By a general usage, the term infant mortality has come to denote the mortality of those of five years of age and under. This, therefore, is the meaning of the title of the paper, and of the expression as it occurs in the following pages.

For the facts relating to the number of inhabitants of the city and of its various sections, and the proportion of infants to adults, I am under great obligations to Col. Carroll D. Wright, Chief of the Bureau of Statistics of Labor, who has kindly given me most valuable information whenever I have applied to him for it. The meteorological observations are these furnished to the Board of Health by Dr. George H. Robé of the U. S. Signal Service.

At the request of his Honor Mayor Cobb, a medical commission was appointed, October 15, 1874, to examine into the sanitary condition of B›ston. In their report, submitted to the Board of Health, under date of November 1, 1875, Dr. Thomas B. Curtis (the Secretary of the Commission) discussed at length the question of the supposed excessive infant mortality of the city, and those especially interested in the subject are referred to that report for much valuable material bearing directly upon the statistical and scientific side of this important question. The object of the present paper is to present, in a somewhat popular form, certain facts which may throw some light upon the causes of this high death-rate, while, at the same time, it suggests measures by the adoption of which, it is to be hoped, the lives of many, now annually sacrificed, may be saved.

I. INFANT MORTALITY IN BOSTON DURING THE YEAR END-
ING APRIL 30, 1876.

According to the census which has been lately taken
(July, 1875), the number of inhabitants of Boston is
341,919. Of this number, 43,936 are five years of age
and under. During the year ending April 30, 1876, the
number of deaths which occurred was 9,154, and of this
number, 4,167 were reported among children of five years
of
age and under. It will thus be seen that, while the death-
rate of those over five years of age was 16.73 per thousand,
the high rate of 94.84 per thousand obtained among infants.
The following table contains the names of the various dis-
eases which have terminated fatally during the year, with
the number of deaths reported from each :-

TABLE I.

Causes of Death of all of Five Years of Age and under.

The causes of death in the preceding table are taken from the death-certificates returned to the Board of Health, and are given here, not with the belief that they are strictly correct, but because, to a certain extent, they give the general character of the diseases which proved most fatal to young children. It is certainly questionable whether dentition, ascites, canker, colic, coryza, and many other diseases, the names of which appear in the above list, should ever be considered, per se, as a cause of death.

At present there exists in Massachusetts no proper system. of medical registration, and it is therefore impossible to obtain any statistics bearing upon the causes and frequency

of disease, which can be depended upon to any great extent. It may not be out of place here to express the hope that the day is not far distant when some additional legislation shall at least prescribe what is meant by the term "any physician," as used in the law now governing this whole subject of deathcertificates.

An examination of these various causes will show that, for the purposes of discussion, they readily admit of classification, as follows:

TABLE II.

Table of Classified Diseases with the Number of Decedents from each Class.

From the following table it will be seen that the liability to death in early life decreases with age, and that the deathrate, with an occasional accidental exception, falls steadily from 792.24 per thousand, which obtained among infants of one month of age and under, to 32.22 per thousand, which was the death-rate of those between four and five years of age.

TABLE III.

Table of Ages at which the Deaths of those of Five Years of Age, and

The following table shows the parentage of those of five years and under, and, for the sake of comparison, the parentage is also given of those over five years of age who have died.

From these figures it will be seen that only 921 (22.11 per cent.) of the children who died were of native parentage,

while 3,246 (77.89 per cent.) were either of foreign, mixed or unknown parentage. It will be noticed, also, that very nearly the same ratio exists between the number of native adults who died, and the whole number of adult deaths.

The following table gives the percentage of the children who died from those diseases which contribute most largely to the sum total of the infant mortality of the city.

TABLE V.

Table showing Number and Parentage of Decedents from certain Diseases.

The following table exhibits the total monthly infant mortality, with the infant death-rate of the city, and the parentage of those who died each month.