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24
I now proceed to make a few observations with regard to each
of the above-mentioned diseases.
Small-pox, it will be observed, does not appear in the list
as a fatal disease in 1886. Three cases, however, two in the
Town sub-district and one in Brompton, were recorded, one of
them being an imported case, treated in the patient's home, and
the other two cases having been removed to hospital. The
recorded cases in the two previous years were 177 and 181
respectively.
Small-pox was very little prevalent in the Metropolis, as a
whole, in 1886. The deaths were only 24, shewing a diminution
of 1,194 deaths, compared with annnal deaths in 1876-85 corrected
for increase of population. These deaths (24) were "fewer—not
merely relatively to the population, but absolutely—than in any
year since the present system of civil registration began; the
years which most nearly approached this minimum being 1875
(46 deaths), 1874 (57 deaths), 1878 (113 deaths), and 1883
136 deaths). The mean annual mortality from this disease
in the six years as yet elapsed of the current decennium
was 0.24 per 1,000, and lower than in any previous decennium."
The Registrar-General, from whose Annual Summary the
preceding quotation is taken, states that London. "in spite
of the disadvantage it suffers from its perpetually shifting
population, and its comparative neglect of vaccination, has
improved its position in regard to small-pox among the
great towns since 1861-70. But the case is otherwise if
London be compared with the aggregate provinces—i.e., the whole
of England and Wales without London itself—for while the provincial
rate has fallen very greatly, the London rate has lagged
behind, so that the difference has become wider and wider." It
having been suggested that this may be attributable to the opening
of the Metropolitan Hospitals in 1871, the Registrar-General
states that "an examination of the successive rates shows that
the increase in the difference between the London and the
provincial rates dates from a time long anterior to the opening of