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The Nursling

By Pierre Budin, Professor of Obstetrics, University of Paris; Director of the Clinique Tarnier; Member of the Academy of Medicine, Paris, France. Authorized translation by William J. Maloney, M.B., Ch. B., 1907.

Appendix X

Infantile Mortality

Balestre and Giletta de Saint Joseph (of Nice) compiled Statistics of Paris and the towns of France which have more than 30,000 inhabitants, comprising a total population of 7,300,000.

Their tables show that from 1892 to 1897 out of every 1000 deaths at all ages 166.2 occurred in infants under one year.

This was the average proportion, but sometimes it was greater. In 1897, for example, the deaths among infants under one year bore the following ratios to the deaths at all ages:--

Chalons-sur-Marne

200.34 per 1000

Elbeuf

240.35 per 1000

Caudebec-lès-Elbeuf

200.83

Beauvais

241.09

Arras

201.21

Troyes

243.92

Nancy

201.68

Rouen

246.95

Saint-Chamond

201.98

Montreuil-sous-Bois

247.43

Denain

202.02

Hazebrouck

249.89

Aubervilliers

202.99

La Ciotat

250.96

Le Cateau

203.39

Fécamp

252.56

Toul

205.13

Reims

253.50

Argenteuil

210.52

Meaux

254.02

Saint-Ouen

213.59

Annonay

259.82

Douarnenez

214.28

Calais

260.33

La Seyne-sur-Mer

217.65

Bailleul

262.02

Firminy

218.52

Hautmont

272.11

Epinal

220.29

Saint-Denis

277.25

Alfortville

220.93

Dieppe

290.13

Puteaux

221.00

Hénin-Liétard

291.26

Boulogne-sur-Mer

221.09

Belfort

300.37

Alais

221.34

Lille

307.00

Vesoul

223.99

Roubeix

312.86

Salon

226.24

La Madeleine

314.85

Lambezellec

226.41

Tourcoing

324.42

Clichy

226.97

Lens

333.34

Lunéville

232.39

Dunkerque

344.24

Chauny

232.87

Le Grand'Combe

345.89

Saint-Dié

234.62

Watrelos

353.49

Pantin

235.52

Bolbec

346.15

Saint-Quentin

235.75

Bruay

352.11

Sotteville-lès-Rouen

237.29

Liévin

378.48

Le Havre

237.22

Croix

400.83

Villeurbanne

238.04

Marc-en-Baroeul

438.20

Armentières

240.02

Halluin

504.85

In these towns, therefore, the mortality under one year was equal to one-fifth, one-quarter, one-third, and even one-half of the total death rate.

Out of every 1000 infantile deaths 385 are caused by diarrhoea, and 147 by pulmonary affections; these two, therefore, give rise to more than half the total death-rate among infants (532 out of every 1000 -- Fig. 126).

All other causes combined (eruptive fevers, contagious diseases, congenital debility, &c.) contribute only 468 out of every 1000 deaths.

Diarrhoea persists throughout the year, but it is particularly virulent during summer. In Fig. 128 its relative fatality during the different months is shown; least in January and February, it becomes more deadly as the atmospheric temperature rises.

The proportion of deaths from diarrhoea is 224.8 per 1000 in March.

The proportion of deaths from diarrhoea is 254.8 per 1000 in April.

The proportion of deaths from diarrhoea is 301.1 per 1000 in May.

The proportion of deaths from diarrhoea is 426.4 per 1000 in June.

The proportion of deaths from diarrhoea is 587 per 1000 in July.

The proportion of deaths from diarrhoea is 604.7 per 1000 in August.

It begins to fall as the weather grows colder

It is no more than 537.7 per 1000 in September.

It is no more than 431.5 per 1000 in October.

It is no more than 304.4 per 1000 in November.

It is no more than 235.9 per 1000 in December.

The mortality due to digestive troubles is thus considerable. In July, August, and September, diarrhoea gives rise to more than half of the infantile deaths (587, 604.7, and 537.7 per 1000). If the five months June, July, August, September, and October are taken together, 517.5 out of every 1000 infantile deaths during this period are seen to be due to diarrhoea.

On the other hand pulmonary affections are most virulent during the cold months. As the death rate from diarrhoea diminishes the mortality from pulmonary affections increases (Fig. 127).

In January diseases of the chest claim 263.2 out of every 1000 infantile deaths; this proportion falls gradually. It is

239.9 per 1000 in February.

228.9 per 1000 in March.

200.9 per 1000 in April.

107.3 per 1000 in June.

61.6 per 1000 in July.

56.4 per 1000 in August.

Then as the atmospheric temperature falls it begins to increase.

It is 61.8 per 1000 in September.

It is 89.3 per 1000 in October.

It is 172.6 per 1000 in November.

It is 246.2 per 1000 in December.

 

Fig. 126. Graphic representation of the relative frequency of the various causes of death in infants under one year.

Fig. 127. Mortality from pulmonary affections during the different months of the year, showing how it increases when the external temperature becomes low.

Fig. 128. Mortality from diarrhoea during the different months of the year, showing the considerable increase during the summer.


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