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14
(5) House very insanitary ; other cases in same house.
(6) 16th child, 9 dead, left a good deal with other children to look
after.
Of the bottle.fed children, 11 were illegitimate, 24 of the mothers
were stated to be engaged in work, only three doing it at home, and in
three other cases the mother was ill when the baby was seized; nine of
the babies were in delicate health before the attack. Improper feeding
"was admitted in six instances only. Tube bottles had been in use in
more than half the cases.
Conyenital Defects and Marasmus.-It is always difficult to know
what these terms mean. They seem to cover a number of conditions,
such as syphilis, improper and unsuitable feeding, and defective
vitality due to the alcoholic condition of the parents, injuries, mental or
physical troubles of the mother, &c. Syphilis ought to appear as the
cause of death much oftener than it does. From the few deaths
recorded, the public are apt to suppose that it is a negligeable quantity,
but were still.births registered, it would be discovered that many of
these, as well as premature ones were referable to that disease.
Medical men are aware of the far.reaching consequences of this disease,
as the antecedent of other ailments, as a cause of insanity, and of other
defects of the nervous system. Prof. Welander, of Sweden, is quoted
in a recent number of the " Lancet" as correctly speaking of syphilis as
"the form of disease which during the past four centuries has perhaps
of all others occasioned among the peoples of our continent the greatest
amount and the highest degree of suffering." As examples of its
effects upon the birth.rate of this country, take the following instances
(the deaths have not been attributed in the death certificates to syphilis,
but a consideration of the circumstances in each case leaves me iu no
doubt in the matter):-
(a) Mother in wretched health, had 16 children, 11 dead; during
the last five years has twice had twins still.born, three other
babies (one premature, lived a few hours, one died at four
months and one at six months).
(b) Mother apparently well, three children healthy, last two dead
(one born dead, one lived three weeks).
(c) Mother seriously ill, four children, three dead, one ill.
Were syphilis to be a notifiable disease, the figures, especially in
large towns would be somewhat startling.
Of the infantile deaths, other than those due to stomach and bowel
affections, in 43 the mothers were stated to be engaged in business in
most instances away from home.
Deaths from tubercular disease are referred to under the general
heading later.