View report page

The diseases which have increased in importance relatively to all causes are,
it will be seen, measles, diphtheria and diarrhœal diseases. With regard to the
latter, it should be observed that the period 1911-20 includes a year of exceptionally
high summer temperature (i.e., 1911, when there were 5,313 deaths from diarrhœa
among infants under two years of age) while the average for the nine other years
in the decennium was 1,880; on the other hand, the ten years 1881-90 were
chararacterised generally by summers of normal temperature.
Bronchitis.
Pneumonia.
Influenza.
Owing to exigency of space it has unfortunately been necessary to show the
contour for bronchitis mortality on a different scale from that of "all causes." Were
the two contours shown on the same scale the middle part of the bronchitis contour
would be thrown up, and its similarity to that for all causes thus be shown to be
closer than the diagram suggests. There is evidence of confusion of bronchitis
and asthma in the early years, especially from 1841-46, but otherwise it does not
seem probable that the movement of the mortality generally thereafter in the earlier
period (i.e., up to the end of the "eighties") is to be attributed in the main either
to alterations in nomenclature or improved certification. The rapid increase during
the first half of the period covered by the diagram is greater than would be accounted
for by increase in population at high ages, for it will be seen on reference to the
supplement to the Registrar-General's Annual Report, No. 75, Part III., page 210,
that, after full correction for changes in age-and-sex constitution of the population,
the mortality in England and Wales from bronchitis still remains higher in the
"seventies" and "eighties " than before or since. The possibility is not lost sight
of that there may have been transfers of deaths from other groups of diseases to the
heading "bronchitis," but diseases of the heart and urinary system, both commonly
associated with bronchitis, were also on the increase during the years of increasing
bronchitis mortality. While in general the course of the mortality from bronchitis
is similar to that from all causes, on comparing the contours of the two curves
it will be noticed that during the "nineties " the bronchitis mortality tends to fall
more than that of all causes. This, however, was the period when influenza pandemics
were prevalent and a glance at the contours showing the mortality from influenza
and pneumonia at this time makes it clear that with the sudden rise observed under
these headings, there occurred simultaneously a reduction in the deaths attributed
to bronchitis. Allowing, however, for the depletion to some extent of the bronchitis
mortality resulting from influenza pandemics and also for the fact that bronchitis
is mainly a disease of old age, the decline in deaths from this cause from the " nineties "
onwards is more marked than that from all causes. The bronchitis mortality
would undoubtedly have begun to decline earlier but for a series of severe winters
experienced between 1886 and 1896. That these years were unfavourable to persons