services of an expert physician in all cases that will arise; but we have reached the point where we furnish public education to all the people of this Nation; and this bill is an extension of that educational system.

Mr. WINSLOW. When this Children's Bureau was established, so far as you recollect, did they then have in mind the maternity feature, or has that been an outgrowth of the original functions of that work?

Dr. HEWETT. Doubtless there must have been a steady evolution of the functions of the Children's Bureau. Whether those who promoted it foresaw all of these questions I would not be able to say.

Mr. WINSLOW. Well, is it not a fair question to discuss as to whether or not this maternity feature is really a proper function to be taken on by a children's welfare bureau, admitting the merit of it all? Are you a doctor?

Dr. HEWETT. I am not an M. D.; I am a doctor of social sciences. Mr. WINSLOW. Well, as a layman with medical experience, would it not seem to you that it would be regarded as essential that back of all of this maternity and childbirth consideration there should be somewhere a medical knowledge and a medical direction?

Dr. HEWETT. It certainly is so. Back of all this we have the great department of health of the United States and of the several States. Mr. WINSLOW. Now, I do not ask the question to embarrass you, but to get your best judgment. Would you feel that a labor bureau, as constituted so far as you know it in this country, was a logical bureau to conduct that part of the work which would involve a medical foundation?

Dr. HEWETT. I feel that the Children's Bureau as now constituted is exactly the agency to handle this work.

Mr. WINSLOW. That was not the question I asked you. Do you think a labor bureau per se is naturally and properly a bureau that has to do with the public health in any of its branches?

Dr. HEWETT. It has been so legislated by the Congress of the United States.

Mr. WINSLOW. When?

Dr. HEWETT. When the Children's Bureau was created.

Mr. WINSLOWw. What were the functions of the Children's Bureau when created?

Dr. HEWETT. I would want to refer that question to Miss Lathrop. Mr. WINSLOW. Well, I will not trouble you further, then. I think I have reached the limit of your real information on the subject.

Mr. BARKLEY. Is there any less reason why the Children's Bureau should be under the Department of Labor than there is why the United States Public Health Service should be under the Secretary of the Treasury?

Dr. HEWETT. I see no difference.

Mr. WINSLOW. That is another absurdity that we want to get rid of as soon as we can.

Dr. HEWETT. If you will permit me one further remark, my point is this, Mr. Congressman: The Children's Bureau is functioning where it is as we hoped it would function.

Mr. WINSLOW. Yes; I do not think I want to take exception to that.

Mr. TOWNER. Mr. Chairman, I would like to call Mrs. Milton P. Higgins, the president of the National Congress of Mothers and Parent-Teacher Associations, who will speak for a few minutes.

STATEMENT OF MRS. MILTON P. HIGGINS, WORCESTER, MASS., PRESIDENT OF THE NATIONAL CONGRESS OF MOTHERS AND PARENT-TEACHER ASSOCIATIONS.

Mrs. HIGGINS. Mr. Chairman and gentlemen, the organization which I represent, the National Congress of Mothers and ParentTeacher Associations, is a rather unique body, comprising, as it does, about 200,000 members scattered throughout many of the States. We have a national organization, State branches, and local associations.

I am particularly interested in this bill because among those who comprise our membership are some members who will benefit from the bill. We are rather unique because we have rich and poor, wise and ignorant, and all of them working together for the good of the children.

During the last two months I have received word of the enthusiastic indorsement and support of this Sheppard-Towner bill from many of our State organizations. Senators and Representatives will bear Ime out in my statement that the requests for its passage are widely representative of the whole country.

When we consider the great need of the practical aid mothers will receive if this bill is made a law you will not wonder that the response has been spontaneous and expeditious.

Many are the pamphlets that have been sent out to all the States in response to most pitiful accounts received of the ignorance and thoughtlessness of both husband and wife in permitting such things as the carrying of heavy burdens and overdoing with the result of a premature birth, oftentimes meaning the loss not only of the child but a weakening of the vitality of the mother, who with knowledge and proper care could have been the mother of many healthy children, but whose health has been ruined through ignorance and lack of skill or outside help.

Now, I think that the recent war and the tragic wiping out of so many precious lives has made us realize anew the value of human life.

Several years ago I was greatly interested in some estimates compiled by Prof. Irving Fisher, of Yale College, who figured the value of life on the basis of the possible earning power through the years that are promised for the individual. This, of course, makes the figures of the younger individual high. In middle life it diminishes and the aged people have less than nothing of value.

The table giving the pecuniary worth of an individual is as follows:

Now, it has been stated that the annual deaths of children under 1 year in the United States numbers 250,000. If each of these children is worth $90 to our country the annual loss of babies amounts to $22,500,000.

On the supposition that only one-third of these babies might have been saved, which I think is a conservative estimate, it still leaves the figures of the unnecessary loss at $7,500,000.

The original Sheppard-Towner bill calls for only $2,480,000 for the year ending June 30, 1920, gradually increasing until for the year ending June 30, 1926, it will have reached the maximum amount. of $4,480,000, at which price it will show an annual saving to the United States of $3,500,000 in money value.

But this saving applies only to the infants. The statement based on the survey made by the Children's Bureau is that 23,000 mothers lose their lives annually on account of childbirth. Applying Dr. Fisher's valuation of $4,000 for the life of an individual between the ages of 20 and 30 we find that the country loses, on account of the death of mothers, annually $9,200,000, making the total deaths of mothers and babies together $31,700,000, one-third of which, $10,566,666, could have been saved according to a very conservative estimate.

Nor is this the total loss. Who can estimate what it means to our country in economics to waste the lives of 23,000 potential mothers, for many of these deaths occur with the birth of the first child and are due to lack of prenatal instruction and advice and entire absence of physician or trained nurse. We will not attempt to estimate this loss in figures.

Again, what does it mean for the future citizenship of our country to have 23,000 homes broken and left without the natural housekeeper, homemaker, and character builder?

In the American home is centered the hope and safety of our Nation. Our United States is in process of transition and unrest. Constructive citizenship is of slow growth and the spirit of loyalty to home, State, and Nation depends largely on the spirit of loyalty engendered by the mother in the home.

Take away 23,000 mothers and it leaves 23,000 disorganized homes in which the family is likely to become more or less a menace to the neighborhood and to the community. The best citizens are those that are born, reared, and trained by mothers who love and understand the nature of each individual child.

To the mothers we owe our very existence as a Nation. If they are willing to go down into the valley of the shadow of death and give to our Nation a new generation of those whom they will train. to become our future loyal citizens, is it not the part of wisdom for our Government to place the stamp of its approval on the high and holy vocation of motherhood and the American home over which she is the presiding spirit.

The whole country is demanding a more healthy, more loyal, and wiser citizenship. The only way to obtain this goal is to increase the efficiency of the home, and this can be accomplished by increasing the knowledge and skill of the mothers and, when necessary, rendering assistance in the bearing and nursing of the children.

The Children's Bureau has for a long time been working on this problem and with its efficient director, Miss Julia Lathrop, is well

fitted to continue and enlarge the work it has already begun, but which, in order to be effective and widespread, must be financed.

Therefore I am in favor of this Sheppard-Towner bill becauseFirst. The indorsement of this bill by organizations and individuals is spontaneous, widespread, and urgent.

Second. The lives saved will yield a far greater asset financially to our Nation than the amount called for in the bill.

Third. Life will be healthier and happier and the quality of citizenship will be improved.

Fourth. The mothers of the Nation will become more enlightened, intelligent, and will take fresh courage because their work is appreciated.

The CHAIRMAN. We are very much obliged to the witnesses who have appeared for the presentation of their views. We will recess until to-morrow morning at 10 o'clock.

Mr. TOWNER. Mr. Chairman, would it be possible to have a session this afternoon?

The CHAIRMAN. I do not think we would have a full attendance this afternoon, and I think that you and the rest of us would want as full attendance as possible. It would be more advantageous all around to have a larger attendance.

(Thereupon the committee adjourned.)

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

HOUSE OF REPRESENTATIVES, Wednesday, December 22, 1920. (The committee met at 10 o'clock a. m., Hon. John J. Esch (chairman) presiding.

The CHAIRMAN. I have received a communication from Edward Martin, commissioner of health, Commonwealth of Pennsylvania, expressing his views with reference to the matter pending before the committee, and also a letter from Dr. Haven Emerson.

Mr. TOWNER. Dr. Haven Emerson is the medical director of the Bureau of War Risk Insurance.

The CHAIRMAN. Yes; these communications can be printed in the hearings at this point.

(The letters referred to follow :)

LETTER SUBMITTED BY MR. EDWARD MARTIN.

[Memorandum to Committee on Interstate and Foreign Commerce.]

Representing the chief executive of Pennsylvania and all her citizens I come to express the hope that this first step in direct coordination on the part of the Federal Government and the States toward conservation of the lives of women and children shall be made an actuality.

The method and the means will be wisely determined by your committee. The end to be attained, and attainable, is beyond price.

Federal cooperation with Pennsylvania, in its struggle against venereal infections, has worked harmoniously and has brought within sight a victory more complete than that which would otherwise have seemed possible.

The cooperation in the direction of mother and child mortality and morbidity will further stimulate efforts in which we are actively engaged.

As a side issue and not without importance, such efforts give from present figures, the only prospect of maintaining a leavening of the native born.

EDWARD MARTIN, Commissioner of Health, Commonwealth of Pennsylvania.

DECEMBER 20, 1920.

MY DEAR DR. RUDE: Since it will be impossible for me to attend the hearing on the Sheppard-Towner bill on Monday, December 20, owing to absence from Washington, temporarily, permit me to offer my testimony in approval of the bill. It is known to me, as to all others who have been responsible for public health administration, that at least 50 per cent of the preventable deaths of children could be avoided if there were adequate attention given to the expectant mother during her pregnancy and suitable provision for her care at the time of confinement. It has been found by careful analysis in cities and rural regions that the cost of burying a baby is greater than the cost of saving its life. A reduction in the mortality of mothers of not less than 10 per cent could be accomplished by the kind of care which is provided for by this bill in cooperation with the various cities under which the services would be administered.

If my testmony is found to be of use to you I beg you will avail yourself of this statement at the House hearing upon the bill.

As a member of the board of directors of the Maternity Center Association in New York and responsible for the recent intensive survey of the maternal and infant welfare situation in the city of Cleveland, and as former commissioner of health of the city of New York, I feel that I am within bounds in saying that no other appropriation of equal amount will bring such definite and accurately ascertainable returns in the form of human life and happiness as may be expected from appropriations administered under the terms of the proposed bill. Sincerely, yours,

HAVEN EMERSON.

The CHAIRMAN. Are you ready to proceed, Judge Towner? Mr. TOWNER. Mr. Chairman, we will call Mr. W. F. Bigelow, the editor of Good Housekeeping Magazine.

STATEMENT OF MR. W. F. BIGELOW, EDITOR GOOD HOUSEKEEPING, 119 WEST FORTIETH STREET, NEW YORK CITY.

Mr. BIGELOW. Mr. Chairman and gentlemen of the committee: Judge Towner has asked me to tell you what I know about public support for this bill. I know too much about that to tell you all I know in a brief hearing, so I shall summarize. I have told several millions of people about this bill. The first article describing the purposes of and the reasons for the Sheppard-Towner bill was sent to press about a year ago to-day. The last article appeared in the December issue. That was a plea for us to stop now the casualties of motherhood. I made a mistake in that first article. I told the readers of Good Housekeeping they could win this legislation in a week. I thought they could. Just at that time we were a proud but sorrowing nation. We had ended a big war, all but the Army of Occupation had come home, and we realized at last that about 70,000 of our boys would not come back. We accepted their loss as a national one because they died in the country's service. We were wondering what we could do to prevent any future deaths of that character. We had decided that the only way to prevent them would be to prevent war, because when there is a war young men will be dying. We had refused to