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addition for a hernia to be actually present, this pouch must receive some of
the contents of the ' stomach ' (abdominal organs), such as bowel coming down
into it. This descent is due to a large number of causes, some of which are
preventible. Among these coughing, sneezing, and straining at stool, acts
frequently repeated, are common reasons for descent of bowel or omentum.
Repeated strains at work may produce similar results, but a single strain
cannot produce a pouch or the descent of intestine into a hernial pouch, unless
the pouch (' sac ') was present at birth. In connection with the prevention
of hernia, constipation, and its associated straining at the closet, is of great
importance.
The ordinary closet, particular that encased in wood, is often so
high that the person using it sits with the abdominal apertures entirely
unsupported by the thighs, and hence there is a great tendency for any
straining in this position to lead to the gradual formation of a hernia.
A lower seat to the closet, or a fixing of a step in front of the seat on
which the feet can rest and the knees be raised, is definitely of considerable
value in the prevention of hernia from this cause."
MATERNITY AND CHILD WELFARE.
Notification of Births.
During the year 320 births were registered as occurring in the Borough.
During the same period 294 notifications of births occurring in the Borough were
received. Of these, 267 were from doctors and' midwives, 27 from parents.
From the 267 notifications of birth forms from doctors or midwives, we are
able to give the following information as to by whom the mothers were attended
at the confinement, etc.:—
Private Doctors 62
Private Midwives 36
Out-patient Midwifery Departments of General Hospitals and
Institutions: —
Externs and others 21
Midwives.—University College Hospital 34
Middlesex Hospital 19
Royal Free Hospital 28
Other Institutions 32
Training Institution for Midwives, Myddelton
Square 35
267
Seven notifications related to stillbirths, and one notified the birth of twins.