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earlier than that of a death-register, and is therefore more available for many practical
purposes. But the returns of the Registrar-general are from their nature more comprehensive,
and hence form a more reliable basis for sanitary investigations. Still the
books of the workhouse will be found to furnish valuable corroboration to the statements
and inferences which have been founded on the mortality returns.
The table on the following page exhibits the cases of disease which came
newly under treatment by the Medical Officers of the workhouse, in the year 1858.
It also distinguishes those diseases to which chief interest attaches, either from their
being more preventible than others, or from their especial prevalence in St. Giles's.
The mortality from all causes, and from each of these diseases, is also given.
Within the workhouse itself, only 864 new cases of disease came under
treatment, and almost the whole of these originated out of the house. The corresponding
number in 1857, was 1037, and it was 1149 in the year 1856. The mortality
among these 861 persons was 209, or 24 per cent. For the explanation of this
enormous mortality, we must as usual look to the peculiar class of the patients, and
the incurable nature of many of their diseases. Nearly half the deaths occurred from
old bronchitis and consumption, though these diseases were not more fatal than usual.
Twenty-three persons died from apoplexy and paralysis, and 18 from mere old age.
Among the residents in the workhouse, there were 66 deaths, chiefly from the
diseases just mentioned. Of zymotic diseases, singularly few cases were received from
without into the infirmary. Among the inmates of the house, a few cases of diarrhæa
occurred among the old people and infants, and four persons become affected with
erysipelas. A good many cases of ophthalmia are found on the registers, and the
disease appears to have prevailed among the inmates of the house in the latter part of
the year.
Among the out-door poor who apply for medical relief at the workhouse,
bronchitis in the cold months, diarrhoea in the autumn, and febrile attacks of small
importance all the year round, are always the principal complaints. In 1858, there
were only three - quarters of the cases of bronchitis, and one-half the cases of
diarrhoea that were seen in 1857. In part this arose from an excess of these complaints
is the earlier year. But in the case of diarrhoea, the fall of 1858 is of very singular
and exceptional extent, and corresponds with the very reduced mortality from the complaint
which we have before noticed with satisfaction.
The patients visited at their homes, in 1858, were more numerous than in
1856, but fewer by 118 than in 1857. In this list, scarlatina has risen, and measles
has fallen from their respective amounts in 1857. Less bronchitis, and less diarrhoea
were met with, in about the same ratios here as in the other class of patients. The
diseases recorded as "Fever," and "Febricula," have slightly risen in numbers, but as
heretofore it is impossible, though most desirable, to separate the true idiopathic fevers
from the mass of diseases grouped with them under these two designations on the workhouse
books.
Two diseases appear in the foregoing table, for the first time this year. Of
the one, ophthalmia, I have already made sufficient mention. The other is Ague—of
which 43 cases came under observation among paupers in St. Giles's. It has been
ascertained by the Association of Medical Officers, that a proportionate number