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of more houses, in diminishing overcrowding, and in taking down slums.
No fever than 16 of these 45 Pneumonia deaths occurred in the East
Ward as well as 4 of the 11 Bronchitis deaths. There was a time
when people said, with a superior air of finality "the weakest must go
to the wall." These were they who, when confronted with the still,
stagnant air of the slums, spoke of the "privileges of the poor."
Public opinion has changed but, alas, we still have our slums. Part of
our east end was condemned years ago, but it still stands. The
following figures speak for themselves. The Infant mortality rate for
the Borough is 76, for the East Ward it is 100. The general mortality
rate for the Borough is 12.0: for the North-West ward 10'3 (the best):
for the East 15.2 (the worst).
Why are the notifications in the case of Pulmonary Tuberculosis
four times greater, and in the case of non-Pulmonary Tuberculosis eight
times more in the East Ward than in the South Ward? We provided
a dentist for our poorer Tuberculous brethren; what we need most of
all for part of the East Ward is a house-breaker. A chain is only as
strong as its weakest link. May it be soon then that the County
Council may be able, in their considerations, to find the money to pull
down this area; right heartily are they helping us at Watergate Street.
Sixteen children in the borough died from Diarrhoea and Enteritis: a rate
of 6.7 per 1,000 births, as compared with 8.4 for London County, 7.3 for
England and Wales, and 9.2 for the 105 great towns.
The Diphtheria notifications fell from 417 in 1923, to 374 (of which
latter the diagnosis in 21, was not upheld). I examined 855 contacts,
finding 2 actually suffering from the disease. Two hundred and sixty
seven of the contacts examined were adults. Seventy-four were swabbed,
and of these, 8 were "positive." As I have explained before, there
is no justification for the existence of Diphtheria. By means of the
Schick test we can determine whether a person is susceptible, and by a
minute inoculation we can protect the susceptible. Until our University
professors teach students of Public Health how to become efficient
public speakers and instructors, we shall tend to remain faced with a
general public who know little of the means whereby they, and theirs,
can be protected from Diphtheria and other diseases. Steady public
instructions by lectures and reports, will reap a rich reward in time.
Although cases of Ophthalmia Neonatorum increased from 15 to 25,
the rapid action taken prevented a single case of impaired vision. I
have felt it to be necessary to say a few words in the text concerning