17,1 Calderon: Obstetrics and Infant Mortality 21 
to the unaided forces of nature, are ordinarily delivered dead, 
when jt would have been comparatively easy to save them by 
means of a premature delivery, or by a timely performance of 
a Cesarean section, according to the circumstances. 
There exists an intimate relationship between prenatal, intra- 
- natal, and neonatal puericulture, as is shown by the fact that 
many fetuses which are sickly and weak at birth bear evidence 
of having become so while in the maternal cloister, either during 
pregnancy or during labor. Such happens, for instance, with 
the congenitally weak, or with those that present symptoms of 
meningitis secondary to a faulty application of the forceps or 
as a consequence of injuries sustained by the fetal head in the 
course of an unduly prolonged labor. 
Such is not always the case, however, for a good many times 
the healthy infant contracts the disease during the first few 
weeks of his life. Such happens, for instance, in umbilical 
tetanus, a very serious and fatal infection which develops 
through the umbilical wound from criminal carelessness or 
negligence on the part of the attendant. This fatal infection 
has been completely eliminated in countries where the practice 
of modern obstetrics has become generalized among the masses; 
but unfortunately it is still rampant not only in the Philippines 
as a whole but in its very metropolis, Manila, where according 
to Professor Albert’s investigations it is found that among the 
30-day-old babies, 102 out of 110 infections that occurred in the 
city of Manila in 1913 died from tetanus; 94 out of 100 in 1914; 
103 out of 110 in 1915; 96 out of 105 in 1916; 102 out of 108 
in 1917. 
The same thing is true of the purulent ophthalmia in the 
newly born, as a consequence of which several children become 
blind, a complication which is almost always preventable and 
‘is likewise attributable to the negligence of the attendant. Un- 
fortunately it has not yet disappeared from the obstetrical an- 
nals of this country. 
I shall not mention the diseases of the alimentary and respira- 
tory tracts which are so frequent among infants before they 
reach their thirtieth day. It suffices to say that altogether too 
many die of such diseases at this age—a vulnerable age—which 
fact is in itself a strong justification for the spread of pueri- 
-culture over the entire Philippine Archipelago. 
The above remarks are sufficient to show that obstetrics is 
so intimately associated with prenatal, intranatal, and even 
neonatal puericulture that, if the obstetrician aims to fulfill the 
