"It has been one of the great faults of our sanitary arrangements and legislation for London," wrote the Medical Officer of Health for St. James' in 1872, "that the metropolis has not been regarded as a whole, and that through the ignorance, or carelessness, of one District or Local Board the whole of the others may be put in peril." * * * * * "It is impossible, with our present municipal machinery, in London, at any rate, to exercise all that power which is necessary for the prevention of the spread of infectious diseases." And the Medical Officer of Health for Whitechapel in 1873 wrote:-- "If any alteration is made in the constitution of the Metropolitan Board of Works it would be desirable to add to its functions that of a sanitary supervision over the whole metropolis." And in 1881 the Medical Officer of Health for Kensington wrote:-- "London is grievously in need of a Central Sanitary Department to establish something like unity in the sanitary arrangements of its 39 divisions.... Every other large centre of population has but one sanitary authority." Though much more time, thought, and labour, were being devoted than ever before to matters relating to the public health, and with very beneficial results, one matter appeared to be quite unaffected thereby, for none of the great measures of sanitary improvement which had been carried out since the central and local authorities had come into being seem to have had any effect during the 1871-80 decade upon infantile mortality. If anything the figures appear higher. In St. George-in-the-East in 1871-2 the deaths of children under five years were 51 per cent. of all the deaths. In Mile-End-Old-Town in 1872-3, out of a total of 2,200 deaths, 1,087, or practically 50 per cent., were deaths of children under five, a mortality which evoked the comment from the Medical Officer of Health:-- "Apart from congenital causes, a large majority of these young lives would, under conditions more favourable to existence, be preserved.... It is certain that the present generation of London children is physically degenerate." And a year later he wrote:-- "I consider about two-thirds of the infantile mortality attributable to neglect, improper feeding, impure air from overcrowding, and general bad management through ignorance and carelessness of parents and nurses." In Kensington, away in the west, the average annual infantile mortality over a period of ten years--1863-73--was 42 per cent. of the total deaths. The Medical Officer of Health for Whitechapel wrote (1873):-- "There must be something very wrong in the condition of the people when we find that out of all children born about one-fifth die before they are one year old, and one-third before they are five."