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the hope of obtaining some uniformity of action. The replies showed
that the classifications adopted were varied in the extreme.
It is obvious that if many of the above terms be discarded in
tabulating diarrhoea deaths, the zymotic death-rate will be comparatively
low, while, on the other hand, if most or all of the terms
be included under the heading diarrhœa, the zymotic death-rate,
especially during the Autumn months, when these terms are most in
use, will be correspondingly magnified.
It has always been my practice to err on the safe side and include
all the above deaths under the heading diarrhœa.
The basis for calculating a true zymotic death-rate is, of course, a
correct estimate of the population. In such a Borough as West Ham
this is more than difficult at the present time. The Registrar-General
estimates our population at the middle of this year at 300,241, but for
the purpose of my statistics I have hitherto reduced that figure by
20,000, somewhat arbitrarily perhaps, but with the object of avoiding
in Census year the unpleasant discovery that I had been prophesying
smooth things.
The Council will therefore recognize that by gathering within the
circle of zymotic diseases as many deaths as possible, and by reducing
the population estimate as low as possible, there is a two-fold means
by which the zymotic death rate may be increased, and consequently
that the rates which I have from time to time recorded have been as
high as ingenuity could make them.
Together with the zymotic death-rate of West Ham I have usually
noted the corresponding rate in London, rather as an item of abstract
information than as a standard of comparison, the circumstances of
the two districts being so essentially different that on just conclusions
can be expected by comparing them merely in one special particular.
As might have been expected, the zymotic death-rate of West Ham is
always higher than that of London. When, however, working-class
districts of London are compared with West Ham and other large
towns of England, the mortality from infectious disease in West Ham
do not appear in such an unfavourable light.