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High Mortality of Children

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That there is need for spreading broadcast fuller knowledge than the public evidently at present possesses of the proper methods of dealing with children, both in health and in illness, is strikingly evident from the statistics carefully collected and detailed by the late Dr. Wm. Farr, of the Registrar General's Office. The facts are so clearly given in Dr. Fair's own words in his annual reports that a few extracts will best show what they are.

" In England and Wales the deaths of 2,374,379 infants in the first year of age were registered in the 26 years 1838-63; and of the number 1,329,287 were boys, 1,045,092 were girls." "Nearly 100,000 infants die annually in the proportion of about 56 boys to 44 girls." "Even in the healthy districts of the country, out of 1,000,000 born, 175,410 children die in the first five years of life; but in Liverpool district, which serves to represent the most unfavourable sanitary conditions, out of the same number born, 460,370, nearly half the number born, die in the five years following their bi rth." That is to say, one in every six children born dies within the first five years of life, even in the healthy parts of the country, but in the unhealthy parts the proportion is one-half. Moreover, Dr. Farr showed that the majority of the deaths occurred within the first year of life. Thus "of 100 children born, 15 (lie in the first year, 5 in the second, 3 in the third, 2 in the fourth, and 1 in the fifth; making 26 in the 5 years of age. Of the 15 who die in the first year, 5 die in the first mouth of life, 2 bi the second, and 1 in the third: Now what is the cause, or what are the causes, of such a tremendous infant mortality ? That question also Dr. Farr tries to answer. The result is given in tabular form. :In the three years 1873-75 the annual number of deaths, from all causes, of children under one year of age to every 1000 births was 278. The separate causes of these 278 are given in the tabletable: Total number of deaths to every 1000 births, 278 Of which the number of deaths caused by premature birth and atrophy (wasting) was 70 „ lung diseases „ bl ,, convulsions „ 31 diarrhea (looseness of bowels) „ 24 „ tubercular disease „ 21 „ whooping-cough „ 12 „ teething ,, 6 measles „ 4 „ scarlet fever 3 222 The causes of the remainder are not detailed.

Of the 278, no less than 125 were due to such diseases as atrophy (wasting), convulsions, and diarrhoea. Commenting on the table Dr. Farr says: "Some of the principal causes are improper and insufficient food, bad manage ment, use of opiates, neglect, early marriages, and debility of mothers ; but whatever may be the special agencies at work which are so pre judicial to infant life, it must be borne in mind that a high death-rate is in a great measure also due to bad sanitary arrangements." " The causes of death which are more directly the result of neglect and mismanagement are convulsions, diarrhoea, and atrophy ;" and again, " the causes most fatal to infant life in factory towns, and which are inseparable from bad nursing and feeding, are diarrhoea, convulsions, and atrophy." It is to be observed that in this table the number of victims of measles and scarlet fever is small, but it is in the second, third, and fourth years of life that these diseases are worst, and not during the first year, to which the table is limited.

It seems that since 1875 a considerable de crease has taken place in the average English death-rate, a decrease affecting not only the adult portion of the population, but the infant portion as well. It seems plain that this im proved state of affairs is due to the operation of acts of parliament referring to public health, to the greater care consequently taken to keep down and rectify, as far as possible, unhealthy conditions, to more vigorous measures in deal ing with and preventing the spread of in fectious diseases, and to other similar causes.

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