JOHN S. FULTON, M. D. 127 



The elements of the antenatal curve are time and frequency, 

 while the post-natal curves include relations of season. The 

 successive polygons on the prenatal side represent time arested 

 at intervals of one month, while the post-natal curve has the 

 figures for flowing time. 



At the end of the antenatal curve we must believe that the 

 direction changes toward the true mortality at the end of the 

 first month, and this we know is above 22 ; according to English 

 experience, in the neighborhood of 40 per 1,000. I have there- 

 fore drawn in dotted lines the English figures for the first 

 nine months of post-natal life, and Pearson's antenatal mortality 

 in the same ratio ; i. e., to the 1,000 born alive. In this way we 

 obtain a graphic expression of mortality during 18 months from 

 the date of conception, distinctions of season being omitted. 1 



I have no doubt about the better expectancy of winter-born 

 babies, after they are born, but it would be rash to assume that 

 a better expectancy attends such children all the way from the 

 date of conception. We cannot be sure that the seasons exert 

 no influence upon mothers, deviating the course of pregnancy 

 as the course of post-natal life is deviated from month to month. 

 It is probable that the course of pregnancy is less affected by the 

 seasons than is the course of early infancy, but it is possible 

 that pregnancy may be deviated in some opposite way, so as to 

 widen the difference of expectancy as between summer-born and 

 winter-born infants. The December-January births recorded 

 by Neumann numbered 34,027; the June-July births in the same 

 population numbered 32,993. Assuming that equivalent numbers 

 of women entered each reproductive undertaking, the winter 

 group had better reproductive expectancy in the ratio of 576 to 

 541 during the gestative period, in addition to their advantage 

 of 221 to 190 in the first year after birth. 



The main outcome of our attempt to study infant mortality, 

 by short intervals of time, and in close proximity to birth, has 

 so far been the annexation of antenatal existence, together with 

 the sickness and disability of child-bearing women. We shall 

 get little light on antenatal deaths from the mortality tables, for 

 still births are not recorded. With respect to maternal sickness 

 and disability we are no better informed. In the Registration 

 Area in 1908 there occurred 7,344 deaths of women in child- 

 bed. In consequence, nearly as many infants were probably 

 lost to record because they were stillborn, or else were recorded 

 as dead from post-natal causes. But these were few in com- 

 parison with the number of infants dead before and after birth 

 on account of maternal sickness and disability not fatal to the 

 mothers, and few also in comparison with the number of unborn 

 infants lost with their mothers in the general mortality of the 

 reproductive group. 



lr rhe recorded births include infants born before their proper birth-day. There 

 is some oxcoss in the assumption of 40 as the correct mortality of the first 

 month, and error also in assuming- the equivalence of 1.605 conceptions and 

 1,000 births. 



