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22
DISEASES OF CHILDHOOD.
to more complete reporting of the disease. The average annual number of deaths during the same
quinquennia were : 36, 30, 27, and 20, the last average being 44 . below the first. The fatalities
were : 8.7 per cent., 6.5, 5.5 and 4.6, showing a fall of 47 . in the course of twenty years.
Comparing the records for the three years, 1910.12, with those for 1920.22, it is found that in the
former triennium there were 723 cases among males and 804 among females, and in the latter 646
cases among males and 700 among females. The age distributions were : 1910.12, males, 0.5 years,
445 ; 5.15, 277 ; and 15 and over, 1. Females (age.groups in same order), 484, 317 and 3. For
1920.22, the figures are : Males, 376, 268 and 2 ; females, 379, 321 and zero.
The deaths during the triennia were : 1910.12, 55 males and 46 females ; 1920.22, males, 22,
females 24. The cases and deaths at ages above 15 can be neglected. The morbidity rates, per 1,000
individuals, enumerated at the Census of each central year, were : Ages 0.5 years, males, 1910.12,
24.6 ; 1920.22, 25.1 ; females, 26.8 and 24.8 ; ages 5.15, males, 1910.12, 9.1 ; 1920.22, 8.9 ; females,
10.1 and 10.3. The fatality rates (per 100 cases) were : 0.5, males, 1910.12, 11.4 ; 1920.22,
5.6 ; females, 9.3 and 6.3. Ages 5.15, males, 1 .4 and 0.3 ; females, 0.3 and zero. The mortality
rates (per 1,000 individuals) were : Ages 0.5 males, 2.82 and 1.40 ; females, 2.49 and 1.63. Ages
5.15, males, 0.13 and 0.03 ; females, 0*03 and zero.
Diarrhcea.—During 1922, 26 deaths (including one from enteritis) were recorded as due to
" diarrhcea," compared with a total of 90 (including 3 from enteritis).in 1921. The disease in adults
differs so much from that in young children under 2 years of age that the 3 deaths above that age
limit recorded in 1921, and the 2 recorded last year will be neglected in the following paragraphs.
The 24 deaths at ages under 2 recorded last year comprised 18 of males and 6 of females. There
was no death from this cause during the third (summer) quarter of the year, which is regarded as the
diarrhceal season. In the first quarter there were 8 deaths, in the second 10, and in the fourth 6.
In the third quarter of 1921 there were 37 deaths from this cause, the annual average for the quarter
during the ten years 1911.20 being 30.
All the Wards shared in the comparative freedom from this disease last year, the totals for the
year being : Queen's Park, 2 (6)* ; Harrow Road, 1 (10) ; Maida Vale, 2 (7) ; Westbourne, 9 (14);
Church, 7 (24) ; Lancaster Gate, West, 1 (2) ; Lancaster Gate, East, 0 (2) ; and Hyde Park, 2 (2).
The low prevalence of this disease was not limited to the Borough, but prevailed throughout the
County of London, and (it is believed) the Country generally. In the County the deaths recorded at
ages 0.2 years during the year numbered 671, compared with 2,133 in 1921. The following were the
quinquennial averages during the twenty years 1901.20 : 1901.05, 3,480 ; 1906.10, 2,293 ; 1911.15,
3,070 ; 1916.20, 1,345. The change is, perhaps, more marked if the numbers recorded in the third
quarter be considered. In 1922 the deaths numbered 127, in 1921, 1,261, while the averages for the
four quinquennial periods were : 2,614, 1,448, 1,937 and 560. An examination of the serial figures
for each quarter of the years 1901.22 does more than suggest that the disease can no longer be
regarded as one peculiar to summer. The tabulation cannot be given here, but it can be said that
within recent years there has been a tendency to a greater prevalence during the autumn and early
months of the year than was observed (say) in 1901.05.
As regards last summer three facts may be stated as having some bearing on the freedom of the
Borough from this disease. In the first place the temperature of the ground, as measured at a depth
of four feet at Greenwich, at no time during the quarter rose to 60° F. The mean of the weekly readings
during the quarter was only 56.2°. In 1911, when there was a particularly severe epidemic of
the disease, the mean—at a depth of 3 ft. 2 in. below the surface—was 64.2°. The rainfall during
the quarter measured 7 • 21 inches, which was above the average for the quarter. Lastly the fly.counts
taken in the Borough, showed that the number of those pests was very small in comparison with the
figures obtained in earlier years.
Chickenpox.—In previous years, when smallpox has threatened to become prevalent, notification
has been extended to this disease on account of the similarity of the rash. Last year the County Council
decided against adding the disease to the list, and in consequence the Borough Council did so at
their meeting of November. The total number of cases known to the Department during the year
was 539, including 22 notified cases. In 1921 the cases numbered 253, and in 1920 567.
Mumps.—Last year 91 cases of this disease were reported to the Department, the total for 1921
having been 494 and that for 1920, 154.
Ringworm.—During 1909.13 172 cases of this affection were reported annually, the average falling
to 140 during 1914.18. That decrease was at the time thought to have been largely due to less strict
supervision of school children, consequent on the war, but the figures for the years subsequent to
1918 lead to a hope that the disease is becoming less prevalent. In 1919 the cases numbered 189,
in 1920, 204, in 1921, 108, and in 1922, 99.
* The figures in parentheses are the decennial annual averages for the respective Wards.