I would not leave this subject without insisting upon the urgent need of State or Federal supervision of the manufacture and sale of patent infant foods. The mortality from this one cause alone is enormous. There has been no satisfactory or comprehensive inquiry into this important matter in this country, and it is therefore impossible to get reliable figures. In Germany, where the law requires that the death certificate of an infant under one year of age must state what the mode of feeding has been as well as the cause of death,—a wise provision which might with advantage be adopted in this country,—it is possible to ascertain approximately the extent of the evil. The records show that of children fed on artificial food 51 per cent die during the first year, while only 8 per cent of the children exclusively nursed by their mothers die during the same period.[170] No one familiar with the work of our infants’ hospitals can fail to be impressed by the large number of cases of illness and death in which artificial feeding appears as a primary or contributing cause. I have gone over the record books of many such hospitals in different parts of the country, with the almost invariable result that artificial foods appeared to be the source of trouble in many cases. Most of the patent foods, one might almost go farther and say all of them,[171] are unhealthful because of the starch they contain, which the little infant stomachs cannot digest. Many of the cheaper kinds of patent infant foods upon the market are, as previously stated, little better than poisons. The testimony of the greatest authorities upon the subject of infant feeding, backed by the grim eloquence of hospital records and the death-rates, points irresistibly to the need of some strict supervision of the production and sale of artificial foods for children. Whether this should be done by the establishment of certain standard formulæ, or by compelling the makers to submit certified samples for official analysis, is a question which only a body of experts should decide.