Diphtheria Death-rates per million, according to density of population.
| Period | Dense | Medium | Sparse | |||
| 1855-60 | 123 | 182 | 248 | |||
| 1861-70 | 163 | 164 | 223 | |||
| 1871-80 | 114 | 125 | 132 |
In Scotland, also, the incidence was the same: e.g. in 1862, of 997 deaths, 360 were in the towns, 617 in the mainland rural and 20 in the insular districts[1375].
The law of incidence of diphtheria upon town and country respectively has become a good deal confused by the extraordinary severity with which diphtheria has fallen in the last two or three years upon most parts of London and upon the adjoining municipal boroughs of Croydon and West Ham. The following table compares the annual death-rates per million in all England and Wales and in London from the year of the first recognition of diphtheria to the present time.
Death-rates from Diphtheria per million, in all England and in London.
| Year | England | London | ||
| 1855 | 20 | — | ||
| 1856 | 32 | — | ||
| 1857 | 82 | — | ||
| 1858 | 339 | — | ||
| 1859 | 517 | 284 | ||
| 1860 | 261 | 174 | ||
| 1861 | 225 | 239 | ||
| 1862 | 241 | 288 | ||
| 1863 | 315 | 275 | ||
| 1864 | 261 | 207 | ||
| 1865 | 126 | 144 | ||
| 1866 | 140 | 152 | ||
| 1867 | 120 | 145 | ||
| 1868 | 137 | 155 | ||
| 1869 | 47 | 107 | ||
| 1870 | 120 | 104 | ||
| 1871 | 111 | 105 | ||
| 1872 | 93 | 80 | ||
| 1873 | 108 | 95 | ||
| 1874 | 150 | 122 | ||
| 1875 | 142 | 167 | ||
| 1876 | 129 | 109 | ||
| 1877 | 111 | 88 | ||
| 1878 | 140 | 155 | ||
| 1879 | 120 | 155 | ||
| 1880 | 109 | 144 | ||
| 1881 | 121 | 171 | ||
| 1882 | 151 | 220 | ||
| 1883 | 158 | 241 | ||
| 1884 | 185 | 236 | ||
| 1885 | 163 | 221 | ||
| 1886 | 147 | 205 | ||
| 1887 | 157 | 226 | ||
| 1888 | 168 | 305 | ||
| 1889 | 185 | 371 | ||
| 1890 | 179 | 330 | ||
| 1891 | 173 | 340 | ||
| 1892 | 222 | 460 | ||
| 1893 | 302 | 740 |
The deaths in London in 1893 were 3196, having been 1962 the year before, but never more than half the latter total in any year previous to 1888. Besides Croydon and West Ham, Cardiff is the great town which has come nearest the London rate, having had O·68 deaths from diphtheria per 1000 living in 1892, while Swansea had only 0·05, Wolverhampton (including Bilston and Willenhall) only 0·06, Huddersfield 0·03 and Blackburn 0·02. In London the very high death-rate of 1893 was distributed not unequally over all the divisions, the highest mortality corresponding to the highest fecundity.
Diphtheria in London in 1893.
| District | Death-rate from all causes | Birth-rate | Diphtheria death-rate | |||
| Eastern | 25·1 | 37·3 | 1·00 | |||
| Central | 26·6 | 29·0 | 0·82 | |||
| Southern | 19·9 | 31·7 | 0·73 | |||
| Northern | 20·0 | 29·3 | 0·73 | |||
| Western | 18·7 | 26·4 | 0·52 |
Diphtheria shows no such decided preference for the late autumnal or early winter season as scarlatina, but the winter is on the whole its most fatal season, according to the following annual averages of the quarters of the year for twenty years from 1870 to 1889 (total of 67,676 deaths in England and Wales).