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In order to assist further, the City Council has taken beds at a
sanatorium, more particularly for the training of consumptive patients
in the methods of preventing infection.
The death rate of children under one year of age in London varied
but little for fifty years (1841 to 1890), except in the decade 1881-90
when meteorological conditions were favourable. The rate in the first
ten years of the half century was 157 per 1,000 births, and in the last
was 159. Since 1900 (which coincides with the period when the Borough
Councils came into existence) the rate has regularly decreased year by
year, until it now stands at 108. For the first five years of the decade,
beginning with 1901, the rate was 138; for the last four years, 117.
It must, however, he kept in mind that during the last three years the
climatic conditions have again been favourable to infant life, and
resemble those existing in 1881-90, but in that decade the infant death
rate only fell to 152 per 1,000.
The marked improvement which has taken place is due to the new
methods which have been introduced in recent years, whereby instruction
is given to mothers in the way to bring up children, by ladies specially
qualified for the work.
The system was begun in Westminster in 1903, and has gradually
extended not only to other parts of London, but to many places
throughout the country. (Manchester and Salford had for many years
previously a society for the promotion of this kind of work.) The
average death rate for the districts which eventually formed the City
was 158 for the ten years 1891-1900, varying in the component
districts from 132 in St. George's to 176 in St. Margaret and St. John,
and in the Strand. The average of the last nine years (1901-9) for
the City is 110, and for the year 1909, 93 per 1,000 births.
In the beginning of 1909 the Notification of Births Act came into
force, the Local Government Board having sanctioned the suggested
arrangement that the Hon. Secretary of the Health Society should be
appointed the Council's Honorary Health Visitor under the direction of
the Medical Officer of Health. The Council provided an office at the
St. George's Baths, Buckingham Palace Puoad, and the Society has thus
become a special centre for health in the district. Detailed records are
kept of individual cases, and systematically indexed for future reference.
The discovery of sickness and ill-health in other members of the family
arises frequently from the infant visiting, and in this way very complete
family histories in disease are gradually being collected, together with
an accumulated knowledge of sanitary and economic conditions. This
collected information is particularly valuable in dealing with school
children, with phthisis, and in many other directions. The Hon. Health
Visitor is assisted in visiting by 25 ladies, and is in close touch with