View report page

31
2.—The second point is to ascertain whether any changes have taken place
in the causes from which infants die.
In the Report of the Physical Deterioration Committee, Vol. I., page 132,
Dr. Tatham has supplied a table for two periods of five years—1873-77 and
1898-1902—showing the male and female infantile mortality rates from 19
causes in a group of urban and in a group of rural counties. The urban
counties show an increase of infantile mortality of about 4 per 1000 births,
and the rural counties a decrease of somewhat over 1 per 1000. Dr. Tatham
savs:—"The causes which contributed to maintain the total infantile mortality
at about its former level were diarrhceal diseases (including enteritis and
gastro-enteritis), diseases of the stomach and liver, pneumonia, premature
birth, and congenital malformation. The increase of pneumonia mortality is
coincident with an increased fatality of that, disease in the general population,
and although this increase between the two quinquennia is proportionally
large, it counts but little against the decrease from the other causes just
mentioned. With diarrhceal diseases and with premature birth and congenital
defects the case is far different, the increased mortality from these causes
being very marked. Taking together diarrlioeal diseases and diseases ot the
stomach and liver, the recent five years show an increase of more than 70 per
cent, in the urban and of nearly 70 per cent. in the rural counties. From
premature birth and congenital defects the increase, though numerically
smaller, was proportionally even greater than that from diarrhceal diseases.
Among males in the urban counties the rate had increased by 70 per cent.,
and among females by 61 per cent., while in the rural counties it had increased
by 74 per cent. in each sex." He then adds that "more accurate certification
of the cause of death has been secured in recent years. This would probably
tend to a transfer of deaths from indefinite to definite headings, but the
changes of mortality indicated in the above comments are so well marked that
they probably represent with approximate accuracy the changes that have
actually taken place, apart from this disturbing influence." I have had Dr.
Tatham's table reduced so as to show the points to which he lias drawn
attention, and set out as follows :—