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58
The Registrar-General, dealing with the question of infantile mortality, in the Annual
Summary for 1906, observes that of the total deaths under one year of age recorded in London, in
1906, nearly 29 per cent, took place in the first month of life; adding that " a considerable
proportion of deaths was due to a group of conditions which may be described under the heading
' Immaturity ': so much is this the case that deaths due to ante-natal influences, such as premature
birth and congenital malformations, in London, in 1906, were more than one-third of the total
infantile deaths. High as this proportion was, however, it was below the average prevailing in the
preceding quinquennium."
Dr. Tatham states that in the autumn of 1904, the President of the Local Government
Board called a conference of authorities to consider this question, and that the Medical Officer of
the Board subsequently took steps to " procure, periodically, from Medical O.ncers of Health
throughout England and Wales, special returns of mortality in the infantile portion of the
community."
This return of " deaths from stated causes " in the Royal Borough, in weeks and months,
under one year of age," for the year 1905, was given at page 56 in my annual report for that year;
whilst at page 57, the deaths were further " grouped in monthly periods." Corresponding tables
for the year 1906 are set out below at pages 59 and 60. The interest and value of the official
table will obviously be increased when the returns for the entire Metropolis shall have been
summarised and compared.
Many of the Metropolitan Sanitary Authorities, in the course of the last few years, have
given practical demonstration of their desire to protect infant life by appointing lady sanitary
inspectors, some of whose time is occupied, as Health Visitors, in visiting poor women as soon as
practicable after confinement, and instructing them with regard to the feeding, and the care,
generally, of their babies. In 1905 the Council appointed one lady to act exclusively as health
visitor, and with such good results that it is to be regretted that they have not yet seen their
way to extend the work by appointing (at least) a second visitor.
Of the 452 deaths under one year, in 1906, the quarterly numbers were 96, 95, 175, and 86,
respectively. August and September were very fatal to infant life: 143 deaths, 79 and 64 in the
two months respectively, having been registered, compared with 113 (77 and 36) in the corresponding
months in 1905.
Diarrhoea was responsible for a large proportion of this excessive mortality, 75 deaths (41
and 34 in the two months) having been registered from this cause. The total deaths under one
year of age from diarrhoea in the year, were 92; of which nearly 82 per cent, were registered in the
two months named. Not far short of a third of the deaths from all causes at this age-period
(135 out of 452) occurred in the first four weeks of life—but only three of them were from
diarrhoea—a fact accounted for by the common practice amongst poor women of suckling their
babies during the puerperal month, when they are mostly confined to the house, and are debarred,
by law, from labour at factories, workshops, etc.
Next in order to diarrhoeal diseases, prematurity of birth stands conspicuous as the cause
of 59 deaths, including 50 in the first week after that event, and all save one within four weeks
of birth. To " wasting diseases," 72 deaths were attributed, including 42 from atrophy,
debility, and marasmus. Some of the deaths from these causes might doubtless have been properly
classified to " tuberculous diseases," which were the registered causes of 28 deaths only. Bronchitis
and Pneumonia were the causes of 21 and 40 deaths respectively. Sixteen were due to violence,
including 6 from " suffocation, overlaying." The births registered as illegitimate were 158, or 4-6
per cent, on total births; the deaths of illegitimate infants were 68, equal to 15 0 per cent, on all
deaths under one year, and 43 0 per cent, on the births registered as illegitimate. Inquests were
held in 45 cases.
[Table.