The Sun.
London, England, 1859-02-18 00:00:00

BIRTHS AND DEATHS IN LONDON.

An interesting report on the births and deaths,
and causes of death in London, during the year 1858
has been_ issued..from the General Register-office.
The following are some extracts from the dochMent
" London has grown like a mighty tree, by exten-
sion rather than by the internal aggregation of con.
stituent parts ; and while foreign cities, girded round
by walls, have grown denser and risen vertically,
London has extended its boundaries freely all around,
and covers now 78,029 acres= 31,576 hectares =l2l
square miles= a square of 11 miles to the side. The
population in this area amounted in 1801 to 958,863,
and in the year 1851 to 2,362,236. The London of
1858 is equal to three Londons of 1801.
"The extent of the population of London gives
weight to the returns extending over short inter-
vals of time, and enables the scientific inquirer to
investigate the effects of atmospheric and other
conditions on the mortality.

The registered births in London amounted 'to
88,620, the deaths amounted to 63,882, in the 52
weeks of 1858 ; and the increase of people in this
way was 24,738. By the calculation the increase
from all cues was 52,690, or nearly 1,000 a week
in the interval from the middle of the year 1857 to

the middle of the year registration of
births, not being compulsory, is not complete in
London ; and a portion of the increase of 52,690 is
thus accounted for. But. in round numbers, itmay
be stated that London i• cre ses at the rate of about
1,000 people weekly, of who i about 500 are immi-
grants in excess of the i ati e emigrants who bid
adieu to the banks of the Thames.

"45,220 boys and 43,400 girls were born in the
year.

" 32,563 males and 31,319 females died in the year.
" The mortality was at the annual rate of 2.356
per cent., or 23 and less than 24 in 1,000. This rate
exceeds he rates (22) of the two years 1816-7, and
the rates of 1850-1.2, namely, 21, 23, 22 ; but it is
below the rates of 26 and 30 of 1848-9, as well as
the rates 24, 29, and 24 of 1853-4-5.
"London is divided into five groups of districts ;
and the mortality to 1,000 living was 21.77 in the
west districts, 22.48 in the north districts, 93.16 in
the central districts, 24.26 in the south districts,
and 25.30 in the east districts. In interpreting
these facts it must be borne in mind that the calcu-
lated population of particular districts cannot be
viewed with the same confidence as the calculated
population of London : and that the populatipn is
often differently constituted in respect to age and
occupation. The reduction in the mortality is
greatest in the south districts.
" 10,004 persons died in the public, institutions j
of London, 5,535 in the workhouses, 57 in the prisons
and 4,412 in hospitals and lunatic asylums. Of the
latter number 317 belong to the Greenwich and
the Chelsea Hospitals, 211 to the military and naval
hospitals. About one in six of the inhabitants of
the metropolis dies in the public institutions; nearly
one in 11 dies in the workhouses. The death of so
many persons in the large workhouses demands in-
quiry. Of the 63,882 deaths in 1858 the causes
were specified in 63,027 instances. The fatal diseases
were nearly all certified by the medical attendants,
by the medical officers of institutions, or by the
coroners.

" 16,704 persons died by diseases of the zymotic
class. These maladies exhibit great fluctuations,
but they are not the less on that account under
human control. Thus 247 persons, children chiefly,
died of small-pox in the year 1858, 154 in 1857,
1,024 in 1855, and 1,617 in 1848. The deaths by
small-pox fluctuate from year to year ' • the cause of
the fluctuation we do not vet know, but we know
well that if all the maple were vaccinated there
would be no deaths from small-pox at all, or very
few. The deaths from cholera were 130 in 1858,
10,708 in 1854, and 14,125 in 1849. The cause of
the difference is obscure ; but it has been demon-
strated that a large part of the mortality of cholera
in London was due to the night soil in the air, in
the cesspools, in the► sewers, in the wells, and in
the water of the Thames; and it is probable that
if the air and water of London arc purified by the
Board of Works the mortality of London will never
be again so high as it was in 1849. Indeed, when
the sanitary defences of the metropolis are com-
plete, and the medical health officers are in full
activity, epidemics may assail, but they will, it is
hoped, never destroy large numbers of the people.
Of typhus 1,902 persons died in 1858 ; and since
1844 the annual deaths have fluctuated from 3,614
to 1,333. The fever under this head is properly
distinguished now by skilful practitioners as ty-
phus, typhoid fever, and relapsing fever. These
descriptions rather than names may be advantage-
ously replaced by real names, such as typhus,
typhia, and typhinia. It has been shown that
typhoid fever or typhia is propagated and some-
times generated by cesspool poison, typhus by
crowding in dirty apartments, and typhinia by fa-
mine. Dr. Murchison proposes to call typhia on
this account pythogenic fever. Diarrhoea, fatal to
2,093 persons, and dysentery to 181, have kindred
a ises. Measles (2,383) and whooping cough
(2,700) caused an unusual number of deaths; but
the mortality from these diseases declined during
the year. It was otherwise with scarlatina and
diphtheria, which in four successive periods of 13
weeks destroyed 473, 588, 1,243, and 1,814 lives,
amounting to 4,118 in the aggregate. The deaths
from carbuncle were 61 ; fewer than in 1856, but
ten times as many as the deaths from the disease in
the earlier years. This troublesome plague of boils
has been prevalent for some time. Syphilis is more
fatal, or it is more accurately distinguished than it
was formerly ; 263 deaths were directly referred to
it, and 42 to scricture of the urethra, in the year.
Alcoholism killed 123 unhappy people by delirium
tremens, 98 in other ways ; it was also undoubtedly
the cause of many fatal diseases. Of cancer, 1,142
persons died ;of mortification, 170. Of the class
of diseases in which tubercles are generally depo-
sited 10,127 persons died; namely, 437 by scrofula,
823 by tabes messenterica, and 7,369 by phthisis
—consumption. Of 1,498 deaths by hydrocephalus
or water on the brain, a certain number were in-
flammations of the membranes and tissues of that
great organ.
" Of the 6,571 deaths by diseases of the nervous
system, 1,423 were by apoplexy, 1,184 by paralysi!.,
2,119 by convulsions.
66 Heart disease often exists without being fatal ;
yet 2,435 deaths are recorded by pericarditis and
other heart maladies ; and 86 persons died of anen-
risms of the large vessels.
" Bronchitis (6,388) and pneumonia (4,150) were
unusually fatal ; exclusive of phthisis, 11,908 persons‘
died of diseases of the respiratory organs. The
deaths were thus distributed through the four
quarters : 4,440, 2,226, 1,167, 4,075. They vary
in the inverse direction of the mean temperature,
which was 38 deg., 51 deg., 61 deg., and 44 deg.
The unusual degree of cold in November was the
main cause of the increase in the last quarter. It
will be observed that the mortality of consumption
was nearly the same in three quarters ; that it
was below the average in summer.
"The 2,573 deaths from diseases of the digestive
organs were very equally distributed over the
seasons ; so were the 831 deaths by diseases of the
urinary organs, except nephria (Bright's disease),
which, like phthisis, is least fatal in the summer,
but is nearly equally fatal in the other
" Of ovarian dropsy, and of
diseases of the order, 205 persons., die( ; of
quarters.lt
other
s died,
diseases, 182. Of skin diseases, 262
piedrscoa of the
uterinelan(*oint
including 48 by ulcer. This gives no
among the
amount of disease and
London by ulcer of the
labouring population of Lorii
enough, not treated
to
legs alone, which is, singular l3' of disability
metria ; 265 of other diseases incidental. child-
bearing
to to any extent in the hospita 165 women died of
bearing ; making 430 mothers dying to 88,620
children
on an average,' one one mother
d
alive. The deaths from
this cause will, we may hope, be greatly reduced
dto 2ob6oril childrenalive or,
in future years.
" 2,591 deaths were referred to atrophy and de-
bility 2,413 to old age, without apparent disease.
1,916 violent deaths happened in the year ; 2
were public executions, 52 were homicides, 238
were suicides, and 1,622 were returned as deaths
by accident or negligence. The homicides were
most numerous in summer. The suicides were least
numerous in the first three months of the year ; of
the suicides, 9 were by gunshot wounds, 60 by other
wounds, 36 by drowning, 76 by hanging, 44 by
poison, and 13 in other ways.
Of the accidental deaths, 755 were y b frac-
tures, contusions, and wounds inflicted in various
ways ; 309 were by burns and scalds ; 235 were by
drowning; and 230 by suffocation in bed and
otherwise. One violent death was not classed.
" The violent deaths increased in London from
1,528 in 1848, to 1,916 in 1858, and it is" desirable
that every means should be adopted likely to lessen
these calamities.

" If the population of London.at each respective
period of age had experienced a mortality at the
same rate as the population of 63 comparatively
healthy districts of England, the deaths in London
in 1858 would have been about 45,988 ; they ac-
tually amounted to 63,882, and consequently 17,8"
unnatural deaths may be referred to causes which
the Metropolitan Board of Works have to investi-
gate, and endeavour to remove or greatly mitigate.
It is an important mission which the country
expects them to fulfil.
" As a preliminary condition of the improvements
which may be expected to flow from the cultivation
of sanitary science, three things are indispensable ;
pure air for the people to breathe, pure water, and
ti healthy soil to live on.
"Thus the cesspools of London, and collections
of putrefying dirt, must be suppressed ; the sewer
air must be carried off or purified, so as not to
poison people in the houses or streets ; the method

I of burning coals must be adopted so as to consume
the smoke,-which is offensive to the senses and in-
jurious to the lungs. Chinches, chapel:, theatres,
and other public buildings, as well as crowded
dwellings, where people drink each other's. breath,
and-draw in disease, must be purified. The pumps
having shallow wells saturated with impurities
should, as 1)r. Thomson, Dr. Lankester, and other
health officers have proposed, be suppressed, and
the water supplied by the companies should be still
further improved. The, streets should be cleansed
every day ; for it is evident that the cleansing
arrangements of the boards should keep pace with
the increase of traffic and population.
"To all this work the representative metropo-
litan boards will, we may hope, anxiously address
themselves, as on their shoulders rests the respon-
sibility of improving the health of the greatest city
in the world, the metropolis of the British empire.
" When this and other work is done, much will
remain to be accomplished. Sanitary science is
yet in its infancy; it can be greatly advanced by
bringing into the field the great medical profession
of the kingdom, armed with all its science and art,
and working under the most advantageous circum-
stances. There arc more than two thousand medi-
cal men in London and its vicinity, but they are
employed chiefly in treating diseases. They are
often paid only in proportion to the quantity of
medicines that their patients take. 'The art of
preventing disease is not cultivated ; it is not taught
iu any of our medical schools ; it is not formally the
subject of examination in our universities. The
father of a family does not go to the doctor and say
to him plainly, How can I preserve my health ?
Instead of this, the common course being never to
consult or to pay the medical man until the evil is
nearly done; until consumption has set in, diphtheria
is developed in the throat, smallpox is furrowing
the skin, fever is racking; the brain, and then there
is a midnight rush to the great blue and red lights
burning in the street ; or in some cases even to the
nostrums of quackery. How vainly the returns
show. The utility of curative medicine is evident
to every rational mind ; the utility of preventive
medicine is still more clear. 'Witness the health of
the British army in the Crimea, which Miss
Nightingale has shown experienced an annuual rate
of mortality ranging from 1,174 to 7 in 1,000 of the
force, according as the principles of preventive
medicine were disregarded or observed.
" A beginning of a movement has been made in
the right direction under Sir Benjamin Hall's Act.
Medical Health officers are appointed in all the
London districts, and many of them are working
courageously in the midst of unhealthy places, and
against ignorant opposition, with success. Their
reports are replete with interesting facts, and con-
tain many words in season of sanitary truth, well
calculated to influence and direct the boards. They
have deserved the public approbation; for they
have done quietly a great deal of good work, and
it is probable have saved many lives, and prevented
much sickness."