Whooping Cough.—The mortality from this complaint was 45, in the Town sub-district 36, and in Brompton 9. The deaths under five were 44.
Fever.—Typhus, was fatal in 9 cases, all in the Town sub-district. The number in the previous year was 6—all likewise in the Town.
Enteric Fever.—The registered deaths from this disease were 28—viz., 19 in the Town and 9 in Brompton. The numbers in 1873 were 19 and 8 respectively. The term Typhoid is often employed to designate this disease, and leads to error in the tabulation of the mortality returns. I have good reason to believe that some of the cases returned by the Registrar-General as typhoid fever were not cases of enteric fever, the word typhoid having been employed in medical certificates of the cause of death to describe a condition of the patient in the last stages of fatal illness of a nature entirely distinct from enteric fever.
Simple continued fever caused 15 deaths (8 under five years), viz., 11 in the Town sub-district and 4 in Brompton. The deaths in 1873 were 7 and I respectively in the two districts.
Diarrhœa was less fatal than in 1873, the deaths being in that year 145, and in 1874 only 112. The annual average number in ten years was 111, without allowances for increase of population. The deaths last year in the two sub-districts were 90 and 22; in the previous year 121 and 24. The large majority of fatal cases occurred in infancy, viz., 100 under one year and 8 between one and five. Above 65 years of age the deaths were 4. At intermediate ages there was no death. The principal mortality was experienced in the warm summer weather, viz., in July 38, and in August 31. Five deaths from Cholera were registered, viz., 3 in the Town and 2 in Brompton.
Other Zymotic Diseases.—Croup was the cause of 26 deaths, 25 under five years, and all save one in the Town sub-district. The deaths in the previous year were 20.
Erysipelas caused 21 deaths, viz., 13 and 8 in the Town and Brompton respectively. The deaths in 1873 were 24.
Puerperal Mortality.—Some difficulty is experienced in procuring a correct record of the deaths arising out of or connected with childbed, owing to the fact that reference to the previous occurrence of childbirth is sometimes omitted in the medical certificate of the cause of death. Some of the deaths, therefore, registered as Peritonitis, Pyæmia, Erysipelas, and even under less suggestive headings, may have been connected with the puerperal state. The deaths actually ascribed to childbed diseases were 24, other 14 being set down to the various accidents incident to that critical period. These numbers together represent a mortality somewhat below one per cent. (0.87) on the births registered. Dr. Matthews Duncan, the successor of Sir James Simpson at the University of Edinburgh, has promulgated an opinion that the true average mortality of the puerperal state is one per cent., i.e., one death in every hundred confinements; an estimate which a practitioner in this parish, who has a most extensive midwifery practice, tells me coincides with his personal experience. The causes of death as registered were:—Puerperal fever, 4; Puerperal peritonitis, 9; Pyæmia, 5; Septicæmia, 1; Metritis, 4; Pelvic cellulitis, 1. Eighteen of the deaths occurred in the Town sub-district, the mortality being pretty evenly spread over the parish, and none of the cases being traceable to contagion. They occurred in the four quarters respectively as follows—9, 6, 5, and 4. The ages at death were: 20–30 years, 18; 30–40 years, 4; 40 years and upwards, 2.
Syphilis nominally caused 12 deaths—a number we may well believe below the actual mortality from this Protean disease.
Constitutional Diseases.—Cancer was the cause of 67 deaths, viz., 51 in the Town and 16 in Brompton. Fifty-four of the deaths took place between the ages of 45 and 75.