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30
previous quarter. From the fact that war conditions are associated with
an increase in tuberculosis incidence it does not follow that any increase
is necessarily due to the war. Epidemics of cerebro-spinal fever are
considered to be associated with wars, but the epidemic of this infection
which occurred in the first two of the war years was preceded by a
growing prevalence in the years which preceded the war. The parallel
course followed by the tuberculosis rate in this war and that in the last,
however, suggests the association of cause and effect; but if so, in what
manner does it occur ? Important as is the part nutrition is considered
to play in the setiology of this infection the reaction must surely
have been too rapid in its onset for it to be affected by any lowering in
the nutritional standards of the community, even though it is suggested
that there has been any. Ignorance of the causes of the increased
incidence precludes the taking of direct measures. That the greatest increase
should occur amongst those women of 15 to 25 and possibly brought
about by their working conditions, whether these are considered to be
the long hours or the hard work or the irregularity of living, is in itself a
justification for the steps taken, amongst other places, in factories in
this area to attempt to discover by routine examination of the employees
those with abnormal chest signs. Not only may the early cases
be discovered before their symptoms would otherwise have led to their
discovery with the resultant advantage to those actually affected, but
the removal of infectious persons will help to reduce the infection of
others. Mass radiography is being increasingly urged though not
universally so, the objection of some being due to the restricted examination
from the point of view of the one disease but of others that any
large-scale action to attempt to effect a diagnosis in an earlier stage is
premature until there is adequate bed accommodation, which, in its
turn, is dependent on an increase in the supply of nurses.
MATERNITY AND CHILD WELFARE.
REGISTRATION AND NOTIFICATION OF BIRTHS.
The total number of live births registered during the year was
2,712 ; 1,415 male and 1,297 female. Of these 126 were illigitimate, being
a percentage of total births of 4.6
1,930 births occurred in the district (1,885 live and 45 still births).
Of this number 289 (284 live and five still births) were to residents of
other districts. Of the local confinements 1,653 were notified by midwives
and 275 by doctors or parents.
966 (941 live and 23 still birth) notifications were transferred from
other districts, being mostly in respect of births occurring to Harrow
mothers in Middlesex County Council or London hospitals.
STILL BIRTHS.
41 male and 37 female still births were registered, being a rate per
1,000 population of — compared with a figure of 0.51 for the country
as a whole.