“The effects of rachitis on the general constitution are extremely severe. The relationship between the nutrition of the infant and the condition of the child and adult has received but little attention. But there can be no doubt that the defects of nutrition occurring in infancy are of paramount importance in regard to the development of the adult. The cases of retarded physical and mental development in the child and the adult are numerous at the present time, and it is probable that their chief cause lies in defective nutrition during the period of infancy. “Rachitis is a disease attended with a high mortality with which it is never credited, for the disease itself is seldom, if ever, fatal. In consequence of the cachectic condition and the extreme debility associated with advanced rachitis, the specific infectious diseases, such as measles, pertussis, and others, are associated with a much higher mortality in these cases than in others. Associated more or less closely with rachitis is a large class of disorders, such as bronchitis, diarrhœa, laryngismus stridulous, convulsions; these are attended with many fatal issues.”—_The Nutrition of the Infant_, by Ralph M. Vincent, M.D., pp. 226 _et seq._ III MIDWIFERY AND DEATH Dr. Thomas Darlington, President of the New York Board of Health, says: Any movement for a proper regulation of midwives has my earnest support. Under the laws of New York as they now exist there is no adequate regulation. It is very easy for a woman to become a midwife in this city. She is required, it is true, to come to the department of health with a certificate from some school of midwifery, here or abroad, or to present statements from two physicians as to her fitness and character, but the _status_ of the school does not enter into the consideration, and that it is not difficult to obtain the indorsement from the two doctors is indicated by the great degree of incompetency and carelessness to be found in the ranks of the 800 midwives of New York City. Under the laws now existing we have no right to demand further proof of qualification. If the applicant meets the slight requirements, we must put her down as a “registered midwife.” She brings this phrase prominently into use in her solicitations for business in her neighborhood, and it inspires confidence—a good deal more confidence than it should. Thus are the people deceived by the laxity of the law. A measure was introduced in the legislature, providing for a much stricter supervision of midwives than is now the case. The bill had the support of this department and of the medical societies of standing, and yet, because of ignorance and indifference concerning the evils of the practice, it failed to reach a place on the statute books. My own opinion is that the midwife should, before being allowed to practise, undergo a schooling at least as long and as careful as that of the trained nurse.