May 9, 1891.] THE BRITISH MEDICAL JOURNAL. 1049 deaths referred to the principal zymotic diseases included 1,790 which resulted from measles, 1,616 from whooping-PUBLIC HEALTH cough, 568 from diphtlheria, 539 from scarlet fever, 478 from AND diarrhcea, 387 from fever" (principally enteric), and 3 front POOR-LAW MEDICAL SERVICES. small-pox. The 1,790 fatal cases of measles recorded in the twenty-eight towns during the first quarter of this year wvere ENGLISII U-RBAN MORTALITY IN THE FIRST equal

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... o ain annual rate of 0.72 per 1,000, which, althouglh it QUAlITER OF 1891w showed a decline from the high rate recorded in the preced-QUARTERfi OF 1891. ing quarter, exceeded the mean rate in the corresponding TuE vital anid mortal statistics of the twenty-eight great periods of the previous nine years, 1882-90. The rate of mor-Englislh towins dealt with by the Registrar-General in his tality from measles in London did not exceed 0.40 per 1,000, weekly returnis are summarised in the accompanying table. while it averaged 0.97 in the twenty-seven provincial towns, During the thlree months ending March last, 79,875 births among which this disease showed the highest proportional were registered in these twenty-eight towns, equal to an fatality in Preston, Oldham, Portsmouth, Bristol, Huddersannual rate of 32.0 per 1,000 of their aggregate population, field, and Blackburn. The 1,616 deaths referred to whoopingestimated at rather more than ten millions of persons. In couglh were equal to an anniual rate of 0.65 per 1,000, which was the corresponding periods of the preceding three years, the considerably below the average rate in the first quarters of the birth-rate in these towns was 32.5, 32.4, and 32.1 per 1,000 repreceding nine years. In Loindon the rate of mortality from spectively. In London the birth-rate last quarter was equal this disease was 0.62 per 1,000, while it averaged 0.67 in the to 31.9 per 1,000, while it averaged 32.1 in the twenty-seven twenty-seven provincial townls, and was highest in Leicester, provincial towns, and ranged from 23.2 in Huddersfield, 25.9 Birmingham, Huddersfield, Salford, and Halifax. The 568 in Bradford, and 26.3 in Briglhton to 39.2 in Sunderland, 39.8 fatal cases of diphtheria were equal to an annual rate of 0.22 in Cardiff, and 41.7 in Newcastle-upon-Tyne. per 1,000, against rates increasing from 0.20 to 0.31 in the pre-During the quarter under notice, 57,472 deaths were regisceding three quarters; this rate exceeded the average in the tered in thle twenty-eight towns, equal to an annual rate of corresponding periods of the previous nine years, although it 233.0 per 1,000, against an average rate of 22.9 in the correwas below the rate in the first quarter of either of the presponding periods of the preceding inine years, 1882-90. In ceding two years. In London the rate of mortality from London thle rate of mortality was 22.6 per 1,000, while it diphtlheria was as high as 0.32 per 1,000, while it averaged averaaed 23.4 in thle twenty-seven provincial towns. The only 0.15 in the twenty-seven provincial towns, among which rates in these lprovincial towns ranged from 16.2 in Derby, this disease showed the higlhest proportional fatalrty in Man-