THE CAUSES OF DEATH 123 



system of the mother, for some reason or other, did not rise 

 to the demands of the situation of carrying the foetus to 

 term. Premature birth, in short, results from a fail- 

 ure or breakdown in some particular of the maternal 

 reproductive system. This failure may be caused in 

 various ways, which do not here concern us. The essential 

 feature from our present viewpoint is that the reproduc- 

 tive system of the mother does break down, and by so 

 doing causes the death of the infant, and that death is 

 recorded statistically under this title "Premature birth.' 

 The death organically is chargeable to the mother. 



A considerable number of cases of premature birth 

 are unquestionably due to placental defects and the pla- 

 centa is a structure of fcetal origin, so such deaths could 

 not be properly charged to the mother. On the other 

 hand, however, they would still stay in the same table be- 

 cause the placenta may fairly be regarded as an organ 

 intimately concerned in reproduction. 



The same reasoning which applies to premature births, 

 mutatis mutandis, applies to the item "Injuries at birth.' 

 An infant death recorded under this head means that 

 some part of the reproductive mechanism of the mother, 

 either structural or functional, failed of normal per- 

 formance in the time of stress. Usually "injury at 

 birth" means a contracted or malformed pelvis of the 

 mother. But in any case the death is purely external and 

 accidental from the standpoint of the infant. It is organ- 

 ically chargeable to a defect of the sex organs of the 

 mother. The female pelvis, in respect of its conforma- 

 tion, is a secondary sex character. 



The immediate reason for including syphilis and 

 gonococcus infection here is obvious, but, particularly in 

 relation to syphilis, the point needs further discussion. 



