as chairman, was appointed to obtain further information and report to the next annual Convention.

In 1813 this committee, having made little progress, was authorized to continue its investigations. Probably it accomplished nothing further, as in 1814 the State Medical Society appointed Drs. Coggswell and Strong a committee to ascertain the number of insane in the State.

They requested the Association of Congregational Clergymen, which society had members residing in every town, to supply the facts. It was supposed that each community in the State could thus be canvassed by local agents, familiar with actual conditions. Yet the report which came through the clergymen was obviously incorrect and the subject received no further consideration by the Society until after the lapse of several years.

But Connecticut physicians were too deeply concerned for the unfortunate insane to abandon efforts in their behalf. At the spring meeting of the Hartford County Medical Society in 1821 the subject was again introduced, and this time by men who had carefully considered it and who were ready to suggest practical measures by which to solve the various problems involved. Action resulted, and the Fellows of the Society were instructed to bring this matter of the insane before the State Convention at its next meeting, in May. This was done, and as a result the State Medical Society appointed Drs. Eli Todd, Thomas Miner and Samuel B. Woodward a committee to formulate a working proposition for the Society.

Dr. Todd, then living in Hartford, was evidently the master promoter of this movement in the County Society. It appears that he had become thoroughly informed as to the usual, and the exceptional methods then in vogue for treating the insane; and having convinced himself that very recent improvements in an English asylum marked a great advance, he resolved that the State of Connecticut should be provided at once with a central asylum, where the more rational methods of care could be

employed to improve the condition of the insane. In this Todd was ably supported by Woodward, who resided in Wethersfield. These two men, general practitioners of medicine, were remarkable for their intellectual poise, their practical sense and their executive ability. Both men were destined to work out here in New England practical reforms in managing the insane. By their personal service in the cause, and their published reports, they virtually moulded for many years, in this section of the country, professional opinions regarding the custody and proper treatment of the insane.

Moreover, the methods of hospital management which these two Connecticut men subsequently inaugurated, Dr. Todd at the Hartford Retreat and Dr. Woodward at the Worcester State Hospital, accorded with institutional standards which are, and will ever remain, preeminent in respect of humane considerations and skillful employment of moral agencies. When, therefore, the medical convention deferred to the judgment of these men, its action was well considered.

The committee reported at once that "immediate work to secure an asylum for the insane ought to be instituted." Whereupon, the State Society added Drs. William Tully and George Sumner to the committee, and instructed its members "to proceed in the undertaking and formulate a constitution for the regulation and government of such an asylum.”

The importance and urgency of this humane departure in the care of Connecticut insane so strongly appealed to these kindhearted and clear-headed doctors, that the committee was requested to report at an adjourned session to be held for that purpose on the 3d of the ensuing October. On the day appointed, the convention re-assembled and listened to the report of the committee. This report was such a masterly presentation of the cause-showing such complete insight as regarded actual conditions which confronted them, and such comprehensive knowledge of what had been attempted elsewhere, and what could be done in the way of bettering the conditions of the insane—that copious extracts from it are necessary to do simple justice to the author-Dr. Todd (in all probability).