If we examine one of the reports of the Registrar General for births, deaths and marriages, we shall gain pretty full information concerning the deaths from disease, accident, old age, etc., that have occurred during the last thirty or forty years.

[Increase of Constitutional Weakness.]

In Report 54, Table 17, the annual death-rates from various causes per million of population are given, and arranged in groups of five years from 1858 to 1890. We have there a history of thirty years, and even in that time a notable change in this history is to be observed. I have arranged the greater number of facts given in Table 17 in the following table, so as best to bring out those points which we are discussing. In the first group of disease are those due to micro-organisms, and a diminution of these diseases to a marked extent is to be observed of late years. Phthisis and scrofula placed by themselves in this group share in this decrease. In the second group are diseases that are due in great measure to carelessness, want of management, neglect and ignorance, such as convulsions, diseases of dentition, parturition and registered accidents. These, too, as one would expect, diminish yearly in a country where surrounding comforts and a sense of responsibility are on the increase. When we turn to the third group, that of constitutional disease, where the hereditary tendency comes in, we find an increase in almost all the hereditary diseases. A tendency to an increase of neurotic affections is shown by an increase in the deaths from nervous diseases, suicide and intemperance. A large increase in the diseases of the respiratory system is due in part to the increasing number of tuberculous patients who, kept from inroads of microbes, nevertheless readily fall a prey to other affections: there is, too, an increase in diseases of the circulatory system, in cancer, diabetes and other constitutional diseases.

Annual death-rates in England from various causes, per million persons living, in groups of years 1858–1890—

[[Version of the table for narrower screens]]

CAUSE OF DEATH.1858–60.1861–65.1866–70.1871–75.1876–80.1881–85.1886–90.
GROUP I.
Phthisis and scrofula3304·03311·03300·22940·62816·82540·82322·2
Other diseases of micro-organisms[17]4403·94498·64677·24055·83233·62708·82417·0
GROUP II.
Diseases of dentition, parturition, convulsions, accident and negligence2257·02262·02191·02077·21860·41678·61538·0
GROUP III.
Some consti­tutional diseases[18]6056·36311·46594·67199 7536·47531·27929·4

[17] These include small-pox, measles, scarlet fever, simple and ill defined fever, whooping cough, diphtheria, miasmatic diseases, cholera, diarrhœa, dysentery, erysipelas, puerperal fever and thrush.

[18] Diseases of the nervous, circulatory and respiratory systems, cancer, diabetes and other constitutional diseases.

This table demonstrates, therefore, in a most marked manner, the action of modern civilisation and of preventive medicine, which, by removing the microbe and diminishing the dangers of child-rearing, has diminished the rate of mortality to a very notable extent in the early years of life. The increase in the number of deaths from constitutional diseases, occurring as they do in middle or advanced age, are probably due to the survival of an increased number of individuals into the period of maturity. From this table it is difficult to say whether or no these individuals are below the mean average type. We have to die at one period of life or at another, and if men and women are preserved from the dangers of childhood and youth, there will be more to fall victims to the lung and chest complaints of more advanced life.