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104
seen that the general mortality has fallen during this period from
23.7 per 1,000 to 19.6 per 1,000 of the population—a diminution in
the general mortality of 41 per 1,000 persons. That is to say, the
annual deaths in London during the last decade of the nineteenth
century were four less for every thousand inhabitants than fifty
years before, i.e., on the present population of London there is an
annual saving of lives amounting to 18,179. This does not represent
the whole improvement from a Public Health point of view enjoyed
by the present population of London over that of 1851. It is calculated
that for every fatal illness there are at least three eases of
recoverable sickness. There is, therefore, a diminution of sickness
corresponding to 54,537 cases per annum.
But while the general mortality in the periods mentioned has
declined to the extent of 41 per 1,000, this is not so in the special
case of the death rate under one year of age—the infant mortality.
Reference to the above table will show that not only has the
infantile mortality not declined, but that during the decade 1891 to
1900 it shows an increase upon the rate for the decade 1851 to
1860 to the extent of 5 per 1,000. This means that five more infants
died annually during the last decade per 1,000 infants born, i.e.,
taking the number of births in London during the year 1901, which
was 131,278, as an annual average, the increase of 5 per 1,000 on
the infant mortality means 656 deaths annually more than if the
rate of 1851 had been maintained. It may here be added that the
same phenomena are exhibited by mortality statistics relating to
Hackney for the same periods. The different behaviour of the
general mortality rate, and the infant mortality rate, the former
continuously falling, and the latter rising, naturally provokes the
enquiry why, coincident with a declining general death rate, there
should be a rising infant death rate.
Now, there is perfect agreement among hygienists of all classes,
that the chief cause of the reduction in the general death rate, and
the sick.rate, witnessed in London and in the country generally
during the last half century, is the direct result of the public health