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104
We do not think it necessary to burden our report with
similar details in reference to the mortality from Whooping Cough
during the period under discussion. It will be sufficient to say
that there has been no decline in the mortality from that disease
corresponding with the decline in Small-Pox mortality.
Great stress has been laid on the fact that the records of
the Registrar-General show that the mortality returned under the
head " fevers " has very largely diminished. But it is notorious
that in comparatively recent years the nomenclature and classification
of diseases where fever is present have undergone great
changes, owing to improved diagnosis. In the case of many such
diseases where the cause of death was formerly returned merely
as " fever," it is now attributed to some other disease separately
specified. The apparent diminution is therefore not entirely a
real one. Changes in nomenclature and classification, however,
cannot wholly explain the diminution in the number of deaths
returned as due to fever, though they prevent exact quantitative
comparison such as can be made in the case of diseases like
Small-pox, Measles, &c. The mortality from fevers has undoubtedly
decreased largely. In considering the relation of this
decrease to improved sanitary conditions, it is important to advert
to the nature of these sanitary improvements. They may be
broadly classed as follows :—(a) Drainage, including in the term
the removal of moisture from damp and swampy places, and the
adequately rapid and effectual removal of the excreta of the
bowels and the kidneys. (b) Ventilation of dwellings or the
rapid and effective renewal of the air surrounding the inhabitants.
(c) Lighting of dwellings. The means taken to secure this
also entail greater ventilation; the two go together, but besides
this the effect of light on organisms or microbes, to which contagia
seem analogous, would lead one to suppose that increased light,
at least sunlight, tended to destroy contagia. (d) A supply of
pure water for drinking purposes. (e) Personal cleanliness.
This, apart from its influence on general health, would have a
tendency to render an individual less likely to receive contagion,