I. Mortality of the City of London.
During the fifty-two weeks, dated from September 30th, 1849, to September 28th, 1850, there died of the population under your charge 2752 persons. The rate of mortality, estimated from these data, for a population[30] of 125,500, would indicate somewhat less than twenty-two deaths (21·92) out of every thousand living persons.
[30] With the required correction for increase of population, the death-rate was probably about 21·25 per 1000.
Last year it was my painful duty to record the ravages of pestilence, then indeed hardly terminated, under the pressure of which our general death-rate had arisen to the alarming height of thirty in the thousand. On this present occasion, I have the happier task of laying before you the evidences of a mortality lessened considerably below its habitual average; and I rejoice in congratulating your Hon. Court on the testimony thus borne to the success of your sanitary exertions. For although, without question, some large share of this striking improvement may have depended on circumstances beyond our cognizance or control; although it may in part be but an instance of that tendency to periodical alternations of activity and repose which we recognise in disease, as in other operations of nature; although I should be over-sanguine if I believed, and premature if I stated, that your sanitary measures during the past twelve months had wrought such a change in the City as to ensure a continuance of this year’s comparative healthfulness; yet I may venture without hesitation to assure you, that the labours of the Commission have been fruitful of real and demonstrable advantage to the health of the people; that a sensible diminution has occurred in the physical causes of disease; and that, from various and disinterested sources, I hear grateful mention of improvements which you have effected.
In confirmation of this assurance, I may inform your Hon. Court that, in collecting my materials for the present statement, I solicited from the Union-Surgeons of the whole City of London certain particulars of information which they were peculiarly able to furnish; I inquired of them, namely, whether, during the past year, there had prevailed among the poorer classes in their several districts more or less than the ordinary pressure of epidemic, endemic, and infectious disease; and whether, in case of such difference having been observed, they could refer it, either for better or worse, to any changes recently wrought in the physical conditions of their respective neighbourhoods. They have had the kindness to furnish me with the information requested of them; and their replies testify with remarkable uniformity, both to the abatement of disease within their several provinces of practice, and to the considerable dependence of that improved condition of health on sanitary works effected under your auspices.
In order to form a correct estimate of the average mortality in any district, it is indispensable that one’s records should extend over many years. Thus only is it that fallacies can be avoided which arise from the alternate pressure and remittance of epidemic disease. The havoc effected by a periodical visitation of influenza, cholera, or plague, varies, in like manner as the ordinary death-rate varies, in different localities; and its variation contributes importantly to fix the healthiness or unhealthiness of such localities. But obviously, if we wish for practical purposes to calculate an annual rate of mortality, and to decide, in respect of any district, what are the chances of life for its population, we must distribute the peculiar mortality of the pestilence-period over those years which intervene between visitations of the pestilence.
Hitherto, in respect of the City of London, I have the record of only two years; two years differing from one another in the proportion of 30 to 22, and the mean mortality deduced from that biennial period would be 26 per thousand per annum.[31] I am, of course, unable to tell you with certainty whether that ratio be the true average death-rate of the City; but I incline to believe that an average calculated from a longer period, with less abrupt fluctuations, would give a lower figure as the accurate one.
[31] On account of corrections [already] adverted to, this mean death-rate should be reduced, probably to 25.2.
In future years, so long as I may have the honour of reporting to the Commission, I purpose proceeding, step by step, to the construction of a cyclical average from the materials which will constantly be increasing; and I trust that many years may elapse before any approach shall again be made to the high death-rate with which the cycle commenced.