I find that in the month of January just passed I registered the deaths of 33 children under 4 years of age, of these 9 were attended by druggists; I believe all by one who has received no medical education: this is at the rate of 108 per annum. Three of the children had no assistance at all, making 12 out of 33 that might possibly have been saved. This number 33, however, is below the average of the year, for in the three months preceding there died in the district, of children under 4 years, 133, or 44 per month; and during the quarter ending 30th September, 1842, 169, or 56 per month; and the general number of those having no attendance, or being attended by druggists, is fully one-third, so that 100 per annum is much below the truth. I some time ago requested Mr. Bennet, the registrar for the Ancoats district, to make similar notes on the cases reported to him, and on inquiry from him I have reason to believe that the evil exists to as great an extent in his district as in mine. I find that in most of the cases no efficient medical treatment was adopted. Cases of pneumonia are seldom or never bled, or proper remedies applied: the disease is probably not recognized, and if it were, the treatment and extent to which it should be pursued is not known to the parties prescribing. A similar practice appears to be prevalent also in the mining districts of Staffordshire and Shropshire. (Vide Reports of the Sub-Commissioners for inquiring into employment in Mines, vol. I., pp. 22, 23; articles 182–6; and pp. 38, 39; pp. 305 to 315, and the recent report respecting the employment of children at Nottingham.) In the course of some recent inquiries by Dr. Lyon Playfair he found the increasing sale of opium in the manufacturing towns was ascribable to the increasing use of it in the form of carminative, or as it was named “quietness” for children, and that the consumption of opium by adults had diminished. On inquiring from the druggists who sold the opium what was the cause of the diminished consumption by the adults, the uniform answer was, the “distress of the times,” which compelled them to dispense with luxuries. He however ascertained clearly that from this terrible practice great numbers of children perish, sometimes suddenly from an overdose, but more commonly slowly, painfully, and insidiously. He was struck, however, with the fact of the increased proportions and rapidity of the births in the places where this infantile mortality was prevalent. It was remarked by the people themselves. So that there was no diminution of the numbers of children, but a woeful diminution of their strength and a proportionate increase of their burdensomeness. Those who escaped with life, became pale and sickly children, and it was very long before they overcame the effects arising from the pernicious practice; if indeed they ever did do so.[41]