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39
The epidemic in 1890 began in January, at a season of
the year, therefore, when we look for an increased mortality
from chest diseases. But in 1891, it began about the beginning
of May, and yet its progress was marked by a corresponding
excess of deaths from these causes. The RegistrarGeneral,
in his Annual Summary, has some interesting
statistics bearing on this subject; and he states that it "can
scarcely be doubted that the main part of the enormous
increase in deaths under diseases of the respiratory organs,
and some part of that under diseases of the circulatory
system " (the deaths we have seen were 1099 in excess)
" and other headings, was in reality determined by the same
cause as were the deaths directly attributed to Influenza."
That this was the case." he further observes, "may be
inferred with much confidence from the fact that the increased
mortality under these headings, and especially under diseases
of the organs of respiration, was synchronous with the
outbreak of Influenza, and that similar synchronising
increases under these headings have occurred in each
previous outbreak." The outbreak, it may be added, "rose
rapidly to a maximum in three weeks, remained practically
stationary for another fortnight, and then subsided gradually
to a termination in the beginning of July. The Tables fully
demonstrate the accuracy of the above observations. It is
further observed that "the outbreak affected all ages, but
was most severely felt by persons in the prime of life, and
after these by those of advanced age, and least of all by the
young," as is proved by a Table which gives the excess of
mortality per cent., at different age-periods, in the second
quarter of 1891 above the average mortality in the corresponding
period of the five immediately preceding years, from
influenza, bronchitis, and pneumonia taken together. It is
noteworthy that in January, 1890, the rise in the mortality
from bronchitis and pneumonia was mainly among persons
between 20 and 60, the brunt of the winter rise from these