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stores, 71,516. Thus for 502,482 women or 44 per cent
of all women working in the state, the new law means a
lessening of toil and a long step toward the forty-eight-hour
week which economists and sociologists generally recognize
as the most that should be exacted under modern conditions
of relentless, high-speed, machine production.

A PPARENTLY the hip-flask virus is producing its own
J["\_ antitoxin to protect the young. From coast to coast,
i.e., Philadelphia, Chicago, San Francisco, comes news of a
spontaneous uprising of "Slow Clubs" which cast cold water
on the popular and fearful legends of flaming youth. The
Slow Club movement for such it has come to be had
its origin in Philadelphia last October when one "Dusty"
wrote a letter to the Evening Bulletin. George F. Kearney
tells the whole story in the current issue of The Playground.
"Dusty" felt that he could pass in looks and manners, but
he couldn't dance, wasn't "extremely collegiate," and
couldn't talk nonsense; was he therefore "dead" or "slow?"
And was it because of this that he had so few girl friends?
On November 5 "Rose Marie" answered his letter through
the Bulletin to say that she considered his sentiments very
sensible. "Wouldn't it be lovely," she sighed, "if we could
start a club of just such persons those who do not go to
extremes in everything?"

From this germ grew a packed meeting in a public
library auditorium. "Rose Marie" turned out to be a 19-
year-old stenographer, a church member who could do a
deft Charleston ; "Dusty" was a high school student of like
age. There seemed to be unlimited numbers of other

youngsters who were out for fun, not fury. Now brought
together by newspaper announcements, helped but not
directed by the Y.W.C.A. and Y.M.C.A., there are
twenty-eight chapters in Philadelphia with a membership
of 15,000. They dance, they give plays, they debate, they
sing, they hike, they organize literary clubs, glee clubs,
camera clubs, athletic clubs. In short, they seem to do all
the things that recreation leaders have dreamed of. The
idea and the name spread to Chicago and on to San Fran-
cisco, sponsored by local newspapers. The initial meeting
in Chicago, presided over by an artist's model of seventeen,
decided the Slow Club members could be anything from
sixteen to thirty-two; that they would dance, but not drink
or pet; that smoking would be left to "individual dis-

How does all this differ from the ideals on which dozens
of earnest organizations have been concentrating for years?
Simply but significantly, if the reports are correct, because
it is fun without a flavor of philanthropy, organized by boys
and girls who know what they want and have found a way
of getting it for themselves.

IGHT months ago the "floating university" set sail
from New York for a high-hearted attempt to trans-
late the "grand tour" of our grandfathers into modern
college terms (see The Survey, October i, p. 42). The
S.S. Ryndam was chartered by the University Travel
Association, Inc., to carry a group of college men who
would pursue their studies under a carefully selected
faculty while they cruised through Occident and Orient and
the broad seas between. But in a last minute shift of plans
some fifty "co-eds" and a group of middle-aged tourists
were included. This complicated the experiment, and the
disquieting tales that have followed in the wake of the
Ryndam are probably due in part to the ill-assorted student
body. From several ports it was necessary to ship home
students who had indulged themselves in "conduct unbe-
coming a gentleman." The editorial columns of The
Binnacle, the Ryndam's college paper, have carried repeated
plea, to students to refrain from excessive drinking in port
and from even more serious misbehavior. But similar out-
breaks are not unknown to campuses ashore and it is
probable that the Ryndam students as a body have suffered
from newspaper reports of the sins of the obvious misfits
among them. Plans for a second cruise next year include
various changes based on the first year's experience. The
student body, composed of men only, will be limited to 375.
Each applicant must present satisfactory credentials as to
character, scholastic standing and health, and be personally
interviewed by a member of the cruise management.

There are all sorts of stirring possibilities in the idea of
taking a year of one's college course at sea. To translate
that idea into actuality includes dealing with such difficult
factors as personality, self-control and poise. But as a
hopeful attempt to give young America first-hand acquaint-
ance with the world in which he lives and the peoples that
dwell on it with him, it deserves sympathetic interest and
unexcited remedying of its initial mistakes.


What Makes Children Grow?


ED the ancient enigma of the hen and the egg is the
philosophical problem of poverty. Are the poor
the cause or the result of the miserable conditions
which mark their lives bad housing, insufficient
food, meager income, lack of education and the like?
Cutting straight across the abstract vicious circle comes

an almost incredibly painstaking official investigation of

Poverty, Nutrition and Growth recently completed by
, Drs. Noel Paton and Leonard Findlay and a group of
; associates under the Medical Research Council of Great
I Britain and just published by His Majesty's Stationery
(Office (No. 101, Special Report Series. 333 pp. Price 10 s.)
j The work which it reports was begun in 1919 and carried

through 1925, with the

aid of grants from the

Carnegie United King-
dom Trust, in the

three largest Scotch

cities, Glasgow, Edin-
burgh and Dundee,

and in agricultural and

mining districts in

Scotland. It outlines an

attempt to evaluate in

concrete terms the

specific influences and

weights of the varied

factors of heredity and

environment in the de-
velopment of children

a pioneer effort

unique in the annals of

public health and so-
ciology both in its scope

and in the meticulous

scientific safeguards to

which both original

data and conclusions

have been subjected.
The evidence on

which the report is

based was obtained by

a corps of trained

workers through child

welfare centers and by

house-to-house visits,

involving nearly II,OOO

children of pre-school

age and about 1,500 of

school age, who were

studied intensively as

to height, weight, nutrition, and growth. Were the city
children smaller and thinner than their country cousins?
In either case, was there a direct relation between the
physical development of the child and the father's income
or the number of children in the family; or the number of
rooms in which the family lived ; or their food, including
the use of milk; or the health of the mother and her
working conditions, in home or factory, before and after
the birth of the children? Each ef these and other similar
questions were studied in the greatest detail, and the results
for this class and group of children were such as apparently
to upset some of the generalizations on which social workers,
nurses and physicians have hoped to rest comfortably.

Slum children be-
tween the ages of one
and five were found
to be about 10 per cent
lighter than country
children, age for age,
but there is evidence
that this difference is
at least in part an in-
born characteristic: the
town parents were
smaller. More and
more the towns are
ceasing to draw re-
cruits from the country
and are breeding their
own population. There
was little evidence of a
difference in the rate
of growth in the two
groups of children ex-
cept in the first eight-
een months of life ; the
country babies seemed
to get a slightly more
rapid start, but after
the first year and a
half the city children
equalled or surpassed
them in this respect.

Likewise there was
little evidence of a
direct relation between
the size or nutrition of
the child and the in-
come of the family per
person; or between the
size of the child and

Courtesy of Maternity & Child Welfare. England
Overcrowding, and inferior mothers, seem to go hand in hand


8 4



April 15, 1927

the air space per person in the dwelling ; or between the
health of the mother and the height and weight of the
children. The three towns afforded absolutely no evidence
that the industrial occupation of the mother was detri-
mental to the growth and nutrition of her children.

No statistical method can answer the fundamental question
of whether the difference in size of town and country children
depends on the diet or whether the difference in the intake of
food is dependent upon the demands of the two types of chil-
dren ... A consideration of the relative weights of adults
and of children in city and country suggests the possibility that
the dwellers in the former require a smaller supply of food
than those who live in the latter. ... In the light of our
present knowledge it would seem that the usually accepted
estimates of the dietary requirements of families, especially of
the urban poor, require revision. . . . The town dweller is
generally one upon whom no great demands for the expenditure
of energy are made, and who is accustomed either from neces-
sity or choice to a restricted diet. The requirements of growth
might therefore be met fully by a surplus food supply smaller
than that required by a big country child with its greater
activity and exposed to all weathers as well as being accus-
tomed to a liberal diet. . . . That the difference in the size
of the town and the country child is not determined by the
amount of fresh milk consumed is indicated by the well-grown
children of rural miners whose family consumption of milk is
as small as that of the slum families. . . . The evidence seems
to show that even upon the low intake of something less than
2,600 calories per man per day and a supply of only about
0.4 pint of milk, the city slum child, at least after 18 months
of age, grows at the same rate as the country child with its
3,250 calories per man per day.

The investigators are careful to point out that because
they found little direct relation between the growth of chil-
dren and the environmental factors which have commonly
been considered important such as food and housing it
cannot be safely assumed that none exists. If such a rela-
tion does not exist, however, it is masked by some other more
powerful condition. For example, there may have been
harmful effects in the absence from home of the factory
mothers, which were more than counterbalanced by the
result of their extra earnings.

IN spite of all the advance expectations of the workers
who were engaged in this study, only one thing stood
out clearly and constantly as affecting the physical develop-
ment of these Scotch children. That was what they called
"maternal efficiency." The correlations between maternal
efficiency and the height and weight of the child were sig-
nificant for all ages and all groups in city and country
alike. Generally speaking, when the mother was interested
and able, all the other measurable conditions of the family
life housing, income, food and so on proved of minor
importance in the growth of her children. Upon her first
and chiefly depended their chances for normal development.
"Maternal efficiency" was hard to define and even harder
to analyze.

Even among animals there are good mothers and bad mothers
good mothers who rear a large proportion of their young
and bad mothers who neglect or are indifferent to their off-
spring. ... A worker of experience is able to classify mothers
in this respect into good, bad and indifferent. When the chil-
dren are repeatedly found to be dirty or verminous, badly
clothed and left in bed until all hours of the day, when the

house is constantly dirty and uncared for, the mother without
doubt is inefficient. It is in this sense the term is used here.

What makes good mothers or, speaking more cautiously
and exactly, under what conditions are good mothers found?
Surprising enough was their first discovery "evidently
within the class studied, income is not a dominant factor
affecting the efficiency of the mother." The mental examina-
tion of a limited group suggested that the good mothers
were more intelligent than the bad ones, and this point is
recommended for further study. The health and efficiency
of the mother seem somewhat interdependent, especially in
the rural families where there is little overcrowding: there
health seemed to be a prime factor in determining the quality
of the mother's care. Yet when the efficiency of the mother
was kept at a constant level, her health bore no significant
relation to the weight and height of the child.

EFFICIENT mothers were found more often among the
smaller families in the less overcrowded homes than
when there were many children and cramped living quarters.

In other words, overcrowded dwellings and an inferior type of
mother tend to go hand in hand. What is cause and which
effect, is, however, another matter. The results of various
statistical studies on fertility show that the population is being
recruited mainly from the improvident type of parents, who
contribute more than their share to the birth-rate. It is thus
a question whether the larger families are the product pri-
marily of inefficient parents, or whether the greater number of
children leads to a less degree of care being shown for the
well-being of the offspring. . . . The provision of improved
housing accommodation by permitting a larger proportion of
mothers to care efficiently for their children and homes might
prove to be a beneficial measure. What is not demonstrated
is that simple increase of income would be followed by improve-
ment in the condition of the children. Bad parents, irrespective
of their incomes, tend to select bad houses, as the money is
often spent on other things.

Like any other careful piece of scientific work, this Scotch
study raises at least as many questions as it answers. Why,
for example, does the country baby get a better start than
the city baby, only to lose it after eighteen months? Are
the good mothers really the more intelligent ones? And
so on. One deduction at least stands out clearly the prob-
lem of poverty is infinitely more complex than a mere lack
of money ; there can be no one panacea which will solve it.

... a position must be taken up removed from that of the
sociological or political theorist, on the one hand, who believes
that a simple increase of income would remedy all evils, and
from that of the thoroughgoing eugenist on the other. The
evidence supports neither extreme, but seems to indicate that
the current teaching gives too much rather than too little weight
to the environmental factors. . . .

And beyond that, even the modest conclusions of the in-
vestigators suggest one direct method of breaking the vicious
circle the pursuit of that complex but all important quality
of maternal efficiency, which seems powerful enough to
negate the bitter handicaps under which many families must
struggle at this time. Any social measures which will arouse
the mother's interest and supplement her efforts to care for
her children and her home promise, if we accept these con-
clusions, a more immediate return in social well-being than
the abstract roads to Utopia which ignore the human factor.

[OQOOO^][[ j 1 [[jjOOOOOl


A /^ A J fvKFFERSW W' M1!

A County Adventure in Dental Hygiene


BARBER COUNTY visions of a great stretch of
water and a clean sandy shore, washed by waves
now gently playful, now violent from the force
of the winds; of tractless stretches of pine woods
and cut-over timber lands, hiding small clearings
and fields peppered with stumps; of cabins where children
swarm in the dooryards, and women work barefooted in the
fields; of snarling dogs as ferocious as wolves.

Over the sandy, hilly roads the open Ford of the county
nurse chugged many miles to the little one-room schools
with their country children ; to classes of women so eager
to learn how to give better care to their sick in that back
country where doctors seldom came, and so anxious to know
more about how to keep their families well, that they would
walk miles, carrying the babies, while small children tugged
at their skirts. There was one doctor for a county of some
seven hundred square miles, one county public health nurse
and no dentist. Never were days more crowded with
tasks to be done by one nurse, never was a nurse more
happy in the doing.

Among the people of Barber County she found an ab-
solute lack of dental care. In one school she found several
children around twelve years of age, who had not a tooth
left in their heads. Inquiry as to the cause led to discovery
of a neighbor possessed of a pair of dental forceps ; if a tooth
ached, she obligingly pulled it. The nearest dentists were
miles away and many families never had a chance to go out-
side the county.

The nurse talked about toothbrushes, diet, and proper
dental care until she was hoarse the children got the first,
>arents attempted the second, but the community had noth-
ng to offer by way of the latter. Something must be done.
The problem was discussed in nursing committee meeting,
and then taken before the town council. Finally it was
lecided to go down to the state dental college to consult
he president, a man greatly interested in public welfare,
surely he would be glad to listen to this need. The town
ouncil agreed to guarantee to any qualified dentist an in-
ome of $150 a month and furnish an office; they laugh-
ngly added a promise to provide all the fishing and hunting
is heart could desire.

~pHE college president was interested particularly in the
J_ fishing and hunting and said that he would come him-
elf were not his vacation plans already made. However, he
jreed to present the matter to his faculty and graduating

ass. The next day he had an answer ready in the person
f one of his best graduates, who hoped eventually to go
ack to a far distant home to practice but had no immediate
esire to leave the state. The college offered to loan him

traveling equipment for the summer.

Triumphantly the news was born back to the town coun-
1, who were reminded that it was more to their advantage
> send in patients enough to pay the promised $150 than
make up a deficit from town funds. They agreed.

Office set up, sign displayed, the dentist waited for work,
-ate that evening the nurse hurried in, eager to hear of
he day's adventures. The dentist grinned his appreciation.

"Just one," he announced.

"Well, they are all waiting for some one to try you out
to see how much it hurts. I've heard them talking about
it wherever I have been. You must remember that many
of these people never saw a dentist before."

"That's all right, but wait until you hear about my case.
You know about the homecoming which everyone is getting
ready for lawns cut, houses painted, and all. Well, a man
came in this morning, sat down in the chair, opened his
mouth obligingly and not a tooth could I see in his head.
Then he explained that he wanted a set of plates made
by next Monday. I told him that I was not equipped to
do that work here. I would take his measurements and send
away, but there was danger that the plates might not fit.
He sat up astonished and said, 'Good God, man, these ain't
for use. I ain't had a tooth in my head since I was twenty.
These is for looks. Wife's folks are coming for homecoming
next week and ever since we went to the city a year ago
she ain't give me no peace about the looks of my mouth.
Now you're here she says there ain't no excuse at all, and
she says if I don't have teeth in my head when her folks
come visiting, she won't let me come to the table. And I
know her. She won't, either. These teeth is just for style,
to last a week part of this homecoming foolishness.' And
now," added the dentist, "it's up to me to produce the
teeth and preserve the family peace. Can you beat it!"

T)ATIENTS came one after another and soon the dentist
J. was busy all day. After several weeks a schedule was
made out whereby he spent half of each month in town and
half in the country. His itinerary was published ahead of
time in the county paper, and announced through the country
churches. The nurse managed this part of his program
for him and made arrangements to get him and his equip-
ment to the distant settlements, where he was put in charge
of the local nursing committee responsible for the public
health work. Once, when the equipment had been set
out and the dentist was ready to begin work over a barber
shop, the barber stuck his head out of the window and in
stentorian voice shouted down the street, "Dentist's ready
to begin. Who's first?" From nearby houses women could
be seen emerging, wiping wet hands on aprons, shooing
reluctant children down the road towards the barber shop.
Again he opened office in the country church and the
tolling of the bell announced his arrival to the country-
side. He worked far into the evening caring for farmers
who could not leave their fields until after sunset.

There was the family of six children whose father's sole
income was gained from the sawing of shingles for the
neighbors, and the meagre crop grown on the tiny clearing.
Never were there six children with mouths in worse condi-
tion. The nurse begged the father to send them to the
dentist at the church. His answer was a shrug, "No
money." Persuasion finally extracted a reluctant promise
"to see what he could do," and the next day the six came
struggling down the road, kicking up a cloud of dust
with their bare toes.



April 15, 1927

Trustingly they came to their friend, the nurse, with the
message, "Pa sent us because he promised you he would,
but he said to tell you to do just one dollar's worth, as
that's all the money he has till he gets more orders for
shingles." They handed out their dollar bill with satis-
faction. It was a problem in high finance to know where
a dollar's worth of work began and ended, but due to the
generosity of the dentist, those six children went home at
the end of the day ready to start school in the fall with
mouths in good condition.

So the summer wore on. Many were the little hands
held by the nurse while the dentist filled and pulled, the
children telling their parents they would go "if the nurse
would stay right with them." And in the fall when
weather grew cold and the snow shut in the roads, after
all villages in the county had been visited, the dentist shut
up shop and started for home. He left behind him children
who were having a better chance at health and a commu-

nity converted to the cause of dental hygiene, looking upon
good teeth as a necessity which they must afford, no matter
how small their incomes. They were resolved to do their
best to induce a dentist to settle permanently, assured of the
fact that they could secure work enough to guarantee him
a comfortable living.

The cost? Not a cent had had to come from the town
treasury. Each month the fees, small individually, had
mounted high above the $150 guarantee set; the leanest
month brought in more than $200. And the dentist? He
had grown tanned from his summer in the open, from the
Sunday fishing excursions and early morning swims; and
he had saved enough from his summer's work to help pur-
chase the equipment needed to start business back in his own
town. It proved an experiment worth repeating in any
isolated rural community that believes in the economy of
spending money to keep well, and that can enlist the co-
operation and interest of a dental college.

Nurse and Social Worker


MANY of us can remember the time when the
visiting nurse's attitude on receiving a call
from the family welfare society was: "Oh,
there is one of those Associated Charities'
cases, and there is never anything important
to do for them." And the attitude of the Associated Chari-
ties' visitor was much the same: "There is one of those
visiting nurse cases and they always want the impossible."
But now organizations of social workers and of public
health nurses are bringing up the subject of professional
cooperation, and both professions are alive to the need and
possibilities of a joint technique.

If all public health nurses were well trained, with a
post-graduate course in public health, and if all social

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