By Victor J.Fourgeaud, , Of St. Louis.
[Population of St. Louis in 1841, 30,000. Latitude, 38 deg., 37 min., 28. see
Longitude, 90 deg., 15 min., 39 sec. west of Greenwich.]
In the year 1841 there were 935 deaths in the city of Saint
Louis — 447 of which were persons over 7 years of age; and
488 were children under 7 years of age.
The mortality among children under 7 years of age was great-
er than among persons over that age; the difference being 41
in favor of the latter. The ratio of mortality among children,
in proportion to the whole population, was a 1 to 61. The
month of July was the most fatal, both to children and adults.
In the year 1842, there were 658 deaths — 388 of which
were persons over 7 years; and 270 were children under 7.
This year was peculiarly favorable, especially to children;
only 270 having died, being 218 less than in 1841, and 375
less than in 1843. The whole number of deaths was 658; 277
less than in 1841, and 481 less than in 1843. This was a very
moderate mortality for a city having at least 30,000 inhabitants.
The ratio of mortality among children, in proportion to the
whole population, was as 1 to 111.
In the year 1843, there were 1139 deaths — 494 of which were persons over 7 years; and 645 were children under 7.
This shows a great increase of mortality, especially among
children; 645 having died, making the aggregate number of
deaths among them amount to 151 over that of all other persons
over 7 years of age. July, August, September and October
were peculiarly unfavorable to infants; no less than 477 having
died during these four months. August, particularly, seemed
to have been the most fatal for them; 209 having died in that
month. The ratio of mortality among them, in proportion to
the whole population, was as 1 to 46.
Thus, there were 1403 deaths among children under 7 years
of age in the course of the last three years. The number of
fatal cases among persons over that age amounts to 1329, being
74 less than among children. The whole mortality in St. Louis
for that period amounts to 2732, including adults and children.
Thus the average mortality of this place rates at 910 2/3 per
annum, or as 1 to 33.
The four first months of the year were most favorable to
children, April especially, only 25 having died in this month
during the thee years. July, August, September and October
were the most unfavorable, especially July and August, 313
having died in the former, and 322 in the latter month, in
During these three years, the diseases most fatal to children
were, cholera infantum (238) and convulsions (147: total, 385).
The whole number of deaths among children being 1403, if
we deduct from this number 297 cases reported as unknown, we
will have 1106 known cases; and we will perceive that these
two maladies alone (cholera infantum and convulsions) have
carried to the grave more than one-third of the whole number of
children whose diseases were recorded.
Respecting convulsions, we deem it only necessary to remind
the reader, that generally they are but a symptom of other
diseases, such, for instance, as encephalitis, meningitis, &c.;
they are often sympathetic, and produced by affections distinct
from those of the nervous centres, as dentition, worms, &c.;
lastly, they may be essential or idiopathic; but these cases are
said, by our most distinguished pathologists, to be of rare
occurrence. We earnestly call the attention of the profession
to this subject, and entreat them to abandon the vague term,
"convulsions," when it denotes but a symptom, and call dis-
eases by their proper names. We urge this because, as we
have already said, they are a symptom attendant on different
diseases, which it would be dangerous to confound. We
should err in believing that during the last three years 147
children have died of "convulsions, essential or idiopathic;" we
can only conclude, that during that time 147 have been the
victims of different diseases, having convulsions for a symptom.
Of the 238 children who died of cholera infantum, the num-
ber of males far exceeds that of females. With one solitary
exception, this was invariably the case during the summer
months of the three years recorded. We know not whether
this fact is of general occurrence, or whether it has been
before remarked by any author. We respectfully request the
physicians of other cities to examine and decide the matter.
Opposed as we are to hypotheses, which has so often misled
our science, and knowing no good reasons by which to account
for this disproportion, so uniform in the statistics of this place
for the last three years, we merely call attention to the fact,
and refrain from all speculative explanations.
The deaths from cholera infantum average in Philadelphia
232 for each year; population, 200,000. In Washington, 44;
population, 18,000. In St. Louis, 79, population, 30,000.
Thus, in Philadelphia, there is 1 death from cholera infan-
tum for every 862 inhabitants; in Washington, 1 do., 411 do.;
in St. Louis, 1 do., 375 do.
Thus, we see that, in other places as well as this, the disease
often baffles the most skilful physicians. It is true, that the
mortality occasioned by this bane of infancy, during the past
year in St. Louis, was most alarming — amounting to 238,
which was in the ratio of 1 in every 126 inhabitants. But the
cause of this I sincerely believe to be the want of proper medical
attendance. I neither desire nor intend to insinuate aught
against my fellow practitioners; on the contrary, our city has
reason to be proud of her physicians. I is not to them, nor to
their mal-practice, that this great mortality must be attributed.
Mothers! it is because you neglect to seek their aid: it is
because you do not employ, or employ them too late, that so
many of your offspring are torn from your embraces. Every
boat brings us a multitude of poor families unable to fee a phy-
sician. True, no man deserving that title, and the respect
due to it, whould refuse his advice and attendance, because
a suffering being could not show the price of the consultation.
Often money cannot pay the physician. His reward — the
greatest, the noblest, is in his heart — in his conscience. A
philanthropic institution has been established in this city — an
institution consecrated to the poor — the dispensary: but either
they know it not, or neglect to avail themselves of its aid. Old
nurses and charlatans are resorted to; substances injurious,
perhaps poisonous, for the infant invalid, are administered in
repeated doses, and the poor baby dies, less the victim of disease,
than of unwise remedies employed for its relief.