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patient informed me that " the disease did not originate in Kensington,
but in the patient's place of business ; " where, he added,
" the drains were very bad." So much for the actual mortality from
" fever " in Brompton (which includes South Kensington) with its
population of 38,000 souls. The deaths in the Town sub-district
were 25 in number nominally, but several of the cases were proved
to have originated outside the parish, or to have been imported;
while others, which were incorrectly returned by the Registrar
General as enteric fever, owing doubtless to some indefinitenessin the
medical certificates of the cause of death, were stated by the medical
men in attendance not to have been cases of Typhoid fever at all.
Eight of the 27 deaths occurred below the age of 5 years,
and 6 between 5 and 17 years of age, the ages at death
in the remaining cases ranging between 21 and 67. The
actual number of deaths registered from Typhoid fever in 1875,
was 21, equal to 1.4 deaths to 10,000 persons living, the rate
in London being 2.4 per 10,000. The deaths were equivalent
to 7.5 in every 1,000 deaths in the parish, and to 10.3 in the
Metropolis as a whole. In 1876 the nominal figures were not quite so
favourable to the parish, for the deaths in Kensington and London
respectively were 1.8 and 2.2per 10,000 persons living, and 9.3 and
10 in every 1,000 deaths. But if the deaths that were really not
due to Typhoid fever at all be deducted, the figures present a much
more favourable complexion, and still more would this be the case if
the deaths that were imported were subtracted. It may be added
that some of the deaths were due to sanitary defects—two of them,
especially, connected with interior iron soil-pipes, of which it
was impossible my department could have any knowledge without
previous information, and which were at once removed when the
houses were inspected on revelation of the disease by the registration
of death. In another case a gentleman lost his life from
standing over his own water-closet while clearing away an
obstruction. If all these cases are taken into consideration, the
importance of 'fever' mortality is much attenuated; and probably
if a similar enquiry were instituted in other parishes, it would lead
to similar results.
But to return to the alleged chronic prevalence of typhoid fever
in South Kensington, it was stated—after it had been shown that
no death from this cause had occurred—that the " disease may be
chronic, although it may not terminate in death, and may exist,
especially among well-to-do people, although the Medical Officer
of Health may be unacquainted with any cases of illness." Within
moderate limits the former part of this statement may be admitted
to be correct: but inasmuch as the mortality from typhoid fever it
one in six cases (not one in twenty as stated), it is obvious thas
the cases could not be numerous : while as to the latter part of
the statement, the accuracy of which is not impugned, it might be