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30
DISEASES OF CHILDHOOD.
It is evident that the seasonal distributions in 1921 and 1923 were not the same as in 1911. There
is evidence that the change has been a progressive one. Below a comparison is made between the
annual average percentage seasonal distributions during 1909-13 and 1919-23.
Paddington.
Quarter 1st 2nd 3rd 4th
1909-13 8.3 11.1 51.4 29.1
1919-23 19.5 19.5 32.6 28.2
The shifting of the seasonal incidence is very clearly indicated by comparing the percentage
distributions for the decennia 1901-10, and 1911-20 with those for 1921-23, in the whole County.
County of London.
Quarter 1st 2nd 3rd 4th
1901-10 6.3 6.9 70.3 16.3
1911-20 10.2 9.0 56.4 24.2
1921-23 15.7 11.4 47.4 25.2
Reverting to what has been written of the changes in the average numbers of deaths in the whole
County, while the index numbers of the averages for the whole year are—
1901-10 100 1911-20 76 1921-23 43
those for the third (summer) quarter—
1901-10 100 1911-20 61 1921-23 29 and
those for the other three quarters are—
1901-10 100 1911-20 112 1921-23 77
In effect, the greater part of the reduction in the number of deaths from the diarrhœal disease in young
children observed in recent years has been due to the lessened prevalence of the disease in the third
or summer quarter rather than to a reduction distributed with any uniformity throughout the year.
In other words, infantile diarrhcea, which used to be a summer disease, is now more a cold weather
disease. Why ?
The usual routine of the Department as to obtaining information of cases of diarrhcea treated at
institutions and as to fly counts, was carried out last year, but consideration of the data collected must
be reserved for another occasion.
Chickenpox.—This disease has been on the list of diseases to be notified for short periods on
several occasions, at times when smallpox has been, or has threatened to be, prevalent. Such addition
has been one of emergency, to meet the difficulty of diagnosis of the two diseases, chickenpox being
frequently confused with disastrous results if smallpox be diagnosed as chickenpox. In 1922 the
Council added the disease permanently to the list.
Last year 753 cases were known to the Department, of which number 465 were formally notified.
The maximum number of cases known in any year since 1914 was 813 in 1918, and the minimum
253 in 1921. Looking at the numbers recorded in Table 3 it will be seen that this disease is apparently
always prevalent in the Borough, the average annual number for the years 1918-22 having
been 487.
Except for its resemblance to smallpox, this disease has little interest from a public health point
of view. The distribution of the rash on the body of the patient is the best guide to a distinction
between the two diseases. Death from chickenpox is exceedingly rare and, as a rule, the disturbance
to the patient's health is slight.
Mumps.—Last year 96 cases of this disease were known, 5 more than in 1922. During 1917-21
(See Table 3) there were, on the average, 336 cases each year, with a maximum of 680 in 1918,
numbers which contrast remarkably with the totals for 1922 (91) and 1923 (96).
Ringworm.—This affection of the skin has decreased notably during the last three years.
During 1917-21 the annual average number of cases was 149 (See Table 3), whereas in 1922 99 cases
were known and last year only 45.