HH62/2/RENFRE/21

Transcription

[Page] 20

in the course of the year, no fewer than thirteen deaths. Towards
the end of 1891 the disease once more broke out in epidemic form in
the village, as will be seen in the further course of this report.
With these preliminary observations, I pass on to a consideration of
the general results of the analysis of the vital statistics of the last
decennium.

Vital Statistics of the Two Districts, 1881-90. - Taking
first the First or Upper District, it is gratifying to observe that not-
withstanding the non-existence of a County Health Department (!)
there emerged a distinct improvement in the condition of the public
health as the decennium advanced. This improvement is masked if
the figures of only one year are compared with those of another; but
when the decennium is divided into quinquennial periods, progress
stands revealed. Thus, we find the mean death-rate fell from 18·6
per thousand of the population in the first five years of the decennium
to 17·0 in the second five years; the zymotic death-rate, from 3·1 to
2·2. The mean death-rate of the decennium was 17·8, the mean
zymotic death-rate 2·7. The scarlet fever death-rate fell from ·9 in
the first period to ·2 in the second - but, as a matter of fact, this dis-
ease appears to have simply burnt itself out in the more populous
districts in the first period, and only now is there becoming aggre-
gated a sufficient bulk of unattacked, susceptible, material to furnish
forth a new conflagration. A slight decline in the mortality from
whooping-cough is counterbalanced by a slight increase in the
diphtheria death-rate. There is a slight decrease in the death-rates
from septic diseases ('blood poisoning'), phthisis, other tubercular
diseases, and diseases of the lungs.
In the Second or Lower District, the death-rate fell from 17·9 per
thousand in the first quinquennium to 16·2 in the second, the zymotic
death-rate from 2·2 to 1·7: the mean rates for the decennium being
17·1 and 2·0 respectively. The scarlet fever death-rate fell from ·4
to ·1, as in the First District, there was as light increase in the death-
rate from diphtheria; the measles death-rate, however, fell from ·3
to ·1. It may be that to some of my readers a fall 'from ·3 to ·1'
does not appear to have much significance; translated into simpler
elements, it means a saving of 24 lives, and of, approximately, 600
cases of illness, with the impairment of constitution which so often
follows upon non-fatal attacks of measles. There was also a slight
decrease in the death rates from septic diseases, phthisis, other tuber-
cular diseases, heart disease, and diseases of the lungs.

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The Condition of the Public Health in the Villatic as
compared with the Landward Sections of the County,
1881-90. - Table V. of the Appendix shows very clearly that the
conditions of life in a purely landward (rural) district, outwith the
villages, as compared with the average conditions in the villages, are
infinitely more favourable to the public health than are the condi-
tions of village life as compared with those of towns. Thus, it will
be seen that the mean death-rate in the villatic section of the county,
over the ten years, has been 19·063 per thousand of the population,
while in the purely landward section it has been as low as 11·032, or
8·031 per thousand less: the difference is much greater than one
would have been inclined to anticipate, even taking into considera-
tion the insanitary conditions prevalent in so many of our villages.
The mean zymotic death-rate in the villages was 2·929, as compared
with 1·204 in the landward districts; considering that proximity of
susceptible persons is an important factor in the spread of infectious
diseases, one is not surprised at this result. The death-rate from
scarlet fever was 560 * per million in the villages, as compared with
140 in the landward portion; measles, 300, as compared with 108;
whooping cough, 577, as compared with 215. But it is of importance
to note, in view of the current discussions to the causation of
diphtheria, that the diphtheria death-rate in villages was 280, as
compared with 190 out in the country. It is of even more impor-
tance to observe that the mean diarrheal death-rate for the villages
was as high as 862, as compared with 380 in the purely landward
district; diarrheal diseases are just what we would expect to follow
in the train of the foul ashpits, wretched scavenging, and general
pollution of the soil which characterise so many of our villages. In
only one important particular does the standard of public health in
the landward districts fail to rise appreciably above that in the vill-
ages, that is in respect of septic diseases - the class of diseases gener-
ally spoken of as arising from 'blood poisoning'; here the villatic
death-rate is 212, as compared with 209 landward; it is painful to
observe the number of women in the country who die of puerperal
fever, in the pure country air this class of diseases should be almost
unknown. I have little difficulty in attributing such a prevalence of
diseases of this class in the country to what is generally regarded
as the healthful muckiness of farm-steadings; it has not yet come to

* Abolishing the decimals.
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