637 
year of age, is the largest single factor determining infant mortality. 
Further investigation demonstrates the significant fact that 75 to 85 
per cent of all infants who die of diarrhea are artificially fed. Thus 
Planchon, in investigating the relation feeding methods had to gas- 
troenteritis in Paris, shows® that, while the diarrheal death rate in 
breast-fed infants varies from a minimum of 2 per thousand in win- 
ter to a maximum of but 20 per thousand during the hot months, the 
diarrheal deaths of the artificially fed fluctuate from a minimum of 
12 per thousand in winter to a maximum of 158 per thousand in the 
summer. 
In Paris during the four summer months of 1897, 2,840 infants 
under 1 year died. Of these 1,470, or 51.7 percent, died of diarrhea. 
Of these 1,470 who died of diarrhea, only 139 were breast fed, and 
1,331, or over 90 per cent, were artificially fed. 
The following table from Harrington (loc. cit.) illustrates ad- 
mirably this point at Berlin. The figures given cover the quin- 
quennium of 1900-1904 and relate to the incidence of deaths among 
the bottle fed and the breast fed when the method of feeding could be 
determined. 
Table 7. 
Year. 
Number of 
deaths 
among in- 
fants under 
1 year of age 
whose mode 
of feeding 
was known. 
Number of 
deaths 
among 
breast fed. 
Percentage 
of deaths 
of breast- 
fed infants. 
Percentage 
of deaths 
among 
others. 
1900 - 
9,558 
895 
9. 36 
90.60 
1901 - 
9,378 
856 
9. 17 
90.80 
1902 
7,027 
768 
10.17 
89. 10 
1903 
7,680 
723 
9. 41 
90.59 
1904 - 
7,780 
753 
9.68 
90.82 
Again, Helle b in analyzing the infantile death rate of the city of 
Graz shows that out of 170 deaths from intestinal disease in the fis- 
cal year of 1903-4 but 4 of these were breast fed, 48 were partly 
breast fed, 117 were bottle fed, and in one case the method of feeding 
was unknown. 
Reference to Table 6 shows that the German city of Barmen, with 
an infant mortality rate of 132 (1906), enjoys the lowest rate of any 
city in Germany, and for a number of years has made a favorable 
showing in this respect. Kriege and Sentemann c attribute this for- 
tunate circumstance to the general prevalence of breast feeding in 
® Planchon : Prevalence of Diarrhea in the Artificially Fed. Obstetrique, 
January, 1900. 
6 K. Helle. Archiv. f. Hygiene, 1905, VI, 18. 
c Centralblatt f. Gesundheitspflege, 1900, XXV, 25. 
