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8
Not only has the total mortality in this district (as is previously stated)
annually increased during the last 4 years, but, as may be seen on referring to
Table 10, the mortality from epidemic diseases has also increased. Thus in
1860 the total mortality from this class of diseases was 346; in 1861 it was
389; in 1862 it was 658; and in 1863 it was 709. This is 29.2 per cent. of
the total mortality. The greatest amount of increase of mortality in this class
of diseases is that of scarlet fever and diphtheria,* which in 1861 had conjointly
a mortality of 70; in 1862 of 91; and in 1863 of 290. This amount
is above that of any return of deaths from these diseases that I have ever had to
record. Out of the 290 deaths caused by scarlet fever and diphtheria conjointly
there are only 12 attritbuted to diphtheria. In London the deaths
from scarlet fever were 5,075, and from diphtheria 724. Scarlet fever has
been the prevailing epidemic during the last year. It is generally supposed
to be propagated by contagion, but the cause of the disease is involved in
mystery. A French writer carries his ideas of contagion so far as to say,
that "an epidemic is the effect and not the cause of contagion." "Cleanliness
and ventilation," says Dr. Christison, "will extinguish any epidemic."
This, I am afraid, is only true to a limited extent; no doubt that when proper
ventilation exists the products of putridity become oxidized, and then they
are innocuous.
The deaths from fever have likewise increased. In 1861 they were 65; in
1862 they were 250; this year, however, they have again declined to 158.
The deaths from diseases of the respiratory organs are 388; from tubercular
diseases, exclusive of consumption, 139; from consumption 295; from violence
and accidents of various kinds 136; from burns and scalds 47; from
suffocation 19 (all children under 5 years old); from suicide 20; and from
murder and manslaughter 5. The deaths in the Workhouse are 324, or 11.7
per cent. of the total mortality. Of this number 109, or 33.6 per cent., were
above 60 years of age. In the City of London 14.5 per cent. of the total
deaths occurred in the Workhouses.
The mortality in the London Hospital was 418 or 15.1 per cent. of the total
deaths. The deaths in these two institutions combined (742) are in the
proportion of 26.8 per cent. of the total mortality in the district.
The number of inquests held during the year was 291 against 225 in the
preceding year. The uncertified deaths are 32 against 42. The absurd
manner (as may be seen in this report) in which some of these deaths are
registered renders it necessary to make some alteration in the law whereby
more correct certificates of death may be obtained.
The medical officers of the Union have attended 14,564 cases of illness,
exclusive of 2479 in the Workhouse. The cases of small-pox have increased
from 115 to 253; of scarlet fever from 118 to 305. A decrease is shown in
* Scarlet fever and diphtheria were formerly considered to be similar diseases, but further
examination inclines medical men to the belief that the two complaints are specifically different.