170 



NATURE 



[April 7, 19 10 



(A most marked feature after gh. was the way in which 

 the streamers formed in the north and moved in a pro- 

 cession towards the west.) 



9.8. — Lower band entirely gone. Upper band still visible, 

 but faint. Numerous vertical streamers forming and inter- 

 secting the horizontal band, 



9.16. — Horizontal band had entirely disappeared. 

 Vertical streamers had increased in numbers and intensity. 

 Constant fluctuations in brilHancy until 9.28, when last 

 streamer had disappeared. 



Mr. S. L. Elborne, writing from Peterborough, reports 

 that on March 28, about 6 p.m., he saw a magnificent 

 ■display of parhelia or mock suns, lasting about twenty 

 minutes ; on each side of the sun, and at equal distances 

 from it in the same straight line, and parallel with the 

 horizon, appeared a brilliant spot displaying the colours of 

 the spectrum in the centre of each, giving the effect of 

 three suns setting simultaneously ; from each arose a 

 luminous band, thus making a splendid arch over the true 

 •sun. 



THE PUBLIC HEALTH OF THE METRO- 

 POLIS.' 



HTHIS report abounds in information of great interest to 

 all who have at heart the well-being of the metropolis. 

 The first part relates almost exclusively to vital statistics, 

 the second to public health administration, and the third 

 part contains much instructive matter upon school hygiene. 



The year 1908 was a very exceptional one for London 

 so far as vital statistics are concerned, for the marriage- 

 rate (15-9), birth-rate (25-2), and death-rate (13-8) were the 

 lowest ever recorded. The death-rate has shown a decline 

 for the past forty years, while in the case of the birth-rate 

 the fall year by year has been slight, but uninterrupted, 

 for some thirty years. What this decline in the death-rate 

 of a population of 4,795,757 persons implies is very forcibly 

 expressed in terms of " life capital." By this expression 

 Is implied the years of life saved to the community by 

 3. reduction in the death-rate. The number of lives saved 

 at each age period (as calculated by comparing the number 

 of deaths for the year, in each age period, with the mean 

 ■death-rates for those age periods for ten years, and crediting 

 each life saved with the years representing the expect^on 

 of life at that age) represented a saving of 26,205 lives, and 

 a gain to the community of 1,066,770 years of " life 

 capital." The highest corrected death-rates were furnished 

 Tjy the City of London, Finsbury, and Bermondsey, and 

 the lowest by Hampstead and Lewisham. 



The infant mortality rate was lower in London for the 

 last decennium than in all save one of the thirteen other 

 large English towns ; and London had a lower figure for 

 1908 than any of those towns. This fact, as Sir Shirley 

 Murphy, the Medical Officer of Health, states, is matter 

 for congratulation, though, as he adds, it needs to be remem- 

 bered that the infant mortality rate is liable to considerable 

 fluctuation, owing to climatic conditions and varying 

 tlegrees of prevalence of epidemic maladies. There are 

 notable differences in the rates of infant mortality in 

 districts well and badly circumstanced socially, a fact which 

 sufficiently indicates the results which might be obtained if 

 the infants of the less favoured districts had extended to 

 them the same care as that bestowed upon infants of the 

 better favoured districts. Among metropolitan boroughs 

 the loss of infant life has for several years been greatest 

 In Shoreditch and Bermondsey, and least in Hampstead. 



The infant mortality rate is, of course, affected by the 

 administrative efforts made to reduce it, but the rate is 

 so extremely sensitive to other influences, which vary from 

 year to year, that the value of this work cannot be judged 

 by the mortality of the moment. Among systematic efforts 

 now being made in the metropolis for the preservation of 

 infant life. Sir Shirley Murphy commends the system of 

 visitation by health visitors, and he points out that the 

 Notification of Births Act, 1907, which is such a valuable 

 measure for enabling this work to be undertaken most 



1 Report of the Public Health Committee of the London County Conncil, 

 submitting the Renort of the Medical Officer of Health of the Coun'y for 

 the Year 1908. (London : P. S. Kin? a ad Son.) Price 31. 6<f. 



advantageously, had in 1908 been adopted in all but eight 

 boroughs. In some districts otVicial workers were supple- 

 mented by a staff of voluntary workers supplied by local 

 health societies. 



During the year 1908 the lowest death-rate from thi 

 epidemic diseases was recorded. No death occurred from 

 small-pox, and the deaths from measles, whooping-cough, 

 diphtherixi, enteric fever, diarrhoea, and phthisis were below 

 the averages of the last ten years, but those from influenza 

 and scarlet fever were above the averages. 



The London vaccination returns give food for thought 

 and apprehension. As legislation has made it more and 

 more easy to obtain exemption from vaccination, the 

 unvaccinated children would be expected to increase. The 

 latest returns recorded are those for the year 1906, when 

 the percentage of unvaccinated children was 21-2, as against 

 26-4 in 1896, 78 in 1886, and 6-5 in 1876. There can be 

 little doubt that the percentage of exemptions for the past 

 three years will, when these are available, demonstrate 

 a considerable increase. A notable feature in the behaviour 

 of enteric fever in London in recent years has been the 

 manifestation of localised prevalence occurring in poor 

 populations and lasting often for a considerable number of 

 weeks. There were two such prevalences in 1908, one in 

 Bethnal Green and the other in Shoreditch, and Dr. Hamer 

 furnishes, in an appendix, a full report on these two 

 outbreaks. 



Special reference is made to results obtained by Dr. 

 Sidney Davics from the voluntary notification of zymotic 

 diarrhoea among infants in Woolwich in the months of 

 July, August, and September. Dr. Davies is of opinion 

 that the infection spreads from person to person, and he 

 thinks the distribution of the cases is consistent with the 

 hypothesis that the disease is conveyed by flies. .An 

 examination of the statistics contained in his inquiry shows 

 that while infants who are breast-fed suffered much less 

 than those artificially fed, there is not much difference 

 between the incidence of attack on children fed on cow's 

 milk and those fed on condensed milk — except among the 

 children fed on cow's milk at the Infants' Milk Depot, 

 who suffered much less than other infants artificially fed. 



The phthisis death-rate for 1908 was the lowest ever 

 recorded. It amounted to 1-32 deaths to every 1000 persons 

 living during the year. In dealing with phthisis the Medical 

 Ofllcer comments' upon the work done in connection with 

 the voluntary notification system in operation in twenty-one 

 London boroughs in 1Q08, and he refers to the Order of 

 the Local Government Board requiring notification of cases 

 of phthisis in London which occur in Poor Law practice. 

 I^ndon is, however, as the medical officer points out, but 

 ' very imperfectly provided with the opportunities which are 

 needed for utilising the knowledge thus gained. Phthisis 

 mortality occurs especially among the poor, and measures 

 for its reduction must not only include sanatoria and 

 hospitals, but also those which afford assistance not only 

 10 the sufferer, but often to the families which are dependent 

 upon him. It is here that the extension of philanthropic 

 effort is greatlv needed. 



For the purpose of enabling the incidence of cancer on 

 Ihe several populations of the London sanitary areas to 

 be more preciselv stated, factors have been calculated for 

 correcting the death-rates, so far as possible, for the differ- 

 ences in the age and sex constitution of the several popula- 

 tions compared. When these allowances are made it is 

 found that in the year 1908 St. Pancras (1-17) had the 

 highest rate, and that the lowest obtained in Fulham (0-79). 



The question of nuisance from flies in connection with 

 deposits of house refuse and stable manure has again been 

 dealt with on lines similar to those followed in 1907, and 

 the observations form the subject of another appendix to 

 the report. In 1907, as in igo8. the large part played by 

 collections of horse manure in determining fly prevalence 

 was abundantlv apparent, and the need for regulating the 

 sanitarv condition of stables was thus again emphasised. 



On July I, 1908, the administration of the General 

 Powers Act, 1907, part iv., was brought into operation, 

 and from that time until the end of the year 620 samples 

 of milk were taken, principally from churns at the large 

 railway stations. Of the samples in which it was found 

 practicable to make a complete examination, ii-6 per cent, 

 were found to be tuberculous. The farms supplying the 



NO. 2IIO, VOL. 83] 



