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in England and Wales, but in rural districts illegitimacy is always more
prevalent.
The figure 29.5 does not represent the actual birth-rate of the
district, and the illegitimate birth-rate is higher than 25 per 1000
births. 1,533 is the number of births registered in the district; some
births occurred in outside institutions, but a list of these has not
been obtained.
The birth-rate is not usually considered within the realms of
public health, and we are deterred even from an adequate discussion
of it by what has been stigmatised as a spurious delicacy, and by a
wholly false conception of morality. Although the remedy is beyond
the control of Sanitary Authorities, it is important that we should
ascertain whether the population is being chiefly recruited from the
fit or from the unfit Preventive medicine must enlarge its scope if
it is to continue to reduce the general death-rate, and if, more particularly,
it is to make substantial advance in promoting the physical
fitness of the people and to create an impression upon such diseases
as infantile diarrhoea and measles. We know that since 1877 the
birth-rate in this country has been steadily declining, but "it is as
important that the right people should be born as that the wrong
people should not be born." Not only has the birth-rate in England
and Wales during the last 25 years undergone a decrease of nearly
20 per cent., but there is reason to believe that the fewer beings now
born are born of the less healthy and less thrifty classes. It is the
birth-rate of the middle classes and the better type of working man
that has been falling off at such an alarming rate. It is unnecessary
to produce statistics in order to ascertain the relative position of the
wards socially. A glance at the number of deaths from the various
diseases in each ward will at once convince any observer as to who are
best and least fitted for the struggle of life. Consumption or Phthisis
is a disease which eminently reflects the influence of poverty, being
determined by overcrowding, physical privation, anxiety, want of rest,
and all the factors which are dependent on poverty. More than half
the deaths from Consumption occurred in the South-West Ward.
Similarly, Infantile Diarrhoea, though dependent upon various
causes, is most fatal in those children whose general standard of
vitality is lowered. 45 out of the 79 deaths from Infantile Diarrhoea
occurred in the South-West Ward.