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53
environment. In most cases there was apparently no reason
for the premature onset of labour. In two cases the birth was.
intentionally brought on prematurely on account of the small
pelvic measurements of the mother. In 5 instances the infant
was one of twins. In one case the onset was apparently clue to
shock and in another to some maternal uterine abnormality
Until more is known of the causation of the on set of normal
labour after a certain period of gestation, the cause of most
premature labours will remain unrecognised. Until that time
most of these deaths cannot be classified as preventable.
Seven deaths were classified as deficient inherent vitality,
atelectasis or debility. In three cases (one a twin) the infant
although full time, was much under weight. These cases, too,
represent a failure of adaptation to new surroundings.
Congenital heart was the cause of death in 10 instances (8
male and 2 female) and other congenital abnormalities in
four (1 male, 3 female). Doubtless some of these occurring
shortly after birth and asc ribed to congenital heart should be
classified in the previous group. As a cause of death, its effect
remains apparent for the rest of the year as, amongst infants
dying from 3-12 months of age, there were two deaths from
this cause. This group must remain amongst those causes of
death which are not preventable.
Birth injuries, in which are included those deaths from
asphyxia and from cerebral hæmorrhage. caused 5 deaths
all of male infants. In two instances the baby was born before
the arrival of the attendant. In the other three cases, labour was
difficult, necessitating the application of forceps for delivery
This type of case is largely preventable by ante-natal supervision
of the mother.
Bronchitis and Pneumonia caused, within one month of bith
4 deaths, and within three months, a total of 11 (8 males, 3
females). Of the earlier ones 2 were of children who had
never been well and represent probably a mode of dying of a
feeble infant. The others, however, appeared to be definite
infections, in some cases there being an acute onset, in others a
progression of disease from an original nasopharyngeal infection.
There is still a lamentable lack of appreciation of the
infectiousness of the common cold and of its possible serious
consequences where occurring in an infant.
None of the deaths within one month of age were ascribed
to enteritis or the infections, which, however, both begin
show their effect in the next month.
The remaining important group is pemphigus which
the death of 8 male infants of ages between one week and
one month.