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first: the conditions were altogether different. The summer
in 1879 was cold and wet, and, as always happens in these
circumstances, the mortality from infantile diarrhoea was
low, just as it is always high when the summer is hot and
dry, as it was in 1878. Per contra, it may be observed that
the conditions that were so favourable to infantile life in
respect of diarrhoea, in 1879, were very unfavourable to life,
both in the young and in the aged, in respect of another
group of diseases, the pulmonary, the mortality from which
throughout the year was excessive, as it always is in cold and
wet seasons.
Again; the significance of a high rate of prevalence of
enteric fever may vary widely in different circumstances : the
disease may be constantly present in one district as the
result of drainage defects, or a polluted water supply; in
another district its introduction may be due to an accidental
pollution of water, or to a specifically contaminated milk
supply—and the same observation in regard to milk applies
equally in the case of scarlet fever also.
These and like circumstances must be kept in view if we
would draw right conclusions from a high or a low rate of
prevalence of diseases, particularly in relation to the sanitary
condition of a district.
Subject to corrections for local and climatic conditions,
and for high rates in previous years, the concurrence of a
low zymotic and a low general death rate, furnishes just
ground for satisfaction; and as the general and the zymotic
rate in Kensington were both lower in 1883 than in any
previous year on record, we are fairly entitled to that
satisfaction. It need hardly be said, on the other hand, that
a persistently high rate of mortality from zymotic diseases is
always a subject for serious consideration. Kensington, as
we shall see in due course, has hitherto been in the happy
position of having a death-rate from these diseases much
below that of the Metropolis generally.