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It needs to be stated that the above figures and diagram relate only to deaths which are
classified by the Registrar-General under the heading " diarrhoea." There is no question that
alteration in nomenclature is largely affecting the number of deaths in London classified under
this heading, the increasing use of the terms " enteritis " and " gastro enteritis," as shown by
the reports of the Registrar-General, leading to the registration of deaths under these headings
which in earlier years would have been classified with " diarrhoea." The number of deaths in
London recorded by the Registrar-General under the heading "enteritis" during the ten years
1881-90 did not in any one year exceed 745, and this number was recorded in 1890, while in the
decennium 1891-1900 the maximum number recorded in any one year exceeded 3,000, viz., in
1899. The subject was under discussion by the Royal College of Physicians, and the following
summary of the minutes of the proceedings of the Royal College of Physicians, London, of 25th
January, 1900, is published in the 62nd report of the Registrar-General.
The Royal College of Physicians is convinced, after careful enquiry—(a) that various unauthorised
and misleading terms, such as "gastroenteritis," " muco-enteritis," "gastric catarrh," &c., are now
commonly employed to designate the disease officially known as "epidemic diarrhoea," whereby its
specific character is in danger of being ignored, and great confusion ensues ; (6) that the present
confusion of terms renders it impossible to determine accurately either the prevalence of the disease
in special places and at special times, the extent to which it influences the public health, or the effects
produced by sanitary measures; (c) that there is a wide-spread objection, on the part of medical
practitioners, to the employment of the term " diarrhoea " in certifying the cause of death, probably
because that term is generally held by the public to imply a mild disease, insufficient by itself to
cause death.
The College, therefore, has sought to discover as an alternative for the authorised term (epidemic
diarrhoea) some other name, which, whilst equally accurate, should convey to the public the idea of
a more serious affection. But the College regards it as essential that the idea of specificity, intended
to be conveyed by the term " epidemic," should be retained.
As the result of much deliberation the College has agreed to authorise the use of the term
" epidemic enteritis" (or if preferred by the practitioner, " zymotic enteritis") as a synonym for
epidemic diarrhoea. The College has further decided to urge upon practitioners the entire disuse, in
medical certificates of death, of such terms as " gastro-enteritis," " muco-enteritis," or " gastric catarrh,"
as synonyms of epidemic diarrhoea.
Cholera.
During the year 1900 five persons were certified to be suffering from cholera. The cases
were thus distributed—
Chelsea, 1. Lambeth, 2.
Newington, 1. Port of London, 1.
Enquiry into each of these cases showed that none of them could be regarded as cases of
Asiatic cholera.
The number of deaths attributed to cholera and choleraic diarrha was 76, of these deaths
57 occurred among children under one year of age.
Erysipelas.
The deaths2 attributed to erysipelas in the Registration County of London in 1900 numbered
182; the corrected annual average of the preceding ten years being 246.
1 See footnote (1), page 5. 2 See footnote (1), page 5.