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all causes in children under 5 years old in the healthy districts
of England and Wales, there were 138 in all England, and 229
in Liverpool; whilst from zymotic diseases there were 140 in
all England and 228 in Liverpool to 100 in the healthy districts.
By these you will see that the death rates from all causes and
from zymotic diseases bear, we may almost say, precisely the
same ratio in both instances. These figures certainly show, in
my opinion, that the comparative mortality from zymotic
diseases is not a better proof, under existing legislation and
practice, of the sanitary condition of a locality than are the
deaths from all causes; and they also, I think, point out the
fallacy of terming zymotic diseases "preventable," as though
medical officers of health or others have the power of preventing
all the deaths from these causes. That small pox is preventable
to a very great extent by vaccination I do not doubt, or that
the mortality from scarlet fever, measles, whooping cough,
diarrhoea, and especially of fever, may be reduced by proper
sanitary measures I fully admit; but I certainly object to the
word preventable being thus applied, as though every death
from these diseases could be prevented.
The figures in Table VIII also show that the mean
number of deaths from the following groups of diseases were
below the average in 1876, viz., from diseases of uncertain seat,
affections of the nervous system, of the respiratory organs, of
the digestive and urinary organs, and from old age; whilst
those from atrophy, debility, and premature birth, as well as
diseases of women and childbirth, were decidedly in excess.
There was a rather large number of deaths from puerperal fever
in one sub-district of Hackney, and chiefly in the practice of one
practitioner, which accounts for the excess of deaths from childbirth.
The mortality from tubercular diseases and affections of
the circulatory organs differed but little from the average of the
six years, but was decidedly below those from 1850-65, and
1866-75.