[396] Buchanan, Report Med. Officer Privy Council for 1864, and Trans. Epid. Soc. 1865, II. 17; Hamilton, Lancet, II. 1867, p. 608 (Liverpool); Martyn, Brit. Med. Journ. July, 1863; Davies, Med. Times and Gaz. II. 1867, p. 427 (Bristol); Thompson, St George’s Hosp. Reports, I. (1866), p. 47 (London); Allbutt, ibid. p. 61 (Leeds).
[397] Buchanan, Report Med. Off. Privy Council for 1865, p. 210.
[398] James Stark, M.D., “Remarks on the Epidemic Fever of Scotland during 1863-64-65” etc., Trans. Epidem. Soc. N. S. II. 312. See also Russell, Glasg. Med. Journ. July, 1864, and R. Beveridge (for Aberdeen), Lancet, I. 1868, p. 630.
[399] Weber, Lancet, I. 1869, pp. 221, 255; Murchison, ibid. II. 1869, pp. 503, 647; Gee (Liverpool), Brit. Med. Journ. II. 1870, p. 246; Robinson (Leeds), Lancet, I. 1871, p. 644; Muirhead (Edinburgh), Edin. Med. Journ. July, 1870, p. 1; Rabagliati (Bradford), ibid. Dec. 1873; Tennant (Glasgow), Glasgow Med. Journ. May, 1871, p. 354; Armstrong (Newcastle), Lancet, I. 1873, p. 48.
[400] Muirhead (l. c.) says: “In no single instance which came under my observation could starvation be said to be the immediate cause of the disease. Not one of those individuals could be said to be emaciated.... On strict and repeated inquiry, not one of them would confess to having been in destitute circumstances.” During the winter of 1870-71 I attended from the Edinburgh New Dispensary several relapsing-fever patients at their homes, and can clearly remember having been surprised at the condition of decency and comfort in which I found them. The appearance of comfort was certainly due in part to the district visitors, who were numerous and active during the epidemic.
[401] Spear, “Typhus Fever in various parts of England, 1886-87.” Rep. Med. Off. Loc. Gov. Bd. N. S. XVI. p. 169.
[402] 2303 of these fever deaths in 1864 occurred in the eight principal towns of Scotland, classified as follows: typhus, 1450, relapsing fever, 371, gastric, enteric, or typhoid, 382.
[403] G. B. Longstaff, M.D., Trans. Epid. Soc. 1884-5, p. 72, reprinted in his Studies in Statistics, Lond. 1891, p. 402. The seasonal curve for the typhoid admissions to the London Fever Hospital over a longer period is nearly the same, as well as that of the registered deaths by typhoid in all London, 1869-84.
[404] The following large registration districts besides those in the Table, had enteric-fever death rates of ·5 and upwards per 1000 persons living, in the ten years 1871-80; in nearly all of them there has been a marked decline in the ten years 1881-90:—Durham, Hartlepool, Easington, Houghton-le-Spring, Darlington, Gateshead (county Durham); Morpeth (Northumberland); Aysgarth, Todmorden, Dewsbury, Pontefract, Barnsley, Rotherham (Yorkshire); Dudley, Leigh, Ormskirk (Lancashire); Crickhowell (Wales); Worksop, Radford (Nottingham); Shrewsbury; Peterborough; Portsea Island (Hants). Of the London districts, Hackney had the highest enteric fever, 0·46 per 1000 in a general death-rate of 20·78. The high rate of a decennium is not unfrequently brought up by one great explosion. In many of the Lancashire, Yorkshire and Midland towns, with rates about ·4 per 1000 persons, the rate has been somewhat steady from year to year. In the decennium 1871-80, many special outbreaks, some of them in villages, were reported on by the inspectors of the Medical Department, and traced for the most part to water-supplies tainted by the percolation of excrement.
[405] The Registration District of Middlesborough was carved out of Stockton and Guisborough in 1875.