of view in a very much
worse condition than most countries, for in Austria and Russia the
infant mortality is higher still, though in Australia and New Zealand
much lower, but still excessive--more than one-fourth of the total
number of deaths every year is of infants under one year of age. In the
opinion of medical officers of health who are in the best position to
form an opinion, about one-half of this mortality, roughly speaking, is
absolutely preventable. Moreover, it is doubtful whether there is any
real movement of decrease in this mortality; during the past half
century it has sometimes slightly risen and sometimes slightly fallen,
and though during the past few years the general movement of
mortality for children under five in England and Wales has shown a
tendency to decrease, in London (according to J.F.J. Sykes, although
Sir Shirley Murphy has attempted to minimize the significance of these
figures) the infantile mortality rate for the first three months of life
actually rose from 69 per 1,000 in the period 1888-1892 to 75 per 1,000
in the period 1898-1901. (This refers, it must be remembered, to the
period before the introduction of the Notification of Births Act.) In any
case, although the general mortality shows a marked tendency to
improvement there is certainly no adequately corresponding
improvement in the infantile mortality. This is scarcely surprising,
when we realize that there has been no change for the better, but rather
for the worse, in the conditions under which our infants are born and
reared. Thus William Hall, who has had an intimate knowledge
extending over fifty-six years of the slums of Leeds, and has weighed
and measured many thousands of slum children, besides examining
over 120,000 boys and girls as to their fitness for factory labor, states
(British Medical Journal, October 14, 1905) that "fifty years ago the
slum mother was much more sober, cleanly, domestic, and motherly
than she is to-day; she was herself better nourished and she almost
always suckled her children, and after weaning they received more
nutritious bone-making food, and she was able to prepare more
wholesome food at home." The system of compulsory education has
had an unfortunate influence in exerting a strain on the parents and
worsening the conditions of the home. For, excellent as education is in
itself, it is not the primary need of life, and has been made compulsory
before the more essential things of life have been made equally
compulsory. How absolutely unnecessary this great mortality is may be
shown, without evoking the good example of Australia and New
Zealand, by merely comparing small English towns; thus while in
Guildford the infantile death rate is 65 per thousand, in Burslem it is
205 per thousand.
It is sometimes said that infantile mortality is an economic question,
and that with improvement in wages it would cease. This is only true to
a limited extent and under certain conditions. In Australia there is no
grinding poverty, but the deaths of infants under one year of age are
still between 80 and 90 per thousand, and one-third of this mortality,
according to Hooper (British Medical Journal, 1908, vol. ii, p. 289),
being due to the ignorance of mothers and the dislike to suckling, is
easily preventable. The employment of married women greatly
diminishes the poverty of a family, but nothing can be worse for the
welfare of the woman as mother, or for the welfare of her child. Reid,
the medical officer of health for Staffordshire, where there are two
large centres of artisan population with identical health conditions, has
shown that in the northern centre, where a very large number of women
are engaged in factories, still-births are three times as frequent as in the
southern centre, where there are practically no trade employments for
women; the frequency of abnormalities is also in the same ratio. The
superiority of Jewish over Christian children, again, and their lower
infantile mortality, seem to be entirely due to the fact that Jewesses are
better mothers. "The Jewish children in the slums," says William Hall
(British Medical Journal, October 14, 1905), speaking from wide and
accurate knowledge, "were superior in weight, in teeth, and in general
bodily development, and they seemed less susceptible to infectious
disease. Yet these Jews were overcrowded, they took little exercise, and
their unsanitary environment was obvious. The fact was, their children
were much better nourished. The pregnant Jewess was more cared for,
and no doubt supplied better nutriment to the foetus. After the children
were born 90 per cent. received breast-milk, and during later childhood
they were abundantly fed on bone-making material; eggs and oil, fish,
fresh vegetables, and fruit entered largely into their diet." G. Newman,
in his important and comprehensive book on Infant Mortality,
emphasizes the conclusion that "first
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