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/ DISEASES OF CHILDHOOD. 29

Last year 53 cases were admitted to hospital, or 5.2 per cent. of the total. In 1918 5.8 per cent.
were admitted, and in 1919, 2.5. The mortality rates for the year were: Persons, 0.16 per 1,000,
males 0.14 and females 0.17.
Diarrhœa.—The deaths of 21 infants (males, 12; females 9) were assigned to "diarrhœa and
enteritis," giving mortality rates per 1,000 births registered of—Persons, 8-01; males, 8.90; females,
7.07. The 21 deaths included 16 at ages under one year (8 of each sex) and 5 at ages 1-2 years (males,
4; female, 1). The mortality rates under one year per 1,000 births were—Persons, 6.1; males, 5.9;
females, 6.2, and those at ages 1-2 years, per 1,000 survivors, aged 1-2—Persons, 1.9; males, 3.1;
females, 0.7.
Last year's total of 21 deaths compares favourably with the annual average of 46 for the years
1918-22. The differences are shown more markedly by comparing the mortality rates calculated on
the numbers living at ages 0-2. For 1918-22 the mean rates were—Persons, 9.2; males 10.6; females,
7.8; and those for 1923—Persons, 3.7; males, 45; females, 3.5. The comparison is to some extent
vitiated by the fact that the summer of 1921—"diarrhoea" in infants is generally held to be a summer
disease—was a particularly hot one. To obviate that objection comparison may be made between the
mean rates for 1909-13 and 1919-23, both of which periods include summers of exceptional characters.
The mean rates—calculated on the estimated numbers living at ages 0-2 years—were for 1909-13—
Persons, 12.5; males, 12.7; females, 12.3; those for 1919-23—Persons, 8.8; males, 10.1; females,
7.4.
The 21 deaths in 1923 were confined to the five northern Wards of the Borough. The subjoined
statement compares the records of last year with the annual average for 1918-22:—
Diarrhœa Deaths: 0-2 Years.
Queen's
Park.
Harrow
Road.
Maida
Vale.
Westbourne.
Church.
Lancaster
West.
Gate.
East.
Hyde
Park.
1923 5 5 1 3 7 — — —
1918-22 4 7 4 11 15 1 2 3
Of the 21 deaths 19 took place in institutions, including 14 in the Paddington Hospital, and 2 in the
Infants' Hospital.
The reduction in the mortality of children from diarrhceal diseases indicated in the preceding
paragraphs is not a local phenomenon, as there has been a fall in number of deaths recorded in the
whole County. The annual average number of deaths at ages 0-2 years in the County during the
decennium 1901-10 was 2,887, that for the decennium 1911-20, 2,209, and that for the three years
1921-23, 1,247. Taking the first average as = 100, the others can be represented as 76 and 43, showing
reductions of 24 and 57 per cent. For the third (summer) quarters the averages were—1901-10, 2,031;
1911-20, 1,248; and 1921-23, 591. Putting the first = 100, the others are represented by 61 and 29,
showing reductions of 39 and 71 per cent. Those very considerable falls in the numbers of deaths
during the summer quarter are in remarkable contrast with the changes in the other quarters of the
year. For the first (winter) quarter the annual averages for 1911-20 and 1921-23—taking that for
1901-10 as= 100—were 123 and 106, showing increases of 23 and 6 per cent; those for the second
(spring) quarter—1911-20, 99; 1921-23, 71, showing reductions of 1 and 19 per cent.; and those for
the fourth (autumn)—1911-20, 113; 1921-23, 67, showing an increase of 13 and a decrease of 33 per
cent.
The variations in the directions of the changes indicated in the preceding paragraph point to
alterations in the seasonal incidents of the diarrhceal diseases. As already stated, diarrhœal disease in
young children has been held to be a disease peculiar to the summer quarter, and specially prevalent in
hot summers. Considering the second point first, in the hot summer of 1911 there were 97 deaths in
the Borough, the total for the whole year being 135. That year nearly 72 per cent. of the deaths
occurred in the summer quarter. During 1921, again a phenomenally hot summer, there were 85
deaths, of which 36 (42.3 per cent.) occurred during the summer quarter. The percentages of deaths
in the four quarters of those two years and in 1923 are set out below.
Quarter 1st 2nd 3rd 4 th
1911 5.9 7.4 71.8 14.8
1921 16.4 17.6 42.3 23.5
1923 19.0 14.3 14.3 52.4