FOUNDLING HOSPITALS. It is significant that these institutions are gradually becoming things of the past, and that there are few countries left in which hospitals are found which exist solely for the purpose of receiving "foundlings," i.e., children who have been abandoned or exposed, and left for the public to find and save. Definite institutions for the care of foundlings were established during the 7th and 8th centuries in Treves, Milan and Montpellier, followed by others in Venice during the 14th and in Paris and Lyons during the 17th centuries. The celebrated Foundling Hospital of London was established by Captain Coram in 1739 and has since completely changed its original character.
The modern method of dealing with illegitimate children—and nearly all those who were placed in Foundling Hospitals were born out of wedlock—is based on the proved advantage both to the mother and child of keeping them together, at any rate for the first year, thereby greatly reducing the infant mortality rate, strengthening the natural ties and lessening the chance of the mother erring a second time. There is also an increasing reluc tance, owing to the great risk of infection, to herd very young children together in large institutions so that the boarding-out, or foster-mother system of caring for these children is being more and more employed in all countries.
At first the London Foundling Hospital admitted any child under two months of age who was free from certain specified dis eases, without any questions being asked or any attempt made to identify its parents. Grants were made by Parliament to the Hos pital from 1Q56 onwards, £I0,000 being paid to the governors in that year, on condition that all children offered under 2 months, subsequently increased to one year, were received. In 1757 no fewer than 3,727 children were admitted and branch hospitals at Ackworth, Shrewsbury, Westerham, Aylesbury and Barnet were opened, to cope with the number of children for whom admission was sought, the cost of establishing these country hospitals amounting to over £40,000. This general admission was soon found to be a serious error, for the social evils surrounding the conditions of illegitimate birth received no check, and of the 14, 934 children received during the 3 years and Io months it was in force, no less than 10,389 died in early infancy. Parents even brought dying children for the purpose of having them buried at the expense of the Hospital, and strangers were employed by par ents to bring their children from the country to the Hospital in Bloomsbury, London, at so much per head ; many such children, through the brutality or criminal negligence of those to whom they were entrusted, never reached their destination alive.
By 1760 the House of Commons decided that the indiscrimi nate admission of children should cease, and State aid came to an end in 1771. From that time onwards the Hospital has had to depend on private philanthropy for its funds, and has gradually amended the conditions under which children are admitted. The following are the present rules for admission : Children can only be received upon the personal application of the mothers. The children of married women and widows are not received. Petitions must set forth the true state of the mother's case, and if any deception is used the petition will be rejected. No application can be received previous to the birth of the child, nor after it is 12 months old. No child can be admitted unless the committee is satisfied, after due enquiry, of the previous good character and present necessity of the mother, and that both mother and child have been deserted by the father.
The children are placed out to nurse with cottagers in the coun try, under the superintendence of medical officers, and are returned to the Hospital about the age of six. The 56 acres comprising the estate of the Hospital, purchased in 1741 for £6,500, had enhanced so much in value by 1926 that the Governors decided that it would be in the best interests of the institution to sell the site and remove to new premises in the country. The sale of the estate and buildings realized £1,650,000 and the children were housed in temporary premises at Redhill until, in July 1935, they were moved to new premises at Berkhampstead. Over 500 children are maintained annually by the institution.
In Russia, according to a report furnished in 1927 by the Red Cross Society of the U.S.S.R., the number of homes for children had increased from 7 in 1917 to 720 by the end of 1925. All maternity and child welfare work under the People's Commissariat of Health is maintained out of a special fund for this purpose, as well as by local health authorities and philanthropic and other bodies. Out of certain funds set aside for the prevention of child vagrancy, homes for married and unmarried mothers with children are provided and premiums given to nursing mothers, with a view to preventing child desertion. The establishment of village nurser ies, of which there were 4,052 in 1927, where mothers who have to work, especially in the fields during the summer months, can tem porarily leave their children, has also helped to solve the problem of the deserted child.
In Roumania there are very few foundling hospitals that are not at the same time orphanages. One such institution, the Alinarea at Galatz, combines the functions of an emergency home for babies with those of a foundling home and orphanage, for it accepts babies temporarily while their mothers are ill, or, if the latter die in childbirth, till the babies are old enough to be cared for in their own homes by the father or other relation. This home, founded in 1901, was the first in the country to receive Government recogni tion. The mortality rate among the foundlings was high, as much as 8o% in some years, due to exposure to cold before they are found deserted in the streets and to certain specific diseases. There are altogether eight foundling hospitals in Roumania. Much of the money spent by the State in aiding institutions of this kind is derived from the sale of the special Assistenta Sociala postage stamp, value 25 bani, which it is obligatory to add to the ordinary stamps on all letters conveyed from one part of the country to another, as well as on all public documents. (J. HA.) United States.—Foundling hospital and foundling are terms no longer common in the United States despite the continued ex istence of a number of institutions for abandoned and deserted children. The foundling hospital in America was instituted about 1850-6o by Catholic nuns, Protestant churches, or private indi viduals such as Dr. George E. Shipman in Chicago and Dr. John S. Parry in Philadelphia, doctors appalled at the high mortality among exposed infants ; records covering a period of 20 years in one hospital show that of a yearly average of 52 admittances there were 35 deaths. The first institution designated for found lings seems to have been St. Vincent's Infant Asylum (448 chil dren), established by the Sisters of Charity (St. Vincent de Paul) in Baltimore, Md., in 1856. Between 186o-73 six others were founded ; two in Washington, D.C., and one each in San Fran cisco, New York, Chicago, and Cleveland. Within the last two decades, many of the babies formerly referred to as "foundlings" or "deserted" have been cared for by legal adoption.
In the latter part of the 29th century several persons in New York city were aroused to the tragic situation of the babies harboured in foundling hospitals. Quoting from the book The Adopted Child, written by Eleanor Garrigue Gallagher and published by John Day in association with Reynal and Hitchcock in 2936—"One of the first women in this country to recognize the need of organized work for the saving of babies was Miss Clara B. Spence, who in 1895 became interested in the subject of adoption, and worked in close co-operation with her friend Miss Josephine Plows-Day, of London—founder of the National Children's Adoption Society of England. The Spence Alumnae Association was formed to carry on her work." Dr. Henry Dwight Chapin, one-time president of the American Pediatric Society, and his wife were also much interested in the subject of the adoption of children and organized the Alice Chapin Adoption Nursery in New York. Most of their babies were cared for in super vised boarding homes—designated as "Speedwell" units.
In 1923, the Cradle Society was organized in Evanston, Illinois. The Cradle is a model adoption nursery for babies deprived by what ever circumstances of the care which is their due. During the first few years of its existence, the mortality rate of infants cared for at The Cradle was remarkably low, in comparison with the io% which had long been accepted as an irreducible minimum for institutions car ing for babies. In 1927, however, there was throughout the United States an epidemic of enteritis with a high mortality rate. It baffled the best medical minds. This problem was solved by work done at The Cradle by Doctors George and Gladys Dick and Dr. J. Lisle Williams. As a result, a new aseptic nursery technique was evolved at The Cradle by Dr. Gladys Dick. It was put into effect in 1928 and has been rigidly adhered to ever since, resulting in a mortality rate of less than r% and no instance of hand-borne cross-infection. In Dr. Louis W. Sauer gave a detailed report on the Dick diet kitchen and nursery technique. Since then New York city and Chicago depart ments of health have passed new regulations requiring all mater pity hospitals to use a similar aseptic technique in their new-born nurseries.
In 1938, The Cradle Society erected a building designed to further scientific research on the prevention of air-borne cross-infections. The Cradle has shown that most homeless infants are adoptable. Over 4,00o infants were placed by The Cradle in 16 years of its existence. Adoption nurseries properly equipped, like The Cradle, for the scien tific care of infants during the first few months of life, when they are under the close observation of pediatricians, can remove the need of institutions for the care of the majority of babies who formerly were reared in foundling hospitals and orphanages. (F. D. W.)