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VITAL STATISTICS OF 1919.
608
THE LANGHAM TELEPHONE EXCHANGE: MEDICAL MEN’S NEW NUMBERS. WE gave last week a list, as complete as possible, of the telephone circuits of medical men and dentists practising in the Harley-street area which were transferred on Saturday, March 5th, from the Mayfair to the Langham Exchange. We anticipated that the list supplied to us was not quite complete and now make the following additions :-
We shall be corrections.
glad
to
publish
any further necessary
_______________
GENERAL COUNCIL OF MEDICAL EDUCATION AND REGISTRATION.
THE
AT an Executive Committee held recently a number of matters of public interest came up for consideration. Reappointment of members.-Official notification was read of the reappointment of the following members of the Council: Dr. Benjamin Bloomfield Connolly, as representative of the Society of Apothecaries of London for one year from Dec. 10th, 1920; Sir Arthur Chance, F.R.C.S.I., as representative of the Royal College of Surgeons in Ireland for one year from Feb. 6th, 1921 ; Dr. Sydney Russell Wells, as representative of the University of London for one year from Feb. 24th, 1921. Restoration of names to the Refjister.-The Registrar reported that the names of the undermentioned practitioners had been restored to the Medical Register, from which they had been erased on account of failure to communicate their addresses to the Registrar :Addinsell, Augustus W. Herbert, Charles A. MacLaren, James P. Dakin-Smith, William H. Milne, John B. Ellis, Robert S. Nash, Charles H. Ennis, John C. ’
Fuller, Ashbury J. S. Fyzee, Ali A. H. Griffiths, Alfred T. Hawkins, Charles T. Hayward, William H.
Oldham, Ralph S. Somerset, Vere E.
Strong, Clement P. Turnbull, Arthur Wright, Reginald H.
Reciprocity with Spain.-A communication was received from the Privy Council enclosing a translation of a Royal Decree relating to the practice of medicine and dentistry in Spain, with a view to applying to Spain the provisions of Part II. of the Medical Act, 1886. The Decree sets out that, henceforth, only doctors and dentists who have obtained their qualifications in countries with which Spain has reciprocal relations will be authorised to practise ; and that temporary authorisations now in force will terminate as soon as the period expires for which they were granted. It was resolved to inquire (1) what privileges of practising in Spain would be afforded to registered British medical practitioners in the event of reciprocity being established with that country, and (2) into the course of’ study and examinations prescribed for the Spanish diploma. -
Indian universities and
midwifery.-After
consider-
ing the replies received from Indian universities and colleges to a circular letter regarding the course of study in midwifery pursued by candidates for Indian medical diplomas, it was resolved that such diplomas under existing conditions did not furnish a sufficient guarantee of the possession of the requisite knowledge and skill for the efficient practice of midwifery within the meaning of Section 13 (i.) of the Medical Act, 1886, and that unless the requirements are forthwith brought
I
into accordance with the Council’s resolutions recogni. tion of the respective medical diplomas must ceae. The btcff telephone book.-The question of the appearance of names in this book was informally under the consideration of the Committee in November. The Bar Council had sent a communication stating that it considered the book to be issued for advertising purposes, and that it had resolved that it is not in accordance with the etiquette of the profession for barristers to insert their names in the book. The Law Society had so far felt a difficulty in expressing an opinion that it was contrary to the etiquette of the profession that solicitors should insert their names in the book.’The view the society had always expressed upon the question of directory advertising was that so’ long as a directory was open to the whole profession without distinction, whether for payment or not, there was no objection to a solicitor allowing his name to appear in it. The Royal College of Veterinary Surgeons desired to be informed of any decision to which the Council might come. It was resolved:That the insertion of the name of a medical practitioner for payment, whether with or without typographical display. in a list issued to the public, and purporting to be a list of local medical practitioners, which is not open to the whole of the profession without such payment, is not in accordance with profesfessional standards in respect of advertising, and might be held to bring a practitioner so advertising himself within the terms of No. 5 of the Council’s warning notices.
The Registrar was directed to bring this opinion to the notice of all persons making inquiry respecting their professional position in regard to this question. Correction of the Medical Register.-The Registrar reported that as the result of the issue of voting papers for the elections of direct representatives for the three divisions of the United Kingdom in November, 1919, 2277 papers in all were returned through the dead letter office. Although there was no legal obligation to do more than send an inquiry under Section 14, very great pains were always taken to prevent the unnecessary removal of names. By the courtesy of the editors a list of those who could not be traced was published in The Lancet and B7°etish ]}Iedical Joiirnal. As a result only 484 names had to be erased ; in other words, 1793 practitioners were saved from the consequences of their own neglect to keep a correct address in the Register. In consequence of the close relationships which have been established between the Ministries of Health and Pensions, the Boards of Education and Trade, Insurance Committees, chemists, &c., and the Council, it was far more difficult now than it used to be for persons whose names did not appear upon the Register to continue to practise as if registered. The system which was in force before the war for correcting the Register had now been followed again, and circulars of inquiry had been sent to all practitioners from the letter " P " to the end of the Register who did not communicate with the office in the course of the year 1920. These would be followed up and the necessary corrections or removals made.
VITAL STATISTICS OF 1919. REGISTRAR-GENERAL’S ANNUAL REPORT. THE birth- and death-rate conditions in 1919 were in respects exceptional. During the first half of the year the birth-rate fell to the lowest point on record, although in the latter half of the year it recovered considerably. The birth-rate for the entire year stands at 18’5 per 1000, which is 5’3 below the rate for 1914the last year unaffected by war conditions. The deathrate in 1919 was 13’7, being the lowest on record with the exception of the rates for 1910 and 1912, notwithstanding the heavy infiuenza fatality in the spring. Among common infectious diseases, the death-rates from enteric fever measles, and whooping-cough were the lowest on record. From tuberculosis, likewise, the mortality was the lowest hitherto observed, in spite of the infiuenza epidemic. From cancer the death-rate in 1919 was the highest yet recorded. This disease presents the some
609 one
great exception to the general tendency to decline
of
mortality. In 1919 the excess of births over deaths was 188,235, as with 362,354 in 1914-the last year influenced by peace conditions. The very low excess in 1918, which took no account of war casualties, except 3827 deaths at home from wounds, was due to the great mortality from influenza, in conjunction with the unprecedentedly low birth-rate. In 1919 both factors were still operative in kee]piiig down the natural increase, although births had slightly increased, and influenza mortality was much less formidable than in the previous year. It is important to note that there was not in 1919, as there had been in the preceding year, a large mortality from warfare abroad. The statistics of 1919 support the general belief that the best criterion of the health of a people consists in the mortality in the earlier days and weeks of life. It is probably for this reason that Dr. T. H. C. Stevenson, in his present review, returns to an examination of this question. He not only obtains additional support for
compared
the general belief, but supplies a series of instructive tables which will be appreciated by medical officers of health, and which throw new light on the whole question of mortality and its causes in early life.
Saving of Life
in
I7cfancy
and Childhood.
Of the deaths registered in 1919, only 12’2 per cent. The were those of infants under the age of 1 year. proportion has fallen rapidly in recent years because of the reduction both in infant mortality and in the birth-rate. So recently as 1901-10 the percentage was no less than 22’6. Infant mortality, in terms of total
than one-third, and that to convulsions was less than half of that so returned 14 years previously. It may be said of these causes, and this is equally true of diarrhoea, that they are gradually disappearing from our returns. The London mortality from convulsions was, as usual, much below, and that from Wales was above, that of the country generally. London has for years led the way in the
elimination of this unsatisfactory form of return. Among other causes deserving mention the following may be selected. Diarrhoea and enteritis with the lowest infant mortality except that of 1912; syphilis, which has declined since the startling rate for 1917, although the pre-war level has not yet been regained; overlying, which has presented a remarkable fall since 1914, so that the 1919 rates were less than half those of a few pre-war years; and atrophy and debility, which shows the lowest mortality ever returned for England and Wales. The unusually high mortality in London from these causes, noted in last year’s report, has now disappeared, the rates being again as usual, much below the average. We find that each of the principal causes contributes to the excessive mortality of the north of England and to the favourable position of the south, and this is true for each class of area in both cases. In proportion’to the mortality thus returned, convulsions is the chief contributor to the difference, for while its share in the total mortality is less than 7 per cent. it accounts for 22 per cent. of the difference between north and south. Atrophy, with a share of 16 per cent. in mortality, accounts for 26 per cent. of the difference, and prematurity, to which half of the total mortality is due, accounts for 41 per cent.
The great excess of mortality in the rural districts of 15’2 per cent. the north, and the fact that it exceeds that of the below the average- in the ten years immediately prenorthern towns, great or small, are features common to ceding. It is the lowest rate hitherto reported. the statistics of recent years. This large excess is The results of life-saving efforts vary considerably in different stages of the first year. The outstanding feature mainly attributable to the indefinite headings atrophy of the year’s record is that the mortality of the first and convulsions. There is no appreciable excess from four weeks of life was higher in 1919 than in any year premature birth. In the case of rural Wales, however, since 1911, while at the succeeding ages it was unpre- the heavy excess of mortality from convulsions must cedentedly low, notwithstanding the prevalence of influenza. largely represent deaths which elsewhere would be The deaths above the age of 1 month have long been attributed to other causes, and so possibly to prerecognised as the most preventable, and success in reduc- maturity. tion of infant mortality has mainly depended on this circumstance. But until the setback in 1919 the recorded Mortality in the First Five Years of Life. rates afforded grounds for hope that the first weeks of life Notwithstanding the continuance during the spring of were also beginning to participate in the improvement, as influenza epidemic, which had quite exceptionally the the result of administrative effort in recent years. The decline in mortality at ages above four weeks is noteworthy, raised the mortality of 1918 at these ages, the rate in but in this case the most remarkable feature in the year’s 1919 was very low. With the possible exception of 1916, record is the unusually low mortality from infectious disease. there has been no year recording so low a figure, and if The importance of this cause of mortality increases with innuenzal fatality be deducted the rate of 1919 is reduced age, and if infectious disease be omitted from comparison much below that of any previous year. the advantage of 1919 over previous years practically disIt is curious to observe that mortality at age 0-1, measured appears. The only infectious diseases specially important at this age in 1919 were measles and whooping-cough, the in terms of estimated population at that age, shows no loss of life from both of which was exceptionally low. As decrease from the corresponding rate of the preceding year, the decline in infant mortality. The already stated, infant mortality varies enormously iní notwithstanding different parts of the country, the rate ranging from 108 per anomaly is explained by the history of the birth-rate 1000 births in the larger towns of the north of England to during the year. The exceptionally scanty births of the 64 in the rural districts of the south. From the very first first two quarters alone contributed to the mid-year day after birth the excess of mortality in the north is well population on which the rate is founded, whereas the marked. After the first day the regular increase from numerous births of the last quarter are taken into south to north becomes the rule. In each of three years account in fixing the infant mortality-rate. The populacited for comparison much the highest rate for the first tion basis exaggerates the mortality of 1919, and that in to births diminishes it; in the one case because day of life has been returned from the rural districts of proportion the north, so that it seems as though the birth risk is for more deaths of very young infants accompanied the high birth-rate of the last quarter than the some reason at its maximum there. In Wales there was a relatively similar rural excess, but not in any part of England. There- mid-year population would account for, and in the other the births of the last quarter, which naturally fore, if defective midwifery service in remote districts be the because yield a lower mortality within the year than those of cause, this does not apply to the midlands or the south. earlier quarters, were in exceptionally high proportion. The increased mortality of the first four weeks after Mortality in the second year of life was lower in 1919 than birth is now shown to be limited to the first two, the in any other of the last few years, and therefore almost third and fourth having remained almost stationary. The certainly the lowest yet experienced, but at each of the three increase in the first two weeks is very general, applying succeeding years, 2-3, 3-4, and 4-5 lower rates were recorded with few exceptions to all types of area throughout the in other years. The tabulation of deaths of infants by separate months of age has been continued throughout the country. second year of life. The process has not been continued Causes of infant Mortality. beyond the second year because of difficulties connected with the estimates. The data for the first two years have From an analysis of the causes of infant mortality learn that in each period after the first four weeks the 1 been obtained by deduction of deaths from births, without for mortality from the principal causes, except influenza and the respiratory affections, was lower in 1919 than in Migration becomes increasingly important with the years immediately preceding the war. It was increase of age; and in view of the approach of the Census it has been thought best to limit the estimates lower than in 1918 from all the specified causes. case of whooping-cough and the other common infectious to the first two years of life. diseases the reduction was very great; specially noteworthy were the further large decreases from tubercle Dr. Eustace Greaves has been appointed an and convulsions, beyond the low records for these causes Official Member of the Legislative Council of the Island of in 1918. The mortality ascribed to tubercle was less Saint Vincent.
births,
was
equal to 89 per
1000, and
was
weI
any allowance
In the
migration.
,
,
...
’
THE LANGHAM TELEPHONE EXCHANGE: MEDICAL MEN’S NEW NUMBERS. WE gave last week a list, as complete as possible, of the telephone circuits of medical men and dentists practising in the Harley-street area which were transferred on Saturday, March 5th, from the Mayfair to the Langham Exchange. We anticipated that the list supplied to us was not quite complete and now make the following additions :-
We shall be corrections.
glad
to
publish
any further necessary
_______________
GENERAL COUNCIL OF MEDICAL EDUCATION AND REGISTRATION.
THE
AT an Executive Committee held recently a number of matters of public interest came up for consideration. Reappointment of members.-Official notification was read of the reappointment of the following members of the Council: Dr. Benjamin Bloomfield Connolly, as representative of the Society of Apothecaries of London for one year from Dec. 10th, 1920; Sir Arthur Chance, F.R.C.S.I., as representative of the Royal College of Surgeons in Ireland for one year from Feb. 6th, 1921 ; Dr. Sydney Russell Wells, as representative of the University of London for one year from Feb. 24th, 1921. Restoration of names to the Refjister.-The Registrar reported that the names of the undermentioned practitioners had been restored to the Medical Register, from which they had been erased on account of failure to communicate their addresses to the Registrar :Addinsell, Augustus W. Herbert, Charles A. MacLaren, James P. Dakin-Smith, William H. Milne, John B. Ellis, Robert S. Nash, Charles H. Ennis, John C. ’
Fuller, Ashbury J. S. Fyzee, Ali A. H. Griffiths, Alfred T. Hawkins, Charles T. Hayward, William H.
Oldham, Ralph S. Somerset, Vere E.
Strong, Clement P. Turnbull, Arthur Wright, Reginald H.
Reciprocity with Spain.-A communication was received from the Privy Council enclosing a translation of a Royal Decree relating to the practice of medicine and dentistry in Spain, with a view to applying to Spain the provisions of Part II. of the Medical Act, 1886. The Decree sets out that, henceforth, only doctors and dentists who have obtained their qualifications in countries with which Spain has reciprocal relations will be authorised to practise ; and that temporary authorisations now in force will terminate as soon as the period expires for which they were granted. It was resolved to inquire (1) what privileges of practising in Spain would be afforded to registered British medical practitioners in the event of reciprocity being established with that country, and (2) into the course of’ study and examinations prescribed for the Spanish diploma. -
Indian universities and
midwifery.-After
consider-
ing the replies received from Indian universities and colleges to a circular letter regarding the course of study in midwifery pursued by candidates for Indian medical diplomas, it was resolved that such diplomas under existing conditions did not furnish a sufficient guarantee of the possession of the requisite knowledge and skill for the efficient practice of midwifery within the meaning of Section 13 (i.) of the Medical Act, 1886, and that unless the requirements are forthwith brought
I
into accordance with the Council’s resolutions recogni. tion of the respective medical diplomas must ceae. The btcff telephone book.-The question of the appearance of names in this book was informally under the consideration of the Committee in November. The Bar Council had sent a communication stating that it considered the book to be issued for advertising purposes, and that it had resolved that it is not in accordance with the etiquette of the profession for barristers to insert their names in the book. The Law Society had so far felt a difficulty in expressing an opinion that it was contrary to the etiquette of the profession that solicitors should insert their names in the book.’The view the society had always expressed upon the question of directory advertising was that so’ long as a directory was open to the whole profession without distinction, whether for payment or not, there was no objection to a solicitor allowing his name to appear in it. The Royal College of Veterinary Surgeons desired to be informed of any decision to which the Council might come. It was resolved:That the insertion of the name of a medical practitioner for payment, whether with or without typographical display. in a list issued to the public, and purporting to be a list of local medical practitioners, which is not open to the whole of the profession without such payment, is not in accordance with profesfessional standards in respect of advertising, and might be held to bring a practitioner so advertising himself within the terms of No. 5 of the Council’s warning notices.
The Registrar was directed to bring this opinion to the notice of all persons making inquiry respecting their professional position in regard to this question. Correction of the Medical Register.-The Registrar reported that as the result of the issue of voting papers for the elections of direct representatives for the three divisions of the United Kingdom in November, 1919, 2277 papers in all were returned through the dead letter office. Although there was no legal obligation to do more than send an inquiry under Section 14, very great pains were always taken to prevent the unnecessary removal of names. By the courtesy of the editors a list of those who could not be traced was published in The Lancet and B7°etish ]}Iedical Joiirnal. As a result only 484 names had to be erased ; in other words, 1793 practitioners were saved from the consequences of their own neglect to keep a correct address in the Register. In consequence of the close relationships which have been established between the Ministries of Health and Pensions, the Boards of Education and Trade, Insurance Committees, chemists, &c., and the Council, it was far more difficult now than it used to be for persons whose names did not appear upon the Register to continue to practise as if registered. The system which was in force before the war for correcting the Register had now been followed again, and circulars of inquiry had been sent to all practitioners from the letter " P " to the end of the Register who did not communicate with the office in the course of the year 1920. These would be followed up and the necessary corrections or removals made.
VITAL STATISTICS OF 1919. REGISTRAR-GENERAL’S ANNUAL REPORT. THE birth- and death-rate conditions in 1919 were in respects exceptional. During the first half of the year the birth-rate fell to the lowest point on record, although in the latter half of the year it recovered considerably. The birth-rate for the entire year stands at 18’5 per 1000, which is 5’3 below the rate for 1914the last year unaffected by war conditions. The deathrate in 1919 was 13’7, being the lowest on record with the exception of the rates for 1910 and 1912, notwithstanding the heavy infiuenza fatality in the spring. Among common infectious diseases, the death-rates from enteric fever measles, and whooping-cough were the lowest on record. From tuberculosis, likewise, the mortality was the lowest hitherto observed, in spite of the infiuenza epidemic. From cancer the death-rate in 1919 was the highest yet recorded. This disease presents the some
609 one
great exception to the general tendency to decline
of
mortality. In 1919 the excess of births over deaths was 188,235, as with 362,354 in 1914-the last year influenced by peace conditions. The very low excess in 1918, which took no account of war casualties, except 3827 deaths at home from wounds, was due to the great mortality from influenza, in conjunction with the unprecedentedly low birth-rate. In 1919 both factors were still operative in kee]piiig down the natural increase, although births had slightly increased, and influenza mortality was much less formidable than in the previous year. It is important to note that there was not in 1919, as there had been in the preceding year, a large mortality from warfare abroad. The statistics of 1919 support the general belief that the best criterion of the health of a people consists in the mortality in the earlier days and weeks of life. It is probably for this reason that Dr. T. H. C. Stevenson, in his present review, returns to an examination of this question. He not only obtains additional support for
compared
the general belief, but supplies a series of instructive tables which will be appreciated by medical officers of health, and which throw new light on the whole question of mortality and its causes in early life.
Saving of Life
in
I7cfancy
and Childhood.
Of the deaths registered in 1919, only 12’2 per cent. The were those of infants under the age of 1 year. proportion has fallen rapidly in recent years because of the reduction both in infant mortality and in the birth-rate. So recently as 1901-10 the percentage was no less than 22’6. Infant mortality, in terms of total
than one-third, and that to convulsions was less than half of that so returned 14 years previously. It may be said of these causes, and this is equally true of diarrhoea, that they are gradually disappearing from our returns. The London mortality from convulsions was, as usual, much below, and that from Wales was above, that of the country generally. London has for years led the way in the
elimination of this unsatisfactory form of return. Among other causes deserving mention the following may be selected. Diarrhoea and enteritis with the lowest infant mortality except that of 1912; syphilis, which has declined since the startling rate for 1917, although the pre-war level has not yet been regained; overlying, which has presented a remarkable fall since 1914, so that the 1919 rates were less than half those of a few pre-war years; and atrophy and debility, which shows the lowest mortality ever returned for England and Wales. The unusually high mortality in London from these causes, noted in last year’s report, has now disappeared, the rates being again as usual, much below the average. We find that each of the principal causes contributes to the excessive mortality of the north of England and to the favourable position of the south, and this is true for each class of area in both cases. In proportion’to the mortality thus returned, convulsions is the chief contributor to the difference, for while its share in the total mortality is less than 7 per cent. it accounts for 22 per cent. of the difference between north and south. Atrophy, with a share of 16 per cent. in mortality, accounts for 26 per cent. of the difference, and prematurity, to which half of the total mortality is due, accounts for 41 per cent.
The great excess of mortality in the rural districts of 15’2 per cent. the north, and the fact that it exceeds that of the below the average- in the ten years immediately prenorthern towns, great or small, are features common to ceding. It is the lowest rate hitherto reported. the statistics of recent years. This large excess is The results of life-saving efforts vary considerably in different stages of the first year. The outstanding feature mainly attributable to the indefinite headings atrophy of the year’s record is that the mortality of the first and convulsions. There is no appreciable excess from four weeks of life was higher in 1919 than in any year premature birth. In the case of rural Wales, however, since 1911, while at the succeeding ages it was unpre- the heavy excess of mortality from convulsions must cedentedly low, notwithstanding the prevalence of influenza. largely represent deaths which elsewhere would be The deaths above the age of 1 month have long been attributed to other causes, and so possibly to prerecognised as the most preventable, and success in reduc- maturity. tion of infant mortality has mainly depended on this circumstance. But until the setback in 1919 the recorded Mortality in the First Five Years of Life. rates afforded grounds for hope that the first weeks of life Notwithstanding the continuance during the spring of were also beginning to participate in the improvement, as influenza epidemic, which had quite exceptionally the the result of administrative effort in recent years. The decline in mortality at ages above four weeks is noteworthy, raised the mortality of 1918 at these ages, the rate in but in this case the most remarkable feature in the year’s 1919 was very low. With the possible exception of 1916, record is the unusually low mortality from infectious disease. there has been no year recording so low a figure, and if The importance of this cause of mortality increases with innuenzal fatality be deducted the rate of 1919 is reduced age, and if infectious disease be omitted from comparison much below that of any previous year. the advantage of 1919 over previous years practically disIt is curious to observe that mortality at age 0-1, measured appears. The only infectious diseases specially important at this age in 1919 were measles and whooping-cough, the in terms of estimated population at that age, shows no loss of life from both of which was exceptionally low. As decrease from the corresponding rate of the preceding year, the decline in infant mortality. The already stated, infant mortality varies enormously iní notwithstanding different parts of the country, the rate ranging from 108 per anomaly is explained by the history of the birth-rate 1000 births in the larger towns of the north of England to during the year. The exceptionally scanty births of the 64 in the rural districts of the south. From the very first first two quarters alone contributed to the mid-year day after birth the excess of mortality in the north is well population on which the rate is founded, whereas the marked. After the first day the regular increase from numerous births of the last quarter are taken into south to north becomes the rule. In each of three years account in fixing the infant mortality-rate. The populacited for comparison much the highest rate for the first tion basis exaggerates the mortality of 1919, and that in to births diminishes it; in the one case because day of life has been returned from the rural districts of proportion the north, so that it seems as though the birth risk is for more deaths of very young infants accompanied the high birth-rate of the last quarter than the some reason at its maximum there. In Wales there was a relatively similar rural excess, but not in any part of England. There- mid-year population would account for, and in the other the births of the last quarter, which naturally fore, if defective midwifery service in remote districts be the because yield a lower mortality within the year than those of cause, this does not apply to the midlands or the south. earlier quarters, were in exceptionally high proportion. The increased mortality of the first four weeks after Mortality in the second year of life was lower in 1919 than birth is now shown to be limited to the first two, the in any other of the last few years, and therefore almost third and fourth having remained almost stationary. The certainly the lowest yet experienced, but at each of the three increase in the first two weeks is very general, applying succeeding years, 2-3, 3-4, and 4-5 lower rates were recorded with few exceptions to all types of area throughout the in other years. The tabulation of deaths of infants by separate months of age has been continued throughout the country. second year of life. The process has not been continued Causes of infant Mortality. beyond the second year because of difficulties connected with the estimates. The data for the first two years have From an analysis of the causes of infant mortality learn that in each period after the first four weeks the 1 been obtained by deduction of deaths from births, without for mortality from the principal causes, except influenza and the respiratory affections, was lower in 1919 than in Migration becomes increasingly important with the years immediately preceding the war. It was increase of age; and in view of the approach of the Census it has been thought best to limit the estimates lower than in 1918 from all the specified causes. case of whooping-cough and the other common infectious to the first two years of life. diseases the reduction was very great; specially noteworthy were the further large decreases from tubercle Dr. Eustace Greaves has been appointed an and convulsions, beyond the low records for these causes Official Member of the Legislative Council of the Island of in 1918. The mortality ascribed to tubercle was less Saint Vincent.
births,
was
equal to 89 per
1000, and
was
weI
any allowance
In the
migration.
,
,
...
’