Licence: Public Domain Mark
Credit: Report on the mortality of cholera in England, 1848-49. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![April iind subsided ; the second rose rapidly from J\ine to July, and sunk again down to the second week of August; its course wiis very much like that pursued by the present epidemic. The deaths returned by the parish clerks in ihe three weeks from July 17 to August 7, in 1832, were 968, 793, 661 ; wiiich, all.iwinij for the defects in their returns and for increase of population,are equivalent to 2323, 1903, 1586, or 5812 deaths in 1849. wh<?n the deatiis registered in the corresponding weeks were 1931, 1967, 1909, or 5807 in the three weeljs July 21st to August nth. A third eruption in 1832 broke out at the end of August, and extended to the Krst weeks of September ; a fourth in 1833. It is satisfactory to find that the deaths of 819 out of the 823 persons who died last week of cholera are certified. They were seen by qualified medical attendants. But it is to be feared that the advice was not obtained in time. Tiie accounts of tiie sudden stoppage of the epidemic by prompt medical treatment and tlie house-to-house visitation are perliaps over-coloured. But a mortality as high now as in 1832 should not take place: it may be prevented by improvements in the treatment—by arresting the premoni- tory symptoms—by still earlier attention to the general health. Medical men are called when the people are dying; but it is then too late. If the families of the middle and higher classes were seen at intervals during the epidemic by their medical attendants, and a corps of medical officers employed by the Guardians to visit the poor at short intervals, the present epidemic might very probably be cut short, and a third eruption be averted. The precise locality in which almost every victim of cholera lived is given in the present return under each district; would it not be practicable for the authorities to have all these and tiie neighbouring localities inspected ? If this were done, and proper precautions taken, the tragedy of Albion-terrace, Wandsworth-road, where 17 persons died in two weeks in ten houses, could scarcely recur. The particulars of the 17 deaths will be found in the notes under Wandsworth and Clapham, Another case appears this week in the note under Hampstead. In the house. No. 6, Albion-terrace, Wandsworth, 5 deaths had been registered—a Wesleyan ministers wife, aged 59 ; his mother, 80; a willow, 49 ; and two old servants. This is all we learn from the Clapham Registrar. The Registrar of Hampstead adds, that, during the week, an aged man came with a friend to Hampstead for change of air,—-breakfasted, dined, went to London to transact business at Ihe Bank of England, and after his return seemed pretty well. At six o'clock the next morning he felt ill, and had medical advice, but died in eight hours. This old minister was apparently tlie last of his fi\mily, for he had seen his mother, wife, and servants die before him in Albion-terrace, and could not fly from the poison which he carried in his breast. Such desolation could scarcely happen without great negligence on the part of the people them- selves and on the part of the authorities. August iith-iith.—It is one of the characters of epidemic diseases, that in some years their fatality is inconsiderable, in other years excessive. Since 1832 and 1833, cases of cholera have appeared in the Tables,—but tlie deaths in the second week of August during the past five years have fluctuated from I to 23. In the week ending Saturday, August i8th, the deaths in London were 2230; of which 1230 were by cholera, 188 by diarrhoea. The deaths from all causes in the last seven weeks were 1070, 1369, 1741, 1931, 1967, 1909, and 2230; the deaths from cholera, 152, 339, 678, 783, 926, 823, and 1230. The deaths from cliolera exceed those in the previous week by 407; but in that week the mortality declined. The population is about 2,206,000 ; so that nearly I in rooo of the inhabitants now die weekly. The deaths from all diseases, except cholera, are 1000, which is the average number of the season; and 539 were at ages under 15, 256 at the ages 15-60, 205 at the age of 60 and upwards. Of the 1230 persons who died from cholera, 318 were under the age of 15, 721 were 15-60, and 191 were 60 and upwards : it carries off an excessive proportion of people in the prime of life. 597 males and 633 females died of tlie disease last week; at an earlier period of the epidemic, the deaths of males exceeded those of females. Of 6194 persons who have died of cholera in London since September 1848, 3524 have died on the south side of the Thames. It has now crossed the River. The mortality last week increased in the districts of St. George Southwark, Newington, and Lambeth : it broke out with extraordinary violence in Greenwich ; and on the north side of the Thames—in Stepney, Shoreditch, and Bethnal Green—55,98, and 125 deaths were registered. The deaths from cliolera in the last two weeks were 35 and 125 in Bethnal Green, 21 and 98 in Shoreditch, 24 and 55 in Stepney, 42 and 76 in the districts of the East, West, and City of London, comprehending the jurisdiction of the City properly so called, 7 and 24 in Marylelione, 17 and 34 in Westminster district, 5 and 20 in Chelsea. This excessive mortality must be viewed with great regret. Looking to the authentic reports of the effects of general sanatory measures, and of efKcient medical relief placed within the reach, or carried to the homes of tiie people, it is quite evident tliat the measures now in operation are unequal to the emer- gency. The classes whicli have the greatest claim for public succour are not idle, habitual paupers, but the hard-working artizan : yet it is stated that in some parishes the arrangements are such that medical relief is not procurable directly from the district medical ofiScers, who are, to the utmost extent of their powers, discharging tiieir painful duties with praiseworthy diligence and humanity. In a disease wiiich so often attacks in tlie night, and is fatal in twenty-four liours, the ]ioor have to procure orders before they can be treated. Unless some cliange be made in these simple administrative arrangements, the mortality from cholera may be higlier tiiaii it has yet been in London. To render all the assistance which the registration syslem can afford for the discovery and removal of the causes of cholera, the Begistrars were last week requested to state in each case— whether the house or street in which the death occurred was close, ill cleansed, over-crowded, or otherwise unfavourable to health. The results will be found in the Notes [to the Weekly Table], which show, besides, the sex, age, profession, duration of disease, date and place of death—in every falal case of cholera and of diarrhoea registered during the week. August i()th~2ith.—In the week ending Saturday, August 25th, the deaths registered in London were](https://iiif.wellcomecollection.org/image/b24751297_0041.jp2/full/800%2C/0/default.jpg)
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