Unfortunately, there is no reason to suppose that the infantile death-rate in the United States is nearly so far below that of England as is generally supposed. The general death-rate is given in the census returns as 16.3 per thousand, or about two per thousand less than in England. But owing to a variety of causes, chief of which is the defective system of registration in several states, these figures are not very reliable, and it is generally agreed that the mortality for the whole country cannot be less than for the “Registration Area,” 17.8 per thousand. Similarly, the difference in the infantile death-rate of the two countries is much less than the following crude figures contained in the census reports appear at first to indicate:— ═════════════════════════════════╤═════════════════════════════════ UNITED STATES │ ENGLAND AND WALES ─────────────────────────────────┼───────────────────────────────── Deaths at all ages, 1,039,094│Deaths at all ages, 587,830 Deaths under 1 year, 199,325│Deaths under 1 year, 142,912 Deaths under 5 years, 317,532│Deaths under 5 years, 209,960 ═════════════════════════════════╧═════════════════════════════════ In the English returns the death of every child having had a separate existence is counted, even though it lived only a few seconds, but in this country there is no uniform rule in this respect. In Chicago, for instance, “no account is taken of deaths occurring within twenty-four hours after birth,”[12] and in Philadelphia a similar custom prevailed until 1904.[13] Such facts seriously vitiate comparisons of the infantile death-rates of the two countries which are based upon the crude statistics of census returns. But while the difference is much less than the figures given would indicate, it is still safe to assume that the infantile death-rate is lower in this country than in England. Such a condition might reasonably be expected for numerous reasons. We have a larger rural population with a higher economic status; new virile blood is being constantly infused by the immigration of the strongest and most aggressive elements of the population of other lands; our people, especially our women, are more temperate. All these factors would tend naturally to a lower death-rate at all ages, but especially of infants. [Illustration: Danny’s Best Smile ] [Illustration: Rickety, Ill fed, and Neglected ] RACHITIC TYPES