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does not follow that all or any of these deaths were caused by
errors of treatment or food, which might have been obviated had
the mothers received official instruction and advice in the management
of their infants. The poverty of parents, which acts prejudicially
in the way of causing lack of attention as well as of food,
and the infant's own poor material, are factors which can neither be
eliminated nor overlooked.
The deaths from convulsions showed an increase of 23 over last
year. The infantile deaths from tuberculosis were slightly less in
the meningeal form, but there was an increase in the abdominal
type. No deaths were recorded either from scarlet fever, small-pox,
or chicken-pox, while those from whooping cough were the same in
number as last year. Measles was responsible for 16 deaths, compared
with 21 in 1912 and 29 in 1913.
There was an increase of seven deaths in syphilis.
Of the 6,671 births registered there were 5,865 notified, of
these 3,129 were received from midwives, and 139 from nurses.
These figures have some interest as showing the great number of
women that are not attended in their confinement by medical
practitioners.
There were only 18 deaths from diphtheria, one less than last
year, which in its turn showed a decrease of five from the year
before. The notifications, on the contrary, showed an increase of
75, but this by no means indicates a definite increase in the prevalence
of the disease, but rather that many reports are now sent
of diphtheria in which there is no clinical evidence of its existence,
but only of slight or severe sore throat, the diagnosis being made
as the result of a bacteriological examination.
The question of such throats is a subject for serious consideration;
at present it is perhaps the safer plan to exclude these
children from school, but, on the other hand, it is certain that many
children's throats contain the organism, and yet these mix with
others one would think to be susceptible, without doing the least
damage. To exclude such children from school attendance is to
seriously handicap them in the competition for prizes, &c. It
would be a very instructive enquiry were the London County
Council to undertake a bacteriological examination of the throats
of children attending their schools, ascertaining how many are
infected by any forms suspicious of diphtheria, and what are the
other organisms which are usually found in such instances.
There were many instances of children being excluded from
school on account of the fact that cultures from their throats have
been examined and have shown the presence of suspicious organisms.
Some of these were taken to doctors, but in others the parents
persisted that there was no need to seek medical advice and that
they had no intention of doing so. It was from this class that
many were brought to the Town Hall, where a specimen was taken
and the school authorities subsequently advised of the result of the
examination.
There were 1,138 notifications of scarlet fever, nearly all of