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person communicating the fact of death. Occasionally in the case of children
the deceased had been attended until a few days previous to death by the
medical staff of the Children's Hospital; and either the authorities there had
declined to give a certificate, or the parents of the deceased had neglected
to apply for one. The large majority of these irregularities occurred in the
Bloomsbury Sub-district where also I find the largest number of deaths of
infants from suffocation, etc., were also registered. These two facts taken in
connexion should prompt the exercise of greater stringency in the reception
of certificates. Every death should be certified either by the medical practitioner
who attended the case, or, failing that, after an inquest into the
cause of death. The register, otherwise, might become a screen for crime.
We notice also the fact that zymotic diseases were below their proportionate
number in St. Giles District; and that this diminution was chiefly
caused by the small number of deaths from scarlet-fever; to which I shall
further allude when I treat more particularly of the miasmatic diseases.
Constitutional diseases,—for example, cancer and phthisis, were considerably
in excess. "We had the large mortality of 44 from cancer, our proportionate
number being 27. The largest number of these deaths occurred in
Bloomsbury. The proportions were as follow: Bloomsbury, 21; St. Giles
South, 17; St. Giles North, 6. The large excess of deaths from cancer in Bloomsbury
apparently arises from the defective nutrition of vital organs, consequent
upon the state of its female population as indicated by its low birth-rate.
The proportion in relation to sex was, for Bloomsbury, males 4, females, 17;
St. Giles South, males 4, females 13; St. Giles North, males 3, females 3.
Diseases of the lungs were also very fatal. Our mortality is, in fact,
kept up beyond its legitimate standard by this order of diseases. Bronchitis
is the chief of this group; and it exerts its most malign power upon infants
and the aged. The ill-fed and badly cared-for infant, and the debilitated
old man or woman, when exposed to the vicissitudes of the seasons, and
particularly to the extreme cold of winter, fall victims to this malady.
Diseases of the heart have also been particularly fatal among us; there
having been 40 per cent. more deaths than there should have been from this
cause. This mortality may probably be explained by the intemperate habits
of the lower classes of people in the District.
Of deaths from diseases of the brain and digestive organs we have
had fewer than our share. These diseases mutually react upon each other;
and it may happen that the inhabitants of St. Giles are not so liable to these
maladies as those of other Districts, among whom a higher mental cultivation,
a more intense and anxious strain of the faculties in the struggle of life, and
more sedentary habits, may induce a predisposition to attacks from cerebral
and abdominal disease. This subject, however, requires wider investigation.
Zymotic Diseases.
The principal epidemics that prevailed in the Metropolis during the
year 1869 were scarlet-fever, whooping-cough, and diarrhoea, to which must
be added relapsing-fever—not indeed on account of its mortality, but of the
number of its attacks. These, unfortunately, cannot be easily ascertained,
as no public register of disease is kept. A proposal, however, having this
object in view has recently been made by Mr. Lewis, of the Registrar
General's Office; and it is to be hoped that an omission so detrimental to the
progress of sanitary science, and the due conservation of the public health
will be, ere long, corrected.
The death-rate from zymotic diseases, of all kinds, has been, in London,
1 in 152 of the population; and in St. Giles District, 1 in 194, which is
obviously a very reduced rate, considering the bad hygienic circumstances in
which we are placed,