The Sun.
London, England, 1865-04-19 00:00:00

HEALTH. OF LONDON,

(From the Registrar-General's Weekly Return.)
In the week that ended last Saturday the births
in London and nine other towns of the United King-
dom were 3,810 ; the deaths 2,927. The annual rate
of mortality in the week in those ten large towns
was 27 per 1,000 persons living, and was less than
in the previous week, when it was 30.
In London the births of 1,036 and 937 girls, in
all 1,973 children, were registered in the week. In
the corresponding weeks of ten years, 1855-64, the
average number, corrected for increase of popula-
tion, was 2,074.

The deaths in London in the same period were
1,533. The average number for the 15th week in 10
years (corrected) is 1,412. There is an excess in the
present return of 121 deaths over the estimated num-
ber.

Whooping-cough was the most fatal in the list of
zymotic diseases ; it carried off 92 children, about
two-thirds of whom were under two years of age.
Seventy-two deaths by typhus were recorded, 46 by
scarlatina and diphtheria, 16 by measles, and 14 by
small-pox. There were 224 deaths from bronchitis,
99 from pneumonia ; the respective averages being
155 and 98. Bronchitis is very fatal for this period
of the year.
The following carriage accidents occurred :—A
carman, aged 50 years, was killed by falling from his
van ; a boy, aged 13, was run over by a van at St.
Luke's ; and a labourer, aged 54, fell from a waggon
at London-wall.

On March 27, at the workhouse, Bethnal-green,
a sawyer, aged 53 years, died from disease of the
lungs, accelerated by the want of proper nourish-
ment. (Inquest).

On the 12th inst. a child died at 1, Skinner's-
court, Greenwich, of scarlatina. The Registrar states
that three deaths from fever occurred recently in
the same room, which is described as in a wretched
condition.

The rate of mortality last week was 27 per 1,000
in London, 27 in Edinburgh, 26 in Dublin, 34 in
Liverpool, 27 in Manchester, 28 in Salford, 25 in
Birmingham, 24 in Leeds, 22 in Bristol, and 32 in
Glasgow. The rate in Vienna was 28 per 1000 dur-
ing the week ending Ist inst., when the temperature
was 3.8 deg. Fahrenheit lower than in the same
week in London, where the rate was 29 per 1,000.
In Liverpool the births were 310, the deaths 308 ;
in Manchester the births 228, the deaths 187 ; in
Salford the births 74, the deaths 60 ; in Birming-
ham the births 281, the deaths 160 ; in Leeds the
births 139, the deaths 105 ; in Bri§tol the births
101, the deaths 67 ; in Edinburgh the births 144,
deaths 91; in Glasgow the births 409, the deaths
262 ; and in Dublin the births 151, the deaths 154.
There were 304 deaths in Vienna during the week
ending the Ist inst.

At the Royal Observatory, Greenwich, the mean
height of the barometer in the week was 29.963 in.
The mean daily reading was above 30 in. on four
days. The reading rose to 30.14 in. on Monnideaayn,
and declined to 29.78 in. on Thursday. The
temperature of the air in the week waste
sbaielek
deg.,ve
which is 7.3 deg. above the average of the
in 50 years (as determined by Mr. Glaish a
er). The
mean daily temperature was above the average
throughout the week ; and on Sunday and Monday
this excess was as much as 11 deg. The highest day
temperature was 72 deg., and was attained on Sun-
day. The lowest night temperature was 374 deg.
on Tuesday. On Sunday and Tuesday the range
of temperature was 32• G deg. ; on Saturday the
range was only 9 deg. The highest reading of a
thermometer in the sun was 122.4 deg. on Tuesday.
The mean degree of humidity of the air was 72,
complete saturation being represented by 100. The
humidity varied from 60 on Sunday to 88 on Satur-
day. Rain fell to the amount of 0.15 in.. nearly all
of it on Good Friday. At Manchester the range of
temperature on that day was only about 2 deg.

NEW YORK, April s.—The Confederates have
captured the propeller Fallnae,ent, and converted her into
a cruiser. She has since captured 17 schooners.

The Epidemic in Russia,

The Journal de St. Petersbourg of the 12th inst,
publishes the following :

" The Minister of the Interior has communicated to us
the following replies which have been made to the questions
addressed by his Excellency the Ambassador of England to
the Russian Government respecting the prevailing epidemic:

" Question I.—What are the names in French and in
German by which the doctors at the hospitals and the phy-
sicians at St. Petersburg designate the malady ?
" ' Reply.—The epidemic does not offer any new features
of note, nothing unknown to science, no special form but
the typhoid class with various known modifications ; thus
typhoid fever, petechial fever, bilious typhus fever (biliceees
typhoid of the Germans), pore recurrens (febris recurrens),
recurrirends /Leber, of the Germans ; relapsing fever of the
English.* Typhus and typhoid fever prevail at St. Peters-
burg nearly every. year in the autumn, and diminish to-
wards the month of November—a period at which a great
number of workmen leave the capital ; towards the follow-
ing months of March and April, the period of the great
careme (Lent), of the melting of the ice and the return of
the vagrant workmen to the capital, these fevers reappear,
and always without offering any particularities unknown
to medical science. The typhus which is now committing
ravages does not differ from the fevers of which we have just
spoken, except by a greater extension and a greater intensity
of the symptoms which characterise it ; yet, other mala-
dies appertaining to the same species of typhoid maladies,
have shown themselves for the first time at St. Petersburg,
and the number of cases returned has exceeded that of the
typhoid fevers during the months of November and Decem-
ber, 1864, and January, February, and March of this year.
They are bilious typhoid fever, and especially relapsing fever
(fierre typhoide bilieuse, and especiallyfievre recurrente).
" Question 2.—Was this malady known previously in
Russia, either in the capital or elsewhere, and, in such case,
what point of development did it reach ?

"'Reply.—Although the relapsing fever (fievrerecurrente)
had never been observed at St. Petersburg, it has been pre-
viously observed in other localities. In 1840 that malady
committed great ravages in Moscow, especially under a
bilious form,f and in 1857-58 at Novo-Archangelsk (Russian
America), where it was studied by Dr. Govorlivoy, and last
year it made its appearance at Odessa. At the present mo-
ment, while it prevails in the capital, it has also shown itself
in various districts of the St. Petersburg radius (Novaia-
Ladoga, Gdow, Peterhof, and Tsarskoe-Selo), and on some
points of the district of Novogorod, especially on the railway
line, whither it seems to have been brought from the capi-
tal. But it is especially the petechial typhus which has com-
mitted ravages in this latter district, as also in the districts
of Penza, Tauris, and Kharkow ; in some other districts
(Astrakhan, Vitebsk Minsk Volhynia, Vladimir, Kalouga„
Kieu, Koursk, and Toula) the typhoid fever has attained
but a slight development, and the returns do not show a
high rate of mortality. With the exception of the epidemic
of 1840 at Moscow, which was followed by the simple
typhoid fever, in no part of Russia has the epidemic of the
relapsing and bilious fever acquired any considerable de-
velopment.
" ' Question 3.—ln the opinion of the highest authorities,
have there been any cases in the hospitals of St. Petersburg
or elsewhere where the disease has been communicated by
touch ?

" Reply.—The relapsing. fever simple and bilious (la
fterre recurrente, simple et bilieuse), has shown itself to be
contagious, like the general typhus. Some doctors, sur-
geons, attendants, and nurses have caught the malady in
the hospital wards; as yet but two cases of death are re-
ported among the doctors, and a few cases among the atten-
dants and nurses. It is especially, as in the case with all
epidemics, in the dwellings of the working men of the in-
digent classes that the contagion spreads, on account of
the bad ventilation and the immediate contact with the
clothing.
" Question 4.—What is known respecting the origin,
nature, and progress of the malady, of the symptoms by
which it declares itself, and of the best treatment to be fol-
lowed to effect a cure ?

" Reply.—The origin of this epidemic may be attributed
;o the bad hygienic arrangements (mauvaises d'hygiene
conditions) ; to the consumption of vegetables (cabbages
and potatoes especially) which have been grown under
unfavourable climatical conditions which has produced
a considerable increase on all articles of food ; to the
immoderate use of spirits made form grain by the work-
ing and lower classes ; to an unusual conglomeration of
workmen in the capital towards last autumn, which occa-
sioned a considerable crowding in their dwellings ; a
crowding very baneful to health (a une bonne hygienie),
especially in the Russian climate. To these accidental
causes there must still be added (and this is applicable to
all epidemics) the frequent atmospheric variations, espe-
cially so common on the shores of the Gulf of Finland, and
which produce what physicians call genius morbarum epi-
denzicus. The relapsing fever (fievre recurrente), which
made its first appearance towards the end of last August
at the rate of five to six cases daily, progressed rapidly.
In November there were already no less than 500 cases of
disease in the town hospitals; towards the end of January
and at the commencement of February the epidemic had
reached its height, as many as 150 persons being taken to
the hospital in one day, and if we include the cases of ordi-
nary typhus and other severe diseases the number arose
to 250 and even 300 per diem. We must, however, observe
that this last number does not give:the exact number of
the sick, as for many days during the time requisite for pre-
paring temporary hospitals numbers of sick had to remain
in their own domiciles. During the last week the number
of cases of relapsing fever (fievre recurrente) has consider-
ably diminished, and the petechial typhus, the typhoid
fever—to which the relapsing fever often turns in its se-
cond paroxysm—takes the place of the relapsing fever. At
the present moment the average total admission into the
town hospitals is from 100 to 150 per diem, including the pe-
techial typhus, or typhoid fever, and other severe maladies,
As regards the symptoms, the relapsing fever (Rene recur-
rents) has shown itself under two forms—a simple and a
bilious form. It always commences by prodromes; the persons
attacked have a shivering fit, sometimes two attacks at
a short interval, sometimes they have a continuous
attack. When the attack is over the patient is
much prostrated, he complains of headache, thirst, sick-
ness (mat au cceur), and want of appetite ; vomiting occurs
at times, the patient is generally constipated ; the prostra-
tion
then increases, and he suffers extreme pain at the ex-
tremities; however, these latter symptoms might not appear
or might diminish in a short time ; they are neither perma-
nent nor constant. Generally speaking, this period of incu-
bation is not of long duration ; often after 24 hours only the
disease displays itself in most distinct characters. The face
has an altered appearance, the lines are depressed, the colour
of the face, red with some and of a grey yellow with others,
is sometimes icterical ; the skin is hot and dry, the head
heavy and burning. If a thermometer is placed under
the armpit of tho patient it marks 30 deg., 40
deg., and 41 deg. de • Celse, and this temperature is
nearly the same all over the body. The tongue is gene-
rally moist, never quite dry ; red at the edges and point,
it is furred at its base. In the greater number of cases
respiration is perfectly free, while in others the patient
has a slight cough without much expectoration. The abdo-
men is not much swollen, yet it is sensible to touch, espe-
cially under the pressure of the left hypocondrium. The
liver is much larger than in a natural state, as it often deve-
lopes itself as far as the navel, and completely oscupies the
left hypocondrial region. The spleen is in a constant state of
great swelling. The invalid does not eat, and even shows dis-
, gust for every species of food, but he has intense thirst; he
goes easily to the closet, and the motions do not show any-
thing extraordinary—they aro rather liquid than solid;
the urine, passed without difficulty, is slightly acid, at times
albuminous. The patient, much prostrated, is taken with
giddiness and cannot stand upright. The pulse is weak and
slow ; from 100 pulsations it reaches 130, at the rate of 140
pulsations per minute. Delirium very seldom occurs. The
state which we have just described lasts four, seven,
and even ten days ; the patient then begins to perspire
copiously, and that perspiration, accompanied by a
most marked diminution of all the symptoms, continues
sometimes from 12 to 36 hours ; but the prostration remains
the same, and the twitches of the muscles continue unabated.
This state continues for many days, when suddenly cold
ensues, followed by shivering fits, and they are followed
by all the symptoms above mentioned, and torment the pa-
tient for many days more. Yet, generally, this second at-
tack is not so violent or so long as the first, and the patient
enters into a state of convalescence. The convalescence is
very slow. Very often the patient has one or two relapses,
apparently less violent, but leaving him in a most prostrate
condition. In some rare cases death occurs in the first
paroxysm—that is to say, before the second attack of shiver-
ing consequent upon a cerebral or pulmonary hemorrhage,
or from an inflammation of the coats of the brain (meninges)
or from paralysis of the heart (Dr. Hermann, Aboukhoff
Hospital). Later, the patient dies either from inflammation
of the lungs or rather from a stoppage (stase) in the lungs,
or from an abscess in the spleen or loins, catarrhs in the
bowels, or hydropsy. At the workmen's hospital extensive
phlegmons of the trunk and extremities have been observed
with suppuration of the inguinal glands, often resulting in
death. Recently, as already previously observed, the relap-
sing fever at its second paroxysm has turned into typhus
or typhoid fever. The second form of the malady—bilious
relapsing fever—Lapvre recurrente bilieuse, may arise from
the first just described ; however it shows itself at once.
From the first day the patient is in an icterical state, he
vomits bile, and has fearful headaches. He becomes deli-
rious, and remains in a prostrate state. This very dan-
gerous condition does not always end in death, but conva-
lescence is always slow, The autopsy has always shown
that the seat of the malady is in the organs of the abdomen,
especially the spleen and liver which are always greatly
enlarged and completely changed : sometimes the loins are
also affected by this inflammation ; a catarrhal affection of
the mucous membrane of the stomach and bowels is also
observable, which sometimes reaches the mucous membrane
of the hilarious channels, and which occasion icterical phe-

*lt is especially to the English doctors MM. Kennedy,
Jenne; Christison, Dundas, Bennet, who have watched
latter species of typhoid fever, particularly to Professor
Bennet, who studied it in 1846 and 1847 in Scotland, that
we are indebted for a knowledge of all its characters. Pro-
fessor Griessinger, of Zurich, on his part, who watched an
epidemic in Egypt, has also greatly contributed to define
this speciee of typhoidal affection.
t The malady was most carefully watched and described
by Doctors rehkan (elder), Heimann, and Levestamra.