150 



MLAUGHLIN AND ANDREWS. 



Compare this infant mortality with that of other countries and the 

 result is striking. According to the United States census of the year 

 1900, the deaths of children under 1 year constitute 18.28 per cent of 

 the total mortality; in France, 4 from 1896 to 1900, the infant mortality 

 constituted 20 per cent of the total, but in Manila the deaths of infants 

 under 1 year aggregate 4S.8 per cent of the total number. 



Table III. — Rate of deaths of child-reft to total number of deaths, in percentages. 



United States 



France 



Manila 



18.28 



20.00 



48.8 



In order to combat intelligently this appalling infant mortality, it is 

 essential to determine accurately what diseases really constitute the 

 greatest factors and these investigations were undertaken with that end 

 in view. 



According to the statistics of the Bureau of Health, the main factors 

 in child mortality for the fiscal year 1908-9, a fairly representative year, 

 were the following: 



Table IV. — Factors in the mortality of children in Manila. 



Cause of death. 



Number 



of deaths, 



children 



under 1 



year. 



Number 



of deaths, 



children 



under 5 



years. 





1,615 

 596 

 595 

 569 

 287 

 286 

 594 



1 , 615 

 596 

 629 

 689 

 510 

 745 



1,257 















Total __ . _. . _ 



4,542 



6, 041 





It was necessary to verify these statistics. The figures for the total 

 number of deaths were undoubtedly correct, but the causes given in the 

 death certificates were demonstrated frequently to be incorrect and 

 indefinite. 



In a previous paper, one 5 of us presented some observations upon 

 cholera in children during the period from August 1 to September 25, 

 1909, and among the conclusions deduced from those observations were 

 the following : 



1. Cholera in children is often unrecognized and unreported as such, the 

 diagnosis being reported as acute or chronic enteritis, gastroenteritis, enterocolitis, 



. "Budin. Ann. de Med. et chir. infant (1903), 7, 181. 



s McLaughlin. Some Observations Upon Cholera in Children. 

 Sec. B (1909), 4, 363. 



This Journal, 



