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be remembered that in the district, namely in Hoxton, is situated a large
lunatic asylum. In this institution there died 26 persons. 159 deaths
are set down to Scrofula, Water-on-the brain, and Mesenteric disease.
The diseases of this class are intimately associated in nature with Phthisis,
and are largely traceable to the influence of hereditary causes and
defective sanitary conditions. Stomach-diseases, including diseases of
the Liver and Kidneys, and "Dropsy," are assigned as the causes of 155
deaths. 101 of these occurred under the age of 60 during adult life, and
many are certainly the result of intemperance in drink. 4 deaths specified
under the head of "Alcoholism," indicate the direct effect of alcoholic
poison. 14G deaths from Atrophy and Debility express vaguely the
operation of various causes, which cannot be analyzed or classified. 121
deaths are ascribed to "Old Age;" but since comparatively few persons
sink without exhbiting more or less obvious disorder of a particular part
of the body, many deaths of persons who might properly be said to have
fallen under the weight of years, are assigned to specified diseases,
especially Bronchitis and Debility. The deaths of 69 infants are ascribed
to "Premature Birth," and "Malformations," that is, they were born
not " viable," or unfitted by defective developement for life.
Epidemic Diseases.—The influence of unhealthy local conditions is more
especially traced in 689 deaths from so-called zymotic or epidemic
diseases. Of these, 7 were cases of Small-Pox, 206 of Fever, 162 of
Scarlatina, 90 of Diarrhœa, and 25 of Diphtheria. From the 206 Fever
deaths registered in Shoreditch, the large deduction of 81 cases occurring
in St. Luke's Workhouse must be made, so that the proper mortality
from Fever in Shoreditch is 125 only. I must beg to refer to my report
for the year 1861, for some observations concerning the distinction in
nature and causation between "Typhus" and "Typhoid" Fevers, which
are necessarily registered under a common designation. The Typhoid
fever is the disease mainly represented in the mortality tables of former
years. It is that form which is chiefly associated with defective sewerage.
It is but feebly infectious. It is almost certain that the causes of this
fever have declined in number in proportion to the extension of sewerageworks
in the district. The excess of Fever deaths is due to the spread of
Typhus fever, a disease especially associated with over-crowding, bad,
and insufficient food, and the other results of destitution. This form