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15
Death-rate in England and Wales and in London and in other Large Towns.—
The death-rate in England and Wales in 1904 was 162 per 1,000 and l·0 per 1,000 below the
average rate in the preceding ten years. The rate in London, as already stated, was 16·6 per 1,000
of the estimated population—0·9 above the corresponding rate in 1903, which had been the lowest
on record; it was, however, 1·7 below the average rate in the 10 years 1894-1903.

Greater London.—The death-rate in "Greater London"—which is co-extensive with the
"Metropolitan" and "City" Police Districts, the population of which at the middle of the year
was 6,907,756 (viz. 4,648,950 in Inner or Registration London and 2,258,806 in the Outer Ring) was
15·5 per 1,000, as compared with 16·3, 16·4 and 14·5, severally in the three preceding years. In the
County of London the mortality was at the rate of 16·6 per 1,000, whilst in the Outer Ring it did
not exceed 13·2. Infantile mortality in Greater London was equal to 143 per 1,000 births, as
compared with 146, 135 and 126, severally in the three preceding years. Last year infantile
mortality was equal to 146 per 1,000 in the County of London and to 138 in the Outer Ring.
Other Large Towns.—The crude death-rate in the seventy-six large towns, including
London (population 15,271,287), was 17·2 per 1,000, or 0·9 above the rate in 1903—ranging from
8·44 in Hornsey, 11·04 in King's Norton, and 120 in Willesden to 21·48 in Wigan, 21·27 in·
Manchester, and 22·59 in Liverpool.* The death-rates of Edinburgh, Glasgow, Dublin and Belfast
were severally 16·6, 19·2, 23·4 and 20·9. The rates are calculated without references to differences
between one town and another with regard to the age and sex distribution of their respective
populations. But the sex and age composition of the several populations having been ascertained
at the Census of 1901, suitable factors have been calculated for correcting the recorded death-rates
in the large towns in order to render them fairly comparable with one another, and in his Annual
Summary the Registrar-General (page iv.) furnishes a table showing the recorded and corrected
death-rates per 1,000 persons living, in each of the 76 great towns in 1904.
Colonial and Foreign Cities.—The authorities of a large number of the principal cities
supply returns of mortality to the Registrar-General. The highest death rates recorded in 1904
were Moscow 27.6, Trieste 25.8, St. Petersburg 23.7, and New York 22.6; the lowest, Sydney 11.2,
Brisbane 11.5, Christiania 13.5, and Chicago 13.6.
Indian and Egyptian Cities.—The death-rate was equal to 30.0 per 1,000 in Calcutta'
37.9 in Madras, and 55.0 in Bombay. In Cairo and Alexandria the death-rates among the native
populations were 38.4 and 37.3 per 1,000 respectively; these high-rates being largely attributable to
to excessive mortality from diarrhoeal diseases.
ASSIGNED CAUSES OF DEATH.
The Registrar-General issued, in 1902, a "New List of Causes of Death" as used in the
Annual Reports of England and Wales, together with "Suggestions to Medical Practitioners
respecting Certificates of Causes of Death," in which it is stated to be "highly desirable that
Medical Practitioners should use only those terms which are recognised by the Royal College of
Physicians of London."* This List takes the place of the one used in these reports for many years
as Table III., and since 1900 as Table VIII. It comprises the "General Diseases," i.e., those in
which the whole body may be said to suffer, and the "Local Diseases," of various systems and
organs, set out in Table VIII., at page 100, in which the first twenty diseases are those formerly
described as "Specific, Febrile or Zymotic Diseases;" chief among them being the nine
"Principal Zymotic Diseases;" three of which were formerly associated under the generic name
"Fever," which comprises three distinct diseases, viz.: Typhus-fever, Enteric-fever, and Simple
continued fever ("Pyrexia").
*The Registrar-General placed at ray disposal a sufficient number of copies of the New List to enable me to forward one
to each registered medical practitioner in the Borough, which was done in October, 1902.