Report on the mortality of cholera in England, 1848-49.

  • William Farr
Date:
1852
Catalogue details

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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    many of them liave taken considerable pains to do, and their notes will, it is hoped, be found serviceable to the guardians and medical inspectors, now and at future times. For it is important to l)ear in mind tiiat cholera only brinjjs into a strong light the localities, wiiicli elaborate calculations in the Annual Re|)orts prove are at all times fatal to the health and life of the inhabitants. Alter the perils of this terrible weei< we seem to see land ; but as many thousands of lives may be lost in an epidemic by negligence, so, many thousands may be saved by skill, vigilance, and energy—by more ample supples of water—by the rapid removal of nuisances from ihe houses and streets—by the jnompt administration of medical appliances and other comforts, by the active co-operation of the medical profession, of the Boards of Guardians, of employers, of every householder, of every individual, with the Board of Health and healtii officers. On the day the above remarks were written, Tuesday, September 4th, the mortality in London was highest; 336 persons died of cholera during the day, 314 died on Wed- nesday, 297 on Thursday, 284 on Friday, and 311 on Saturday. As the decline of the epidemic was slow, and the registration takes place 3 or 4 days after death, the return for the week ending September 8th was heavier than the return on the week preceding. The mortahly was now 3 times as high as the average; many people had lost friends or acquaintances that they had lately seen alive : and the uninterrupted increase inspired feelings of terror in some minds—a general uneasiness in all. Under these circumstances it was deemed right to advert to the epidemic's decline, which its previous course, the law which governs its progress, its actual operations, and the season of the year—all rendered probable, and next to certain. The natural tendency of the public mind is to make no timely provision against distant dangers, and to exaggerat'i dangers present; apathy had now given way to excitement, which the announcenient of the next week was unfortunately calculated to increase. September 2nd to September f'th.—The Bills of Mortality were commenced in the reign of Queen Elizabetii; and ever since the year 1603, have been published by authority in London. In this respect the English metropolis stands alone; no Weekly Tables of the causes of death of every inhabitant are pul)lished in the capital of any other European state. Various motives for the measure have been assigned ; but tiie fact of continuous publication, from a period anterior to the ap])earance of newspapers and gazettes, is remarkal)le and cliaracteristic. It may be fairly referred to the natural inclination of the English people, when they are in trouble, to know tiie truth ; and to see in figures the precise extent of their losses; although at times the sight might well make the courage of the bravest quail. On the Continent ''precautions have been used in publishing the mortality of cholera in 1849 i '^^^ deaths from all causes have not yet been made known. Tiie parish clerks of London in the seventeenth century, when the plague was at its height, counted the deaths and recorded their supposed causes ; and the citizen, when the deatii-cart traversed the streets, anxiously studied the bill, surrounded by its gloomy symbolical border, announcing 8297 deatiis in a week out of a population of 600,000. In the hands of Price, Heherden, Willis, Bateman, and other statists, these records have disclosed the laws of mortality, and the causes of the insalubrity of the present cities. One of their immediate advantages, however, is the evidence wiiich they furnish that the most fatal and threatening plagues go through, with some perturbations, certain prescribed orbits ; and after raging for a given number of weeks, disappear. Plague, influenza, and ciiolera have been vanquished before; and to despair now would be as unreasonable as it was in the beginning of the year to deny that the cholera epidemic was impending. Those officers who are struggling with tlie triumphant enemy under every disadvantage will yet be victors; for if they have art, they have also !:ature on their side. The mortality in the week ending Safurdaj', September 8tii, declined in the west and east districts of London, and increased slightly in ihe north and central districts, so that the deaths registered (1741) on the nortii sitle the Thames were 19 less than in the previous week. It was otherwise on the soulh side the river, where the deatlis registered in the week were 1442! The total deaths registered in London were 3183: of males, 1460 ; females, 1723. The deaths of females exceeded tiie deaths of males by 263 ; the reverse of the usual proportions. The deaths from cholera were 2026 ; the numbers decreased in the districts of Shoreditch, Bethnal Green, Whitecliapel, Stepney, Westminsler; increased in Bermondsey, St. George Southwark, Newington, Lambeth, Wandsworth, Cuniberwell, and Rotherhitiie. Tlie epidemic, whicli had been partially subdued, broke out again with terrible violence in Lambeth, where 279 persons died of cholera in the week. Mr. Daws, one of the Registrars of Lambeth, who has made careful inquiries on the subject, says: At least half the cases J have registered were allowed to proceed unchecked, until ihe most alarming and dangerous sijmptoms had manifested themselves; but lately more circumspection seems to have been used. Nevertheless, tlie cases are still numerous, in which persons seem (from the ]iainless nature of the attack) to he unconscious how higlily necessary it is that immediate attention should be paid to it. People are so ninch accustomed to associate danger exclusively with jiain, that the most fatal symptom unaccom- panied by pain is neglected. They must, however, be taught to look u]ion painless diarrlioea with the anxiety that people in the plague looked upon tlie swellings, called tokens—which were also pain- less—but witli less fear; for tiie premonitory symptom now seems to be scut not so much to announce death as to give timely warning, and to call attention to that stage of the malady in which medicine can heal.
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