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the lowest rate hitherto recorded in London, the lowest previous rate being 9.59, in
1920. The chief factor in infant mortality from diarrhoea is the summer temperature,
but as was shown in last year's Report, there has since 1914 been a remarkable
diminution in the effect of high summer temperature upon the mortality from
infantile diarrhoea. The average temperature in the summer quarter of 1922 was
2.4 below the average of the past fifty years, and below that of any summer since
1887.
Tuberculosis. The deaths from tuberculosis of the respiratory system in the civil population
of London during 1922 numbered 4,888, giving a death-rate of 1.08 per 1,000; the
corresponding figures for 1921 were 4,813 and 1.07 respectively. Deaths from other
forms of tuberculosis numbered 936 as against 964 in the preceding year. The International
List of Causes of Deaths adopted in 1911 was modified in 1921 in respect
of the classification of tuberculosis mortality; the heading "Pulmonary Tuberculosis"
is replaced by "Tuberculosis of the Respiratory System" and does not
include acute miliary tuberculosis, which is now classed to the heading disseminated
tuberculosis. Prior to 1911 acute miliary tuberculosis was not included with
"phthisis" and the figures under the heading tuberculosis of the respiratory system
are, therefore, comparable with the earlier phthisis deaths. For the period 1911-1920
the deaths, excluding miliary tuberculosis, in London, and the similar figures
classed according to the new code in 1921 and 1922, were as follows:—
Year.
Deaths.
Approximate death-rates.
Males. Females Total. Males. Females. Total.
1911 3,744 2,376 6,120 1.76 0.99 1.35
1912 3,803 2,312 6,115 1.79 0.97 1.35
1913 3,634 2,229 5,863 1.71 0.93 1.30
1914 3,901 2,430 6,331 1.84 1.01 1.40
1915 4,064 2,651 6,715 1.92 1.11 1.49
1916 3,737 2,527 6,264 1.88 1.05 1.44
1917 4,040 2,728 6,768 2.01 1.14 1.53
1918 3,946 2,974 6,920 1.99 1.24 1.58
1919 2,945 2,252 5,197 1.47 0.94 1.18
1920 2,675 2,000 4,675 1.29 0.82 1.04
1921 2,737 2,076 4,813 1.32 0.85 1.07
1922 2,841 2,047 4,888 1.35 0.84 1.08
With regard to the approximate death-rates shown in this table, it will be found
that those for the war years differ considerably from rates published previously
in these Reports. Until the census population figures became available, it was not
possible to make any reliable estimate of the population at risk since 1914,
and throughout the war period the phthisis rates have been calculated upon the
residual civil population of London. Rates so calculated are, however, obviously
not comparable with the rates of normal times, since the civil population of war
time contained practically all men suffering from phthisis. The number of deaths
from phthisis in the field was consequently very small, men on service developing
phthisis while abroad being as far as possible sent back to England. In arriving
at the rates given a proportion of the Army and Navy deaths occurring in England
has been added, and the total population, instead of the civil population, has been
used, with some adjustment to allow for war losses. In "Pulmonary Tuberculosis"
Sir James Kingston Fowler gives (page 42) a tabular statement relating
to the incidence and mortality of tuberculosis among troops of various nationalities
stationed in France and Belgium in 1918 from which it appears that the mortality
in British troops there was only 5 per 100,000, a practically insignificant rate.
The figures for 1921 and 1922 show a slight increase upon those for 1920. Thia
is most noticeable among young adults, but some increase is observable at ages
between 55 and 65.