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77
disease, but due to persistence of the normal heart after the placental
circulation is abolished. The highest number of neo-natal
deaths is attributed to prematurity; 9 deaths were assigned to
this cause. Prematurity of itself does not prevent survival;
though premature infants are more difficult to rear, many are
successfully reared and develop into healthy, normal children. But
the causes of prematurity are not clear. Some suggest that lack
of vitamin E plays an important part, and any failure of the nutrition
of the embryo will destroy its vitality. At one time syphilis
was supposed to be the cause of many premature births, and some
ante-natal clinics adopted the practice of making a Wassermann
test an essential part of ante-natal supervision, but most clinics
have discarded this. Syphilis is not now regarded as a common
cause of prematurity, and prematurity is not more common in
poorly fed and sickly mothers than it is in those who are well cared
for and healthy.
V
Altogether 23 deaths occurred in infants under 4 weeks old,
compared with 29 in 1935.
In the period between 1 and 12 months the most fatal causes
were diarrhoea and pneumonia, and it is difficult to explain the
higher incidence of death from these two diseases. In neither
case could climatic conditions be blamed for the winter months
of the year were not extremely cold nor were the summer months
abnormally hot and dry.
Toddlers.
In last year's report a full account was given of the work
done among Toddlers. Last year Circular 1550 was issued which
urged upon Local Authorities the extension of arrangements made
by them for the supervision of the health of children not in attendance
at school. This Circular was considered by the Child
Welfare Committee and it was decided to establish a Special Toddlers
Clinic as an experiment at the Steele Road Centre. The Centre
is held on Friday afternoons and Dr. Mann attends once a month.
Dr. Mann carries out a modified medical examination on the lines
set out in the School Medical Schedule.
The establishment of this Clinic has been a success, but
there are difficulties of staff and accommodation which prevent
the establishment of similar Clinics at the other centres at the present
time.