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The fact that London experienced in 1908 the lowest recorded infantile mortality rate is matter
for congratulation, but it needs to be remembered that this rate is liable to considerable fluctuation
owing to climatic conditions and varying degrees of prevalence of epidemic maladies. Diarrhœa,
which is largely dependent upon the temperature of the summer quarter, in 1908, caused 919 deaths
more than in 1907, while bronchitis and pneumonia caused 500, and measles and whooping-cough
344 fewer deaths in 1908 than in 1907, compensating for all but 75 of the excess of deaths from
diarrhœa, which, while more numerous than in 1907, was still markedly below the average
number of deaths from this cause during the preceding ten years. The number of deaths from
bronchitis and pneumonia appears often to vary with the prevalence of whooping cough and influenza.
Thus, if the number of deaths from these causes during each of the last twenty years is compared
with the number for the antecedent year, it is found that when the deaths from whooping-cough
under one year of age, and from influenza at all ages, both show decline or increase above the number
in the preceding year, the number of deaths from bronchitis and pneumonia under one year of age
frequently show also decline or increase. Whooping-cough and influenza both declined or both
increased ten times during this period, and on seven of these occasions there was corresponding
decline or increase in the number of deaths from bronchitis and pneumonia under one year of age.
The infantile mortality rate is in point of fact, extremely sensitive to influences which vary from
year to year, and for the effects of which administrative effort can as yet but imperfectly compensate.
The result, therefore, of the efforts which are now being made to lessen infantile mortality must not
be judged by the mortality of the moment. It is sufficient that these efforts should be rightly designed
and properly applied, and there need be no feeling of doubt that when the accumulated experience of
some years is available, it will prove them to be of value. The difference between the rates of infantile
mortality in districts well and badly circumstanced socially is sufficient indication of the results which
might be obtained if the infants of the less favoured districts had extended to them the same care as that
bestowed upon infants of the better favoured districts.