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There has been a marked decrease in the mortality from tuberculosis
in infancy throughout the whole 21 years, some drop in
that for the ages 1—5, but no corresponding decrease in the fatal
tuberculosis of children between the ages of 5 and 15. This may
in part be due to more accurate diagnosis, whereby deaths are now
labelled as due to tuberculosis which might formerly have been
attributed to some other condition.
In one form of the disease, viz., abdominal tuberculosis, the
great bulk of the cases may be regarded as due to ingestion of
tuberculous milk. The table shows a marked decrease in fatal
abdominal tuberculosis in infancy, and a low but stationary mortality
from this condition among children aged 1—5.
(d) Bronchitis and Pneumonia account for a very considerable
part of the mortality at all the age-periods under consideration—
for 18 per cent, in infancy, 30 per cent, at ages 1—5, and 12 per
cent, at ages 5—15. Since 1905 there has been no appreciable improvement
in the death-rate from bronchitis and pneumonia at 5
years and under, while there has been some increase at ages 5—15.
These diseases are relatively a much more important factor in the
death-rates for children up to 15 than they were 21 years ago.
(e) Convulsions. A considerable number of deaths of children,
and particularly of infants, are ascribed to convulsions, without
further determination of the cause of the convulsions. Convulsions
continued to be a material factor in the infant death-rate
throughout the whole 21 years, though the condition became
steadily of less importance at successive periods. There was a
corresponding decrease in fatal convulsions at ages 1—5.
(f) Factors Operating at the time of birth: (1) Injury at birth ;
(2) Atelectasis (lack of expansion of lungs.) Neither of
these factors take a large part in the total mortality in infancy. In
neither was there any notable improvement during the period of
21 years.
(g) Factors operating at or shortly after birth: (1) Premature
birth; (2) Atrophy, Debility and Marasmus; (3) Congenital malformations.
Premature birth and the conditions known as
atrophy, debility and marasmus are large factors in the total deathrate
in infancy; congenital malformations are of relatively small
importance as a cause of death. During the 21 years there has
been only a slight decrease in the death-rate due to premature
birth, and to atrophy, debility and marasmus. Both are relatively
more important factors in the infantile death-rate than they were
21 years ago. There has similarly been no decrease in the deathrate
in infancy due to congenital malformations.