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The importance was pointed out in last year's Annual Report of making correction for qualitative
as well as quantitative changes affecting the age constitution of potential mothers and fathers, and it
was stated that a particularly important qualitative correction was that rendered necessary owing to
the migratory character and the increased urbanisation of the population, during the last fifty years.
Mr. Udny Yule's hint as to the indirect effect of trade, or the more indirect influence of some other
variable, may be borne in mind here. The fall of prices since 1876 is largely attributable to increased
facilities for the transport of commodities, and these same facilities have affected the movement of
population as well as that of goods. In particular the growth in capacity of sailing and steam ships
was first conspicuously manifested from the seventies onwards, and this growth has undoubtedly had
considerable influence upon the constitution of most European populations of child-bearing age. It
is a well recognised fact that in dealing with death-rates, the arithmetical correction for age distribution
is at best only a partial one, and similarly in the case of birth-rates it clearly cannot be assumed, as
there has been some tendency to do, that an arithmetical correction is all-sufficient.
It may be urged, however, that if the decline in the European birth-rate be largely attributable
to emigration the countries to which the emigrants go should show high birth rates. The case of Australia
has been already referred to; elsewhere, records are imperfect or wanting, but it may be noted that the
United States have received nearly 20 millions of young adults from Europe during the last forty years,
and as H. P. Fairchild notes, "the high birth rate of our now large foreign born population" is notorious;
moreover, the years of this great exodus are precisely those of the declining birth rates throughout
Europe. France, as was noted in the Annual Report for 1912, occupies a peculiar position among
European countries. There has been little emigration, but the huge losses sustained during the Napoleonic
wars doubtless account in large degree for the slow growth of population in the first half of the nineteenth
century ; while the Italian, Austrian and German wars have certainly played a part in preventing a
return to more normal conditions in later years.
Deaths (all causes).
The number of deaths among civilians in the administrative county of London in 1915 was 72,393,
as compared with 66,037 in 1914, and the death-rate, calculated on the estimated civil population, was
16.8, comparing with 14.6 in 1914.

The increased number of deaths at ages 1-5 years is mainly due to the prevalence of measles
and respiratory diseases in the winter months. At ages over 55 years, bronchitis, and other diseases of
the respiratory system were responsible for the greater part of the increase, to which organic heart
disease and influenza both, however, also contribute.
Infnnt
mortality.
The deaths among children under one year ot age in the administrative county ot London during
1915 numbered 11,464, being in the proportion of 112 per 1,000 births. The deaths and
death-rate in 1914 were 11,477 and 104 respectively. In the summer of 1914 the conditions were less
favourable than in 1915, the temperature in June, July and August of 1914 being considerably above
the average : hence the deaths from diarrhoea and enteritis among infants aged 0-1 were in excess in
1914, numbering 2,608, as compared with 2,126 in 1915. On the other hand, the winter of 1915 was
less favourable and the deaths from diseases of the respiratory system in that year were 2,481, as compared
with 1,956 in 1914.
The question of maternal mortality in connection with child-bearing is dealt with by Dr. Newsholm
in a supplement to the forty-fourth annual report of the Local Government Board. From the
statistics presented in the report, it appears that London occupies a very favourable position among
the counties of England and Wales in regard to the total death-rate incidental to child-birth.
Smallpox.
Three deaths from smallpox occurred in London during 1915, all three being in Fulham. Thirteen
civilian cases were notified, but three of these were subsequently found to have been wrongly diagnosed.
In all 20 suspects were examined by Dr. Brincker or Dr. Ross on behalf of the Council.
The ten actual cases must be ascribed to four separate importations of smallpox into London.
(a) This group consisted of six patients in one family and residing in the same house. The
primary case, E.H., aged 56, was a bedmaker at Earl's Court Refugee Home. A case of smallpox
had occurred in a stewardess on board the s.s. Mecklenburg, a Belgian refugee boat, which had arrived
in Folkestone, and from which refugees had been sent to Earl's Court. The vessel sailed from Flushing
to Folkestone on 23rd January with about 500 refugees on board, and again on 25th January with about