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27
DIARRHŒA.
Diarrhoea was the cause of 97 deaths, compared with 105, 115, and 78, in the three
preceding years; 90 in the Town sub-district and 7 in Brompton; the corrected decennial
average being 100. The rate of mortality was 0 54 per 1,000 of the population.
[For an account of an enquiry made with respect to fatal cases of infantile diarrhoea in the
Borough in 1903, see page 44.]
The deaths in London, as a whole, were 2,958, and 786 below the corrected decennial
average (3,744): 2,643 of the deaths were of children under five years of age, including 2,168 of
infants under one year. The rate of mortality was 0·64 per 1,000 of the population.
The advice given by the Registrar-General in 1901, as to certification of fatal cases of this
disease,* has been followed to a fair extent by medical practitioners in the Borough during the past
year, and it may be anticipated that in course of time the object of the Royal College of Physicians
and the Registrar-General, accuracy in nomenclature, will be attained. In this connection it is
interesting to note that in London, as a whole, of the 2,958 total deaths from this cause 1,397 were
certified as Epidemic Diarrhœa and Infective Enteritis and 1,561 as Diarrhœa, Dysentery.
INFLUENZA.
Forty-one deaths were registered from influenza, as compared with 85, 28, and 68, in the
three preceding years; 31 in the Town sub-district, and 10 in Brompton. The deaths in
London, as a whole, from this cause were 644, against 1,950, 664, and 1,073, in the three
preceding years; and 635 below the corrected decennial average.
OTHER "GENERAL DISEASES."
Syphilis was the cause of 13 deaths, all of them in the Town sub-district: Gonorrhœa, Stricture
of Urethra, of one. Puerperal Diseases were the causes of two deaths—between 25 and 45 years of
age—both of them in the Town sub-district. Six deaths, five of them in the Town sub-district,
were registered as having occurred from accidents connected with childbirth. The deaths thus
registered as having been caused by diseases and accidents associated with parturition (eight in all),
were equal to 2·2 per 1,000 live births, compared with rates of 6·7, 3·1, and 2·9, per 1,000 in the three
preceding years respectively.
Bearing in mind the disastrous series of cases of Puerperal Fever on which I reported in 1883,
when a verdict of manslaughter was returned by a coroner's jury against a midwife, under circumstances
set out in the fourth and sixth reports for that year, I have since made it my duty to warn
nurses, and other women concerned with these painful cases, of the responsibility they incur by
attending parturient women until after a period of three or four weeks, and disinfection of their
persons, clothing, etc. This course was adopted in respect of the cases notified in 1903 with
satisfactory results, there having been no spread of the disease.
Erysipelas was the cause of six deaths, five of them in the Town sub-district. The notifications
of Erysipelas were 177; some of the cases were of traumatic origin, and others unimportant
in character, such as the framers of the Act could scarcely have intended to be notified.
Tuberculosis in its various forms was the cause of 285 deaths, as compared with 306, 314,
and 310, in the three preceding years; 257 in the Town sub-district and 28 in Brompton; 49 of them
under five years of age. Tubercular Phthisis (Pulmonary Tuberculosis) was the certified cause of 161
deaths (144 and 17 in the Town and Brompton sub-districts respectively) and "Phthisis" of 51—
Total 212 or 1·19 per 1,000 of the population. Tubercular Meningitis was the cause of 31 deaths;
Tubercular Peritonitis of 10; and General Tuberculosis of 25. The deaths from Tubercular Diseases
were, proportionately to population, not so numerous in Brompton as in the Town sub-district.
The total deaths were in the proportion of 1·6 per 1,000 of the population.
[Under other headings—"The Prevention and Treatment of Consumption"; "Sanatoria,"
and "Notification of Consumption," further information on the subject of Tuberculosis will be
found at pages 37-44.]
The deaths from Tubercular Diseases in London, as a whole, were 10,088, the corrected
decennial average being 11,410. Of these deaths 7,347 were due to Phthisis, the corrected decennial
average being 8,176. The death-rate from Phthisis in London, in 1903, per 1,000 persons living,
was 1·60 against 1·79, 1·71, and 1·64, in the three preceding years.
* Vide Annual Report of the Medical Officer of Health for 1902, page 38.