240 DISCUSSION. 



most of us. This brings me to the remarkable figures which have been 

 given of the comparative death rate between breast-fed and artificially 

 fed infants. Surely there is a flaw somewhere in the statistics, for the 

 proportion of 70 per cent of deaths in breast-fed infants is totally at 

 variance with that shown us by the history of the world since the days 

 of Adam. I was glad to hear that the authors of the paper did not 

 carry this question to its logical conclusion, and advise artificial feeding. 

 The flaw in the figures is probably due to incorrect information with 

 regard to the feeding of the infants. As had already been pointed out 

 by one of the previous speakers, very few of the native infants are 

 entirely breast-fed. This is also true in Siam. As a rule, at the third 

 month, but often earlier, in the latter country mothers are in the habit 

 of supplementing their milk by feeding their children on softboiled rice, 

 uncooked bananas, and frequently on other articles of diet of a far more 

 indigestible nature. 



I have always been of the opinion that the high death rate among 

 infants is the result of digestive troubles brought on by all the mixtures 

 rammed down these poor infants' gullets, but that the condition pro- 

 duced might be beriberi is a new consideration to me. However, the 

 subject of infant mortality is of supreme importance in any country. 

 It is in Siam and no doubt in the Philippine Islands as well, so that I 

 hope the mother will always be kept to the fore in the work of this 

 association. 



Dr. Victor G. Reiser, Director of Health for the Philippine Islands pro- 

 fessor of hygiene, Philippine Medical School, Manila, P. I. — This paper is 

 a most valuable contribution on the subject of infant mortality in the 

 Philippines, and is, I believe, in spite of all that has been said and 

 written upon this question, the first scientific work which has been 

 done for the purpose of ascertaining the actual cause of death in a series 

 of eases. 



I feel that a statement should be made in regard to the statistics 

 relating to naturally and artificially fed infants. Several years ago the 

 Bureau of Health was requested to collect statistics showing whether 

 the deaths which occurred among infants under one year of age were in 

 cases which had been naturally or artificially fed; at that time I de- 

 murred because of the improbability of obtaining reliable figures of 

 this nature by inquiries made by a clerk. It is well known to those who 

 have experience in the Philippine Islands that almost from birth it is 

 the custom to give rice, potatoes, and other solid food to children that 

 are nursing. Anyone who has the least doubt in regard to the accuracy 

 of this statement can easily satisfy himself by going through any native 

 town and observing the children, and in a comparatively few observa- 

 tions he can witness mothers engaged in this practice. Furthermore, 

 it is characteristic of the more ignorant classes to reply to questions of 

 this nature in the manner in which they believe an answer is desired, 



