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39
The advice in the memorandum 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 and the Registrar-General will be attained. In this connexion it is interesting
to note that in London as a whole, of the 2,504 total deaths from this cause 1,079 were certified as
Epidemic Diarrhœa and Epidemic Enteritis, and 1,425 as Diarrhœa, Dysentery.
INFLUENZA.
Sixty eight deaths were registered from influenza, as compared with 103, 85, and 28, in the
three preceding years: 47 in the Town sub-district, and 21 in Brompton. The deaths in London,
as a whole, from this cause were 1,073, against 1,817, 1,950, and 664, in the three preceding years ;
and 358 below the decennial average (1,431).
OTHER "GENERAL DISEASES."
Syphilis was the cause of 21 deaths, all but three in the Town sub-district: Gonorrhoea, Stricture
of Urethra, of one. Puerperal Diseases were the causes of five deaths—between 15 and 35 years of
age—four of them in the Town sub-district. Five deaths (four of them in the Town sub-district)
were registered as having occured from accidents connected with childbirth. The deaths thus
registered as having been caused by diseases and accidents associated with parturition (ten in all),
were equal to 2.9 per 1,000 live births, compared with rates of 2.5, 6'7, and 3.1 per 1,000 in the
three preceding years.
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 1902 with
satisfactory results, there having been no spread of the disease.
Erysipelas was the cause of six deaths, all in the Town sub-district. The notifications of
Erysipelas were 189, some of the cases being 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 310 deaths, as compared with 319, 306, and
314, in the three preceding years; 267 in the Town sub-district and 43 in Brompton; 59 of them
under five years of age. Tubercular Phthisis (Pulmonary Tuberculosis) was accountable for 220
of the deaths; 188 and 32 in the Town and Brompton sub-districts respectively and 1.24 per
1,000 of the population. Tubercular Meningitis was the cause of 38 deaths; Tubercular Peritonitis
of 9; General Tuberculosis of 3, and Scrofula (an objectionable term), of 40.
The deaths from Tubercular Diseases were, proportionately to population, not so numerous
in Brompton as the Town sub-district. The total deaths were in the proportion of 1.7 per 1,000 of
the population. [Under the heading "The Prevention and Treatment of Consumption," further
information on the subject of Tuberculosis will be found at page 49.]
The deaths from Tubercular Diseases in London, as a whole, in 53 weeks, were 10,377, the
corrected decennial average being 11,776. Of these deaths 7,621 were due to Phthisis, the
corrected decennial average being 8,389. The death-rate from Phthisis in London, in 1902, per
1,000 persons living, was 1.64 (against 1.90, 1.79, and 1.71, in the three preceeding years), the rate
in the several districts being West, 1.40 ; South, 1.52 ; North, 1.56 ; East, 1.85 ; Central, 2.13.
Alcoholism, Delirium Tremens, was the cause of eleven deaths, six in the Town sub-district
and five in Brompton. The deaths in London, as a whole, in 53 weeks, were 666, the
corrected decennial average being 620.
It is scarcely necessary, perhaps, to remark that if all the deaths due, directly or indirectly,
to the immoderate use of intoxicating liquors were correctly certified, alcoholism would occupy a
more prominent position in the bills of mortality; but many deaths due to the misuse of alcohol
get certified, and are necessarily classified, to visceral and degenerative diseases caused or
aggravated by drink.
Rheumatic Fever, Acute Rheumatism, was the cause of 15 deaths, 13 of them in the Town
sub-district.