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from the last week in July to the first week in September. In the fourth week of August,
out of 50 deaths, 21 were attributed to zymotic disease. The number of zymotic deaths
was low during the remainder of September and October; and then another remarkable
rise took place in the latter weeks of November. This, however, was to a less extent
than that just referred to; the highest number of deaths was 19, out of a total mortality of
56. It will be observed that the first rise was coincident with the elevation of atmospheric
temperature, the second, with its depression. The first was mainly due to summer diarrhoea,
the second, to measles and other diseases associated with pulmonary complications.
10. The more common Epidemic diseases are those to the varying fatality of which the highest
interest attaches—Table 4 exhibits the number of deaths from each, which occurred in
Islington and its Sub-districts. In order to facilitate comparison with the whole Metropolis,
it was necessary to bring all the numbers to an uniform standard: the percentage of deaths
from each disease in London and Islington has consequently been introduced.
Small-Pox only occasioned 8 deaths, the proportion to the entire mortality being greatly
under that of London at large (Cols. 9 & 10). The per centage of deaths from other epidemic
diseases of infancy, measles, scarlatina, hooping-cough, and diarrhoea was in each case greater.
Typhus, on the other hand, was about one-fourth less fatal than in the metropolis generally.
With the single exception of hooping cough, all the epidemic diseases mentioned were
proportionally more fatal in the East than in the West Sub-district (Cols. 9 to 22). This
difference was most manifest in the instance of scarlatina, diarrhoea, and typhus. It is to
be further remarked that, in the West Sub-district, the per centage of mortality from each of
the epidemic diseases, except measles and hooping cough, was smaller than in all the Metropolitan
districts taken together. In the case of typhus it was only one-half.
The greatest mortality from measles occurred (Table 2) in the months of November and
December, especially in the last week of the former and the first week of the latter month.
This did not appear due to any malignancy of the disease, but to the pulmonary complications
which were present in nearly every instance, and it corresponded, as will be seen by the
Diagram, to a great diminution of the atmospheric temperature in those weeks, and to a high
mortality from other diseases, involving primarily the organs of respiration. The mortality
from scarlatina was rather higher during the early than the latter half of the year, and that
from hooping cough was chiefly observed during the first seven months. Out of the 109
deaths from diarrhoea, 78 occurred during the months of July, August, and September.
The mortality from typhus was less during the months of April, May, and June, than during
other months of the year, over which it was pretty equally diffused. The highest mortality
from fever however occurred in the summer months, at a time when the zymotic mortality
generally as well as that from diarrhoea, was greatest.
11. Why was the zymotic mortality of Islington so high as to exceed, in proportion to the
entire mortality, that of London at large ? The endeavour to reply to this will raise
another question of still greater importance to you, viz.: the cause of the remarkable difference
in this respect between different parts of your Parish.
12. The zymotic mortality of any district may be expected to be high when young persons
form an unusally large proportion of the population. No less than 71 per cent. of all the
deaths from zymotic disease occurred to children under 5 years of age, and Table 4 (Col. 6)
shows that, at the census in 1851, for every 1000 living at all ages in Islington, 127.8 were
under 5 years of age, while in the whole metropolis they formed 124.2 per 1000 of the population.
It also appears from the same Table that of the more common epidemic diseases,
those which specially affect young persons, produced a proportional mortality in excess of
London, while typhus, a disease more frequent at more advanced periods of life, was proportionally
less fatal. That this is not the explanation, however, appears first, from the fact
that it would only account for half of the disproportion between Islington and the Metropolis ;
and secondly, from the fact that the Sub-district, in which the proportion of children under
5 years in 1851 was lowest, is that in which the proportion of zymotic deaths has been highest
(Col. 6). It further appears (Cols. 7 & 8) that, for every 1000 of the population under
5 years (1851), the mortality under 5 years from zymotic diseases was very much higher in
the Eastern than in the Western Sub-district. It is then in the East Sub-district that wa
must look particularly for the circumstance on which the excess of zymotic mortality we are
considering depends. If there be local causes in operation, they might be expected to influence