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60
It is very deplorable that this, the largest group of infant
deaths should be, at present, unrelieved by public health methods.
However, the reason is obvious. The cause of the evil is a
social and an economic one. The remedy must be adjusted to
this end. Public health measures are practically useless.
Congenital Defects.—It is probable that some of these deaths
are really cases of premature birth, and the foregoing considerations
would then apply with equal force.
Others may possibly be prevented by the mothers resting for
some weeks before their confinements. To advise rest, however,
for these mothers is too often to prescribe the impossible. They
cannot leave their employment. They cannot afford to pay a
substitute to do the household cleaning.
These deaths are not " public health deaths."
Marasmus.—This is a very loose term and means that the
exact cause of death was ill defined, but the baby wasted for
some time before its end. That is, the wasting was a marked
feature of the child's illness.
Some of these deaths are probably due to syphilis—a few to
tuberculosis. Excluding these two sets, the other babies are
often frail and puny from birth ; however well they are ted,
however well they are clothed, they do not thrive, and slowly but
surely degenerate into the "wasters" so common in childrens'
hospitals.
The fault is in the original stock whence they are sprung—the
material is of very poor quality and faulty. The organs of the
body are apparently incapable of performing the work of food
assimilation attendant upon growth and development.
These are the babies born of weak, flaccid overworked mothers,
devoid of tone, and with little or no energy and reserve power.
If these mothers, before confinement, were better fed, and less
worked, the babies when born would start life with more grit,
more stamina, more staying power, more highly developed and