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mortality in the Metropolis from whooping-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.
Diarrhcea 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 the diminished mortality in 1879 had no relation
to the excessive mortality in 1878. The conditions were
altogether different : the summer of 1879 was cold and wet;
and, as always happens in these circumstances, the mortality
from infantile diarrhcea was low ; just, as it is always high when
the summer is hot and dry, as happened in 1878.
Again, the significance of a high rate of prevalence of
Enteric Fever varies widely in different circumstances. This
disease may be constantly present in a district as a result of
drainage defects, or of a polluted water supply; whilst in
another district its introduction may be wholly accidental, as
when it is due to casual pollution of water, or to a specifically
contaminated milk supply introduced from without.
These and like circumstances must be kept in view if we
would draw sound conclusions from a high or a low rate of
prevalence of zymotic diseases, particularly in relation to the
sanitary condition of a district.
Subject to corrections for local circumstances, for climatic
influences, and for high rates in previous years, the concurrence
of a low zymotic death rate, with a low general death rate,
furnishes just ground for satisfaction For some years past the
general rate and the zymotic rate have both been below the
decennial average in Kensington But in 1887 it was otherwise,
for although the general death rate was below, the zymotic
death rate was rather above the average. It need hardly be
said that a persistently high rate of mortality from zymotic
diseases furnishes matter for serious consideration. Kensington,