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TO THE VESTRY OF ST. MARY, ISLINGTON.
Gentlemen,
I am afraid that there are some very erroneous notions entertained as to the
value of what is called "tho death-rate" as indicating the healthiness or unhealthiness
of any place or district, both when people compare the death-rate of the
same place at different times, and when they compare the death-rate of one place with
that of another. And more especially do enquirers sometimes delude themselves,
when they attribute differences of death-rate, as a necessary and invariable result, to
corresponding differences in the degree to which some one class of morbid causes
prevails, at whoso door they are pleased to lay the burthen of every ill that flesh is
heir to; forgetting, or possibly never having known, that the causes of disease
are manifold, and so complicated and interwoven in their operation, that the
more they are studied, the more cautious does the student of them become, when
distributing occurrences as effects among them, lest he should overstep the bounds
of strict induction, or the limits of a reasonable probability.
And first let me say that what Lord Bacon would have called an " Idol of the
market," has something to do with the confused ideas which are not rarely entertained
on this subject. I allude to the ambiguity of the terms " healthy" and
"healthiness," as these words aro popularly employed. Thus, when wo say "tho
parish is healthy," and when wo say "this is a healthy parish," I think it must be
apparent that we commonly use the word " healthy" in two quite different senses.
In the one phrase we use it to declare the absence of disease, in the other to declare
the absence of certain local causes of disease. This double applicability of the term
is unfortunate, since it forms a trap by means of which people are apt to fall into
one of the most fatal of logical errors, namely, confounding an effect with its cause.
I propose, then, in future, to employ a different word when referring to ths absenco
or presence of local causes of disease, namely, the word " wholesome," limiting tho
word " healthy" to those occasions when popular freedom from disease is]referred to.
If there is at any time much sickness and a high mortality, no matter from what
cause, the people must be said to be unhealthy ; but for all that, the place itself
may be wholesome—that is, the unhealthiness may be due to other causes than local
unwholesomeness. To enumerate some of these other causes. There may be much
unhealthiness among a people, and a higher death-rate than usual; or a higher
death-rate then is met with elsewhere, because there is an excess of persons at the
extremes of life, either very young, or else of old persons, who are both more liable
to disease, and whose diseases are more liable to be fatal, than persons in the intermediate
periods of life; or the difference may depend upon a difference in the proportion
of the sexes, and the occupations which males or females respectively follow
at the different periods of their lives; or it may be connected with a difference in
the stationary or shifting character of tho population, the amount of increase from