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4
of 21.9 per 1000 per annum, whilst that for London is at the apparent
rate of 19.9 per 1000 per annum. The real death-rate could be arrived
at by adding the deaths of those inhabitants of London, who dying
outside registration London, at the Metropolitan Asylums Hospitals
and ships at Darenth, are not included in the figures from which the
death-rate above is compiled. The same remark applies with increased
force when calculating the zymotic death-rate, which for London
seems to be only 3.6 per 1000, but would be much higher were the
deaths at Darenth from small-pox added. The Whitechapel District
zymotic death-rate is only 2.8 per 1000. All the deaths from diarrhœa
were amongst infants who, with one exception, were under a year
old. Improper and irregular feeding is no doubt responsible for
many deaths in infants from this disease. A careful inspection of
the Tables alluded to calls for congratulation at the low mortality
from epidemic diseases, as only 5 deaths are recorded from small-pox,
and only 1 of these took place in the District.
Concerning infant mortality—a matter of the highest importance
in these Reports—I notice that the infants who died under one year
in London equalled 22.2 per cent. of the total deaths and 13.1 per
cent. of the registered births. The deaths of children under five
years of age, including the above, equalled 44.0 per cent. of the
total deaths, and 25.9 per cent. of the registered births. In the
Whitechapel District, the infants who died under one year, equalled
20.2 per cent. of the total deaths, and 12.7 per cent. of the registered
births, whilst the deaths of children under the age of five, including
the above, equalled 38.9 per cent. of the total deaths, and 21.6 per
cent. of the registered births. On the same table to which I have
been referring, will be found the cases attended by the Dislrict
Medical Officers during the quarter, as also those under treatment in
the Infirmary, which were admitted during the same period. From
the first of the two columns I have excluded the 450 cases which
were sent into the Infirmary, or removed to special hospitals, as they
mostly appear in the adjoining column, which was compiled for me
by Dr. Ilott.
The Vaccination Returns by the Vaccination Officer, Mr.
W. M. S. Sherman, again show much useful work. In my last Report
I called attention to the necessity which existed for the enforcement
of Vaccination and Re-Vaccination. I should strongly advise that
the Public Vaccinators should have power to re-vaccinate children
after seven years of age, and for this reason : Extracting the details