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than that of the Metropolis generally; but at the least it cannot be
deemed to have been so unfavorable as the rise of 3.0 per 1,000 above
the low death-rate of 1877 might seem to indicate,—seeing that the
rise in the Metropolitan death-rate was only 1.6; because the rate in
1877 was 2.2 per 1,000 below the decennial average, while that of the
Metropolis was only l.3 per 1,000 below the average. A death-rate
much below the average one year, is nearly sure to be followed by a
rate above the average in the next or following year; and, therefore,
though it may be well to refer to the fluctuations in the rate from
year to year, it would be unwise to attach too much importance to
them, whether they represent an elevation or a depression of the wave
of mortality. The healthiness of a district must be judged by the
decennial rate.
It may be here mentioned, in passing, and in some sort as an
illustration of the above remarks, that in 1877 the deaths from the "seven
principal diseases" of the zymotic class were far below our decennial
average, while in 1878, they were considerably above that average.
Only 339 in the former year, they sprung up to 573* in the latter.
There is some little satisfaction in noting, however, that the increase
in the number of deaths from these maladies in 1878, was not due to
the prevalence of the more serious members of the class, but to the
unusual fatality of two infantile diseases, viz., whooping cough and
diarrhoea, which were the causes of 185 and 181 deaths respectively.
The excess of deaths from these two diseases alone (233) exactly
accounts for the rise from 339 deaths from the "seven principal
diseases of the zymotic class" in 1877 to 573 in 1878. The Unusual
fatality of these two diseases raised the " zymotic death-rate" to 3.7
per 1,000 living, which is considerably above the decennial average
(3.2), and not much below the rate, in 1878, for the whole Metropolis
(4.1). It accounts likewise for the high rate of infantile mortality
throughout the year, the deaths of children under five years having
numbered 1,429, including 823 of infants in the first year of life;
whereas, in 1877, only 1,040 children died under five years, including
648 under one year, numbers considerably below the average. Particulars
with reference to the deaths from zymotic diseases, and the
causes of deaths generally, will be furnished latter on.
* These totals include the deaths at the Hospitals of the Metropolitan Asylums Board.