London's Pulse: Medical Officer of Health reports 1848-1972

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Paddington 1900

[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]

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58
[Appendix IY.
Table 29 shows the incidence of the mortality from tubercular diseases at various ages and the
variations in the quinquennial mean rates. It must suffice on this occasion to point out the special
age.incidences which are disclosed by the table.
The mortality due to tabes mesenterial (tubercular disease of the digestive organs) is practically
limited to children under 5 years of age, and that of tubercular meningitis (disease of the
nervous system) to persons under 25 years of age. Tuberculosis of the lungs (phthisis or consumption)
affects all ages of life, but the mortality is highest at ages from 25 to 65 years. Other forms
of tuberculosis (scrofula, struma, tubercular diseases of organs other than digestive, nervous, or
respiratory) do not apparently specially affect any particular age, but the incidence of mortality is
slightly greater at ages under 15 years.
In general terms it may be said that there is an indication that, at about the age of 15 years,
the locality affected by tuberculosis changes, and on such an assumption the following table (Table
30) has been drawn up. It cannot be considered satisfactory, but must serve for present purposes.
The table, moreover, suffers from the fact that the tabulation of deaths during the selected periods
has been made by two persons, and that there is no indication of the rules which governed the work
in 1875-79. Something ought probably to be allowed for differences in practice in this matter;
but, from such information as exists, it is probable that any such difference has been in favour of
the rates of 1875-79, i.e., shows them lower than they would have been had the rules of 1895-99
been adopted. It will be seen from this table that the mean rates for 1895-99 were lower than
those for 1875-79, except in the case of " all forms, excluding phthisis " at ages over 15 years.
There can be little doubt that much of the increase in this case (173 per cent.) is due to different
classification. Probably the same cause has operated to some extent with regard to phthisis at ages
under 15 years, where the decrease has amounted to 71 per cent.

TABLE 30. Comparison of mortalities in 2 age-groups.

0-15.15-1.
All formsMean rate,* 1875-793.4192.276
Mean rate, 1895-991.9381.658
increase or decrease per cent.—43—27
All forms excluding PhthisisMean rate, 1875-792.6580.046
Mean rate, 1895-991.7200.126
Increase or decrease per cent.—35+ 173
PhthisisMean rate, 1875-790.7612.229
Mean rate, 1895-990.2181.531
Increase or decrease per cent.—71—31

* Rates per 1,000 persons in each age-group.
Prior to 1891 the deaths were not tabulated according to sex nor according to ages in the two
Sub-Districts. Such complete tabulation has been made since that date, but the calculation of the
rates based thereon has been delayed until the results of the new census are known. The differences
in prevalence of mortality (as affecting persons at all ages) are shown in Table 28. The disease
has been markedly more prevalent in St. Mary than in St. John, but the diminution in the mortality
from all forms of tuberculosis in the fifth period, as compared with the first, has been the same (36
per cent.). In all probability, however, the diminution in St. John has been greater than that in
St. Mary as the apparent great increase in mortality from other forms of tuberculosis in the former
district may be due to change in system of classification.
Since 1891 the deaths from tuberculosis have been allotted to the streets given as the home
addresses of the deceased persons. During the 10 years 1891-1900, 2,268 deaths were recorded from all
forms of tuberculosis, 1,890 of the deceased persons being returned as residents in St. Mary and 378
in St. John. Of the 1,890 deaths from St. Mary, 69 have been excluded, on account of want of, or