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Several interesting facts may be learnt from the above table: thus
we learn that the most fatal of these diseases is scarlet-fever, the deaths
from this disease having been in the course of 34 years 86,791; the
next in fatality is fever, the deaths having been during the same period
78,866; then follows whooping-cough, which shows a mortality of
74,969; then diarrhoea, 74,478; then measles, 49,331; and lastly, smallpox,
which, notwithstanding the great epidemic of 1871, shows a mortality
of only 37,388. We also learn that the metropolis is never entirely
free from any of these diseases. If the deaths in one year are few from
any one of these epidemics, it frequently happens that either one or
more of the others is in excess. Thus, in 1846, when the deaths from
small-pox were only 154, the deaths from fever were 2,203, and in
1871, when the deaths from small-pox were 7,876, the deaths from
fever were reduced to 1,746.
The two great epidemics of small-pox which have occurred within the
last 34 years happened in 1838 and in 1871; the proportionate number
of deaths in each of those years being, in relation to the population, nearly
the same. Thus the deaths from small-pox in 1838 were 3,817, which in
a population of about 1,700,000, is at the rate of 22.4 per 10,000, and the
deaths from the same disease in 1871 were 7,876, which is at the rate of
24.2 per 10,000.
Scarlet-fever during the years 1869-70-71 was very fatal, the deaths
in the metropolis from this disease amounting to 13,697, while the deaths
from small-pox during the same period were 9,107. It further appears
from the perusal of the preceding table that while small-pox is only
an occasional epidemic, scarlet-fever is almost always with us in a
severe form. The smallest number of deaths in any one year from this
disease in London was in 1841, when the deaths were only 663, the
average number for each year is 2,552, and the annual average number
of deaths from small-pox is 1,099.
Science is not sufficiently advanced to enable us to account for the
rapid spread of an epidemic disease, which at one time extends its ravages
over large communities, while the same disease at another time attacks
only a very few. If there be any peculiar condition of the atmosphere
which causes the particular disease to spread at one time and not at
another, chemists have not been able to tell us what it is ; and if, as
is alleged, some people are more susceptible to disease at one time than
at another, we may fairly ask in what does that susceptibility consist?
Again, if any epidemic disease were propagated by contagion only we
may further ask, why does it cease its ravages in large communities where
intercourse is always going on, and which cannot be prevented? but the
disease does cease, and for a time we hear little or nothing about it;
but, after a period of a longer or shorter duration, it again makes its
appearance.
When an epidemic attacks a large city, the number of deaths usually increases
week by week until a culminating point is reached, when it is
observed gradually week by week to decline, until it ceases to prevail as an
epidemic. As it has been with our occasional visitor the cholera, so it
was with the cattle plague; the number of deaths at first augmenting
week by week, and then in a similar way gradually declining, and then
entirely ceasing. The effect we see, but we cannot satisfactorily explain
the cause. It would appear, that the disease after a time loses its power
of reproduction.
Typhoid, or enteric fever, is said upon high authority to be caused
only by a specific poison which hals been thrown off from the body of
some person sick of the same disease, and that this disease is not
produced by the emanations arising from the decomposition of foecal
matter which are given off from the sewers ; but as typhoid fever is