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6-12 months, while in 1929 there was, in addition, an increase in deaths
under four weeks. It will be seen that, during these years, amongst
children in the older age-group, pneumonia was much in evidence,
while amongst infants under four weeks, convulsions, congenital malformations
and premature births showed an actual increase.
The continued high percentage of deaths occurring within the first
four weeks of life (35 per cent, to 40 per cent, of the total) calls for
comment. The figure in 1929 is actually higher than in the decennium
1915-1924.
Mortality in the first few weeks of life is not amenable to those
preventive measures which prove efficacious in later infancy. The high
death-rate in the first four weeks, and especially in the first week of life
is associated with conditions existing in the pre-natal period, and is
closely connected with the causes responsible for the continued high
mortality and morbidity amongst women in the lying-in period. It is
not too much to say that maternal mortality and the early infant
mortality both reflect the same problem, the solution to which has yet
to be found.
It stresses, however, the importance of every gravid woman's
placing herself under medical supervision. By so doing, ill-health in
the mother or mal-presentations of the child may be detected and
remedied in time.
Special Noteworthy Causes of Sickness or Invalidity.
In the absence of any system by which information of current
illness would be accessible to the Medical Officer of Health it is not
possible to express an opinion, except in very general terms, as to what
specific cause the bulk of illness amongst the population is attributable.
Clearly, the death returns, dealing as they do mainly with the causes
leading up to the fatal issue, give little information upon which any
estimate of the amount of invalidity may be based. Thus, to take an
extreme example : Pneumonia and cancer in 1929 caused practically
the same number of deaths, but it is obvious that the extent and period
of invalidity in the two cases would bear no possible relationship.
Consideration, however, of the preceding mortality tables shows
that although yearly fluctuations occur, the most common causes of
death, in descending sequence, are associated with the circulatory and