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Phthisis.
The deaths from phthisis, it will be seen in the diagram, reached a maximum
about the "seventies," but a clearer idea of the movement of phthisis mortality
will be obtained on reference to the diagram given in the Annual Report of the
medical officer of Health for 1914, opposite page 28. The figures upon which this
diagram is based have been corrected for differences in the age-constitution of the
population. It will be noticed that the movement of the female mortality rate
is more regular than that of male. The mortality of both sexes began to decline
about the middle of "the sixties" and the decrease has been continuous since then
up to the close of the last century and extending also even to the close of the first
decade of the present century. During the War, as will be seen on reference to
recent reports of the medical officer of health, there was a considerable increase
in the death-rate, especially among young adults. On comparing the contours
in the diagram of bronchitis and phthisis mortality, it will be seen that the variations
above noted are observed in both contours. Since the two diseases are very often
concurrent, some transfer from one to the other might be expected to have occurred
in the course of so long a period, but there does not seem to be any reason for thinking
(from the generally similar trend of the two curves) that any considerable changes
in allocation of deaths as between one disease and the other have occurred in the
whole period under review. It is of interest to note in regard to the bronchitis
contour that in a study of the trend of pneumonia mortality in Massachusetts by
Drs. Eugene R. Kelley and Angeline D. Hamblen (Public Health Reports of
United States Public Health Service, volume 40, No. 32—August, 1925) it is shown
that the bronchitis mortality in Massachusetts increased from "the seventies"
to "the nineties" and thereafter continuously decreased, showing, therefore, much
the same progression as that observed in London.
Diseases of
the heart
and
circulatory
system.
The group of diseases of the heart and circulatory system comprises a number
of specified diseases, of which the most important is valvular disease of the heart
including endocarditis. The deaths classed to this heading have greatly increased
since 1881, when these deaths were first separately stated. No other specified
disease in the heart group shows anything like the same extent of increase. There
is reason for thinking that the increase is very largely, if not entirely, due to improved
diagnosis and certification.
The mortality from heart diseases falls largely upon ages over 65 years, and
the population at this age in the decennium 1891-1900 was nearly double that in
1851-1860. On comparing the deaths above 65 years in these two decennia, it
is found that while deaths from diseases of the nervous, respiratory and digestive
systems have increased more or less proportionately to the increase in population,