■.'f^^'C. r-- :^^.-.-,r7'^p^ fh' ..::>■ ON SOME OF THE CAUSES OF THE EXCESSIVE MORTALITY OT YOUNG CHILDREN IN THB CITY OF MONTREAL. BY PHILIP P. CARPENTER, B. A., Ph. D., Hon- SecreUry of the Montreal Sanitary Amociation. (Reprinted from the Canadian Natcbalibt for June, 1869.) 02f SOME OF THE CAUSES OF THE EXCESSIVE MORTALITY OF YOUNG CHILDREN IN THE CITY OP MONTREAL. By Philip P. Carpentek, B.A., Ph. D.. Hon. Secretary of the Mont:eal Sanitary Association. The object of the present paper is (1) to continue and enlarge upon the data given in the Canadian Naturalist, New Series, Vol. 3, pp. 134-156, under the head of " Vital Statisticii of Montreal ;" and (2) to enquire into some of the causes of the most unusual disproportion between the deaths of young children and adults. The lettering and numbering is so given as to correspond with the previous article, to which the reader would do well to refer back. The figures for 1866 are repeated, along with the general average of 12 years, in order to make a suitable comparison with the succeeding years. It should be remembered that in each of the years beginning with 1866 the official directors and executors of public hygiene have stated that the city was never before in so cleanly a condition. A. — The Census Returns. In advance of the approaching Census, it is most important to remember how inaccurate the last was proved to be ; the double entry of "uncooked" figures for Quebec deaths presenting a discrepancy of 296 (see p. 134), and the Montreal deaths pre- senting a known deficiency of 1,143 (see Table 8, p. 147). It behoves all members of the governments therefore, both federal, provincial and municipal, and all who can bring influence to bear upon these governments, to see to it that the appointments are not given to incompetent political favourites, but to the best men that can be found for so important a public work. The citizens of the largest (and the most unhealthy) city in the Dominion should especially see to this. B. — The Protonotary's Returns. These continue to be the only accessible data for the Births in Montreal, as well as for both Births and Deaths in the surrounding counties. Yet they only record religious ceremonies. The births among Baptists (a very small sect, however, in this city and province) are not publicly registered. An imperative Registration of Births and Deaths (with the proximate and remote causes of the latter under medical certificate) is among the first duties of our government. If should not be left to the peculiar views of the leaders in either Province, but should be uniform for the whole Dominion^ ?nd enforced by sufiicient penalties. In the following tables, Vaudreuil and Soulanges, having been permanently removed to another registration district, are no longer represented by averages. The population of the six counties was 81,291 in 1861 , to which the average increase, viz., 2,938, is added year by year. This alteration somewhat affects the averages as previously given : — 4. Montreal City: Returns of Baptisms and Funeral Services. p'o"p^u?aTon.' Births. 1 ! Deaths. Excess Deaths of Births per over 1, 000 Deaths. Living. Deaths per 100 Births. Average of 7 years 93,583 4,545 3,390 1,155 36.2 74 Montreal City in 1865 1866 ' 1867 " 1868 103,363 5,543 1 1 1.374 5,158 , 116,608 5,598 I22,c88 5,060 3,761 3,381 4.247 4,567 1 1,782 ' 364 ».777 ; 303 1,351 37-7 493 '' 37-4 68 6s 76 90 Average of 4 years "3,358 5.339 3,989 1. 350 ; 35-4 75 5. Six adjacent Counties : Returns of Baptisms and Funeral Services. Year. 1 Excess ! Deaths. Deaths per 1,000 Living.' Deaths per 100 Births. Average of 8 Counties for 7 years 109,611 3,923 1,911 3,012 174 48 Six Counties in 1865 1866 « 1867 " i868 93.043 95.981 98,919 101,857 2,763 1,651 2,591 1,415 2,686 1,603 2,588 1,532 1,113 1,176 1,083 1,056 1,107 177 14-8 16.2 154 59 59 59 59 97,450 2,657 i 1,550 16.0 16.0 35-4 59 Ditto, corrected to the Popu- lation of Montreal Ditto, Montreal City 113,358 113,358 1 3,091 1,803 5,339 [ 3,989 1,288 1.350 59 75 Balance for and against the ritv 2,348 \ 3,186 1 62 19.4 16 /) It appears, therelore, that though our mothers give birtli to more than 2,000 infants yearly, in addition to the infants born among the same number of country people, the city only gains 62 lives, as the fruit of all this sufiFering and loss ! The deaths registered by the Clergy, in the city of Montreal, as compared with those registered at the Cemeteries, present the following results. 8. Comparison of Mortality-Records in Montreal City, 1 866— 1 868. Year. t'emetery Returns. iS66 1 3,6io 1867 1 4,465 1868 4,843 Total 12,917 Clergy Returns. 3,381 4.247 4.567 12,195 Not Entered in Clergy Returns. 229 218 375 722 Or, per 100 Deaths. 6.3 4-9 5-7 S-6 Or, per 1,00a Living. a-o 19 2-2 C. — Interments at the Cemeteries. The allowances to be made in estimating the accuracy of these returns are stated at p. 147 ; for the comparison of years, of seasons and of ages with each other, they are invaluable. During the last year, the descriptive columns in the weekly sheets have been filled up with much more accuracy than heretofore, in consequence of urgent representations from the Sanitary and Medical Associations; but they are not yet accurate enough for the requirements either of medical, sanitary or statistical science. This is greatly to be regretted and deprecated ; because in a large city, whore all the interments are made at two cemeteries, a very little determination on the part of the officials would produce nearly all that can be desired. 6 I II otk\ 0> rsovo ♦ Or, per lOO ivin 06 :^33- « W MJ! • ss o age WItl [ties 8=^-2 = t CT; »n >,"£• = M *^ « f^ « >Qi3-S %-s^ u e *3 u « > *.E ^ U V 00 o»o v» Cs. ?^ M (^ « « M " SB, 5i = -| 10 ( fi CO 0^ °-M.> m m i"~~ *n N 55 p- *o ■* « w vD -^X f« ^i f^ fJl ^ ^ ■♦ ' ui 1 1 of n to 100 dult Deaths Childre every : 'ths of a « ^ ^ tH 00 0> WTi) M N « m T3 1 _ be ».«.S n.'-o-^ '^ moo 00 Or 1000 ages *n >^ ts.06 wi « « M « ei — " R "««■ ■*•-■♦ m ■*= 2; N 00 N m s'5;2 ". (^ « in 0. 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"O cn 5 11*^.5 3 -5 1 ^ r ^ i ^1-- rnoo ^ *n rs-^ mot M rnOl ^ loao »• 00 Oi ^r o c n ^000 M MOO MVlMt^^ (> rn N no »noo tn N 1^ ^vo ■■ tN. m ^ O O <^oo fn N (X moo c o tl"- : s 2-5- s> : « S ts 6 V e e 2 S ^ C ^ ?i >* bfl^ i3 > u o ^0 8 •4: « »n»0 O t<.0 « fs.0 sft^fs.-^ < « N O 00 in tO'O VI t/too o r^ IN 6 00 00 (s.o6 IS. 00 00 q6 < 2 OOmONtsONOO^rtN O nO 00 \0 ' O tsoo mtN^»n-^« tso rs m in>o tsONMftonori 00 o^^p o o* o^ »rt fivo m o^ in fO m fn ■♦ fi ♦ rs\o V ci m m m tsOO O^ O O »0 * O ^0 IS.O Onnf40oooonr« tnoo ts in 6 n6 6 " PT^p (>6o6 ■^00 ^ tN inqo 00 O^^ f*i O^ in *n ^ MM r^ m -^ n mx t** t^oc h o « sO 00 C^ f*l "^sO m«0 00 O w CT* m m m tso m o O r»o \p in ^ 4) 0>. < 2 InO^m <-inO O ^m ^l^f^M N ill'? 5i « c u g e 3 s - ST u o V > < s ■<; a ^ ^ ^^ ^ fc* ^ " ■^f o 3 'A o 4! •^ ,C s ♦* C << TJ •o j: C 3 s 1 b Si S i> XI IS o rt JZ •73 a » o . N X (A 1^ 3 u n O c c rt >4 ^ o c H g c 8 c 3 j: « .s 3 •o 3 !1 3 £: ^ ^ o >> >1 u. fl ^ E 1—1 s n ^ •J" c V H Sf •o OS u r* s > "j- M o 1) ■n a» < X 4) c M C ■5 o JJ c •c o >^ to c s 3 o o IXi 5 i . ■a rt r, ij rt rt JS u 4> n ■*- 4> o E 3 >, C c J3 ^ 3 C 1 • 3 v" 0) .t 9 1 8. IVeeks of Maximum and Minimum Mortality, for all ages, in Montreal. Highest Mortality, in week ending 1866 1867 1868 July 21. .121 .185 209 27 18. Lowest Mortality, in week ending It" une 9.44 ec. 1-45 Nov. 2.39 Jan. 18.48 Which is at the Range of yearly rate, per variation, at 1,000 living, of yearly rate MaxWiium Minituuin per 1,000. 54 19 35 82 >7 6S 89 20 69 Actual Range General Average of the of variation, between max. and min. weeks. ' 77 146 161 year, per 1000 3a- a 38- 3* 39-6 Or, for Children under 1 2 years of age only 1864' July 2.. 1 16 Oct. 22.. 25 S8 12 46 91 1 1 34» i86s " I. 103 " 28... 24 5. 10 40 79 1 26.8 1866 " 21.. 102 Jan. 6. ..25 48 II 37 77 21. 4 1867 " 27- '57 Dec. 28... 19 i 70 9 61 138 27-4 1868 '• 18.. 152 \ Jan. 18 \ Oct. 24 3^ 64 '' \ SO 120 1 38.8 Or, for Adults only : — 1864 Apr. 30..3C Sept. 3- • • • 7 186? Aug. 5.. 33 •' 23.... . 10 1866 May 19.. 37 July 14. . . .14 1867 " "--SS June 22. . . . 10 1868 JuIyi8..S7t Sep. 12. . . . 12 18 3 'S 16 5 II .8 7 II 16 5 II 1 ^4 5 19 29 23 23 25 45 II. 2 II. o II. o 10.9 10.8 • If the mortality (corrected for increase of population) had been calculated from September ist, 1866, to September ist, 1867, it would have given the death-rate of the year as 40.6 per 1000. t Thirty of these were from sunstroke: see note to Table 11. It appears that, with this exception, the range of variation for adults is remarkably uniform. These tables, compiled with the greatest attainable accuracy for the space of 14 years, prove to an absolute demonstration, after making all reasonable deductions for possibilities of error, not merely on the average of years, but in each single successive year, (1) that the mortality of Montreal is excessive as compared with the immediately adjacent country districts, under the same climatal conditions, but less favoured as regards wealth and intelligence; (2), that this excess is utterly disproportionate in the ratio of the deaths of children and adults; (3), that this excessive mortality of children uniformly attains its greatest height during the heats of summer. It is possible to bring out these facts with even greater distinctness. Thr^ mortality of July, 1867, having reached a higher point than that of any previous year without special epidemics or unusual heat, in spite of comforting assurances from the city 10 authorities that the yards had never been so well cleansed, the Sanitary Association instituted enquiries into the condition, during the same season, of New York and Boston, and analyzed the returns on the cemetery sheets to ascertain during what period of life the special mortality prevailed. The following are the results. 21. Analysis of Children's Deaths in Montreal, for the year 1867. Deaths. Under I year, (including 201 blanks, or still-bom.) Above I year, and under 5. Above 5 years, and under 12. Total Children under 12, Total, all ages above 12. 2,063 2,063 910 228 19.6 218 144.0 3.191 266 16.7 1.374 Condition* according to the 4.46s 203.0 Proportion of total deaths per Uader I year. I Total I under 5. Total interments Percentage of /o/a/ deaths ... ■•Percentage oichildntCs deaths Supposed number of children living, corrected from the census of 1861 Deaths of children, per 1,000 living at the same age ■ ■ ■ Or, I in every (living at the same age.) Ditto, average of 10 years Ditto, average of Lower Ca- nada, less principal cities . 2,063 46.2 64.6 5,158 399-9 i-5 25 ».973 66.6 93-2 19,627 151.4 6.6 7 o Total under 12. 3.191 71-5 100. o 37.761 84.5 11.8 130 27.0 Supposed number of persons I living m the city 1 Deaths per i,ooo living ai the same aee I Or, 1 in every j (living at the same age. ) Between 5 and 12. IS, 144 12.0 83 Total above 5. Total above 12. 96,981 j 78.837 '5-4 65 16.1 62 Total, all ages. 4.46s 100. o 1 16,608 383 26 38 96 Total, all ages. 116,608 38-3 26 It is evident, therefore, that the children from 5 years upward are remarkably healthy in this city, the principal reason being that all the moribund children are killed off at an earlier age. It is thost children who are confined to the house or to its immediate surroundings who are, in this city, so peculiarly 11 unhealthy. The principal causes of the death-rate, therefore, must be looked-for in the condition of the dwellings. But, as it is shewn that the special mortality of the city follows the months, not indeed for adults, but for childreu, let us examine whether it specially follows any particular period of childhood. 22. Deaths of Childten in Montreal, 1867, according to '*hs. ages and m. January . . . February . March • • • • April May June July August ... September October . . . November . December . Total. Under i year. Total. 94 109 159 126 13s 229 404 359 157 95 lOI 95 2163 Weekly average From I to s yrs. 23- 5 27.2 31-8 315 33-7 4S-8 lOI-O 71-8 39-2 237 25-2 19.0 39-7 Total ^^^•''y ^°'*'- average. 46 49 63 62 70 101 146 172 107 40 From 5 to 12 yrs. Total. 910 17s 22 16 26 13 18 32 28 16 13 12 1 218 Weekly average. 5-S 4.0 S-2 3-2 4-5 6.4 7.0 3- 3- 3- 3- I. 4-2 All ages under 12. Total. 162 >74 238 201 223 362 277 '47 140 142 319' Weekly average. 40- S 43- S 47.6 40.2 44-7 72.4 144.5 109.4 69.2 36.7 35° 28. 4 61.3 The numbers are so few in the third column that they cannot be relied on for averages in a single year ; but the very slight increase of June and July over the early months of the year is very noteworthy. In the second column, while the July death- rate is three times that of February, in the first colnjnn it is is nearly four times. It would appear, therefore, that the summer influences affect but slightly children above 5 ; and, most of all, those under 1 year. A single average year of life in each of the columns gives the following death-rate for an average week: — 12 23- Average Weekly Death-rate of Children in Montreal, 1 867, for each year of life. December July June, July, August April, May, September, October. Nov., Dec, Jan., Feb., March Average for year Under 1 year. From I to s. From 5 to 12. 19.0 lOI .0 1.9 91 0.2 1.0 72. 9 32.0 25-3 7.6 4-3 2.4 0.8 0.5 0.6 39-7 4.4 0.6 Total. 2-4 12.0 9.1 4.4 3-3 It appears, therefore, that a boy of 5 years has about 100 times the chance of life that can be hoped for an infant of months, both in December and July. But according to seasons, the older child has 42 chances of life, as compared with his baby- brother, in winter ; 6-1 chances in spring and uutumn ; and 91 chances in summer. So the child under 5, as compared with tlie baby, has 10 chances in December, 11 in July, ^\ in summer, 7^ in spring and autumn, 10^ in winter. On the average of the year, the child under 5 has nine chances of life as compared with the baby; the child ;ibove 5, sixty-six chances. Against what fearful odds do the iui'ants in this city struggle into life ! 24. Comparison of Montreal Children's Death-rate in air-poisoning, open, and frost-bound months. Average. Average weekly death-rate of children, under i year, 1867 . . Ditto, between i and 5 years . . 1867. . Ditto, between 5 and 12 years. .1867. . Ditto, all ages under 12 years . .186 Average week for 10 years, all ages. 867. Air-poisoning \ Open Months : Months : June, July, April, May, August. I Sept., Oct. 72.9 30-4 S-6 32.0 17.4 35 108.8 61.9 S30 39-2 Frost-bound Months : Nov., Dec, Jan., Feb., March. 25-3 9-7 4.0 39 3 34-5 That the excessive infantite mortality of July, 1867, was not due to exceptional climatal influences, will appear from the following statistics of Boston, obl'gingly furnished by Mr. Antonio, the 13 Registrar of that city. Boston is far more crowded than Montreal, with a much larger proportion of Irish lodging-houses, and with a raw, damp climate. But " the sanitary laws are good, audi faith- fully executed.''^ 25. Comparative Sanitary Statistics of Boston, 1867. Average population of Boston for previous lo years 178,500 Supposed " " for 1867 196,000 Total Yearly Deaths on the average of 10 years 2,474 Or, per i.ooo of present population 12.7 Deaths in highest month {A ugusi) on average of 10 years 461 Or, per 1,000 oj present population, at yearly rate of 28.2 Deaths in lowest month (June) on average of 10 years 299 Or, per 1,000 of present population, at yearly rate of. 18.3 Total Deaths during July, 1866 482 July, 1867 36s " August, 1867 432 Deaths of infants under i year, July, 1867 107 " children between i and s years, July, 1867 62 " " S and 10 years, July, 1867 18 " infants under i year, Aug., 1867 158 " children between 1 and 5 years, Aug., 1867 86 " " S and 10 years, Aug., 1867 22 Yearly rate of Deaths among 5,500 children under i year, July, 1867, per 1,000. 233.0 " " 24,000 " 5 years, " " 84.5 " " 43,000 " 10 years, " " 52.2 Deaths from Cholera infantum, July, '866 89.0 July, 1867 49.0 By correcting these numbers according to the ratio of Montreal population, it appears that the July deaths were here more than three times those of Boston, although an unprecedented number of families had left our city ; that of the total deaths in the year, only 39 per cent in Boston are of children under 5 years, instead of 65 per cent in Montreal ; and that of these only 24 per cent in Boston were under one year, instead of -16 per cent in Montreal. Of the children horn in Montreal, two out of every five died within the year. These being the frightful facts of the case, so far as they can be at present ascertained, it becomes the duty of every thought- ful citizen to enquire into their causes. The most evident of these is the fearful number of illegitimate children each year thrown away by their unnatural and most wicked parents, and placed under the fostering care of the Soeurs Grises at their Foundling Hospital. The condition in which they are received will be understood from the following table. 14 26. Condition of Infants received at the Montreal Foundling Hospital Condition. Without covering With only a cotton cloth Almost frozen Bleeding through want of the necessary offices at birth Not washed after birth' Wounded by Instruments Tainted with Syphilis Sick Dying Dead With bloody flux With Hoemorrhage of the lungs Not classed as above, but frequently ) covered with vermin ) Total received iS6s. 1866. 1867. 1868. 334 i8 286 424 10 293 6 7 20 '5 11 13 25 3> 8 84 29 4 80 18 8 46 30 7 139 118 28 8s 26 .'7 23 *2 18 2 .... 3 4 'S 13 .... '3 10 8 8s 75 20 94 729 624 652 678 Total. 1.337 28 33 64 108 27 349 300 95 9 28 31 274 2,683 Whenever there appears a chance of life, these infants are sent into the country, in the care of nurses under surveillance. Even under favourable circumstances, there would be but poor chance of saving the livesof most of these abandoned ones; but it appears from a Report presented by the Medical officers to the City Council that the nurses are often unable to supply them with natural aliment. When they die, the corpses are sent to Montreal for interment, and are entered in our city bills of mortality, as their baptisms had been in the Protonotary's returns. The following statistics have been compiled from the Register of Deaths kept at the Hopital G^n6ral. 15 2/. Mortality at the Montreal Foundling Hospital. Year. 1863 j 1864 1865 1866 1867 t868 Total. Average of six years. January February March 26 ; 49 33 1 22 38 54 48 ! 53 59 1 43 80 ! 6e 58 38 ^7 SI 68 104 70 4' 43 42 31 39 34 43 68 66 68 94 64 35 50 36 32 32 34 *7 47 S3 82 101 8S 43 31 44 35 34 33 48 61 6i lOI 94 76 49 29 34 25 23s 193 282 344 333 464 S8i 417 252 246 241 210 39 32 47 57 55 77 97 69 40 35 lii^y Tune ■ lulv 102 63 48 43 39 45 86 59 36 5° 46 42 September October November December Total 623 8 605 16 66s 20 629 IS 634 '5 642 t 3.798 74 t t Deduct .^. Years. Si- 's 3 o- 147 8 6 12 •9 45 II ToUl Ci and Country 1865 44 40 42 .30 II IS 26 25 7 29 44 I 2 I 286 176 239 322 729 1866 83, 18; 9 98I 20 »t 624 1867 652 1868 IIO> ^^ 30 86 21 678 440 no 120 30 Total..... Yearly average. 156 39 67 »7 105 26 4 I 1023 256 2683 67. A comparison may now be instituted between the mortality of ordinary children and those neglected by their parents. 3 1 . Comparative Mortality of Montreal Foundlings and Ordinary Infants. 1867. Baptized. Interred. Or, per lOO living ac same age. Total, Montreal Infants 5.598 652 4.946 I i«8 2,063 583 1,480 I in 2.5 36-8 89.4 29.9 (extra deaths) 59.5 17-4 Of whom were FoundliriE'S *' Ordinary Children Proiiortioii of Foundlings to ditto Total, Boston Infants In comparing Montreal with other cities, it would not be fair to make deductions for the peculiarities of our local institutions, beciuso such peculiarities aflfect all large cities more or less ; but, for the satisfaction of the inhabitants, the following table may be given. The strangers who are baptized in the city may be reckoned against those born here who are not baptized as infants. 32. Corrected Death-rate for Montreal City. Year. Total Deaths. Proportion for Deaths of Imported Children. Deaths of natives and ordinary inhabitants. Corrected Death-rate per 1,000 living, at all ages. Total Death-rate. 1865 4.02s 3,610 4,46s 4,842 258 .64 219 302 3,767 3.446 4,246 4,540 36. 3 30- 9 36- 4 37-2 37-8 32.2 38. 3 39-6 1866 . 1867 1868 Average of 4 years 4,235 236 4,000 35-2 36.9 19 It follows that, although a portion of the lowered death-rate in 1866 was due to the unusually small number of infants received from the country, the balance, as compared with the average of the years before and after, viz., no fewer than 550 lives, or 54 per 1 ,000 inhahitants, may fairly be assigned to the anti-cholera cleansing. What a rebuke it gives to the members of the Council, and to the citizens who intrust to their care their own health and the very lives of their little ones, that in each succeeding year, notwithstand- ing the yearly boast that " the city was never so clean before," the death-rate has risen even above the previous number, humiliating as that is as compared with much larger and more crowded cities ! This table further rebukes those who attribute our excessive mortality to the strangers received at the Foundling Hospital, by showing that the average deduction to be made for this cauSe only amounts to 1*7 deaths per 1,000 inhahitants. At the discussions which were held at the Natural History Society on this subject, a great variety of causes were assigned for the excessive mortality among our children. Probably all of these have more or less effect; but many of them apply with, fully equal, if not greater force to other cities ; and others again apply to the country districte just as much as to ourselves. Thus the frightful number of unwelcome children born among us, averaging 400 yearly, besides those who are provided-for by their parents, may be attributed in part to the large garrison which has been till lately stationed here ; but it is the fruit of the same sin that curses humanity eslewhere. A large number of infantile deaths are undoubtedly caused by the drunkenness of their parents ; but Montreal is not an unusually drunken city. The milk sold by many dealers is of inferior quality ; but taking the city through, it is probably better and cheaper than in most English cities. Errors in diet, and deficiency of parental care are undoubtedly grievous causes of disease ; but there is no reason to think that Montreal mothers are less careful and enlightened than in the country round : they ought to be more so. As to unripe fruit, &c., the country children get far more of it than we; and at the ages at which city children get most of it, it has been proved that they are unusually healthy. And as to the idea that catholic infants are predisposed to death from exposure to cold through the custom of early christening, it so happens that the coldest months, during which this cause ought to operate most, are by far the lowest in the death-rate. 20 Tt is only distracting attention from the main and solemn issue, thus to beat around the bush. Every thoughtful person who has observed and studied the simplest facts and first prin- ciples in sanitary science, must be aware that a sufficient cause for all our deaths is to be found in the filth and pollutions which are allowed to remain in our midst, and which poison the air, more or less, of the whole city, but most of all of the low and swampy districts. A large proportion of the inhabitants pour their slops daily on the spongy soil around their dwellings ; house drains or even paved water-courses are little known ; the contents of privies surcharge the porous earth around ; and our back-yards, unusually large as compared with English cities, and which ought therefore to add greatly to our healthiness, aro only so many more square feet soaked through and through with foetid matter, forming (except during the merciful winter frost) an incesssant poison factory, wafting disease and death into our dwellings. A large number of our houses are built on stumps driven into this putrid soil or even marsh ; the collars are always charged with miasms, which find their way into the upper rooms ; and too often the houses, even if not back to back, have no doors or windows except on one side. Very lately an M.D. of this city, with above the average of reputation, planted a group of cottages of this description on one of the worst undrained swamps in our midst. As if these evils, which may not meet the gaze of strangers, were not enough, the corporation persist in laying most of the streets in soft limestone, which in a very few days is ground to fine dust, and soon becomes charged with effete animal matter, in which form it enters our dwellings and lungs ; or else it is in a state of mud, which emits so nauseous a stench that cottagers, who have shut their back windows to keep out the smell of the yards, are obliged to shut the front also to keep out the smell of the street. It is impossible fiithfuUy to execute the contracts for street-cleaning, while this stone, long since reported against by the City Surveyor, and theoretically abandoned by the Road Committee, continues in full use : and as to the vaunted scaveng- ing by-law, the Council have re/used the money to carry it out ! It may be said with very few exceptions, that in the more crowd- ed parts of the city inhabited by all except the wealthy, there is scarcely a square yard of ground which is not charged with effete matter, ready to generate poisonous gases under the influence of every summer sun. 21 - The foregoing may be regarded in great measure as errors of neglect or ignorance; but the very remedies applied at high cost are continual causes of disease. A large part of the older sewers in the city are made of absorbent and now putrid wood ; and al- though the Council have determined to la^ down no more, the brick sewers are often so badly constructed that the effete matter oozes through them, and deposits soon accumulate in their slug- gish course. Moreover a large proportion of the house drains, even in high-rented dwellings, are still made of wood and un- trapped. Only the new sewers are trapped at the gulley-holes ; and at times, and in special places, the stench from these old poison pits is insupportable. Thus our sewer ?ud house drain system may be called (with few exceptions) an express contrivance for conveying the ordinary air-poisons, and the extraordinary infec- tions of small-pox, scarlatina, &c., into every part of the city ; and especially from the low into the higher levels, lest the rich should selfishly conclude that they were not affected by the evils which they allow to scourge the poor. The prevailing currents of air also, in the general direction of the river, v^hile they serve somewhat to mitigate the unheafthiness of Griffintown, carry the air-poisons over the higher districts, where, being intercepted by the " Mountain," they impinge upon the fashionable streets and villas of our city. Infants are more dependent on pure air even than children ; they, more than adults ; yet to all of us, unvitiated air is a necessary condition of health. Moreover, infants cannot escape from the air of their dwellings, nor from the poisons which fester there. The infantile death-rate is therefore the readiest thermometer, by which we estimate the virulence of poisonous emanations. How this thermometer rises and falls with the heat of the sun, has here been shewn. So far from wondering why so many children die in this city, we might rather wonder how so many manage to struggle into life, against such murderous forces. All these (as well as other) corrupting influences must be removed, if we hope to render up our account to the great Judge, free from the blood of these hundreds of children, to whom the Lord gave Life ; who in their helplessness cry to us to nurture and guard it; but whom we, to save a few wretched dollars and a little toil and trouble, consign to a premature and therefore to a guilt-bearing Death. Montreal, July 20th, 1869.