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At the Social Science Congress, 1872, Dr. Acland, F.R.S., D.C.L., etc., delivered the address on Health. At the close of his paper is given the following simple yet expressive form of Diagram to show the Proportion of Ann. Deaths p. 1000 of the Pop: [figures taken
from Weekly Rep. of Reg.-Gen., 25th Oct. 1872] : London
19 Wolverhampton Birmingham Leicester
40 Bradford Leeds Sheffield
29 Foreign Cities. Bombay
39 New York
28 From the “Ann. Summary” of the Reg.-Gen. for 1872 we draw the following most important details regarding the death-rate of Lond. and 17 other large cities and towns : ANALYSIS OF THE MORT. IN 18 OF THE LARGEST ENGLISH TOWNS IN 52 WEEKS
ENDING 28TH DECEMBER, 1872.
Regarding Lond. itself, the following T. of additional details is given. This is prob.
[Note. --The pop. upon which these rates of mort. have been calculated are deduced from the numbers enumerated at the four censuses of 1841, 1851, 1861, and 1871. The deaths used for the 32 years 1840-71 are for the complete years, while those for 1872 are the numbers regis, in the 52 weeks ending 28th Dec. in that year; the 1872 rates have not been corrected for the difference between 365 '2422 days and the 364 days included by those 52 weeks. Certain alterations affecting the West and Central groups of districts were made in the year 1868, but no corrections have been made in the results given in this T. for any year prior to 1861.]
The Reg.-Gen. says regarding this last T.:
Some disappointment may be felt that the mort. of Lond., which should be below 20, has not descended permanently to that rate: the reason is too obvious, for the water supply is still drawn from the stream of the upper Thames, which drains a populous basin, and receives much of its impurities. Then it has been shown that although the main sewers have been well laid, the branch sewers, under the district boards, are still imperfect; they are in places ponds of impurities, as Dr. Hardwick and others have discovered by inspection, even in the West End of London. Fine old houses have had vast cesspools laid in the precloacal age; and those cesspools in many cases remain undisturbed, exhaling their fumes through the air. The London Building Act, in some respects worse than the Sanitary Acts applying to country districts, has no adequate clauses to provide for the effectual purity of the new dwellings erected. There is still a want of thoroughness in the London sanitary work, accounting fully for the higher rates of mort., which look unfavourable by the side of a high standard of salubrity, but favourable as compared with the rates of other cities left in a worse state.
In the year 1872 the ann. rate of mort. fell to 21'4 p. 1000 : this contrasts favourably not only with 1849 and 1854, when the ann. rates were, owing to cholera, 30*1 and 29:4, but with every year except 1850, after the cholera had swept off the feeble, when the rate was 21'o. The causes of this better state of things can be most conveniently discussed in the Ann. Rep., for they were in general operation throughout the kingdom. In the mean time, Lond. may accept the improvement in the vitality of her pop. as of good augury.
The following are the death-rates p. 1000 of the pop. of some of the leading cities on the American continent, as obtained from special sources by Dr. Charles P. Russell, medical officer of the New York Board of Health, 1873: San Francisco 17 Brooklyn
28 New York...
32 St. Louis
30 Savannah Cincinnati
30 Montreal Baltimore
46 Philadelphia... 26 Halifax
31 Valparaiso, Chili 66 Chicago...
27 DEATH, SIGNS OF.—In 1834 M. Julia de Fontenelle, a man of science, pub. Medico-Legal
Researches on the Uncertainty of the Signs of Death. This work was for many years, if it be not now, the standard one upon the subject. In the Quarterly Review for 1849 there
is a most able article upon the subject, full of interest, based upon the work of Fontenelle, DEATH, TIME OF.—This question is discussed under DEATH, PRESUMPTION OF. (DEATH,
HOUR OF.] DEATH-WOUND. A term applied to a ship, when she springs a leak which the pumps
cannot subdue; or receives any other injury which in the end proves fatal to her. [DAYS
or GRACE- Marine.] DEATHS, AS A MEASURE OF THE EXPECTATION OF LIFE.-It is well known to all those
practically conversant with the construction of Mort. T. that the deaths in a pop. can only be employed as a measure of the prob. duration of life, i.e. as a basis for the construction of accurate Mort. T., when the births and deaths are equal, and there is no emigration-a state of matters which very rarely happens in any community ; and which, whenever it does happen, cannot long continue.
It follows, as a necessary consequence, that the early Mort. T., which were all constructed upon the records of deaths alone, cannot be correct. The measure of their inaccuracy will depend upon the degree in which the births exceeded the deaths, as they must always do where the pop. is increasing without influx by immigration ; or were less than the deaths, as they must be where the pop. is decreasing without the aid of emigration. The element required to be associated with the number of deaths, in order to arrive at correct results, is the number of living out of which the deaths occurred—that is, the numbers living at the ages at which the deaths occurred.
Dr. Price himself, alihough he constructed several of his Mort. T. from the records of deaths alone, became aware of the fallacy involved in the method.
Mr. Milne, in his art. Law of Mort., which first appeared in the Encyclo. Brit. in 1824, handled the point with great distinctness :
The number of years in the mean duration of life from birth, according to a Mort. T. properly constructed from the necessary data, will, when the pop. has remained stationary for a century or more, be the same as the number of persons in the whole pop. out of which , dies annually. When the pop. has been increasing, the mean duration of life, according to the T., will be less than the number out of which I dies ann, in that pop.; but the difference will be small, except under particular circumstances.
Again : When T. of Mort. are constructed from the numbers of deaths only in the different intervals of age, without comparing them with the number of living persons in the same intervals;
and the pop.
is increasing; the number of years in the mean duration of life from birth, according to that T., will fall short of the number of people out of which I dies ann., by a much greater number than in the case we have just been considering, of the T. of Mort. having been properly constructed from the Decessary data.
When what we have shown here is clearly understood, and the proportion of the people dying ann. is known, it will not be difficult to judge whether a T. of Mort. for that people has been constructed properly from the necessary data ; or, what is much more common, and more easily effected, merely by summation of the deaths at all ages.
The Reg.-Gen. in his 5th Ann. Rep. 1843 [Returns for 1841), says: The duration of life in England is 41 years; if the pop. were stationary, the mean age of those who died would be 41 years; and 1 in 41 would die every year. The pop. has, however, increased 1'41 p.c. ann. during the last 40 years; and we find that the mean age of the persons who died in the year 1841, instead of being 41, is 29 years; while I in 46 of the pop. died. This agrees with wbat Mr. Milne lays
down as the result of other obs. (DEATH-RATE.] [MEAN DURATION OF Life.] DEATHS, AS A MEASURE OF THE POPULATION. — Among the many expedients which were
employed for estimating the pop., prior to the estab. of a national census in Gt. Brit., was that of multiplying the number of deaths by the number of living out of which I death was supposed to occur ann. Thus if the deaths in any place were found to be 50,000 p.a., and it was supposed that i in every 30 of the living died ann., it would work out that the pop. of such place must be taken at 1,500,000. But the process was really that of placing the cart before the horse : for the death-rate itself can only be accurately ascertained by comparing the ann. deaths with the numbers living, as ascertained by actual enumeration. All such estimates were therefore necessarily fallacious, or at least lacked the element of certainty. Again, if the law of mort. were uniform in its operations in all countries and towns, the death-rate being ascertained for one place, then the pop. of all other places might be ascertained by means of the rule named. But as the mort. of every country, and of all the principal towns in each country, varies, it is clear that the rule never could have any general application.
Graunt was prob. the first who attempted (1662) to number the pop. by means of the ann. deaths. He estimated the rate of mort. as I death p.a. out of 32 living-exclusive of the mort. produced by the plague ; and multiplying the deaths shown in the bills of mort. by 32, he made the pop. of Lond. to be 403,000.
Sir William Petty in 1683 applied the same method. He took the ann. mort. to be i to 30 persons living. Multiplying the deaths by 30, he made the pop. 669,930.
Šussmilch, in one of the later editions of his Gottliche Ordnung, had applied the same test to the pop. of Rome. Struyk had about the same period (1752) applied a similar test to Amsterdam,
Dr. Brakenridge, in a paper submitted to the Royal So. in 1755, undertook to determine the number of inhabitants in Lond. by means of the ann. number of burials, adding 2000 to the bills for omissions, and supposing a 30th part to die every year.
Dr. Price, in his Reversionary Payments, 1771, laid down the following proposition : In every place which just supports itself in the number of its inhabitants, without any recruits from other places, or where for a course of years there has been no increase or decrease, the number of persons dying every year at any particular age, and above it, must be equal to the number of the living at that age. The number for instance dying every year at all ages, from the beginning to the utmost extremity of life, must in such a situation be just equal to the whole number born every year. And, for the same reason, the number dying every year at 1 year of age, and upwards; and 2 years of age, and upwards; and 3 and upwards, and so on, must be equal to the numbers that attain to those ages every year; or, which is the same, to the numbers of the living at those ages. It is obvious that unless this happens, the number of inhabitants cannot remain the same. If the former number is greater than the latter, the inhabitants must decrease; if less, they must increase. From this obs. it follows, that in a town or country, where there is no increase or decrease, bills of mort. which give the ages at which all die, will show the exact number of inhabitants; and also the exact law according to which human life wastes in that town or country.
Dr. Price considered that he produced "evidence little short of demonstration, that at least 1 in 20 died ann. in Lond. about 1771; and that consequently the number of inhabitants, if the omissions in the B. of Mort. were 6000 p.a., could not exceed 601,750.”
It is not necessary to follow up the subject: the system is not only exploded, but all necessity for its application has long since passed away. It had this radical defect in practice, in add. to the defects already pointed out, viz. that it was very likely to make the pop. appear the largest at those particular periods when it was in reality the smallest; for instance, the mort. being rendered unusually large by an epidemic or other cause, the increase of deaths, which actually lessened the number living, would, as a necessary con. sequence, show a very large apparent increase in the pop. at the same period.
[ESTIMATES.] [Morr., LAW OF.] [POPULATION.] DEATHS, INFLUENCE OF THE SEASONS ON.-See SEASONS, INFLUENCE OF. DEATHS IN PUBLIC INSTITUTIONS.—The deaths in the Public Institutions of a country,
or of a city, give rise to the necessity for a “correction" of its mortuary returns, in view of furnishing the correct death-rate for such country or place. For instance, the deaths in military and naval hospitals do not really belong to the districts in which such inst, are situated ; for the army and navy are recruited from the pop. of the entire country ; and the deaths resulting are to be spread over the entire deaths of the country. But here again another “correction” becomes necessary : the health of soldiers and sailors-of soldiers especially-becomes deteriorated by foreign service, and by residence in unhealthy barracks in towns. The rural districts are not to be debited with a rate of mort. which does not belong to them, as arising from such causes. They are to be debited simply
with the ordinary death-rate of the country, assuming the same number of persons to be engaged in ordinary pursuits.
So in cities and towns, the deaths in the hospitals, prisons, workhouses, asylums, etc., belong in part to the pop. of the surrounding districts, from which their occupants were drawn ; and in seaport towns many of the deaths are those of foreigners.
We mention these points only to show that they are all duly considered and dealt with by the Reg.-Gen. and his able staff of assistants. We shall give a few details illustrative of these points. The mort. of the army is dealt with as a whole; and the national returns are from time to time corrected accordingly.
In 1861 there were, as shown by the census, 154,602 inmates in 853 public institutions of E. and W. There died during the same year 32,437 inmates ; and assuming the average number of inmates to be represented by the number at the date of the census, the mort. was at the rate of 20'98 p.c., or 210 p. 1000 ; while the mort. of the pop. of E. and W. was at the rate of 22 p. 1000 of the pop. The mort. of the public inst. of the country was therefore ten times as high as the mort. in the pop. generally. The ann. average rate of mort. p. 1000 average inmates was 190 in 690 workhouses ; 569 in 106 hospitals; and u in 57 lunatic asylums.
During 1870 there were regis. 43,017 deaths in 1034 of the largest public inst. of E. and W. Of these inst. 690 were workhouses, 266 were hospitals or infirmaries, and 78 were lunatic asylums.' Of each 100 deaths regis. in E. and W. during 1870, 5'6 were recorded in workhouses, 2:0 in hospitals, and 7 p.c. in lunatic asylums; these per-centages exactly correspond with those which prevailed in 1869. The proportion of deaths in public inst. as usual varied very considerably in the different regis. divisions ; in the Metropolitan Divisions 16'1 p.c. of the total deaths were returned in the large public institutions ; in the South-eastern Division, including Surrey (extra-metropolitan), Kent (extrametropolitan), Sussex, Hampshire, and Berkshire, the proportion was 9:6 p.c., owing in great measure to several large metropolitan inst. being situated therein ; and in the north-western counties, Lancashire and Cheshire, it was 8.8 p.c. The smallest proportions were 3.8 p.c. in the Welsh ; 5'2 each in the North-Midland and Yorkshire; and 5'3 in the Northern Regis. divisions.
Regarding the metropolis, we have more precise returns. In 1867, 12,002 persons died in 120 public inst. in London, constituting about a sixth part of the total deaths of the metropolis. In other words, of 1000 deaths in Lond. in 1867, no less than 170 occurred in one or other of the public inst. ; and of every 1000 of pop. in Lond. 3-9 were inmates of these inst. at the time of their death. Of every 1000 deaths 63.4 occurred in one or other of the 36 metropolitan hospitals—viz. 3291, or 46.6 p. 1000, in 16 general hospitals ; 929, or 13'2 p. 1000, in 8 hospitals for special diseases; 82, or l'1 p 1000, in 4 lying-in hospitals ; and 177, or 2.5 p. 1000, in 8 military and naval hospitals. The mort. of Lond. is not unduly augmented by the deaths of persons in the metropolitan hospitals who came from other parts, or contracted diseases in the wards, as these cases are compensated for by the residents of Lond. who left it consumptive to die elsewhere. There were also three hospitals and asylums for foreigners, in which 100 deaths occurred, being in the proportion of 1.4 p. 1000 of the total deaths. 147 deaths, or 2'I p. 1000, took place in 4 military and naval asylums. In the 19 lunatic asylums 357 deaths were regis., being in the proportion of 5:1 to every 1000 deaths. It may be stated that two large lunatic asylums-Hanwell and Colney Hatch, in which many Lond. lunatics die—are beyond the limits of the metropolis. In the 46 metropolitan workhouses there were 6829 deaths, or 96.7 out of every 1000 deaths in Lond. occurred ainong the inmates of workhouses ; 90 deaths, or 1'3 per 1000, were recorded in 12 prisonsa The following T. exhibits the facts more clearly : Number of Deaths in the different Classes of Public Institutions of London
during the Year 1867,