March 14, 1891.] TEB BRITISH MEDlCAL JOURNAL. 613 Square, St. James Westminster, St. Martin-in-the-Fields, and London City, the birth-rates were considerably below the PUBLIC HEALTH average; while in Fulham, Shoreditch, Bethnal Green, AND Whitechapel, St. George-in-the-East, and Mile-End Old- POOR-LAW MEDICAL SERVICES. Town, where the population contains a large proportion of young married persons, the birth-rates showed an excess. The deaths of persons belonging to London registered THE TRUE DEATTH-RATES OF LONDON SANITARY during the year under notice were 89,694, equal to an annual DISTRICTS DURING 1890. rate of 20.0 per 1,000 of the estimated population; this rate IN tlle accompanying table will be found summarised the vital exceeded that recorded in any year since 1884, since which and mortal statistics of the forty-one sanitary districts of the date, when the rate was 20.4, it had continuously declined to, metropolis, based upon the Registrar-General's returns for the 17.4 in 1889, the lowest rate since the establishment of civil year 1890. The mortality figures in the table relate to the registration in 1837. During the decade just ended, 1881-90, deatlhs of persons actually belonging to the respective sani- the rate of mortality in London averaged only 19.9 per 1,000;. tary districts, anid( are the result of a complete system of dis- in the ten years 1861-70, it was equal to 24.4, and in the fol- tribution of deaths occurring in the public institutions of lowing ten years, 1871-80, to 22.5 per 1,000. This marked de- London among the various sanitary districts in which the cline in the London death-rate since 1880 implies that nearly patients had previously resided. By this means alone cani! 150,000 persons in London have survived, wliose deaths would trustworthmy data be secured upon which to calculate re- lhave been recorded had the rate of mortality in the ten years liable rates of imortality. 1881-90 equalled that which prevailed during the preceding The 130,690 births registered in London during the year 1890 twenty years, 1861-80. The lowest death-rates in the forty- were equal to an annual rate of 29.1 per 1,000 of the popula- one sanitary districts during 1890 were 14.7 in Lewisham (ex- tion, estimated at 4,421,661 persomis, wlicil showed a further cluding Penge), 14.8 in Kensington, 14.9 in Hampstead, 15.0- decline fronm time rates in recenit years, and was actually lower in St. George Hanover Square, 15.8 in Camberwell, 16.3 in than in any of the past fifty years. In the various sanitary Battersea, 16.4 in Hackney, 16.7 in Plumstead, and 17.8 in districts the birth-mates showed time usual wide variations, Islington. In the other districts the rates ranged upwards owing to the differences in time sex and age distribution of to 26.9 in London City and in Stepney, 27.0 in St. George. their populations. In Kenisington, St. George Hanover Southwark, 28.2 in St. Saviour Southwark, 28.8 in White- Analysis oj the Vital and Iortal Statistics of the Sanitary Districts of the Metropolis, after Complete Distribution of Deaths occurring in Public Institutions, duringl the Year 1890. 'R 17. _~ . Annual Rate per - 11-15 0 cm, 3: C) = 1,000 Livirmg. o 0 =3 0,, c-, 2 ,-z-.C SANITA Ity AIlEAS. E .z C O) P ._ c C O- .;m T. = 0 _, "-r - Pe, E- c) P.4 (Z) = 14 cm -. O.I . I m ;.4 C.) '5 9: 0 - 1- 94.:. CL or .P ;m4 _m- PL4 z LONDON ... ... ... 4,421,011 130,6190 89,694 29.1 20.0 2 - 3 3,285 861 1,387 Vest I)istr ict,'. 12,188 592 3:3 2,744 162 Iladdingtoii ... ... 113,215 2,903 2,109 25.2 18.3 2.4 274 1 79 71 40 80 94 .58 135; Kensin-ton ... ... 198.122 :3,865 2.+983 19.2 14.8 1." 387 - 27 34 15; 77 171 liaminiX1ersImiitli 1(o3,000 2,826 1,910 27.0 18.2 .3:3 :346 957° 17 49 ;i 96 171 Full1aill ...... ... ... ... 77.500 3, 14 1,908 139.9 21.2 4.8 3,) - 125 32 22 112 (Chelsca 25.5 11) 182 ... ... ... 10f6,)694 2,7;61 2.017 18.9 2.2 241 1 56t; 4.3 11 - 46 150 St. George, <(1510))Clr 87,862 1 1 343 17.9 15.0 1.6 144 I - 46 13 IX S(qulC" ,596 .3 1 2.5 1.55 estrninstelr 54,349 1,476 1,454 26.7 26.3 2.6 141 - 34 11 9 50 :3 160 St. James, WNestmlinAster ... 26,940 5.50 5521 20.1 19.0 1.8 49 I 3 3 12 2 North Dixtricts. 4 12 178 18 Marylehone ... 41,2i96, 4,455 3,313 29.4 21.8 2.5 '375 I; 123 14 27 18 :3 93 143 Ilanpstead ... ... ... 59,537 1,504 899j 24.9 14.1) 1.8 107 l1 21 204621,_ 25 122 St. Pancras ... ... 215,,ss:3 7, 082 5,161 28.3 20.6 2.5 621 - 12.5 27 132 1.53:_ :34 1 141) 164 1slington... 313S,181 9,0|419 6,11f8 27.0 17.8 2.2 j71 202 3.5 818 I ( .34 5 180 158 Ilackney .... ... ... ... 250,078 6 751 8 26.6 16.4 2.4 4,17 618 36 4 (Cetral Districts. 4 118 143 St. Giles ... ... ... 38,698 1,183 1,012 30.1 26.5 2.0 80 1 17 85 101 1 1 21 156 St. Martin-in-the-Fields ... 11.552 267 :32.5 18.1 22.0 1.6 24 1 1 3 210 Strand ... ... ... ... 28,189 .159.8 730 20.6 25.2 2.0 58 I 20 2 4 118 2 16 211 lfolhoin . ... ... ... 29,895 916 96f;7 3lo.7 :32.4 4.1 122 22 1.5 18 31 223 (lerkenwell ... ... ... 71,102 2,201 1 645 '30.4 22.7 :1.() 216 :34 22 I l.' 8 68 175 St. LI;ke's ... ... ... 52.00(0 1,61 1,308 32.1 24.7 i.6 189 - 48 41 146i Londoin (itv ... :35,636 764 .47.5 21.1 265.9 1.5 11 5 11 East D)i.st icts. 12 147 Slhoreditch I -25.284 4,4619 3,164 35.1 21.8 4.2 5)3:3 121 45 58 204,;' 13 115 175 l3etliial Grecn. ... ... 1:82.815 4,811 3,199 35.6 2:1.7 3.7 39 116 li- 91 162 Wh-Iiitcelhapel ... 6ti. 146 2.782 41.2 28.8 4.2 t 1,1(17 70 19 '1 17 68IS 185 St. George-in-the-l,ast ... 46,0)55 1,8141 1,618 39 1 31.6 5.5 219 68 20 ;30 75 234 Stepney ... ... 1,901 5,0,,975 1,611 :31.8 26.9 4.6 278 1,3 28 69()1 1 49 195 Mile Enid 01(1 Tom ... 117.35'3 4,087 2,517 34.3 21.1 :3.1 368 23 44 74 161 Ploplar 198,636 5,932 3,883 1:0.1 19.7 3.1 619 - 199 41 7 11 1 Soath. Distit-ics. 0 40 1 11:1 168 St. Saviour, Soutlinwra1 26,938 895 773 32.7 28.2 4.5 1214 34 St. Geor .51 16:2 1ii) - 20 185 ge, Soutlhuvzrk.ar 60,404 2,051 1 ,)5.9 33.4 27.0 :3.6 218 1 57 15 14 4 1 ,r) 7 209 Newington ... 12),15.56 3,992 2,7,57 31.3 21.6 2.8 362 - 10:3 :37 32 8 1 84 171 St. Olave, Sonthwvalz .. 1-1,500 4il8 317 30.4 21.5 :3.t) 44 !- 4 6; 4 139 18 4 14 .145; lierinoindsey 90,s17 3,082 2,046 3:3.4 22.2 3.0 280 30 19t 637 152 Rotherhithe ... 45,068 1,416 931 30.9 20.3 3.1 144 38 7 8 934 1 260 - .35 170 Lambeth ... 291,261 9,017 5,862 30.1 19.6 2.3 698 -_ 183 57 76 :311i.)7 3 154 1.52 Blattersea ... ... 171,709 5,105 2,899 28.7 1 6..3 2.9 5'20 _I l(;O 19 40 67 11 122 169' Wandsworth . 13:3,542 4,113 2,471 30.3 18.2 2.4 32:1 - 89 9' 22 84 148 (Camberwell ... ... ... 28 276,'585 7,29)8 4,43-5 26.0 15 8 2.2 613 - 165 51 5l 1681248 1, 119 1.52 (Greenwicli ... ... ... 162,697 5,375 3,235 32..5 19.6 2.6 423 127 27 47 19 - 108 159, Lewisham (excluding Penge) 6i9,952 1,722 1,042 24.2 14.7 1 . 108 1 17 4 15 6 _ 27 141 Woolvicll ... ... 37:326 1,266 1(05 33.4 23.9 3.0 112 - 52 4 .1 4 - 19 171 Plumstead ... ... 82,750 2,836 1,407 34.0 16.7 2.2 183 1 41 15 19 6 - 33 ,129@ 614 614THTH-E- BRITISHBRTHMECAMEDICAL JOURNAL.JORA.[ac1418. [AIlareli 14, 1891. towns ranged from 16.6 in Brighton, 17.3 in WNolverlhampton, 17.4 in Nott- chapel, 32.4 in Holborn, and 34.6 ill St.