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57
The Council will remember that the London County Council, in 1903, issued an Order
applicable to measles, making certain infectious disease provisions of the Public Health (London)
Act, 1891—including sections 63 and 65, which relate to the letting of a house or part of a house in
which infected persons had resided, without previous disinfection. Now if disinfection is admitted
to be necessary after measles, no instructed person will venture to say it is unnecessary after
consumption. And if in the interests of public health, it is right to enforce disinfection after
measles, a fortiori disinfection should be made compulsory after consumption, a disease which kills
four times as many persons as measles, whose victims are children under five years of age, those of
consumption being, for the most part, adults in the prime of life.
Disinfection after consumption being obviously necessary, I recommended the Council* (1)
to represent to the London County Council the desirability of issuing an Order to make it compulsory
under the provisions of the Public Health (London) Act, 1891; and (2) to request the
other Metropolitan Borough Councils to address a similar representation to the County Council. I
had the less hesitation in submitting these recommendations, the Conference of Representatives of
Metropolitan Borough Councils, convened by the County Council, in July, 1904, having unanimously
adopted a resolution to the effect—
" That the Sanitary Authorities should disinfect the premises in which a person suffering
from phthisis has died, or from which a patient has removed, or has been removed."
No effort has been spared to give effect to the instructions of the Council in regard to this
matter since proceedings to control phthisis were initiated, at the beginning of 1902—with what
imperfect results, has been shown.
The need for disinfection was dealt with by the Local Government Board for Scotland in
their letter to local authorities on the Administrative Control of Phthisis, as follows :—
" The provisions of the Statute with regard to disinfection are available in dealing with
pulmonary phthisis, and it is the duty of the Local Authority to secure that, whenever necessary,
these provisions are enforced. ... Not only the homes, but also the workshops, or other places,
where consumptives have been employed, should be carefully and thoroughly disinfected."
INFANTILE MORTALITY.
Public attention was much given last year to the question of infantile mortality, in connection
with the National Conference to which reference is made below. No question is more deserving of
the attention of Sanitary Authorities. The birth-rate for many years has been falling, and the only
means to compensate for the ill effects of this factor upon the rate of increase of the population, is
by way of conservation of infantile life. The subject of "Mortality of Infants " is dealt with in a
Letter to the Registrar-General, on "Analysis of the Causes of Death, in England and Wales," by
Dr. Tatham, Superintendent of Statistics at the General Register Office, appended to the sixtyeighth
annual report, for 1905, of the Registrar-General, wherein it is stated that—
" Although the general mortality in this country has steadily fallen in the course of the
last half century, nevertheless infants in the first year of life have not shared in the benefit.
For infants in their first year of life perish as rapidly now as they did half a
century ago About one-fifth part of the total loss of life in the first year after
birth takes places within a week of that event, whilst by the end of the first month the proportion
reaches one-third, and by the end of the third month it exceeds one half ....
The high mortality in the first week is mainly due to the decease of infants that, either from
immaturity or from debility at birth, can hardly be regarded as viable. Most of the deaths
occurring at this early age are attributed either to wasting diseases, including prematurity,
congenital defects, atrophy, &c., or to convulsions, The same diseases account for a large
share of the (reduced) mortality in the second, third, and fourth week of life, when it falls to
less than a quarter of that in the first week .... The first month past, these causes,
become rapidly less fatal, but in their stead, diarrhceal diseases, bronchitis, pneumonia, and
whooping-cough become conspicuous in the death roll. From the first to the fourth month
of life diarrlioeal diseases steadily increase in destructiveness . . . . It is in the second
month of life that bronchitis destroys the largest number of victims, whilst pneumonia is
most destructive in the later months of the first year."
•In No. 1 Monthly Report, 1906, page 10.