Vol. 60, 1909 - University of North Carolina at Chapel Hill

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THE CHARLOTTE MEDICAL JOURNAL.
DENSITY PER SQUARE MILE
166 1S6 379 1718 4499 12359 65823
RATE FOR ALL AGES
16.0 18.1 21.9 24,8 28.0 32.9 38.6
RATE FOR FIVE YEARS
37.3 47.5 65.0 82.1 94.0 111.9 139.5
The mortality in the cities is about double
that ill the country districts, and the above
table shows that city life is an important
factor in hi, 1909). Dr. Neumaii, in Berlin, gathered
statistics in regad to room space. He
found that out of 2,701 infant deaths, 1,792
occurred in one room dwellings, 745 in two
rooms, 122 in three rooms and 43 in large
dwellings.
The mother who has to go out to work
will make a poor nurse. There was a great
falling off in infant moitality in England
during the American Civil War from 1861
to 1865. During this time cotton was not
shipped from America to England in usual
quantities, and the women there who were
forced to do a large portion of factory labor
were forced to remain at home. As a result,
factories in large numbers were closed.
Although 24 per cent, of the population
became objects of charity, the death rate
was low. After the close of the war, the
factories were re-opened, and the death rates
rose to their usual height.
Meinert has gathered statistics to show
that it is not solely the excessive temperature
or the lack of cubic space per capita
in the home that causes the high mortality.
A temporary total cessation of spontaneous
ventilation in the houses arising from their
construction and occurring only under certain
barometric conditions constitutes the
decisive factor. The number of cases of
infant diarrhea decreased at once with a
strong wind and increased rapidly as soon
as the wind fell again.
Dr. James Wood, of China, told me that
he was able to reduce infant mortality 40
per cent, by removing a large number of
infants to a higher elevation in the surrounding
hills where the air was not so hot
and there was more wind.
The influence of prosperity on the mortality
of infants due to ailments of the stomach
and bowels has been studied by Professor
W. Pransnitz, of Gratz. He divided
the deaths into four classes, (1) rich, (2)
middle-class, (3) poor, (4) destitute; and
the percentage of deaths from these diseases
has been calculated for each class. By this
means, it was shown that in Gratz, for example,
in the last fifth of the past century
not one child died in a rich family: while
in the second class about 4 per cent., in the
'
third, 3() per cent., and in the fourth, 6C'i
per cent, fell victims.
The campaign against infant mortality;
must be along the lines adopted for tuber-
culosis. It should be a much discussed:
subject, and literature dealing with it must j
be sent to families in which births are rej
ported. The midwife must be supplied witb I
the proper literature and she should receive I
proper instructions herself. Certainly 5(
per cent, of the deaths among infants is i
preventable, audit is within the power oli
medical men to save something like 100, OOC I
lives in each year.
In 1908, the English parliament passed a:
law for the protection of infants and chil-
dren. In England no child can be adoptee;
without a permit. In 1909, a bill was ini
troduced in Congress to form a Federa i
Childrens' Bureau to deal with the facts o\
birth rate, infant mortality, physical de I
generation and other juvenile matters. Thit(
bureau bids fair to be of great value to the|
country. ,
Sir Thomas Browne must have had in j
mind infant mortality when he said, "Foij
the world I count it not an Inn, but ar
Hospital, not a place to live in but to di«j
in." i
We who hold so tenaciously to life, anc i
hold with Socrates, "life is worth living,', j
should use our best efforts to protect th«(
lives of helpless infants who have no say as J
to their fate. ;
The Surgical Treatment of Hepatic )
Ascites."
By \V. Lowndes Peple, M.D., Richmond, \"a., Pro I
fessorof Histology and Assistant to the Chair j
of Clinical Surgery, University College of |
Medicine. j
1 have selected the foregoing subject pri |
marily to aflord an opportunity to bring be
fore the Academy a case which seems typi '{,
cally illustrative, and yet presents manj, i
puzzling features. Since several among u:i
have had an opportunity of a more or lesi,^
critical study of it from time to time, i ,
seemed well to present it in its entirety U],
to the present date, with its clinical find i
ings and the subsequent history (which
have, fortunately, been enabled to follow) i
so that we may thresh it out here upon thi;
floor, and thus clear up the obscurer points
j
I
I
Hepatic ascites is regarded as a seepagt I
of serum into the peritoneal cavity, due t(
resistance offered to the flow of the porta' |
blood through the liver from deposits o'j
fibrous tissue within the liver structure
Let it be borne in mind that the operativt |
procedures to be reviewed are not intendec i
to deal with cirrhosis of the liver, but an; I
*Read before the Richnioml Academy of MedijfJ
I
cine and Surgery, September 21, 1909.
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