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30
Comparison with other Towns and Boroughs.
In the Journal of the Incorporated Society of Medical Officers of Health—
"Public Health" —for April, 1907, p. 408, under the heading of "Diseases
producing infant mortality," will be found the following annotation:—
"We turn to Dr. Tatham's letter to the Registrar General for accurate
information on this subject. It is noteworthy that one-fifth of the total loss
of life in infancy occurs in the first week of extra-uterine life, a fact which
tends to moderate our hopes of affecting one-fifth of the total infant mortality,
unless it be by measures affecting the mother during pregnancy. Urban
infant mortality is 30 per cent. in excess of rural; the excess of urban over
rural mortality is only 6 per cent. in the first week of life, while it is over
50 per cent. in the later months of the first year. Half of this excess is due
to diarrhœal diseases, one-eighth to premature birth and congenital defects,
one-eighth to pneumonia, and smaller proportions to tuberculous diseases,
bronchitis, &c. These important facts bring us face to face with the conclusion
that the chief way to diminish infant mortality is to prevent epidemic
diarrhoea."
Infantile mortality in the third or summer quarter of the year is said to be
governed by climatic conditions, so that the mortality is high when the
temperature is excessive and the rainfull is deficient. Excessive temperature
leads to the rapid decomposition of dead organic substances, which means the
rapid multiplication of living micro-organisms. Deficient rainfall means the
drying of surfaces, the creation of dust, and the liberation of micro-organisms
to be wafted and spread by the air and by insects of the air over food.
The one and only food for babies is milk, and the effect of milk loaded with
microbes, or decomposed, or stale, upon a baby is to cause abdominal disorder,
which manifests itself as diarrhoea with or without vomiting. So that in the
summer or third quarter of the year amongst hand-fed babies there is an
excessive mortality from abdominal diseases, typified by diarrhoea.
To prevent this as far as possible, the milk provided for babies must be
absolutely fresh, free from microbes, and protected against the access of
microbes. The only milk that is at all times in this condition is the milk contained
in the human breast. Therefore, the supreme remedy against the
mortality of babies from summer diarrhoea is breast-feeding.
In St. Pancras the procedure has been to make every effort to obtain and
maintain breast-feeding during the suckling period of the first year of life,
and especially to maintain it through the summer months or third quarter
of the year.
The effect of this procedure upon the mortality is shown in the two following
tables, the one showing the 76 large towns and the other the 29 City and
Metropolitan Boroughs, arranged in order of merit, commencing with the
lowest, during the third quarter of the years 1904, 1905, and 1906.
By adopting this method we get rid of the difficulty of varying temperature
in different years, as instead of comparing one summer with another, we
compare one place with another in the same summer.
It will be observed in the tables that of the 76 large towns in the summer
of 1904 St. Pancras was 40th, in 1905 was 34th, and in 1906 was 16th. Of
the 29 City and Boroughs of London, St. Pancras was 25th in the summer of
1904, 18th in 1905, and 13th in 1906. The progress is steadily marked.