Public Health and Poor-Law Medical Services

1892 BMJ (Clinical Research Edition)  
HEALTH OF ENGLISH TOWNS. IN twenty-eight of the largest English towDs, including London, 3,794 births and 4,106 deaths were registered during the week ending Saturday, December 26th. The annual rate of mortality in these towns, which haci declined in the preceding three weeks fromi 22.6 to 19.1, rose again to 22.8 during the week under notice. The rates in the several towns ranged from 13.2 in Leicester, 16.4 in Huddersfield, 16.5 in Birminghamii, and 16.9 in Hull to 27.0 in Sunderland, 27.1 in
more » ... Sunderland, 27.1 in Manchester, 28.1 in Liverpool, and 45.1 in Newcastle-upon-Tyne. In the twenty-seven provincial towns the mean deatlh-rate was 23.5 per 1,000, and exceeded by 1.6 the rate recorded in London, which was 21.9 per 1,o00. The 4,106 deaths registered during the week under notice in the twenty-eight towns included 461 which were referred to the principal zymotic diseases, against numbers declining from 477 to 395 in the preceding three weeks; of these, 170 resulted from measles, 167 from whooping-cough, 39 from scarlet fever, 34 from diphtheria, 26 from " fever" (principally enteric), 20 from diarrhcea, and not one from small-pox. These 461 deaths were equal to an annual rate of 2.6 per 1,000; iD London the zymotic death-rate was 2.9, while it averaged 2.3 per 1,000 in the twenty-seven provincial towns, and ranged from 0.0 in Brighton and in Halifax. 0.3 in Portsmouth, 0.5 in Bristol, and 0.8 in Hull to 4.1 in Bolton and in Manch6ster, 4.2 in Liverpool, 4.4 in Wolverhampton, and 6.4 in Newcastle-upon-Tyne. Measles caused the highest proportional fatality in Derby, Manchester, Sunderland, Wolverhampton, Newcastle-upon-Tyne, Liverpool, and Cardiff; scarlet fever in Huddersfield; whooping-cough in London, Manchester, WVolverhampton, Blackburn, Bolton, and Newcastle-upon-Tyne; and diarrhloa in Preston. The mortality from " fever" showed no marked excess in any of the twentyeight large towns. The 34 deaths from diphtheria registered last week in these towns included 20 in London, 4 in Liverpool, 2 in Manchester, and 2 in Newcastle-upon-Tyne. No fatal case of small-pox was recorded either in London or in any of the twenty-seven provincial towns; one small-pox patient was under treatment in the Metropolitan Asylums Hospital at Dartford on Saturday last, Decemiiber 2ffth. The number of scarlet
doi:10.1136/bmj.1.1618.44 fatcat:7rwfdn64hbgvzgkejlpedidzmm