London's Pulse: Medical Officer of Health reports 1848-1972

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Kensington 1872

[Report of the Medical Officer of Health for Kensington]

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6
The lower death-rate in 1872 was due in a large measure to a
diminished mortality from zymotic diseases. Thus in 1871 the
death-rate from the seven principal members of this class (viz.,
Small-pox, Measles, Scarlet Fever, Diphtheria, Whoopingcough,
Fever, and Diarrhoea) was equivalent to 6 per 1000 in London
generally, and 4.5 per 1000 in Kensington, whereas in 1872 the
death-rate from the same diseases in London and in Kensington
respectively, was 3.8 and 3 per 1000, a reduction in the whole
Metropolis of 2.2 per 1000, and of 1.5 per 1000 in Kensington.

I he subjoined table shows the percentage of deaths from the: diseases to total deaths ;—

1871.1872.Reduction in 1872.
Kensington23.318.15.2 per cent.
London24.217.96.3 „

The average percentage of deaths from these diseases to total
deaths in Kensington in 10 years was 18.7. It was as low as 13.3
in 1866, which, though a Cholera year, was an exceptionally
healthy year, as judged by the comparative freedom from zymotic
diseases. The general rate of mortality however was 22 per 1000,
nearly 5 per thousand higher than in 1872. The highest proportional
mortality from zymotic diseases in ten years (1862-71)
occurred in 1871, viz., 23.3 percent, on the total deaths, which
however, were equal, as before stated, to only 18.9 per 1000.
The high rate of mortality from the zymotic diseases in 1871
arose from the prevalence of small pox, which killed 120 persons,
the average number in ten years being only 13. This excessive
mortality from small pox in 1871 may probably be the explanation
of the moderate death rate from zymotic diseases in 1872, a
low mortality from all not being unusual when any member of the
class has previously prevailed in a severely epidemic form. Zymotic
diseases are due to an action set up in the body, not unlike that of
fermentation (as exemplified in yeast),the particular poison having
the power of reproducing itself almost indefinitely, and in several
of the diseases of manifesting itself in the shape of an eruption upon
the skin. The mo it striking illustration is afforded by small-pox.
The ferment, i.e., the matter of small pox, being taken into the
system, whether through the lungs in respiration or through the
skin by inoculation, multiplies itself to an enormous extent, and
is, in due course, thrown off by the skin in the form of countless
pustules, each charged with the means of spreading the disease,
either by infection or by contagion. It does not often happen that
more than one of the eruptive diseases is violently active at the
same time. This fact has led some persons to imagine a correlation
of the several diseases which they hold to be due to a common
poison, manifesting itself in one form or another according to the
" epidemic constitution of the year." In other words they consider
these diseases to be convertible the one into the other, just as the