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14
Death-rate in England and Wales, and in London and Greater London.— The
death-rate in England and Wales, in 1903, was 15·4 per 1,000, the lowest yet recorded, and 2·2
per 1,000 below the average for the ten years 1893-1902. The London rate was 15·7 per 1,000, and
2·2 below the decennial average and the lowest yet recorded.

Greater London.— The death-rate in "Greater London," which is co-extensive with the
Metropolitan and City Police districts, the population at the middle of the year numbering 6,806,299
(viz., 4,613,812 in Inner or Registration London, which is co-terminous with the administrative
County, and 2,192,484 in the Outer Ring) was 14·5 per 1,000 as compared with 17·7, 16·3 and 16·4
in the three preceding years respectively. The deaths properly belonging to the Outer Ring, as
distinguished from those in the County of London, were equivalent to a rate of only 12·0 per 1,000,
the rate in the County being 15·7.
The infantile mortality rate of Greater London was 126 per 1,000 births registered; of the
County of London, 131, of Outer London, 114.
ASSIGNED CAUSES OF DEATH.
In my annual report for 1873 (page 10) the following passage occurs:—
"New Forms for Recording Vital and Mortal Statistics."—The tables in the Appendix, numbered
I. to VI., inclusive, have been drawn up by the Society of Medical Officers of Health for
general use throughout the country, and with a view to facilitate comparison between different
districts, and with standard areas. The want of uniformity in statistical returns of the medical
reports had long been felt; I was induced, therefore, to bring the subject before the Society,
which, after a most careful consideration, and having obtained the views of a great many
medical officers of health, settled these forms, which it is hoped will supply all the information
that is absolutely requisite without imposing an undue amount of work on those who may use
them. Should the tables come into general use they cannot fail to invest the vital statistics in
the reports of medical officers with a much greater and more universal interest than heretofore."
Tables similar to those referred to as being numbered I. to VI., had previously been employed
in my annual reports, and Tables I. to VI. were used from 1873 onwards to 1899, inclusive, in the
tabulation of vital, mortal, and sanitary statistics. These tables, between 1894 and 1899, were
supplemented by others ("A" and "B"), directed by the Local Government Board to be used,
so as to secure a "tabular statement of mortality, and a tabular statement of infectious disease in
all districts on a uniform plan." Tables A and B have now been superseded by Tables, numbered
I. to IV., directed by the Board to be used. The other tables used in preceding annual reports,
now numbered from VI. to X., will be found in Appendix I., pp. 90—100.
NEW LIST OF CAUSES OF DEATH.
The Registrar-General issued, in 1902, a "New List of Causes of Death" as used in the
Annual Reports of England and Wales, together with "Suggestions to Medical Practitioners
respecting Certificates of Causes of Death," in which it is stated to be "highly desirable that
Medical Practitioners should use only those terms which are recognised by the Royal College of
Physicians of London."* This List takes the place of that used in these reports for many years as
Table III., and since 1900 as Table VIII. It comprises the "General Diseases," i.e., those in
which the whole body may be said to suffer, and the "Local Diseases," of various systems and
organs, set out in Table VIII. at page 92, in which the first twenty diseases are those formerly
described as "Specific, Febrile or Zymotic Diseases;" chief among them being the nine
"Principal Zymotic diseases;" three of which were formerly associated under the generic name
"Fever," which comprises three distinct diseases, viz.: Typhus-fever, Enteric-fever, and Simple
continued fever ("Pyrexia ").
* The Registrar-General placed at my disposal a sufficient number of copies of the New List to enable me to forward one
to each registered medical practitioner in the borough, which was done in October, 1902.