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44
1909]
maturity and immaturity are the chief causes of infantile mortality, and arise
in the main from the poor physique or ill health or ill nutrition of the mother.
(2) That bronchitis and pneumonia are due in a large degree to exposure both
to cold and inattention, for people do not sufficiently realize the fact of the
fall of temperature on a newborn child when it issues forth from an environment
of body temperature to a cold world, nor of the innumerable subsequent
occasions of exposure to unequal temperatures through which the child passes
both in health and such sickness as measles. (3) Atrophy and diarrhoea are
obviously due to the disturbance of the alimentary system owing to wrong and
insufficient feeding. Here then are three primary things, the physique of the
mother, including both ante-natal and post-natal disability, infant mismanagement
and exposure arising partly from ignorance and partly from neglect and
unsatisfactory feeding. There can be no doubt about these things lying at the
root of the problem of infantile mortality. And whilst to them must be added
a variety of incidental circumstances such as accidents, inattention, teething,
etc., the main proportion of mortality would appear to be due to withholding
from the child a reasonable inheritance of warmth, food and rest. The fatal
results to the nation of malnutrition in infancy are far-reaching, and can hardly
be exaggerated."
There is an old argument which is always used when a discussion on
infantile mortality arises and it is that the fittest will survive. Unfortunately
this is not supported by evidence, for it is too true that the opposite very
frequently happens and that the weaklings do not always die off. There is
hardly a medical man who does not know of many cases in which the delicate
ones have survived while strong children in the same family have been taken
away. The fact is that when a child is very delicate at its birth it naturally
receives more attention than the child who is strong and healthy, who
is too often fed and exposed to climatic changes in a manner a mother
would not adopt with a delicate child who sometimes grows up to be
a lifelong burden to himself, and oftentimes on society. We see this
especially in such a disease as rickets, which is the direct result of
insufficient and improper food, that is of food necessary for the growing
bones. This disease essentially arises from ignorance as to how the child
should be fed. It is not caused by heredity and it does not arise from a
bacillus. As a rule it is not a fatal disease, but it is impossible to look around
our schools or to note the children in our streets without seeing large numbers
of them who are ricketty. To dissipate the ignorance of mothers well
meaning persons have suggested that children, especially girls, should be