THE WASTE OF CHILDREN 553 



strating an increasing success in bringing children through the most 

 critical stages of life and in lessening the necessary waste. The thou- 

 sands who die are not the victims of the law of natural selection. It 

 is not largely an elimination of the unfit. More definitely than ever 

 before is it being established that most children enter life with an 

 endowment of native vitality sufficient to weather the ordinary condi- 

 tions of adversity. The great variations in death rates after the first 

 few months are due largely to postnatal influences, to the social and 

 economic environment in which the child is caught, from which it 

 has no appeal, and which make or mar its future. 



The wide range of infant mortality from the lowest rates of the 

 healthful country districts to the fearful massacre of infants in the 

 crowded and unsanitary portions of our larger cities indicates the 

 magnitude of the task still before us. That eminent authority on vital 

 statistics — Dr. Farr — estimated that the annual unnecessarv deaths 

 of infants in England during the decade 1851-60 numbered more than 

 64,000. The conditions in respect to food, water, cleanliness, mal- 

 nutrition and midwifery, he regarded as the chief causes of this need- 

 less loss of life. The proportion of loss suffered from these sources 

 has since undoubtedly diminished, but the aggregate number is greater 

 now than then. The effect of the various factors which influence the 

 rate of our annual loss of children is marked in the difference between 

 our urban and rural rates, and between those of white and colored 

 children. The comparative healthfulness of rural life is attested to 

 by ample evidence. It is indicated not only by the farmer's long 

 expectation of life, but also by the low death rate prevailing among 

 his children. A comparison of the chances of the child in the country 

 and in the city is a proof of the wholesome influence of a favorable 

 environment. It suggests the need of increasing effort to raise the 

 city to the high level of rural vitalit3 r . In the registration states the 

 infant mortality for white children varied in 1900 from an average of 

 116 per 1,000 births in the rural districts to 180 in the cities. The 

 urban rate seems to be more than 50 per cent, higher than that ob- 

 served among the country population. For every two infants dying 

 in the country, three are sacrificed in the city districts. Yet this is 

 not everywhere the case, nor is it necessarily so. In parts of Germany 

 the rural death rate is enormous. Especially is this true in the agri- 

 cultural districts of southern Bavaria, where an almost hopeless infant 

 mortality is recorded. The rural region of Prussia shows higher rates 

 than do our American cities, but they still possess a slight advantage 

 over Prussian urban centers. This heavy mortality indicates a social 

 lethargy and backward conditions among the agricultural population, 

 which in spite of many natural sanitary advantages remains handi- 

 capped by unfavorable social and industrial surroundings; and these 

 preclude proper attention to the wants of children. In England, 



