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39
month with mild days and cold and frosty nights. It is probable that these
conditions, together with the presence of a severe Measles epidemic, were
sufficient to account for this increase in infantile deaths in February.
It is significant that in March the infantile deaths from Pneumonia and
Diarrhoea dropped suddenly to 9. In March the rainfall was above the
average and the weather was unsettled and cold. Compared with the 36
deaths in February, 1934, there were 5 deaths in February, 1933 (6 in
February, 1935).
Embryological Reasons.
These reasons are Congenital malformations and Premature Births.
In 1934 there were 22 more deaths than in 1933.
It would appear therefore that in comparing the number of deaths in
1933 and 1934 an increase of 79 deaths can be attributed to Measles, to
Pneumonia and Diarrhoea in February, and to embryological reasons.
In order to show how easily the Infant Mortality rate can fluctuate and
how easily it has been affected in 1934, I calculate that, if it had not been
for the above three reasons, the rate would have been 66.3 per 1,000 births
—a rate which corresponds very favourably with that of 1933.
What are the lessons to be learned from 1934 ? So far as Measles is
concerned it must be remembered that 1934 was the year for the regular
biennial epidemic in London. I have suggested elsewhere the preparations
that should be made for the next epidemic in 1935-36.
So far as the embryological reasons are concerned, these are intimately
wrapped up with the prevention of Maternal Mortality. The schemes for
improving the Ante-natal care and the health of the expectant mother will
have a corresponding effect on the embryo, especially so far as prematurity
is concerned, and therefore on the health of the infant in the first few weeks
of life.
So far as Diarrhoea is concerned this is primarily a matter of better
education of the parents and I deal with this aspect later in this report.
There is a need, however, for investigation into the reason why infants
develop typical "Summer" Diarrhoea in the winter months.
Schemes Generally for the Prevention of Maternal and Infantile
Mortality.
The Maternity and Infant Welfare services in Stepney have always been
considered to be reasonably efficient. Certain improvements and amendments
were necessary, however, and at the time of writing this report the Council