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Annual Report of the Medical Officer of Health—1896. 11
well known to specialists in children's diseases that " wasting " constitutes one of the
commonest causes of death among infants. Thousands of children die every year in
London simply because they are fed on food which they cannot digest, and which acts
as an irritant to the stomach and intestines.

From the foregoing list it is seen that "debility, atrophy, and inanitation," is
returned as the chief cause of infantile death in St. George's. This ill-defined group
refers mainly to chronic wasting disease, produced by malnutrition, which is again a
consequence of improper feeding. The infants fed on mother's milk for the most part
escape these fatal consequences, which chiefly aSect children brought up by hand.
The many causes leading to loss of infant life in St. George's may be thus
summarised:-
(1) Bad environment, such as insanitary conditions, overcrowding and absence of
parks and open spaces. (2) Improper and insufficient food. (3) Mismanagement
through maternal ignorance. (4) Early marriages. (5) Debility, disease and dissipation
of parents. (6) Maternal neglect, due to mothers being more or less employed
away from home in factories and workshops. (6) Use of opiates; usually in the form
of patent medicines.
The question of how to lessen the excessive destruction of child-life is an important
one. It is a complex result traceable to many causes, each of which demands careful
consideration and separate treatment. Among general measures it may be broadly
stated that anything which tends to raise the standard of wholesomeness of a district
will also help to diminish the infantile death-rate. Another valuable aid to prevention
would be the education of parents generally in the simpler laws of healthy living with
special reference to the diet and clothing of their oSspring.
Without active and intelligent help on the part of those interested in the care of
children, special measures of the local authorities will be of little avail in checking the
disastrous loss of life which occurs under five years of age in all our great centres of
population. Before leaving this subject I would again urge upon your Vestry the
desirability of the founding of creches.
The necessary site for such a day nursery might perhaps be found in the Falcon
Court Area, which should be available to a greater or less extent for public purposes.
Another portion of the Area might with advantage be laid out as a playground for the
children of this poor and crowded district.