DR. PHILIP VAN INGEN'S PAPER 357 



A CAMPAIGN OF PRE-NATAL HYGIENE 

 IN NEW YORK. 



BY PHILIP VAN INGEN, M.D. 



New York City. 



WHEREVER consistent, determined effort is being 

 made, the infantile mortality rate is falling slowly, 

 to be sure, but nevertheless falling. But when we 

 study the details of the mortality returns certain 

 facts are brought out very sharply. In New York 

 City the rate for the three years, 1905 to 1907, was 

 152*3; for 1908 to 1910, i27 : 8. In 1911 it was 

 iir6, and in 1912, 105*3. While there has been 

 a marked reduction in the deaths of babies, this has 

 practically all occurred at ages over one month. 



I month, and 



Under I month under i year 



1908 to 1910 43-3 93-2 



igil ... ... ... 40*4 ... 82-0 



I 9 I2 ... 4 I'I ... 75-3 



The decrease has been marked at the more 

 advanced age, while it has been very slight at ages 

 under one month. About 40 per cent, of deaths in 

 babies are set down in mortality tables to that group 

 of conditions known as " wasting diseases," among 

 which we find such vague terms as "congenital 

 debility," "inanition," "malnutrition," "lack of breast 

 milk," &c. These deaths occur- mostly during the 

 first month of life, and are sometimes called the 

 " unavoidable " infant mortality. It is generally 

 admitted, I think, that these conditions are largely 

 the result of processes acting upon the child before 

 its birth, through the mother. If this is so, the pre- 

 vention of this 40 per cent, of the infantile mortality 

 must be accomplished by methods directed toward 

 the mother before the child is born. We must try to 

 secure a healthier child by having a healthier mother, 

 and one who is better able to nurse her baby. 



