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rare, and it is now this rarity which creates difficulties in finding the
source, because this can usually be conjectured only by finding one source
as common to a number of cases. Today, tuberculosis is so common that,
apart from those cases where there is a family infection or where there is
some equally obvious possible source such as of nurses in sanatoria, there
is no knowing where the patient picked up the infection. Is it too much
to hope that the fall in incidence might be to such low levels that the
diagnosis of disease in any person will be followed with the same object
by enquiries similar to those now made on the occurrence of a case of
typhoid fever ?
MATERNITY AND CHILD WELFARE.
REGISTRATION AND NOTIFICATION OF BIRTHS.
The total number of live births registered during the year was
3,500; 1,815 male and 1,685 female.
Of these 150 were illegitimate, being a percentage of total births
of 4.3.
2,488 births occurred in the district (2,437 live and 51 still births).
Of this number 416 (407 live and nine still births) were to residents of
other districts. Of the local confinements, 2,383 were notified by midwives
and 105 by doctors or parents.
1,437 (1,390 live and 47 still birth) notifications were transferred from
other districts, being mostly of births occurring to Harrow mothers in
Middlesex County Council or London hospitals.
STILL BIRTHS.
56 male and 45 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.
For all but two of the years 1934 to 1939 this figure was near 0.55,
being slightly below the average national rate of 0.61. Both locally and
nationally the average figures for the years 1940 to 1942 showed a decline,
the local figure to 0.42, and the figure for the country to 0.53.
Of the 50 cases about which any particulars have been obtained,
four were dead before the onset of a premature labour (in one, shock was
thought to be the cause, in another multiple pregnancy) while in 12 other
cases the confinement was premature (toxaemia 3, ante-partum haemorrhage
2, a fall 1, severe developmental abnormality 1, long labour 1).
In 3 the foetus was dead before the onset of labour at term (a fall being
the assumed cause in one and shock in another), while in 34 the foetus
was considered to be alive at the onset of labour at term. In 9 labour
was difficult; caesarian section was performed in 2 cases; the cord was
round the neck in 2, and prolapsed in another 2; the mother was
suffering from some degree of toxaemia in 5 instances, while 1 infant was
suffering from developmental abnormality.
CHILD MORTALITY.
In the following table is set out an analysis of the ages at which
the deaths amongst children under five occurred in each of the four
years, 1940 to 1943.