The Portland daily press., 1877-07-27

TIE first thirteen diseases mentioned are
grouped together as being members of the in
fective class and are placed at the head of the
list, as they are affections with which public
measures have most concern. Diphtheria and
Group are reckoned as one, inasmuoh as there
exists decided and growing disposition among
the best physicians to recognize their identity.
The diarrbeal diseases are associated, sin oe
medical attendants often experience difficulty
in distinguishing them, and what one would
call simply 'diarrhoea", another would name
'cholera infantum." Three cases recorded as
"Infantum" are counted with s'cholera infant
um, that disease being evidently intended In
very many cases only the location of the
ever particular disorder of such part was
specified, it is put by itself for the sake of dis.
tinctness. Thus "pneumonia' is separated
from those causes of death which are vaguely
classified under diseases of the lungs" Under
the heading "pneumonia" are embraced not
only those entered as such, but also congestion
of the lungs and 'luDg fever" the latter being
term more frequently perhaps, applied to
pneumonia than to any other ini1ammatory
affection of the lungs. What were recorded as
fits have been merged with ''convulsions''
"Infantile' includes two cases whose disease
was entered as "Infant child Of" The liberty
is taken of placing in the list of casualties as
dead from poison one case of which the cause
of death is stated as "Over dose off, Those
called unknown" are all transcribed as such
ton. In this case was unable to recognize In
the entry any words belonging TO living or
dead language, and am therefore driven to this
confession OF ignorance. The record, as nearly
as it can be made out, ia "Kunin Evel." In
order that no one may fall into the error of
supposing that all the rest of the report is clear
and ineligible to a medical man. it is desira-
BILE to state that very large number of entries
which seem explicit and lucid convey scarcely
any idea of the difficulty which caused the de-
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instance, in one hundred cases the seat only of
the disease is designated. The statement that
person died on account of disease of lungs"
or OF any other part is too vague to be of any
disgnostic help. Childbirth is perfectly ply
siological process, and to call it fatal disease
in any case is no more proper than to say that
an individual has died of digestion. Even
this is hardly as absurd as those entries which
would have US believe that our people are dying
because of ''bowels'', "lungs", Kidneys and
improbable of all, ''brains.''J Dropsy and
convulsions are not diseases at all, but only
symptoms which assist us in determining the
character of certain disorders. 'Infantile" is
meaningless to the point of unmitgated idiocy |;
for it seems to imply that infancy IS of itself a
sufici cause of death. 'Tumor," "conges-
tion," 'lamepess," "humor" and others are
devoid of significance and might well be made
to swell the number marked unknown
In analyzipg this partially corrected report
Will d FlGW VI ODtdluiuS lIUu IL LQ0 RT6dIeSG
possible amount of instruction, it is necessary
at first to deduct from the whole number the
twenty-njne still born, in conformity to the
custom which universally obtains among santa
ry statisticians-although the advantage or fair
ness of the procedure is by no means urques-
toned. This leaves GA as the number from
which we may properly make our calcula-
tions.
The population of Portland at the beginning
of the last municipal year was 35,031. This
makes the death-rate for the year 1924 per
thousand. The normal death-rate is reck-
oned at II per thousand per annum; that is to
say, of every thousand people of all ages and
conditions who are living in selected, healthy
localities at the beginning of a year, seventeen
will on the average, be dead at the end of the
are peculially favorable this numberlmay be
reduced to fourteen. Thus we see that the
mortality in Portland is higher than the nor
NAL by 2.A per thousand; in other words, 78
deaths occurred here in the last year which
must be regarded as entirely unnecessary in q
place so well situated from sanitary point of
view as this is. There are few cities with bet
ter natural advantages in this regard. Our
territory is small, comprising but 1866 acres; it
s nearly surrounded by salt water which is
renewed With every tide; the land slopes from
the centre on all sides, giving rare opportuni-
ties for drainage; the main supply of water is
derived from pond of remarkable purity. and
the sea.breezess not only effect frequent
change OF air, but prevent the violent extremes
of temperature ch are so common in these
northern latitudes A sanitariaD, searching
for spot on which to locate typical Hygeop-
oils would hardly need look further after be.
holding this peninsula on which Portland is
built. Ard YET, in spite OF these favoring Cir
cumstances, and with a defective mortuary
registration, our death rate is shown to be con-
slderably greaterl han it should be. The fact
that it is less than that of many other cities
should not lead us to disregard the evident ab-
solute excess. What would be very low death
rate for some cities must be considered as high
for Portland AT all events, we should not ig-
more threatened destruction because others are
reckless OF lde. Our opportunities are such
that even with an accurate registration, we
might reduce our death-rate below the STAN
dard. But let us examine the statistics and
see if we can find any indication of the cause of
this waste of life.
There died from infective diseases (those
named before "consum ption" on the list) 178,
or 26.4 per cent. of the whole number. This
per cent. should probably be increased by the
addition of other cases which are obscurely re-
corded. For example, it Is fair to suppose that
some of the 2S decedents from ''disease of
brain" of the from "dsease of bowels" of
the from 'disease of throat" of the II from
''convulsions," of the II from ''infantile,' of
the from 'fever," of the from 'teething," :"
and of the 2S unknown and unreported (1O1 in
alD would, if correctly recorded, be included in
this group, for the reason that, in several of
these maladies, the brain, bowels or throat are
often conspicuously affected: convulsions and
fev er are common phenomena in almost all of
them; infants are prone to contract them; and
''teething," which is a normal process, is made
to cover prodigous amount of careless dag
nosis and pretentous ignorance 1t may, with
cut doubt. be asserted in opposition to this idea
that possibly some of the cases included ucder
the infective diseases do not belong there. But
the error in this direction is probably very
small-if, indeed, it exists; for all these dis
eases are common and, as rule, easily recog-
nized. Now, it is well understood by the medi-
cal profession thai these diseases are SO largely
dependent upon uncleanliness of some kind as
TO deserve the name of filth diseases; and it
is Furthermore known that, while not absolute
ly preventable, they are to great extent con-
trollable. They are to be regarded as accidents
just as much as injuries received from storm,
lightning, excessive heat ard cold, and other
meteorological agencies whose influence we
cannot entirely avoid, but from which we can
in notable degree defend ourselves. 1t is
quite as practicable for community to protect
itself from smallpox as from thunder bolts.
Thus it is seen that more than quarter of our
deaths are needless and might be prevented. In
order, however, to wholly Danish these diseases
| from the community, something is necessary