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DISEASES OF CHILDHOOD.
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which contrasts unfavourably with the rates among legitimate children, viz.: Total, 64; males, 76;
females, 52. The mean rates (1918-22) for illegitimates are: Total, 177; males, 204; females, 147;
and the corresponding rates for legitimates: Total, 79; males, 89; females, 69. In comparison
with the means last year's rates for illegitimates show greater reductions than do those for legitimates
the fall in the total illegitimate rate amounting to 33 per cent. of the mean, that in the legitimate, 19.
The reductions in the rates for males were, illegitimates 37 per cent., legitimates 15, and those in the
rates for females, illegitimates 29, legitimates 25. The ratio of the total legitimate mortality to the
illegitimate was 1: 2.2 during 1918-22 and 1:1.8 last year.
The illegitimate infantile mortality was zero in Queen's Park and Lancaster Gate, East Wards,
and varied from a maximum of 210 per 1,000 in Harrow Road Ward (4 deaths), to a minimum of
91 in Lancaster Gate, West Ward (1 death only).
Occupations of Mothers.—Attention has been directed frequently to the large proportion of mothers
of deceased illegitimate children who have described themselves as domestic servants. During the
war the proportion fell, but it now shows signs of increasing again. During 1909-13 241 deaths of
illegitimate children were recorded, the mothers of 143 (59.3 per cent.) being returned as domestic
servants. During 1914-18 (340 deaths) the proportion fell to 44.6 per cent., while in the following
quinquennium (1919-23), when there were 220 deaths, the proportion increased to 50.9.
DISEASES OF CHILDHOOD.
Measles.—For administrative purposes no difference is made between "measles (morbilli)"
and "german measles (roiheln)." Last year 324 persons (all ages) were certified to be suffering from
measles and 48 from german measles. The weekly tabulation of the records indicates that 80 other
cases (of the two diseases) came to the knowledge of the Department through various channels, bringing
the uncorrected total of cases to 452, giving an average for the year of 8.7 cases per week.
Notification has been in force since the early months of 1914. In that year the weekly average
of known cases was 8.2, but it is practically certain that notification was incomplete. If the records
of 1914 be passed over, last year's average is the lowest on record, save that for 1921, when 208 cases
(both diseases) were known to the Department giving a weekly average of 4 cases. The difficulty
of instituting reliable comparisons between the records of successive years will be understood when
it is stated that in three years since 1914, viz., 1917 (4,444 cases), 1915 (3,826 cases) and 1922 (3,241
cases) the averages exceeded 50 cases per week, being for the years mentioned, 85.4, 73.5 and 62.3.
The fatality (ratio of fatal cases to all cases) tends to vary in an irregular manner with the intensity
of the disease, but there does not appear to be any clear indication that fatality is directly connected
with the seasonal distribution of the cases. For present purposes the returns for last year will be
compared with those for 1917, the year of maximal incidence and 1921, that of minimum.
Of the 452 cases 128 came on record during the first quarter of the year, 103 during the second,
92 during the third and 129 during the fourth, in which quarter there was a sudden increase of cases
in the last three weeks (80 out of the total of 129 for the quarter) which were the forerunners of the
epidemic of the current year.
On checking the returns at the close of the year, the total number of cases (both diseases) was
reduced to 449, comprising 396 of measles and 53 of german measles. Of the former disease 207 cases
occurred in males and 242 in females (of all ages), and of the latter 20 and 23 respectively. Both
diseases being of limited age incidence, it seems undesirable to submit morbidity rates based on the
total population or the population of each sex. In the appended statement the sex-age distribution
of both cases and deaths is well shown. As so many children now enter school at the age of 3, the
school-age has been taken as 3-15 years. In the same statement a comparison is instituted between
the records for the past year and the years 1917 and 1921.

Figures in parentheses indicate fatal cases.
The fatality of the disease last year was at the rate of 0.7 per 100 cases, as compared with 2.7
in 1917 and 1.5 in 1921, a comparison which may be regarded as satisfactory. The rate for males
was 1.1 per cent. last year, 3.5 in 1917 and 2.1 in 1921, those for females (in the same order) 0.5,