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18
The "class" of diseases called Zymotic comprises in the
Registrar-General's classification of the "causes of death" six
"Orders." The first and second Orders, ('"Miasmatic" and.
"Diarrhoeal"), include the diseases which the Registrar-General
calls "the seven principal diseases of the zymotic class," still
grouping as he does under the generic term "Fever" the three
distinct fevers, "Typhus," "Enteric," and "Simple Continued."
These diseases have a high interest for sanitarians, arising out of
the fact that they are admittedly of a more or less preventible
character; it being customary, moreover, to regard the absence or
the prevalence of some of them as a test of the sanitary condition
of a district. But, without under-rating the importance of this
test, there are limitations to its applicability which must be borne
in mind if we would draw sound conclusions. What I mean may
be best explained by an illustration or two founded on our own
local experiences within the last few years. Thus Measles was
very fatal in 1874 and 1876; the deaths were far above the
average; it was the zymotic disease that gave a special character
to those years. In 1875 and 1877, on the other hand, the deaths
from Measles were below the average; but the lower mortality,
evidence of the diminished prevalence of the disease, was the result of
the excessive prevalence and fatality of the malady in the precedingyears.
(Vide Table V., Appendix.) In saying this, I do not, of
course, ignore the fact that one epidemic of a zymotic disease may
be more severe than another; nor am I forgetful of the fact that
the fatality of an epidemic disease may be influenced by the
measures taken, or the neglect to take any measures, for limiting
the spread of infection. Again, the rate of mortality in the
Metropolis from ichooping cough in 1881 was the lowest on record;
it is not surprising to find, therefore, that in 1882 the disease was
excessively fatal. In our own parish the large total of 185 deaths
from this disease, in 1878, followed the minimum return of 34
in the previous year.
Diarrhoea may be cited as an illustration of quite another kind.
The mortality from this disease amongst infants was excessive in
1878; the mortality in 1879 was much below the average; but