14

   It will thus be seen that the epidemic mortality has very definite characters.

   Following the weekly deaths at Amritsar for each age separately the curve for
children under two years was found to rise almost sheer reaching its maximum in
the second and third week of October, but at once falling rapidly. The curve of
children under 10 rises more slowly and reaches its maximum in the first week in
November. The curve of adult deaths rises still more gradually and reaches its
maximum only in the last week in November. The curve of old people resembles
that of children under 10.

   Looking at the curve shown by deaths in Amritsar it will be clear that its con-
formation is largely due to the facts we have described. The first rush upwards of
the line and the first peak is largely due to the sudden mortality amongst infants and
young children, the second peak is due to the increasing deaths amongst adults
together with the continuance of high death rate among children under 10.
Between the two peaks is a notch which is always shown in the figures for different
parts of Amritsar city. A similar notch is seen in the curves for Delhi and
Palwal.

   At Bhera and Miani where adult mortality was low the second peak or hump
is not apparent, nor is the same breadth of the curve visible. Both characters are
seen, however, in the curves for Sonepat, Mehrauli and Jhelum. At Palwal the
second peak due, as at Amritsar to deaths among adults reaching their maximum
later than did those among infants, is even higher than the first.

Stillbirths.

   Associated with the increased mortality at Amritsar was an extraordinary
increase in deaths returned as "stillborn." The increase was so great, reaching,
in the four months September to December, the figure of 568, that it must be con-
sidered part of the effect of the epidemic. Since the records come from the ceme-
teries the term stillbirth could scarcely have been applied to any condition other
than a birth within the last three months of pregnancy or to children dying within
the first day or so of birth. We may (in order to see the significance of the figures
and allowing a latitude greater than we have indicated) consider that deaths
recorded as stillbirths represent deaths in the fœtus during the last six months of
uterine life. In this case the number for a year would be 1,136 or nearly as high
a rate as occurred amongst children after birth. If stillbirths were taken as
representing the mortality among fœtuses three months or less prior to birth, the
rate would almost continue the curve of mortality into the prenatal condition.

   The distribution of stillbirths also does not follow that of the adult mortality,
but reaches its greatest height at the same period as deaths among children under
two years.