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however, are they so large as in the rest of London,
though they far exceed the average for all England.
Phthisis, too, is most fatal in the Central district, where
it contributes 13.6 per cent. of all the deaths. In the
Eastern district it amounts to only 12.7 percent., and
in the Western to 13; but everywhere within the
City the mortality from this disease is larger than in
the rest of London (11.5 per cent.), and much larger
than the average (10.9) for the whole of England.
It is manifest, therefore, that the circumstances
which give activity to this affection are very prevalent
within the City, especially in the central part of it.
Tabes, scrofula, and hydrocephalus, which are the
tubercular affections of children, are most marked in
the Eastern and Western districts, where the birthrate
is largest, and where unwholesome endemic influences
are most active. The same is the case with
other wasting disorders of infancy, as marasmus,
atrophy, &c. Taking, in fact, the whole of these infantile
maladies, it will be noticed that they contribute
about 72 per 1,000 of all the deaths in the City—the
range being from 49 per 1,000 in the Central district to
81 and 84 per 1,000 in the Eastern and Western. In
the rest of London the proportion is 86 per 1,000, and
in all England it is 96; but considering the
comparatively small birth-rate of the City, it is
evident that the mortality from tubercular and
other wasting diseases of infancy is excessive—it
being very apparent when we place it in juxtaposition
with the number of births, for we then find