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24
ASSIGNED CAUSES OF DEATH.
Class I.—Specific Febrile or Zymotic Diseases.*—
The "Class" of diseases called Zymotic comprises, in the
Registrar-General's arrangement of the "causes of death,"
six "Orders." The first and second orders (" Miasmatic "
and "Diarrhœal") include the diseases which the RegistrarGeneral
describes as "the seven principal diseases of the
zymotic class," grouping as he does, under the generic term
" Fever," the three distinct fevers, " Typhus," " Enteric," and
" Simple Continued."
These zymotic diseases have a special interest for
sanitarians, being admittedly of a more or less preventable
character : the absence or the prevalence of certain of them,
therefore, is regarded as a test of the sanitary condition of a
district. But, without underrating the importance of this
test, it must be said that there are limitations to its applicability
necessary to be borne in mind in drawing inferences
from mere numbers. What I mean may be best explained by
an illustration, founded on our own local experience within
the last few years. Thus, Measles, was very prevalent in
1888 and 1890, the deaths being considerably above the
average. In 1889 and 1891, on the other hand, the deaths
from measles were greatly below the average : but the lowered
mortality, regarded as evidence of the diminished prevalence
of the disease, was the result of its excessive prevalence and
* The classification of the causes of death in the Weekly Returns and Annual
Summary of the Registrar-General, was considerably modified in 1882. The list of
cattscs, in its new form, is an abbreviation of the more detailed list used in the
Annual Reports of Births, Deaths and Marriages in England. Table III. in my
reports prior to 1882, was framed upon the lines of the abridged list of the causes
in the Annual Summary, and was the basis of some of the other Tables. It being
desirable that Tabic III. should accord with the new list used in the Annual
Report, the Society of Medical Officers of Health revised certain Tables framed, at
my instance, for uniformity, in 1872, and settled the forms of Tables I.—V. as they
appear in the Appendix.