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11
patient becoming diffused and appreciated in the circles in which he
moves.
The main difficulty amongst the poorer classes is the fact that the
early stage of phthisis is very often insidious in its onset, and that
the persons affected do not seek medical advice and treatment until
the disease has already progressed beyond the initial stage, irreparable
damage to the lungs having already occurred, and the patient being not
only unable to continue his employment, but being also unsuitable for
sanatorium treatment by reason of the stage of the disease attained, and
the doubtful prognosis for cure or arrest. There is also the difficulty
experienced in persuading the bread-winner of families to stay for a
sufficiently long period in the sanatorium to obtain permanent benefit.
The question of the provision of gratuitous open-air sanatoria by
the Metropolitan Asylums Board is still under consideration by the
Local Government Board—the Board being understood to be awaiting
a report by its expert medical advisers on the results so far attained by
open-air sanatoria in this country and abroad.
Of the 112 deaths from phthisis in Chelsea in 1905, 60, or
53 per cent. of the total, occurred in the Chelsea Workhouse Infirmary,
and 9, or 8 per cent.. in other public institutions, so that only 39 per cent,
of the total deaths from this disease occurred at the patients' own
homes. The later stages of this disease being generally acknowledged
to be the most dangerous as regards the communicability of infection to
other members of the family or household, it is evident that amongst
the poor the ability of the consumptive to spend his last days in the
Infirmary is as much a gain to the public health as it is a mitigation of
suffering to the dying person.
Births and Deaths of Infants under One Year.—During the
year 1905, 30 births were registered as occurring amongst the occupants
of industrial dwellings in Chelsea (including Sir Thomas More Buildings,
Beaufort-street). This is equal to a birth-rate of 25.6 per 1,000, as compared
with a birth-rate of 21.3 per 1,000 for the whole Borough. The
deaths of infants under one year of age numbered 8, which is equivalent
to 100 per 1,000 births, or 10 per cent., as compared with a rate of
116 per 1,000 for the Borough.
In the 11 poor class streets, 127 births were registered, equivalent
to a birth-rate of 30.8 per 1000, and the deaths of infants under one
year numbered 25, or at the rate of 197 deaths to 1,000 births. It follows,
therefore, that whilst the birth-rate in these streets was 17 per cent, in
excess of the birth-rate in industrial dwellings in Chelsea, the rate of
infantile mortality was very nearly double (97 per cent. in excess) that
of the industrial dwellings.
INFANTILE MORTALITY.
During the past year, 1905, there has been a very satisfactory
decrease in the rate of infantile mortality in Chelsea (deaths of infants
under one year to 1,000 births), and also in the deaths of children aged
1 to 5 years, as shown in the following Table:—