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of 52 or 53; diarrhoea 79 deaths (and this is after exclusion of all the infants
who died from this cause in the Great Coram Street Home) instead of its quota
of 64. Typhus and other fevers caused 115 deaths instead of their quota of
62. Important considerations arise from these facts. Of whooping cough,
indeed, we can say little as to connexion with unwholesome conditions; except
that density of lodgment encourages the spread of this disease in a popnlation.
But diarrhoea and fevers are commonly held to be indicative of other insalubrious
conditions that are more readily under the controul of sanitary authorities.
Diarrhœa, it has been already said, was more prevalent in London in 1865 than
in any recent year; in St. Giles it was distinctly more prevalent than in London
as a whole, though perhaps not more prevalent than in the districts
immediately surrounding our own.
Continued fevers are grouped together by the Registrar General, and as a
whole, have been in serious excess of their prevalence in average parts of
London. The registered names of the various fevers do not afford conclusive
evidence as to their nature; but it appears that the registered number of 112
deaths from continued fever, (disregarding 3 puerperal) is made up of 75 typhus,
18 typhoid, and 19 of "fever" unnamed or undescribed. The separation, so
far as it is reliable, is of much practical moment. Doubtless, real typhus has
been greatly more prevalent in St. Giles than elsewhere in London; in the first
quarter (Appendix IV) it was even three times more fatal than in the average
of the town. But typhoid has probably not been excessively, though it has
been largely prevalent in our district. Now typhus fever, a very contcgious
disease, is spread by overcrowding and dirtiness, personal and domestic, and is
scarcely affected by other unwholesome conditions about houses; whereas
typhoid fever, a far less contagious disorder, appears usually to require for its
dissemination contamination of air or water by sewage, and is far less affected
by the personal habits of the community among whom it prevails. Hence
arises the conclusion that the mortality of St. Giles from fever in 1865, being
mainly from typhus, shows the special deficiency in the lodgment of the
poor, and that deficient drainage and bad water supply (though doubtless these
causes have been in lamentable frequent operation) are not even in the main
chargeable with the excess in the St. Giles's fever rate above that of London.
The class of constitutional diseases in 1865, shows the same high deathrate
that has been recorded from them in all previous reports. Cancerous, and
the still more important group of tuberculous diseases, were both more fatal in
St. Gdes than in the average of London. It is probable that an excessive amount
of consumption actually originates in our district, but as long as St. Giles contains
a disproportionate share of the common lodging-houses of the town, it is
pretty sure (whether consumption be generated or not specially in our district)
always to give an excessive mortality from this cause to the death registers.
Local diseases, which form the third class of the Registrar General, were
in the greatest excess of all in St. Giles in 1865; but all organs and systems
whose diseases are included under this title, did not contribute equally to the
excess. Diseases of the nervous system, of the digestive and generative organs,
of the bones and of the skin, did not cause so many deaths in our district as
the calculated quota for its population. But diseases of the circulating and
urinary organs, and above all, diseases of the organs of respiration—which are
just those that suffer most from the effects of physical work and exposure—
each of these produced an undue degree of mortality in St. Giles. Bronchitis
alone, in the inclement season of 1865, caused more deaths in St. Giles than
all lung diseases put together would be estimated to produce in the population,
and yet lung diseases were much more fatal in London than usual. Taking with
bronchitis, inflammation and other disorders of the lungs, the deaths from this
group of diseases were nearly 60 per cent. in excess of those of an equal population
elsewhere in London,