Mr. BARKLEY. Yes. It may be that, but may it not be something else?

Mr. CADWALADER. Well, that is the only kind of quarantine that the Federal Government can enforce.

Mr. BARKLEY. May they not extend it beyond matters of commerce?

Mr. CADWALADER. My child may get measles, and an officer may quarantine my house, but it can not be a Federal officer, because the United States Government has nothing to do with that.

Mr. BARKLEY. The Public Health Service has much broader power than mere matters of quarantine.

Mr. CADWALADER. The Public Health Service, as I understand it, relates to all the employees of the Government. It relates to the Army and Navy; it relates to conditions here in the District of Columbia; it relates to the Veterans' Bureau, who are ex-soldiers of the United States; and it relates to subjects over which Congress has been given specific authority to legislate.

Mr. BARKLEY. It also relates to cooperation with the health officers of the States in the conserving of health, does it not?

Mr. CADWALADER. I am not familiar with all the laws of the Public Health Service, but if it does do that I would say that it certainly goes beyond the constitutional limits, just as this does.

Mr. RAYBURN. Should not the questions that you raise now be raised with reference to all quarantine questions?

Mr. CADWALADER. I do not think so.

Mr. RAYBURN. I think so. I think you will find, if you read the history, that that is so.

Mr. CADWALADER. The reason I think so is that in reading the briefs in the case that came up to the Supreme Court, no reference is made by either side to such cases.

Mr. NEWTON. You quoted from the Budget message of the President for the year 1924, wherein he referred to the broadening of the granting of Federal aid. Do you not consider that the fair interpretation of that would mean the extending of medical aid to other objects than that which Congress has already acted upon?

Mr. CADWALADER. Possibly, if he had not gone on to say: "My conviction is that they can be curtailed with benefit to both the Federal and State Governments."

Mr. NEWTON. In view of the fact that there is a letter here from the Secretary of the Department of Labor recommending an extension of this work, and there is reference to a communication between the Director of the Budget and the President, how do you draw the conclusion that the President wants to curtail only maternal legislation, which comprises but a very small percentage of this $100,000,000 that he has talked about?

Mr.. CADWALADER. I have tried to draw no conclusion, because I think it is beyond the scope of human ingenuity to draw conclusions from two conflicting statements, if they are conflicting. I merely read what the President said in a certain Budget message, and if he has said anything inconsistent since then, it is for the President to explain that inconsistency, not for me. But I do think that the gentleman from Connecticut (Mr. Merritt) made a point worth considering by this committee when he said that the quoted lan

guage of the President referred to the fiscal policy of the Government, and that the President merely meant that the amount of this appropriation was not going beyond the limits set by the Budget, and has nothing to do with the principle involved.

Mr. NEWTON. Do you not think that if the President was not in favor of this extension the head of the department would have refrained from recommending it, and when the matter was brought to the attention of the President in a fiscal way he would see that suitable word to that affect was transmitted to Congress?

Mr. CADWALADER. Mr. Newton, it may be the President is for it to-day. I am merely quoting the authority of his remarks a year ago. I can not answer that question.

Mr. NEWTON. Now, you have inserted some tables prepared by Senator Reed.

Mr. CADWALADER. Yes.

Mr. NEWTON. You do not mean to convey to this committee, do you, the idea that Senator Reed opposed the enactment of this measure in the first instance, or that he is opposed to its extension now?

Mr. CADWALADER. I really can not answer that question. I do not know how he voted on the question; I do not know how he will vote. I imagine that his purpose in inserting these tables was to call attention to the condition that I referred to.

Mr. NEWTON. Well, it is imagination then upon which any deduction of yours would be based with reference to the maternity bill? Mr. DENISON. I do not think he was a member of the Senate at that time.

Mr. NEWTON. My impression is that he was.
Mr. DENISON. In 1921?

Mr. NEWTON. The Sixty-seventh Congress.

Mr. CADWALADER. I do not think he was.

Mr. BARKLEY. One question, Mr. Cadwalader. Believing as you do, as I gather from your opening statement, in the theory of the fathers as they handed the Government down to us in its pristine glory, Congress ought to exercise its own judgment regardless of the opinions of the President or anybody else, ought it not?

Mr. CADWALADER. Yes, certainly.

Mr. BARKLEY. And the President will exercise his authority when he signs or vetoes the bill.

Mr. CADWALADER. Exactly.

Mr. PHILLIPS. I think we are not particularly concerned with the constitutionality of the proposition just at the present moment, but we are interested in the general welfare of the women and children and everybody else in our citizenship. What, in your opinion, is the effect of what we call "paternalistic legislation" on the local communities? Does it have a tendency to stimulate them to go into that kind of work more thoroughly, or does it have a tendency to make them feel that they are relieved of the responsibility for work · that primarily belongs to the State? I can readily see that the Federal Government might go into a community and by teaching the people, show them the results that can be obtained, and create a local interest in the work so that they would eventually carry it on themselves, perhaps; or it might go into a community and under

take a certain amount of work, and the local authorities would assume that the Federal Government is going to do it, therefore we are relieved from responsibility and further obligation. Now, what would be the effect, in your opinion, in general?

Mr. CADWALADER. Well, in general and in the long run I firmly believe that the effect is going to be to weaken local initiative and enterprise. I could say a good deal along that line, but I have not time to do it. But I would say that in the long run-of course, there may be specific instances where an officer from Washington comes in with a lot of money behind him and he interests the people-but in the course of a few years the local interest will be stifled by reason of the fact that people from Washington are attending to it.

Mr. PHILLIPS. What do you think about the Federal Government starting in that kind of work very vigorously and then gradually withdrawing, as the local authorities-local people-become interested in it?

Mr. CADWALADER. Of course, I would like to see the Federal Government withdraw at once, if it will, or gradually, so long as it withdraws. I would rather see it withdraw gradually than not to withdraw at all.

Mr. SHALLENBERGER. Does it not come down, after all, to the welfare of the child? Can we not explain by that the reason that Massachusetts, we will say, or Pennsylvania-Massachusetts, I think, is the wealthiest State in the Union in proportion to her populationthat they feel they can afford themselves and they do, no doubt, as has been stated here, take care of their child-welfare work; but is it not a fact that the maternity cost now, if the child shall have the modern care both from the surgeon and from the midwife, and all that, at childbirth-that that is so great now that in thousands of cases in this country the child does not enjoy them? I read in the Saturday Evening Post an article by Dr. Stanley Rinehart, I believe it is, from Pennsylvania, the husband of a very distinguished writer, in which he went into that thing and made the direct statement that the cost of maternity now was so tremendous that, compared to the cost of my childrens' birth I was astonished. I can not quote it, but I know it was far beyond the possibility of payment of the ordinary person.

Now, the defendants of States' rights as great as yourself, the very eloquent lady from Massachusetts as one, said that you are confronted with a condition here and not a theory, and if the States that are unable to do so-feel they are unable to do so refuse to do so, is it not the duty of this Nation to take into consideration the care and welfare of the child that comes into this world without any consideration of its own, or any possibility of protecting itself, that he shall receive proper care and treatment, and that there is no comparison whatever between the fixing of a road, for instance, and the life or care of a child, of which we have had comparisons here? Some of them justify the Federal Government for fixing up a hole in the road that runs past my place, but if I was unable to do so why should not the Government help me to take care of my child?

Mr. CADWALADER. In answer to that I would say this: The people who made this country came across the sea 3,000 miles. They had

no public health nurses or doctors to look after them, and the home government did not send them any, and they grew into a great Nation, and they did it because they were independent, self-reliant people who tackled their own problems. Our Constitution was organized by the sons of those people, upon the same principles. They were adopted by the people even in the wilds of the States that the gentleman from Texas does not like to hear referred to as wild States--but perhaps the States of the East think they are, although wrongly-New Mexico-the deserts of New Mexico or Arizonawhere the people are expected to be as self-reliant as the small band of settlers on the shores of the eastern part of the United States, and I do not think they should be fed with Government pap, no matter who they are, and be self-respecting American citizens.

Mr. SHALLENBERGER. You have observed, no doubt, in your life, as I have in mine, many children that are in situations that you feel are unfair to them. Would you object as a principle of constitutional law to the States stepping in and giving the child the opportunity it is entitled to under the American flag?

Mr. CADWALADER. Mr. Shallenberger. I think the answer to that is that private charity and local community effort is the only answer, and if a community has sunk so low that it does not give that effort, that it has no benevolent persons within its limits, then it is the misfortune of that community, but it is not part of the business of the Government of the United Stat s to remedy that situation.

Mr. SHALLENBERGER. So you would have the child go on suffering, even though the community refused to do its duty by it?

Mr. CADWALADER. There are a great many sufferings that have to occur in this world by the nature of things that can not be remedied by anything, and I think that a wrong remedy for an evil will only bring worse wrongs and worse evils in its train.

Mr. BARKLEY. Do you carry that same doctrine to the irrigation of the arid lands in the West by the Federal Government?

Mr. CADWALADER. Mr. Chairman, I came here to discuss the maternity bill.

Mr. BARKLEY. You have discussed it on broad principles.

Mr. CADWALADER. I do not know anything about irrigation, but if you want to know why the Government should or might irrigate lands, I will say because the Government owns the lands out there and can develop its own property.

Mr. BARKLEY. It does not happen to own those lands that it is irrigating.

Mr. CADWALADER. I do not think it ought to irrigate any land that it does not own.

Mr. BARKLEY. So you would have those lands lie out there waste without the ability of man to cultivate them because the State in which they might be located could not irrigate them?

Mr. CADWALADER. There are thousands of acres of land in my own State lying waste to-day for various reasons. I do not expect the Government to come in and fertilize them.

Mr. BARKLEY. Not for lack of irrigation.

Mr. CADWALADER. But for lack of fertilizer, for lack of ability on the part of the farmers to make ends meet. We eastern farmers are not crying out for Government aid, in spite of the fact that we

have just as hard a time as the western ones. I am a farmer on the side myself.

Mr. BARKLEY. You do not look like one. [Laughter.]

Mr. DENISON. I guess that will conclude the time for your side. We are much obliged to you, Mr. Cadwalader. Now, Mrs. Park has 10 minutes.

Mrs. PARK. I should like to ask permission for the directors of States in different parts of the country who are here but are not able to speak to file their statements about the work that is being done in their States.

Mr. DENISON. About how much will that be?

Mrs. PARK. There are four other directors here, from New York, Michigan, Kentucky, and Indiana.

Mr. DENISON. Is there any objection from any member of the -committee?

Mr. FREDERICKS. I would like to make the suggestion that if that is done they include in the brief a statement as to how long this aid should continue.

Mr. DENISON. Will you accept that suggestion from Mr. Fredericks and suggest that to the parties?

Mrs. PARK. Yes.

(The papers referred to follow :)

STATEMENT FILED BY DR. ELIZABETH GARDINER, ACTING DIRECTOR OF THE BUREAU OF MATERNITY, INFANCY, AND CHILD HYGIENE, STATE DEPARTMENT OF HEALTH, ALBANY, N. Y.

The following is a brief statement of the work done in New York State under the provisions of the Federal maternity and infancy act during the fiscal year July 1, 1924, to July 1, 1925:

Administrative agency

Department of health, division of maternity, infancy, and child hygiene.

Staff

Director, associate director (physician), executive clerk (physician), 4 physicians, 23 staff nurses (and 24 part-time maternity and infancy community nurses employed from Sheppard-Towner and local funds), 3 county nurses, 2 midwife inspectors (nurses), 1 organizing field agent, 1 office manager, 4 clerks, 8 stenographers, 1 advance agent, 1 chauffeur.

Activities

Child-health conferences, 236, at which 4,895 children were examined. In addition to the conferences conducted by the State staff, 2,049 conferences were conducted in local communities where the staff was partly supported by maternity and infancy funds, with 17,694 children attending, and 6,027 physical examinations made. In selecting communities in which the State units were to conduct child-health conferences preference was given to those most likely to continue them on a local basis after one or two demonstrations by the State unit.

Prenatal conferences, 155, at which 525 examinations were made. The local staffs partly supported by maternity and infancy funds held 1,488 additional conferences, with 8,406 women in attendance, and 3,116 examined. The prenatal conferences conducted by the State unit were organized by a nurse who made the preliminary arrangements, called on prospective patients, obtained the permission of physicians for patients' attendance, and if, necessary, made the follow-up visits on patients who attended the conferences. If there was a local nurse, she generally did the follow-up work.