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136
tone and pallor has been taken as sufficient to call for active treatment;
beading of the ribs and bossing of the skull bones seem less easy to be sure
about. Even so, none of these signs are unequivocal, and instances of
rickets are frequent, particularly a type which develops quickly towards
the end of the first year. They give support to the view that general
prophylaxis is the best plan.
The experiment is being made of giving a short printed leaflet on diet
to all expectant and nursing mothers.
The Circular thus is really a call to apply certain preventive measures
on a wide scale and marks an interesting step linking experimental work
with public health administration.
Next to deficiencies of diet, the overcrowded rooms in which so large
a proportion of the children have to spend their infancy are nearly as
great an enemy to health. The improvement in a baby that follows
several hours' regular outing every day is often as dramatic as anything
that can be seen in medicine. Yet, as things have existed hitherto, it
may be the hardest remedy for the mothers to apply. Some cannot do
more than take the baby out for the short daily journey to the shops.
Rules confining the use of the backyard to the ground floor tenants are
rigidly enforced, and if they are relaxed often enough the favour is not
easy to accept.
The hopes aroused by recent plans to start rehousing will see little
good result to young babies in their first two years of life, if this point
is not taken into account. The remedy lies in the provision of a small
open balcony to every dwelling, whether house or flat. It could be
made of iron and the cost would be small, for something large enough to
contain a cradle is all that is needed. If the Borough Surveyor were
given power to insist on this small addition being included in every plan,
the balcony being on the south or west aspect wherever possible, the
general improvement in infant health would be incalculable.
H. K. WALLER,
Senior Medical Officer.