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mentioned — (1) that when application was made to the
parishioner asking him to " specify the particular houses or streets
in which typhoid fever is chronic in South Kensington," he
" declined for reasons which must be obvious," to furnish the desired
information ; and (2) that with the approval of your Vestry I
have on three occasions specially appealed to my medical brethren
for information of the occurrence of infectious diseases, so that if
we are without such information as we should possess, it is not for
want of effort to obtain it. I am free, indeed, to confess that we
obtain little information of non-fatal infectious diseases among the
well-to-do classes (the exceptional instances being those in which
our sanitary assistance is sought) nor do I expect any material
difference in this respect, until such time as we shall have an
official registration of diseases or a legislative enactment for the compulsory
disclosure to the sanitary authority of infectious diseases
—a measure, the necessity of which I have constantly advocated.
As regards fatal cases of infectious disease, it may not be
out of place to remark that your Yestry were the first in
London to take measures to obtain immediate information
of deaths, by entering into a special arrangement with the
sub-district Registrars: so that during my term of office every
such case has been reported to me within a few hours after registration
of death. And as it has been sought to affix a stigma of
special unhealthiness on one of the most attractive and salubrious
localities in all London : it may be permissible to state that whereas
the Metropolitan death-rate last year was 22.3 per 1,000, and that
of Kensington generally (including the deaths of non-parishioners
in the Consumption Hospital, &c.) 19.5 per 1,000, the rate
in the Brompton sub-district (population 38,000) which includes
South Kensington, was only 14.9 per 1,000.
I might have concluded here, my notice of a statement beyond
question injurious, though wholly unfounded, but that, in the
course of the public discussion to which it gave rise, the Lancet
stated (Aug. 12, 1876, p. 266) that " the zymotic death-rate of the
South Kensington district is steadily increasing," and that " a
death-rate from zymotic diseases of more than 2 per 1,000 persons
living is absurdly high for such a suburb as South Kensington."
To this the reply is that the death-rate from zymotic diseases
quoted is not that for South Kensington, but for the Brompton
registration sub-district; and that in order to form a just notion
of the proper or usual death-rate from such diseases in any district,
it is necessary to take into the calculation a sufficient number
of years. The reason for this is obvious, and was well expressed
by the Sanitary Commissioner of the Lancet (at page 258)
in the same number of that journal. "In attaching importance
to an increased death-rate from zymotic diseases during any period,
reference " he says, " must be made to prior conditions. A