TABLE 1.-Registration Districts with Birth-rates above or equal to the State

In addition to the districts ranked in the above table, the only ones with annual birth-rates of at least 10.0 are Santa Rosa city and the counties of Calaveras, Marin, San Benito, San Mateo, San Joaquin (outside Stockton), Sierra, and Sutter.

It will be observed that the registration districts with high birthrates include nearly all the cities having freeholders' charters, Salinas with 9.8 and Stockton with 8.8 being the only cities with rates below 10.0, and Eureka being the only freeholders' charter city not reporting vital statistics. In fact, for the twenty freeholders' charter cities, with a total estimated population of 916,459, the 12,962 births give a birthrate of 14.1 per 1,000 inhabitants. But for all the rest of the State, with an estimated population of 868,062, the 7,947 births give a birthrate of only 9.2, or 4.9 less in each 1,000 than for the cities. As a rule, it is more difficult to secure complete registration of births in rural districts than in urban centers, though there are several counties where the Recorders as local registrars have obtained satisfactory returns of births.

Sex and Race.-The proportion of the sexes among the 20,909 children born in 1905-1906 is: Male, 10,835, or 51.8 per cent; and female, 10,074, or 48.2 per cent. The race distribution is: White, 20,537, or 98.2 per cent; Japanese, 156, or 0.8 per cent; Chinese, 141, or 0.7 per cent; negro, 70, or 0.3 per cent; Indian, 5, or less than one-tenth of 1 per

cent. The per cents male and female are the same for the white as for all children, 51.8 and 48.2 per cent, respectively, but among the 372 non-Caucasians the males were 198, or 53.2 per cent, and the females 174, or 46.8 per cent.

No marked differences appear between various sections of California, either in the proportion of the sexes or in the race distribution. Thus, among the several geographic divisions into which the fifty-seven counties of the State have been grouped the per cent male varies only from 52.9 for the interior counties of Central California to 51.1 for the interior counties of Northern California and for the coast counties of Central California. Similarly, the per cent white ranges only from 99.1 for the six counties of Southern California other than Los Angeles to 97.1 for the City and County of San Francisco.

Nativity of Mothers. However, there are great differences between certain sections of the State in the nativity of the mothers of the white children. These differences are shown in the table below, giving the number and per cent of white mothers born in California, born in other states, and foreign born. The few of unknown nativity, numbering only 172, or 0.8 per cent of all in the entire State, have been included with those born elsewhere in the United States than California. Figures are shown for each of the geographic divisions of the State heretofore described in the Monthly Bulletin (Vol. I, No. 8, p. 55, January, 1906), and also for the metropolitan area, comprising San Francisco and the other bay counties (Alameda, Contra Costa, Marin, and San Mateo), in contrast with the rural counties of Northern and Central California.

TABLE 2.-White Mothers Classified by Nativity, with per cent Distribution, for Geographic Divisions: 1905-1906.

It appears from the preceding table that of the 20,537 white mothers bearing children in California in 1905-1906, 7,683, or 37.4 per cent. were natives of the Golden State; 7,478, or 36.4 per cent, were natives of other states, and 5,376, or 26.2 per cent, were foreign born. per cents for Southern California, however, differ greatly from those for either Northern or Central California.

The

South of Tehachapi the great bulk of the white mothers, 59.6 per cent of all, were born in other states than California. In Los Angeles county the per cent foreign born is even greater than the per cent born in California, though in the other six counties south of Tehachapi the California born mothers at least outnumber the foreign born.

North of Tehachapi, especially far north, the bulk of the white mothers were natives of the Golden State, the per cent born here being 54.7 for Northern California and 43.2 for Central California. In each division of Northern and Central California, except only in San Francisco, the per cent born elsewhere in the United States than California is greater, and except for the other bay counties is much greater than the per cent foreign born.

In San Francisco, as in the rest of Northern and Central California, most of the white mothers were natives of the Golden State. In the metropolis, however, the native daughters bearing children are followed closely by the foreign born, the per cent being 41.9 for the former and 39.6 for the latter, while those born elsewhere in the United States than California comprise only 18.5 per cent of all the white mothers. In the other bay counties (Alameda, Contra Costa, Marin, and San Mateo), where, as in San Francisco, 41.9 per cent of the white mothers were born in California, the per cent born in other states is about the same as the per cent foreign born, 29.1 against 29.0.

For the metropolitan area, comprising San Francisco and the other bay counties, the per cents of white mothers born in California and in other States are lower than the corresponding per cents for the remaining rural counties north of Tehachapi. Conversely, the per cent foreign born is much higher for the metropolitan area than for the rural counties of Northern and Central California.

VITAL STATISTICS FOR JULY.

Summary. The vital statistics reported for July are as follows: Living births, 1,720; deaths, exclusive of stillbirths, 2,180, and mar riages, 1,885. For an estimated State population of 1,882,483 in 1906 the returns for July give the folowing annual rates: Births, 11.0; deaths, 13.9, and marriages, 12.0, per 1,000 population.

As usual, tuberculosis was the leading cause of death, and typhoid fever was the most fatal epidemic disease. Between June and July there was a decline in the proportion of all deaths due to diseases of the respiratory system, but, on the other hand, there was a rise in the proportion for diseases of the digestive system, especially infantile diarrhea.

Causes of Death. The following table gives the number of deaths due to certain important causes for the State in July, as well as the proportion from each cause per 1,000 total deaths for both July and June:

Tuberculosis, as usual, was the leading cause of death in July, with diseases of the circulatory and nervous systems next in order. The proportion of all deaths due to pneumonia and other diseases of the respiratory system was much less in July than in June. On the other hand, there was an appreciable rise between June and July in the proportion of all deaths caused by diseases of the digestive system, especially diarrhea and enteritis among young children.

Typhoid fever is again the most fatal epidemic disease in the State. The proportion of all deaths due to typhoid fever was even greater for July than for June, though the proportions for all other epidemic diseases declined.

MENTAL HEALTH OF SCHOOL CHILDREN.

As the end of the school year approached the newspapers brought the usual crop of sad stories with regard to children on whose developing mental faculties the pressure of school work had made serious havoc. At the end of May there began to be occasional reports of children disappearing from their homes, running away from school, and otherwise making themselves subjects for newspaper comment more than at any other season of the year. During June the stories of children, especially girls, who were noted as acting queerly as the result of overwork at school, became more frequent. Toward the end of the month there were a few reported suicides. In most of the cases a direct connection between worry over school work, competition for prizes, and preparation for examinations could be traced. Of course, we realize that there is likely to be considerable sensational exaggeration in such stories. They make toothsome morsels for the sensational newspaper, but there is no doubt that there is a large germ of truth

in most of the stories, and that, unfortunately, there is every year during June an increased number of reported developments of mental disturbance in children because of the burden of school work placed on them at this time.

Almost needless to say, the children who develop such mental peculiarities and degenerate traits are not the robust, either of mind or of body. Especially is it true that in most cases a distinct neurotic family history can be traced. This, of itself, however, should have proved a warning of the necessity of guarding such children against the stress and strain of competitive school work. Unfortunately, little attention is likely to be paid to this. Family physicians, however, usually are aware of the dangers in this matter, and should warn parents of the possibility of morbid results. At this season of the year the medical inspectors of the schools should take special precautions in order to see that any pupil developing even slight mental peculiarities should at once be reported to them. There is serious danger of neglect and delay in this matter. Even with the exercise of all due care it seems not unlikely that in the modern over-strenuosity of education developing brains will suffer occasional lamentable harm. If even a few children, however, each year can be saved from the more serious manifestations of mental disturbance, enough will have been accomplished to reward amply every effort that has been taken.

It is now, while the subject is fresh, that the resolution with regard to prophylactic measures for another year should be taken. There seems no doubt that it will eventually be necessary to instruct the teachers as to the initial symptoms that are displayed in the commoner mental disturbances of children, in order that the strain of study may be then at once interrupted. This is a work that in its far-reaching benevolence will appeal to all who are interested in making child life more happy and less amenable to the stresses of modern civilization. No effort can seem too great, no warning exaggerated, that concerns school children under such circumstances, since it is evident their future careers and life usefulness are at stake.-Journal A. M. A.

The above article is quoted in its entirety, for no part should be left out, as it applies with the greatest force to California schools. It seems to be the effort from primary grade to university to crowd the child's brain to the utmost, and each year we see wrecks, mental and physical, leaving our schools.

The object of education is to make better citizens, and this is defeated by the very efforts put forth for its accomplishment. The medical inspectors should be a part of our school organizations, and the position should be filled by one skilled in diagnosis, deeply interested in child life, and with a willingness to work a little extra time for the good of the cause.