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38
Hackney as for all England and London, as the highest rate was
18.90 per 5000 inhabitants, and the lowest 17.80; the highest
decennial death-rate from all causes being 20 37 per 1000 population,
and the lowest 1914 ; the variation in the zymotic rate
being l.l and of the death-rate from all causes 1.19, or almost
identical. The highest death-rate from all causes in England for
any one of the decennial periods during the thirty years, 1841-71,
was 22 51, viz. in 1861-71, and the lowest in the five years
1871-75, viz., 21.76, giving a range of 0.75 per 1000 inhabitants,
whilst the death-rate from seven epidemic diseases varied
between 20.8 and 18.4, or a range of 2.4 per 5000 population.
In London the highest death-rate from all causes in 10 years was
24.77 per 1000 inhabitants, and the lowest occurred in the 5 years
1871-75, viz., 22.25, giving a range of 1.82, whilst the rates for
the seven epidemics were 20.28 and 19.18, or 1.1 per 5000
inhabitants, which is precisely the same variation as for Hackney.
A similar comparison between the death-rate from other diseases,
as far as my present enquiries have led me, will show rather
greater differences than those just mentioned. I therefore do
not consider these diseases to be preventible in the sense placed
on this word by the public, but I do believe that by means of
isolation, disinfection, and other proper sanitary action, a large
number of cases may be prevented, the intensity of the poison
lessened, and the death-rate consequently reduced from its present
high rate. How far this reduction can be carried, experience only
can show, but I think that cases of death from scarlet fever,
whooping cough and measles can never be entirely prevented, or
anything approaching it, unless some living agent can be applied
to the body for its protection against them in the same way as the
vaccine virus is used to prevent small pox. In regard to infantile
diarrhoea, as there seems to be a close connection between its
excessive mortality as an epidemic and the want of proper subsoil
drainage, some effective means may be adopted so as to reduce
the number of deaths to a very considerable extent.
I now propose carrying this discussion somewhat further by
calculating the mean number of deaths in each decennial period