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60 MORTALITY IN CHILDHOOD.
Infantile mortality during the summer months is a question of high or low diarrhceal
mortality. Owing to the exceptionally low mortality from that disorder-a feature which was
observed in almost every part of the country-the total infantile mortality fell to a minimum-in
England and Wales to 79 per 1,000 births, 61 per 1,000 below the annual average for the
quarter (ten years 1902.11), and 122 less than the 1911 (3rd quarter) rate. In the County of
London the infantile mortality was only 81 per 1,000 births.
The "summer" rate of mortality from diarrhoea per 1,000 persons aged 0.2 years (see
Table 35) was 13.49 in the County, just exceeding one.seventh of the 1911 rate (92'25), and
less than one.quarter of the average (5438). In the Western Districts last year's rate (977)
showed even greater differences, being less than one.ninth of the 1911 rate, and a trifle over
one.sixth of the average (56 63). In the Eastern Districts, where the mortality in 1911 was
highest, the reductions were notable-rate 1912, 22.07 ; 1911, 122.27; 1906.10, 67.52.
The rate observed in the Borough (18T2) was the highest recorded in the Western Districts,
the lowest being that of Fulham (3.35), which should be contrasted with the 1911 figure (13139).
It would be an interesting study to examine the factors which produced such differences in the
relative positions (order of magnitude) of the different cities and boroughs in the two years.
Arranged in descending order of magnitude of mortality, the boroughs included in the Western
Districts stood thus in 1911 and 1912:-
1911. 1912.
Maximum. Fulham (131). Paddington (18).
Hammersmith (113). Westminster (14).
Kensington (85). Kensington (10).
Chelsea (78). Hammersmith (10).
Paddington (50). Chelsea (4).
Minimum. Westminster (49). Fulham (3).
Arrangements were made for obtaining information of attacks of diarrhoea on the lines
described in previous reports. The "Diarrhœa Register" was opened on Monday, June 10th,
and closed on Monday, November 25th, being open for a period of 24 weeks. During the
greater part of that period "fly counts" were made three days a week. The reported cases
included 146 in children under 2 years of age-89 being patients at St. Mary's Hospital, and 14
under the care of the District (Poor Law) Medical Officers. Thirty other cases were reported
from various sources, both lay and medical, and 13 were traced by search through the admissions
to the Infirmary. After making the necessary corrections for repeated reports, wrong addresses,
&c., the corrected number of cases was reduced to 129. By including 25 deaths registered
during the same period (the attacks not being known during life) as cases, a grand total of
154 attacks is obtained, as compared with 456 in 1911. The weekly distribution of (known)
dates of onset and of death is given in Table 36. The contrast between the cases known in
1911 and 1912 is very striking, not merely from a numerical standpoint, but also as regards the
distribution of the cases week by week. Last year in the three weeks ended August 10th, 37
attacks were recorded, and in the following three weeks (to August 31st), 11. In the two
corresponding periods of 1911 the reported attacks numbered 115 and 147 respectively. The
distributions by months of the cases of which the dates of onset were known were as follows:-
June
July
August
September
October
November
Diagrams have been prepa
1912. 1911.
18 21
23 25
38 242
18 65
23 17
10 5
d for 1911 and 1912-on the same scale, but with a lower
datum line for earth temperature, 45° instead of 55°-showing the weekly variations in