| Ages. | London. | Vienna. | Berlin. | Country parish of Brandenburg. | Holy Cross, near Shrewsbury. | Pais de Vaud, in Switzerland. | |||||||
| At birth | 2 | to 1 | 2 | to 1 | 2 | to 1 | 4 | to 1 | 5 | to 1 | 5 | to 1 | |
| Age | 12 | 75 | to 1 | 84 | to 1 | 123 | to 1 | 112 | to 1 | 144 | to 1 | 160 | to 1 |
| 25 | 56 | to 1 | 66 | to 1 | 50 | to 1 | 110 | to 1 | 100 | to 1 | 117 | to 1 | |
| 30 | 45 | to 1 | 56 | to 1 | 44 | to 1 | 107 | to 1 | 96 | to 1 | 111 | to 1 | |
| 40 | 31 | to 1 | 36 | to 1 | 32 | to 1 | 78 | to 1 | 55 | to 1 | 83 | to 1 | |
| 50 | 24 | to 1 | 27 | to 1 | 30 | to 1 | 50 | to 1 | 50 | to 1 | 49 | to 1 | |
| 60 | 18 | to 1 | 19 | to 1 | 18 | to 1 | 25 | to 1 | 26 | to 1 | 23 | to 1 | |
| 70 | 12 | to 1 | 11 | to 1 | 12 | to 1 | 11 | to 1 | 16 | to 1 | 10 | to 1 | |
| 80 | 7 | to 1 | 7 | to 1 | 7 | to 1 | 6 | to 1 | 8 | to 1 | 4 | to 1 | |
Having in the preceding part endeavoured to establish the mortality of the human species at different ages, I am now to attempt a more arduous task; to ascertain the mortality by different diseases. I propose therefore, in imitation of the geographers, to spread out and to review, in one general Chart, the enormous host of diseases which disgorge their virulence over the earth, and, with frightful rapacity, wage incessant hostilities with mankind. By this means, we shall, to use a military phrase, reconnoitre more distinctly our enemies arranged in hostile front; and be warned to make the best disposition and preparation for defence where the greatest danger is apprehended, and the most formidable assaults to be sustained. Armed with diseases, the grim King of Terrors appears in the most hideous aspect. Under all these predatory disguises and morbifick forms, I shall track him grappling with mankind, and with his tremendous scythe mowing down generations. The learned Sauvages thus expresses himself: “Utinam numerus respectivus diversorum morborum a nostratibus inquirarentur.” It is, in some measure, from ignorance in this subject, that the streams of medical inquiries, of academick rudiments, and of charitable donations to poverty in disease, have not yet been pointedly directed to publick utility.
I could easily have exhibited tables of the Diseases and Casualties in London during the greater part of the last century. But, compared to its present magnitude, the British metropolis was then insignificant in size: 23 new parishes have been since gradually added to the London bills: there is also a chasm of 10 years in which the registers are lost. Again, until 1665 and 6, London was infested with the plague; which disease, previous to that date, seems to have been one primary object of the registers: and to adopt Graunt and Short’s sentiments, these records, from various political and religious obstacles, were then very negligently managed. During the early part of this interval, the kingdom was distracted with civil war; and after the great pestilence in 1665, London must have required some years to recruit. Besides, had I attempted to form tables for even the latter part of the last century, the reader would have been fruitlesly embarrassed; and such an attempt must ever prove abortive. For example, under one and the same title, in the annual bills of mortality, are often confounded flox, small pox, and measles: consumptions and tissick: cancer, canker, and thrush: wolf, cancer, gangrene, and fistula: cancer, gangrene, fistula, and mortification: gout and sciatica: vapours and water in the head: quinsey and thrush: teeth and worms: sores, ulcers, bruised and broken limbs: cough, cold, and chincough, &c. These are a few specimens of Nosological absurdity in the superintendents of the publick registers.
Notwithstanding this rabble of diseases in commenting upon the London bills and diseases of the present century, I constantly refer back, and contrast them with the bills of the last thirty years of the preceding century; so that, as near as the imperfection of the materials will admit, the mortality and diseases of 105 years in London is presented at one view; and comprehends the various acute and chronic diseases, by which about two million and a half of the human species have been destroyed. The few authors who have written on bills of mortality, have obscured their works in a cloud of figures and calculation: the reader must have no small portion of phlegm and resolution to follow them throughout with attention: they often tax the memory and patience with a numerical superfluity, even to a nuisance.
For the above, and many other reasons, I have compressed into one chart, the London Diseases and Casualties of seventy-five years in the present century: each disease and casualty arranged in a progressive series of fifteen years mortality; in a fifth column is added together the mortality of the preceding five divisions. During this period, London has been more populous and stationary in numbers: and by this means, the actual and comparative magnitude, rise, and declension of different diseases, will be more conspicuous in each period or interval: and by measuring the mortality with the population, we are enabled, with certain precautions and exceptions, to make the diseases and casualties of London serve as a morbid barometer to the whole nation. The important reason which determined me in forming an arrangement of fifteen years, in preference to any other number or period, was, that the annual havock by similar diseases and casualties, throughout this and the neighbouring island, might be computed with some probability by each fifteen years of the London bills; and thereby to elicite a new, curious, and comprehensive proportion in medicine. For instance, if we suppose the standing number, on an average, of the London inhabitants at six hundred thousand; and the total inhabitants in Britain and Ireland at nine million; and if the same diseases and casualties were equally diffused and fatal to this whole community, then, in such case, the London bills would serve as a scale or index of mortality to both kingdoms: as many would die annually of every disease and casualty throughout nine million, as are cut off in fifteen years in London; for six hundred thousand multiplied by fifteen, amounts to nine million.
But to supply the probable deficiency in the annual mortality of London by different diseases and casualties, we must make an addition to each of one third or fourth. To the mortality of Small-Pox, in London, during fifteen years, and rated at thirty thousand, we should add one third or fourth more to raise it to its just standard; that is, to about thirty-eight thousand; which would be the annual mortality amongst nine million in Britain and Ireland, supposing small-pox equally universal, one time or other, and destructive. By the same hypothesis, amongst two hundred million in Europe Variolous mortality annually, would amount to four hundred thousand; and, amongst eight hundred million; that is, the whole human race would exceed three million annually. On this simple principle, a gross estimate may be formed of the annual havock by every other disease and casualty; taking the precaution, however, to attend to the subsequent criticisms on the London bills.
Another curious corollary may be grounded on the above hypothesis; which is, to form a probable conjecture of the numbers who are annually Sick, or afflicted with different diseases. Example: if one of every seven die of the Small Pox, and the variolous deaths throughout Britain and Ireland are rated at thirty-eight thousand annually, this number, multiplied by seven, amounts to two hundred and sixty-six thousand annually, infected with variolous contagion. Apply the same rule to Childbed mortality; rate the annual havock by parturition in the two islands at four thousand: it will hereafter be shewn, that in London one of seventy-four women die in childbed: multiply therefore 4,000 by 74, the product is 296,000, which, in reality, cannot be very distant from the total annual procreation in both islands. And in these two examples, I have suggested what may be termed an inverse proof of both propositions. From these tables and commentaries, we are likewise furnished with a key to the comparative mortality of each disease amongst a community: whether its devastation is in the proportion of a fifth, tenth, twentieth, or hundredth. Gentlemen who have not particularly attended to the subject of morbid calculations (and very few of the medical profession have) will, on better information, be astonished at the flagrant errors daily committed by authors when treating of these topicks. Out of the many examples which might be enumerated, I shall merely select one in proof. Baron Dimsdale, in a Treatise on Inoculation, dedicated to the present Empress of Russia, calculated that, at least, two million were annually destroyed by Small Pox alone in the Russian empire; and it was not until after the publication of my Observations on his different Inoculating Essays, that this error and others were erased.
I would request the reader’s particular attention to another circumstance: which is, that on comparing the gradations of mortality in the following chart, we are not to estimate the relative number, frequency, or proportion of certain diseases, compared to others by the absolute mortality of each. For instance, Apoplexy kills rather more annually in London than Measles; but yet the latter disease is infinitely more universal and diffused amongst the community, and consequently less dangerous to life: Cancerous and Venereal cases are widely different in the annual number afflicted with each, although the deaths are not far distant from an equality. The same observations will apply to Rheumatism, compared to the Dropsy, and to many other diseases.