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of the total of 88 fatal cases dying in public institutions away from their
own homes. The average for the 11 years 1901-11 is 44.5 per cent. in the
Chelsea Infirmary and 15.8 per cent. in other public institutions, making
a total of 60.3 per cent. of the total deaths. In 1911 the percentage dying
away from home was 73.7 per cent.
It will be interesting to observe what will be the influence of the
sanatorium benefit provisions of the National Health Insurance Act upon
these figures in future years.
Of the 88 deaths from phthisis in Chelsea in 1912, 61 were deaths of
males and 27 deaths of females. Other tubercular diseases caused 10
deaths in males and 8 in females. The death-rate of males from all
tubercular diseases in Chelsea in 1912 was 2.5 per 1,000, the corresponding
rate for females being only 0 9 per 1,000. In May, 1912, there were 45
male phthisical patients in the Chelsea Infirmary, and 26 female
phthisical patients.
Diseases of the Heart and Blood-vessels.—These diseases caused 125
deaths in Chelsea in 1912. There does not appear to be any ground,
so far as Chelsea is concerned, for the belief that these diseases are
increasing as the result of the competitive stress and strain of modern
life. The average number of annual deaths in the 6 years 1901-6 was
125, and in the 6 years 1907-12 119 deaths, the corresponding average
death-rates being 1.76 per 1,000 (1901-6) and 1.78 per 1,000 (1907-12)—an
almost neglible increase.
Cancer.—Malignant cancerous disease caused 98 deaths in Chelsea in
1912. Forty-five of the fatal cases were North Chelsea residents, and 53
were South Chelsea. The average number of deaths from cancer in
Chelsea in the past 4 quinqueunial periods has been as follows :—

Prom the above figures it will be seen that cancer as a cause of
death is steadily increasing, the increase during the past two years
having been a rapid one. Some part of this increase, however, may be
due to greater precision in diagnosis, and to the relatively larger number
of old people in the population owing to the continuous decrease in the
birth-rate during the past 22 years.
Alcoholism.—Twenty deaths were registered in 1912 as being due to
alcoholism or cirrhosis of the liver, as against 17 in 1911. These figures
merely represent the deaths which are palpably and unmistakably the
results of alcoholic excess. Probably far larger numbers are indirectly
due to excessive drinking; but until the system of death certification is
amended, definite allocation of disease to its effective cause, in such cases
as these, cannot be expected.