The efficient work done by the school nurses in New York City, and elsewhere, though sadly restricted in its scope, suggests far wider possibilities. If nurses were appointed in far greater numbers, at least one to each large school, their functions might be enlarged. If, as has been suggested, they were to receive special social training, possibly at the expense of part of their present medical training, they might attend to the needs of those below school age as well as of those enrolled at school. Above all, they might be made a potent means of educating the mothers. It has been found that visiting nurses attached to the schools receive cordial welcome as a rule, are not viewed with suspicion as other officials or philanthropic visitors are, and have a correspondingly greater influence. The weak point in such a proposal lies in the fact that the school nurse would not, if her work was based upon the school registration, reach those families not represented in the schools. Thus the most important cases of all, educationally, young mothers with their first babies, would not be reached. Elsewhere I have referred to the efforts made in some cities to educate mothers by the distribution of leaflets and pamphlets upon the subject of infant feeding and general care. Some of these leaflets and pamphlets which I have seen are models of concise lucidity, and their wide distribution among mothers intelligent enough to profit by them would be of great value. One of the first difficulties presented when this plan is attempted upon a large scale is the efficient distribution of the literature. To accomplish anything at all, the literature must be printed in the various languages represented in the city’s industrial population, and it is no easy matter to see that each mother gets literature in her own language. Quite recently, I heard of a tenement in which there were families representing no less than fourteen nationalities, and in which lived Mrs. O’Hara, a German, speaking little English! Added to this difficulty is the expense of distribution. If sent by mail,—and in large cities no other method seems possible,—the cost is enormous. To send a single circular to the registered voters of New York City, for instance, requires an expenditure of upwards of $60,000 for postage alone.[168] There would seem to be no good reason why the Federal Government should not authorize the Health Boards to send all such educational matter through the mails free of cost. Why should the Health Department of a city not have the privilege of a local frank? Nothing could well be more foolish than the system under which the city, while performing a national service, must pay the national post-office for doing its share of the work.