[Extracted from The American Journal of the Medical Sciences for April, 1859.]
lortilitB of fgilalulpgiit  fur 1858.
                      REPORT

                                ON

METEOROLOGY   AND   EPIDEMICS.

                            READ BEFORE

       THE  COLLEGE OF PHYSICIANS OF PHILADELPHIA,

                   FEBBUABY  S3,  1859.

                                 BY
              WILSON  JEWELL,  M. D.
  In submitting the annual report to the College, on meteorology and epi-
demics, I have occasion anew to refer to the incompleteness of the tables
and computations, the inevitable result of inherent difficulties from defective
returns under the existing law for the registration of deaths.
  The best estimate of the health of our city can only be derived from its
records  of mortality as compared with those of former years and other
cities.   The value, therefore,  of such a record, depends upon its accuracy
and truthfulness.
  Our statistics, however, are,  like many elsewhere  collected, not only im-
perfect in systematic arrangement, but very general, and, in some instances,
of doubtful character.  This latter defect is attributable in a great measure
to the irresponsible sources from which they emanate, and  to the frequent
false returns made by ignorant and knavish pretenders in medicine, between
whom and the  scientific and educated physician the statute-books of our
commonwealth,  as well as a misguided public, recognize no  distinction.   ^
  While it is humiliating to  refer to the existence of such irregularities,  it
is no less essential,  in order that proper allowance be made for the incon-
gruities which may be discovered in these records of mortality.
   But  notwithstanding the imperfections alluded to, fragments of reliable
information have been gathered through these channels, from which may
        1 
2
be drawn truthful conclusions bearing upon the relative cause and effect of
disease, as it has prevailed from year to year in the midst of our population.
   Nor are these scanty records less useful for stimulating us with enlarged
desires to  secure the collection of more perfect returns, not only of deaths,
but of  births and  marriages, until the vital statistics  of  our  extended
municipality  shall  become a  stand-point from which  we may not  only
look  abroad,  and,  with some degree of precision, discover and investi-
gate the nature and cause of our prevalent  diseases, but provide  adequate
means to  guard against the introduction of those deleterious agents that
vitiate our atmosphere,  or in other ways  become the causes of sickness
and death in our community.
   I shall not therefore be  considered ultra  in  my opinion if I affirm, that
our mortality tables for Philadelphia never  can be otherwise than as repre-
sented, until a more complete system of registration has  been secured  by
legislative enactment.   In this connection I cannot resist  adverting to the
many imperfections in the nomenclature of diseases, as employed by those
who furnish the certificates of death received at the health office in our city.
I refer more especially to the entire absence of a uniform method in  report-
ing the causes of  death.  Yery few of our physicians adhere to any one
particular nosological  arrangement.  Indeed, I apprehend that many, whose
duty it becomes to  give certificates of death,  have so limited an appreciation
of this important department  of science,  that they  feel no  incentive to
answer its demands; while to the unscrupulous pretender, who never looks
beyond the sordid motive of pecuniary gain in the pursuit of his calling, it
is a question of entire indifference what name he shall  give the disease of
which his patient  died, admitting that he possesses sufficient intelligence to
inform himself  of the true cause of death.   I do not make these remarks
in a censorious spirit,  nor  from a belief that this want of accuracy is pecu-
liar to our own city.   Similar imperfections exist elsewhere, in other cities,
and,  in some instances, to  a far greater extent. The true cause of the irre-
 gularity to which  I have reference will be found in the absence of a uniform
 and approved nosological  classification of  diseases.
    A careful comparison of the  record of deaths for 1858 with that of  the
 two preceding years,  will present a single  feature which can only be  attri-
 buted to the defective plan now pursued in certifying to  and in  recording
 deaths.   In the table  of mortality for 1857, as reported to the College, the
 causes of death are represented by 201 distinct names, and in 1856 by 195;
 in the one under consideration, for 1858, there will be found only 112,  less
 by 86 than the average of those in the two preceding years.  In presenting
 this  statement, I do not desire to be understood as entertaining for a single
 moment  the  opinion, that the causes of death from one year to another
 should correspond in  every particular, both as to numbers and variety;  but
 while I take a common sense view of this  subject, and make careful allow-
 ance for changes and  inaccuracies in each tabulated record of names of dis- 
3
eases, I cannot understand  on what principle  so  great a difference should
occur as that referred to, especially when there  are no deaths recorded from
some of the most frequent forms of disease.
  Under the title of cancer and scirrhus will be found  125 deaths, but in
no instance is the special organ or structure involved, designated.  Nor are
there deaths named in the table from any form of  disease of the uterus or
ovaries, except the 36 deaths from puerperal  fever, which fall below the
usual  amount  for the year.   Deaths from hemorrhage of  the lungs, sto-
mach, or bowels, disease of the bladder or  kidneys, are all wanting.   It is
asking too much to believe that during the year there had not been a single
death from  any  of  these diseases.   The  fact should not  be  overlooked,
however, that  the unusual health of our population might possibly have
exerted an influence  upon the change  in  the  causes of death to which I
have reference.   Still, I  am not  disposed  to  advocate  the idea,  that  this
apparent exemption from sickness would effect  an alteration to the like ex-
tent as manifested in  the record, much less from the same class of diseases.
 It must have resulted from other and less legitimate causes.
   The only rational causes I can educe for the absence of these terms from
 the record are the loose and  imperfect system of registration, a defective
 classification of  diseases, and, last, though not least, sheer carelessness and
 incompetence in many to investigate the cause of  death.
   This entire subject of registration and  classification of  diseases in this
 country is now commanding more attention than  ever before.  Physicians,
 men of science, statesmen, and political economists are becoming interested
 in those great principles which involve the science of life, and are thoroughly
 investigating their influence.
   Eight of these United States  have at this  time in successful operation
 well regulated and  reliable plans, legally enforced, to  register the births,
 marriages,  and  deaths  in their respective commonwealths.   In several
 other  States the subject has been agitated, and preliminary steps taken to
 secure similar laws.   Pennsylvania still slumbers over  these vital interests
 of humanity.   Other and less important claims she watches with an Argus
 eye, but can behold  no  wisdom in watching over the health  and the lives
 of  her citizens.
    I am happy to announce, however, that another effort,  bearing the ap-
 proval of this College, is now in progress to procure a law for Philadelphia
 only, for  the registration of  births, marriages, and deaths.   I confidently
 hope  that  the  next report on  this subject  will  embrace so desirable an
 improvement, and  harbinger the dawn of a new era,  in the collection and
 analyzation of the vital statistics of our city.   In this event, the foundation
 for a superstructure will be laid, that shall augment in value and import-
 ance from year to year, as the work progresses, until it shall exhibit a proud
 monument, teeming  on every side with reliable data, for  the employment 
4
 of the intellect and industry of a future statistician, out of which he may
 determine with accuracy the growth or the decay of the public health.
   Nor will the advantage be  confined to our own city.   I flatter myself,
 that, if the law is secured, its usefulness will be made so evident in  a few
 years,  that the necessity for  one embracing the entire  State will  be so
 widely recognized, that no difficulty  will be experienced  in obtaining its
 passage through the Legislature.
   The report of  that  distinguished statistician, Edward Jarvis, M.  D., of
 Mass.,  presented at the last session of the American Medical Association,
 on the law of registration, is replete  with  interest.   It  evinces a  sound
 knowledge of the subject, and reflects great credit upon its author, placing
 him high in the list of writers on medical literature and medical statistics.
 In this article a  statistical  nosology is furnished, for the consideration of
 the profession, which is a revision of the one adopted by the association in
 1847.   Dr. Farr's plan of classification of diseases, as  followed by  the
 Registrar-General  of England in his valuable reports, is also  appended;
 and the writer says, "it  is worth our consideration whether it would  not
 be better to adopt  this system for the American  States, although looking
 to its merits alone, it may be inferior to that already in use."
   Highly as I appreciate the experience and judgment of Dr. Jarvis  in all
 matters that appertain  to sound  logic in medical statistics, and much as I
 may approve  the  motive that  directed the above opinion, I  am not  ready
 to indorse it.   There is no reason why we should not establish a system of
 statistical nosology peculiarly our own.   We are not only capable, but our
 national character, our  social condition,  our climate,  our physical and
 mental  peculiarities, our habits  and manners, and our  principles  of free
 government, all seem to urge upon us strong claims for an American system
 of classification of  diseases.
   At present this  question is an unsettled one in our country.   Doubtless
 it will  remain so for some time, or until  the combined judgments of the
 States shall see eye to eye in behalf of  those vital interests of health and
 life, which are intimately allied to this whole subject.
   When that  enlightened period arrives, and it may not be far distant—
 when each State shall be prepared to enact uniform  laws of registration,
 then will be the proper time (and the appointment of a medical commission,
 embracing delegates from all the  States, suggests itself to my mind as the
 only sure provision) for arranging and securing a system of classification of
 diseases, which shall not only be uniform in its arrangement, but acceptable,
efficient, and permanent in its operation.
   For  present use,  the nomenclature of the American Medical Association,
adopted in 1847, with  a few slight  alterations, may answer  our purpose.
 It is concise, simple, easily understood, and available.

   The   annexed record  contains an  abstract from  observations on the 
5
atmosphere and its phenomena, as made by my friend, Jas. A. Kirkpatrick,
A. M., Professor of Civil Engineering in the  Philadelphia  High School,
whose kindness I must again acknowledge.
  These observations  have been  prepared with great care for the Smith-
sonian Institution,  at Washington,  and may be relied upon for  their
accuracy.
  From this abstract we learn that the mean temperature for the  year was
55.20°, an increase of 1.72° over that of 1857, and a higher mean tempera-
ture by 1.31° than for the last seven years.
  The maximum temperature for the year was 96^°.  This was on the
28th of June.  The minimum temperature was 10° on the  5th and 6th of
March.
   The warmest days were the 28th of June  and the  11th of July—the
mean temperature being 89.2°.
   The coldest day was the 5th of March, when the mean  of the thermo-
meter was 14.3°.
   February was the  coldest  month  in  the year—the mean temperature
being 30.11°.
   July was the warmest month—the mean heat being 79.20°.
   The monthly range of the thermometer for the year was 86£°, and the
daily range 5.18°.
   The mean  of the thermometer for  the summer was 77.24°, and for  the
 winter 37.22°.
   The least variable month was  May, the range standing 35°.
   The barometer  ranged for the  year, monthly, 1.325 inch—while  the
 annual mean was 29.885 inches; nearly equivalent to the mean  for seven
 years.
   The highest point of pressure  shown by the barometer was on the 8th of
 January, when it stood 30.531 inches; and the  lowest was on the 21st of
 December, 29.206 inches.
   The due point in  its maximum for the  year was 78.5°, and  the mini-
 mum 13.5°.                                         .
   The relative humidity of the atmosphere in  its maximum was 100 per
 cent, while the minimum per cent, was 18.
   The amount of rain that fell during the year was 41.059 inches, which
 was less than the  rain in 1857 by 7.389 inches.  The greatest depth of
 rain and snow in any month  was in December, amounting to 5.459 inches.
 The least quantity was in March, only 1.124  inch.
   The rain for the year was 2.94 inches less than for the last seven years.
   Following this meteorological record, will be found the  several tables of
 mortality analytically arranged. 
General Abstract of Meteorological Observations, made at Philadelphia, Pa., during the year 1858.
  By James A. Kirkpatrick, A. M., Prof, of Civil Engineering in the Philadelphia High School.
1858.				Thermometer.										Barometer Reduced to 32° F.						
Months.				7 A. M.	2 P. M.	9 P. M. .Mean. Max. 1			Min.	Range.		Mean of			9 P. M.	Mean.		1 Ra.noe.		
										Monthly.	Meau daily.	dailv ■ 1 oscilla- 7 A. M. ! 2 P. M. tions. i					Max.	Min. Monthly. Mean daily.		
January February Miirch April . May . Juue . July . August Soptembe October Novembe Peoembei	r r			o 36.65 24.84 34.11 47.00 55.26 73.78 75.13 70.08 61.32 53.32 38.52 34.50	0 45.44 34.95 47.71 59.40 64.79 83.57 S.5.31 S1.03 76.03 66 63 46.23 40.97	0 40.31 30.52 40.19 51.15 57.S7 75.28 77.23 73.77 66.37 58.53 41.90 37.47	o 40.81 30.11 40.69 52.52 59.31 77.5 j 79.22 74.96 67.92 59.49 42.22 37.65	0 62 53 71 S4 81 9.5 J-90 SS 90 68 63	o 22 11 10 33 46 53 00 54 41 35 24 15	0 40 42 61 51 35 434 354. 36 47 55 44 48	o 5.94 6.08 5.98 7.03 5.48 4.39 3.67 4.42 4.05 5.32 3.53 6.30	0 14.0 14.4 17.1 17.3 14.6 18.3 17.2 16.1 19.7 17.3 12.3 11.8	Inches. 29.970 29.907 29.829 29.774 29.819 29.836 29.845 29.843 29.944 29.934 29.805 30.002	Inches. 29.925 29.848 29.777 29.729 29.790 29.797 29.805 29.809 29.892 29.876 29.780 29.955	Inches. 29.959 20.867 29.S15 29.751 29.809 29.808 29.831 29.S:iO 29.925 29.918 29.807 29.966	Inches. 29.9.51 29.874 29.807 29.751 29.805 29.813 29.827 29.829 29.922 29 906 29.797 29.974	Inches. 30.531 30.253 30.271 30.049 30.250 30.011 30.124 30.098 30.217 30.318 30.060 30.4.59	Inches. 29.410 20.404 29.306 29.325 29.386 29.605 29.534 29.550 29.343 29.382 29.430 29.206	Inches. 1.121 .849 .965 .724 .861 .4.;<; .590 .548 .874 .936 .630 1.2.53	Inches. .208 .190 .171 .150 .159 .072 .094 .095 .135 .143 .136 .206
An mini means				60.3 S	61.00	54.22 55.20 96|			10	S6i	5.18	15.8 29.875		29.832	29.S.5S 1 29.S.5.5 1 30.531 1 29.206				1.325 1 .146	
Winter . . . . Spring . . . . Summer .... Autumn ....				32.97 4.5.46 73.00 51.06	41.92 57.30 83.30 62.96	37.05 j 37.32 j 64 49.74 50 84 84 75.43 77.24 ' 96J 55.60 56.54 90			11 10 53 24	53 74 43* 66	5.91 6.16 4.16 4.30	13.9 29.931 16.3 j 29.807 17.2 29.S41 16.4 | 29.S91		29.881 29.765 29.804 29.849	29.912 29.792 29.S25 29.883	29.90S | 30..531 29.266 29.7SS 30.271 | 29.306 29.823 I 30.124 . 29.534 29.874 | 30.318 ) 29.343			1.265 | .201 .965 I .160 .590 .087 .975 i .138	
For seven	ye	ar	i .				.53. S9	1001.	-51	1054	5.52					29.880	30.709	28.^9.5	1.814	| .151
 
Meteorological Observations—.Continued.
																					
1858.		Relative Humidity.					Force of Vapour.						Winds.	Clouds. Tenths of sky covered.			Dew-point.				
Months.		7 A.M. 2 P.M.		)P.M.	Max.	Min.	J A.M. 2 P.M.		)P.M.	Max.	Min.	Rain Monthly resultant; and No. of times in melted 1000. snow.		7 A.M.	2 P. M.	9 P. M.	7 A.M.	2 P.M.	9 P.M.	Max.	Min.
January . • February . . March . • • April • • • May. • • June . • July • • August. • September October November. December .		Per ct. 1 75 71 65 71 75 72 72 78 79 79 79 80	Per ct. 59 54 44 49 60 55 50 5o 50 53 61 69	Per ct. 69 67 58 66 72 72 69 71 72 73 73 78	Perct.j 96 96 90 96 97 94 86 95 95 97 96 100	Perct. 26 26 18 23 26 31 32 37 34 24 33 33	Inch. .171 .102 .138 .238 .330 .606 .632 .589 .4.51 .238 .192 .169	Inch. .187 .111 .162 .248 .366 .627 .615 .583 465 .351 .195 .172	Inch. .182 .119 .156 .256 .352 .641 .657 .605 .483 .373 .204 .188	Inch. .505 .246 .448 .505 .691 .934 .975 .864 .792 .591 .361 .424	Inch. .078 .042 .023 .089 .191 .361 .368 .319 .166 .126 .090 .071	Inches. 2.686 2.393 1.124 4.681 5.308 4.205 1.454 5.157 1.389 1.778 5.225 5.459	N. 54°44'W., 299 N. 64° 32' W., 302 N. 71° O'W., 398 N. 3°38'E., 104 N. 63°26'E., 210 N. 71° 34' W., 234 S. 37° 42'W., 173 N. 77°28'W., 55 S. 88°38'W., 258 S. 84° 48' W., 202 N. 41° 5'W., 309 N. 34° 26 W., 245	5.9 6.1 4.9 6.4 7.8 5.3 4.8 5.6 39 5.3 6.5 7.6 5.8	6.4 6.1 4.6 6.9 6.9 5.9 5.2 6.2 3.9 5.1 6.8 7.2 5.9	5.1 4.5 3.0 6.0 6.2 4.1 2.6 4.5 2.5 4.3 6.5 6.3 4.6	29.40 16.70 23.10 37.59 46.87 63.78 65.09 63.03 54.61 46.62 32.43 28.82 42.34	31.19 19.32 25.31 38.06 49.07 64.85 64.10 62.52 55.35 47.06 32.23 30.80 43.32	30.76 21.02 25.86 39.64 48.32 65.42 66.26 63.71 56.65 49.81 33.82 31.11 44.36	59.3 39.8 55.9 59.3 68.3 77.2 78.5 74.9 723 63.7 5.00 60.3 78.5	12.9 —0.7 —13.5 15.S 29.2 50.0 50.5 46.7 29.9 23.5 16.1 10.9 —13.5
Annual means . Winter . . . Spring . . • Summer . .		75 75 70 74 79	55 58 51 53 55	70 70 65 71 73	100 96 97 95 97	18 26 18 31 24	.330 .153 .23.5 .609 .327	.310 .161 .259 .608 .337	.351 .105 .255 .634 .353	.526 .691 .975 .792	.042 .023 .319 .090	10.582 11.113 10.816 8.592	N. 59° 2'W.,277 N. 27°25'W., 123 S. 82°39'W., 127 N. 71° 43'W., 233	6.4 6.4 6.2 5.2	6.0 6.1 6.8 5.3	4.6 5.1 3.7 4.4	25.82 35.85 63.97 44.55	27.23 37.48 63.82 44.88	27 95 37.94 65.13 46.76	60.4 68.3 75.5 72.3	—0.7 —13.5 46.7 16.1
For seven years		"	58		100	16		.344		.975	.023	43.153	N. 73°33'W., 215								
		J---																			
 
8
Table I.—Mortality for the year 1858, Col luted from
		FIRST QUARTER, Commencing January 2, 1S.5S.											SKCON'I) Commencing			
DISEASES.		Jan.		Feb.		March.		3 -«1	00 h O a s	3 0	April.		May.		June.	
		M. F.		M.| F.		M.	F.				M. F.		M. 6 4 3 2 6 12 1 4 2 11 5 53 14 9 19 5 14 8 5 2 15 8 1 3 3 2 i 18 3 2 "2 4	F. B 1 8 2 3 2 2 1 1 3 4 77 21 6 2 14 3 2 9 8 1 9 10 3 2 i 2 1 1 3 1 9 4 3 2 3	M. 1 '8 2 4 io 2 16 2 32 2 15 2 81 46 14 4 20 12 1 1 14 2 13 5 23 4 4 7 3 4 2 •• •• 6 4 2 ■• i 1 8	F.
Albuminuria Aneurism .... Asphyxia .... Asthma .... Caries..... Burns and scalds Cholera infantum " morbus Cirrhosis .... Childbed .... Congestion of the brain . " " liver " " lungs Consumption of the lungs Convulsions Coup de soleil . Coxalgia .... Constipation Diabetes .... " " brain . " " liver . " " lungs . " " stomach and boi " of the brain . " " chest . '• " heart . Dyspepsia .... Effusion on the brain Enlargement of the heart. Erysipelas . • . Fever, bilious " brain " congestive " intermittent . " nervous . " puerperal " remittent Gangrene .... Gout..... Hernia..... Hydrophobia ....	vels .	5 h ■■ "4 13 1 6 1 1 2 11 1 2 77 21 4 "2 6 .. 3 .3 1 18 1 i 'e 'i 2 i 2i 8 4 .. 1	1 :: 1 •• '7 1 i 6 3 '{ 11 30 1° 23 2 1 12 1 2 "2 'i 3 1 1 2i 3 1 ■3 .1	1 13 1 3 1 1 6 63 22 2 :: i7 4 s '3 i7 :: 2 3 4 1 i 18 9 4 1 .. 4	4 "4 6 5 1 i 6 7 70 27 13 17 3 4 11 "2 ii 4 '3 4 1 i 20 10 3 1 4 ..	2 ii i 3 4 17 4 4 1 2 2 1 6 3 R4 31 17 1 28 "2 9 ii 7 3 2 16 12 3 4 1 3 ■ id 14 5 2 3 ;	3 i *6 3 6 6 i 5 i 5 4 85 26 22 2 i 20 "2 4 12 4 2 2 15 13 3 1 4 3 1 8 2 i 21 7 4 1 '2 8	10 27 i 23 46 5 13 3 9 i i 14 8 391 11 i 7<> 6 8 36 12 7 5 37 3 6 1 7 2 i 17 5 1 i 1 1 33 11 3 *6 i	6 i 2 1 : 12 2 10 1 1 1 1 3 2 30 1 9 67 146 105 10 44 '6 21 25 6 6 1 52 28 i 6 1 18 2 1 9 i 1 i 119 18 10 2 4 22	16 2S i 1 12 60 15 14 4 1 10 3 3 'i 44 1 17 458 157 105 10 i 120 \2 29 61 18 13 6 89 31 6 2 13 1 20 2 2 26 5 i 2 i 2 120 51 21 5 io . 22 1	1 ":i 1 2 11 1 8 1 2 1 8 2 86 28 8 2 2 15 1 3 7 9 2 3 4 3 15 7 1 1 2 3 1 9 6 4 4 6	1 2 2 i 1 10 5 69 10 8 1 20 3 4 2 3 11 7 i 2 2 '7 1 18 8 2 "s				'7 i 9 1 6 1 29 2 11 8 67 31 12 2 3 8 8 1 11 2 14 4 2 11 2 4 *7 *8 5 2 1 4 2i
 
9
Returns made to the Health Office.  By Wilson Jewell, M. D.
QUARTER,			1	THIRD QUARTER,										FOURTH QUARTER,								
April 3, 1858				Commencing July 3, 1858.									Commencing October 2,1858.									>,
				July.		Aug.		Sept.				|	Oct.		Nov.		Dec.					.C
	■3 <	g								i2	t.	^							•2	t.	_j	
		a	o	M.	F.	M.	F.	M.	F.	a TS <1	a		M.	F.	M.	F.	M.	F.	a	S	0 Eh	
	2	1	3	4			1		1	5	1	6 ,	1	2	i 1	1	3	..	4 1 1	2 i	6 1 2	31 1 2
	32	3	35	6	1	7	3	4	3	23	1	24	9.	1	7	5	3	fi	24		24	111
		8	8	4	3	5		3		1	14	15	9,			1	7	4	4	10	14	37
	5		5		1	1			1	2	1	3 '	1					2	3		3	12
	27	3	30	2	7	4	17	3	10	36	7	43	1	8	5	8	3	2	24	3	27	12o 1 22
		10	10																			
	28	15	43	11	3	5	4	21	6	23	27	50	6	3	9	2	17	1	25	13	38	191
		8	8		1		1	3		1	4	fl	2	5	2	5	5	8	6	21	27	65
	25	13	38	26	1	9	1	19	1	35	22	57	10 1		4	2	2		15 1	3	18 1	127 5
	1		1																			1 1
	4	1	5	3	2		1		1	7		7	9,	1	1				4		4	26
		69	69	151	128	117	102	39	38		575	575	4	8		3				15	15	662
	5	3	8	12	11	5	7	4 1	2	34 1	7	41 1			1				1		1	63 1 1
	1		1																			1
	16	42	58	19	20	16	22	14	6	34	63	97	1	6	7	7	16	5	19	23	42	241 1
	10	16	26	9.	6	1	1	3	3	10	5	15	4	1	i	3	5	6	9	11	20	7S
	381	52	433	55	62	47	68	72	87	350	41	391	45	55	51	55	92	79	359	18	377	16o9
	10	140	150	30	48	23	25	28	18	14	158	172	23	25	24	16	20	22	8	122	130	609
	1	56	57	7	3	5	8	fi	4	1	32	33	13	9	22	11	20	22		97	97	
	1	10	11			1	2	2	1		6	6	4	2		1	3	2		12	12	39
	22	1	23	3						2	1	3										26
	2	1	3																			1
	51	37	88	20	9.2	9,4	12	38	17	60	73	133	13	14	20	13	27	29	55	61	116	457
	9		9,	1						1		1										3
	6	6	12	32	23	19	13	8	9	24	80	104	3	1	1	2	3 1		7 1	3	10 1	138 1
	19	30	+9	7	fi	fi	5	10	1	11	24	35	4		5	2	5	5	12	9	21	134
	3		3		1				1	1	1	2	1	2			1	2	6	1	6	11
	40	14	54	9	6	8	10	12	5	34	16	50	4	5	10	11	10	10	40	10	50	215
	19	6	25			3	3	3	2	8	3	11	2	2	3	2	3	2	12	2	14	23
	4	fi	10																			
	4 4 4	9 83	6 6 87	1	17	1 19	19	1 9	7	1 2	2 90	3 92	10	8	7	1 7	7	1 12	6	2 45	61	12 95 261
	36	4	40	4	9	7	fi	8	9	37	6	43	0	7	9	6	11	13	60	1	61	27
	10	1	11	?	9	1	?	9	1	8	2	10	1		1	1	1		4		4	
	8	17	25	33	28	43	41	23	IS	53	133	186	2	3	1	3	4	3	V	9	16	1
	4	8 1	12 1	9	3	4	4	1	5	0	21	26	2	3	3	2	3	1				72 3 2 58 43
	12	5	17	?	1	9	?	4		4	7	11	3									
	3		3	4	1	7	5	6	1	18	6	24	3	4	2	1	i		y	2	11	
		1	1																			1 2
	1 15 "i 21 10	'9 3 64 S 5	1 17 3 68 29 15	4 7 5	6 3 3 4	4 13 3 7	5 4 9 1 2	'2 is 2 4	2 3 5 10 4 3	11 2 I 35 14 14	2 3 19 22 5 2	13 5 20 57 19 16	i 7 14 1	2 1 7 9 3	3 3 7 2	2 3 5 1	'7 14 5	6 11 4	6 2 46 13	i 31 14 3 1	7 33 60 16	36 17 241 197 71 16 16
		1	1	3		1		3	2	1	8	9					1		1		1	1
	14	4	18	3	1	2	1	3	4	9	6	14	1 5			1	1	3 1	7 3	5 1	12 4	54 5
		1 49	1 49	7	8	15	13	5 ••	11	1	58	59		5	.2	6	2	3		23	23	153 1
 
10
Table I.—Mortality
DISEASES.
Icterus    ....
Inanition  ....
Inflammation of the bladder
      "       "   brain .
      "       "   bronchi
      "       "   chest .
      "  •    "   heart .
      "       "   kidneys
      "       "   liver .
      "       "   lungs .
      "       "   peritoneum
      "       "   pleura
      "       "   stomach &
      "       "   throat
Intemperance
Intussusception .
Malformation
Mania .
Mania a potu
Marasmus .
Measles
Mortification
Obstruction of the bowels
Old age
Osteo-sarcoma  .
Neuralgia .
Palsy .
Purpura
Rheumatism
Scrofula
Smallpox .
Softening of  the brain
Sore throat.
Stillborn
Syphilis
Tabes mesenterica
Teething
Tetanus
Tumours
Strangury .
Ulceration .
Unknown .
Worms
Uremia
     FIRST QUARTER,
Commencim) January 2, 1858.
Jan.
M. F
Feb.
M. F
Totals of the sex
Monthly totals.....722
From the almshouse
From the country
People of colour
March.
132812461  137 37
April. 
11
for 1858—Continued.
QUARTER,				THIRD QUARTER, j									FOURTH QUARTER,									
April 3, 1858.				Commencing July 3,1858.									Commencing October 2,1858.									«2
				July.		Aug.		Sept.				1	Oct.		Nov.		Dec.					
	**	o	<s							a	o	S i							a	a	d	"d
								1							t							
	a 9,	1	o E* 3	M.	F.	M 2	F. 1	M. F.		«1 1	2	Eh ' 3	M. 1	F.	M. F.		M.	F.I	<	2	Eh 4	Eh
																2		H 2				16
	R	14	20	8	3	10	4	5	4	4	30	34		3	1	4	5	3, ..		16	16	91
	1		1																			3
	13	59	72	29	14	?3	14	21	13	11	03 114		3	8	14	8	12	12 14		43	57	315
	7	23	30	2	6	2	3	5	6	11	13	24	4	2	1	6	2	7	14	8	22	100
	1		1																			1
	1		1					1	1	2		2		2					1	1	2	7
	fi		fi	9:	?	1	1	3	3	9	3	12				1	1	2 4		"	4	30
	42	05	47	93	17	19	22	21	12	15	99	114	18	16	23	20	52	3S, 36		131	167	i^bi
	13	8	21	4	2	3	3		3	12	3	15	1	1	1	1	4	3| "'		4	11	21
	33	33	66	23	17	12	11	17	24	52	52	104	4	10	4	7	16	13' 40		14	54	273' 6' 1 2
		4	4																			
	1		1						1	1		1			1				1			
				I							1	1										2
	9,		9,	?			9.	1		5		5				1			1		1	9
	W		fi)	7		9	3	10	2	30	1	31	3	1	5	1	3		13		13	85
	11	99	110	31	31	55	45	29	24	11	204	215	12	10	7	7	14	8	8	b6	08	28 10
	i	7 2	7 3	2	3	4 1	2			1 1	10	11 1		1 2	4		3	1	i	9 1	2	
	i 122	1 i	2 122 1	19	22	12	12	15	18	98		98	7 1	12	12	13	11	27				358 1 1
	22	l	23	5	5	5	3	6	2	25	1	26	7	4	2, 5		6	8	31	1 1	32 1	105 1
	10 3	3 9	13 12	1 4	.3	*3	1	1 6	1 2	2 6	2 12	4 18	2 2		1	1 3	i	1 1	4	1 7	5 7	34 54
	1	2	3			1	1	1			3	3										3
	2		2																			4
		134	isi	is	i5	is	i2	27	24		114	114	25	17	24	20	23	26		135	135	535 3
	1 1	1 7	2 8	4	7	a	1	4	4	2	21	23	1		3					1 1	1 2	56
	i	1 3	1 4	1 1	1	2 5	2 2	2 1	2	4	10 2	10 6	'i		1		1		1			13
	4		4		1				4	4	1	5										8
	1	1	2																			1
	34	18	52	IS	12	8	f	£	7	31	24			:					1		1	183 3
		1	1 3																			3
																						
	123:	S135	2584	70	1 60S	, 63(	)571	56t	45<	1275	226-	3536	303 29		) 32-	i29	S46	422	108!	103(	)2ilt	,10697
				1310		1201		1025					602		625		889					
				58 9 70		53 1 50		51 6 46					30 3 31		24 1 26		27 3 38					573 52 611
 
12
Table I—Mortality for 1S;">S—Continued.
			FIRST QUARTEK,						SECOND QUARTBR,				
		Commbncino January 2,					1858.	Commen		'i.sd April		3, 1858. i ; ^ c 5	
				I -3 §			d			OP d	« "3		
				•o 1 3				p.		a	■o ■-		o
		~=	&,	i «=>			Eh	■<		>->	< i s		Eh
Under 1 year		194	186	248 , .. ..			62S	199	193	303 ..			695
From 1 to 2 years		116	96	113 ..			325	85	57	105 ..			247
" 2 to 6 "		38	56	s» ..			1S3	66	60	99			22.5
" 6 to 10 "		22	23	39 ..			S4	31	16	28 ..			75
" 10 to 15 "		13	11	14			38	13	11	9 ..			33
" 15 to 20 "		IS	26	27			71	23	21	31 .. ..			75
" 20 to 30 "		89	77	112			278	87	92	102 ..			281
" 30 to 40 "		68	92	90			250	7.5	72	100 ..			247
" 40 to 50 "		48	48	68			164	64	59	76 ..			199
" 50 to 60 "		35	35	61			131	44	44	56 ..			144
" 60 to 70 "		35	45	49			129	52	47	66 1 ..			1.5:5
" 70 to 80 "		31	23	49			108	43	35	39 ! ..			117
" 80 to 90 "		14	20	22			56	22	23	33 , ..			78
" 90 to 100 "		1	2	11			14	4	2	7 ..			13
" 100 to 110 "			1	1			2			.. ..			
Total of monthly mortality		722	746	993				80S	732	1044 | ..			
Total males for the quarter							1305			.. j ..			1407
" females "							1156						1177
" adults "					1133					.. 11233			
" minors "						1328				....		1351	
							2461			.. j ..		;■	2584
			THI	RD QUARTER,				FOURTH QUARTER					
		C	jmme.v	cinq July 3, 18			58.	Commencing October 2,					1858.
					A	«	•				w		
		>.	b«>	~	0	o	c3	^	>		0	o	09
													
		i->	■<	■/.'	■<	«	Eh	o	X	A	<	s	H
Under 1 year		584	516	305			1405	173	174	231			578
From 1 to 2 years		145	156	116			417	51	55	78			184
" 2 to 5 "		95	69	61			225	40	51	68			159
" 5 to 10 "		28	17	16			61	12	9	15			36
" 10 to 1.5 "		22	19	18			59	13	5	13			31
" 15 to 20 "		22	40	36			98	11	10	27			4n
" 20 to 30 "		99	95	119			313	6.5	76	94			235
" 30 to 40 "		81	57	99			237	68	62	87			217
" 40 to 50 "		59	74	81			214	54	46	80			180
" 50 to 60 "		57	52	62			171	47	38	67			152
" 60 to 70 "		49	45	39			133	31	45	37			113
" 70 to 80 "		43	37	45			123	20	33	53			106
" 80 to 90 "		20	22	22			64	10	11	31			62
" 90 to 100 "		5	1	5			11	7	8	8			23
"100 to 110 "		1	1	1			3		1				1
"110 to 120 "									1				1
Total of monthly mortality		1310	1201	1025				602	625	889			
Total males for the quarter							1906						1097
" females "							1630						1019
" adults "					1272						1086		
" minors "						2261						1030	
							3536						2116
 
13
TABLE II.—Mortality from Diseases of the Lungs and Air-passages.
		Annual Aggregates.			Quarters op 1858.			
DISEASES.								
		1856.	1857.	1858.	1st.	2d.	3d. 1	4th.
Abscess, pulmonary ....		1						
Angina pectoris ....		5	1					
Apnoea .....		1						
Asphyxia .....		28	15	37		8	\b	14
Asthma .....		21	33	12	i	b	'6	3
Catarrh .....			33	22	12	10		
Collapse of lungs		i						
Congestion of the lungs		97	132	78	iv	2b	lb	20
Consumption, laryngeal " of the lungs		1 1501	1544	1659	458	43.3	391	377
Croup ....		268	256	292	105 57		33	9<
Disease of the chest .		6	7	11	...; 3		2	b
" lungs .		37	53	23	13 ! 10			
Dropsy of the chest .		61	48	140	6 40		43	bi
Effusion on the chest .		7	3		...			
" lungs		4	4					
Emphysema .		2	1					
Empyema ....		2	1					
Gangrene of the lungs			1					
Hemorrhage from the lungs		28	18					
Influenza ....		2	9					
Inflammation of the bronchi		250	179	100 24 1 30			24	
" " chest .		7	16	1 1				
" " larynx " " lungs .		34 379	14 504	562	134	147	114	107
" " pleura		16	27	2	2			
" " trachea		9	11					
Ulceration of larynx .		2				769	640	757
		2770	2910	2939	773			
Hooping-cough .		77	51	153	22	49	fay	23 780
Totals...... Total mortality, exclusive of stillborn Per cent, from diseases of the lungs .		2847	2961	3092	795	818	699	
		11722	10338	10162				
		22.77	28.13	30.43				
Per cent, from consumption of th	3 lungs	12.80	14.93	16.33				
 
14
Table III.—Deaths from Consumption of the Lungs, during each Month in
  the year 1858, at fourteen distinct periods of life, with the Sexes designated
  for each month.
			(A											0>	
AGES.			d a a >"3	cd a ,0	.a 03 S		to	© a a i-s	a >->	1 a <1	6	0 0 0	B p-0 __	OJ	3 Eh
Under 1 year			3	2		2	1	1						9	
From 1 to 2 years .			7	2	*3	2								...! 14	
	1 2 to 5	a		1	3	3	'*2	1						... Id	
	' 5 to 10	u	4	1	5	2	1	3	i	i				...	18
	' 10 to 15	((	3	1	1	3	3	1	3	0	"i			...	18
	' 15 to 20	a	C	16	9	11	5	11	3	19	11	(i	'2	10 109	
	' 20 to 30	ii	45	48	58	43	50	52	41	31	64	27	4r>	50 i>f>4	
	' 30 to 40	ii	34	33	38	39	31	37	25	26	37	32	2°	44 398	
	' 40 to 50	it	2b	11	15	25	19	25	16	20	18	11	lb	26 226	
	' 50 to 60	11	13	9	18	14	9	12	17	12	17	15	9	2b	170
	' 60 to 70	n	10	8	16	7	9	3	7	4	7	3	12	9	9b
	' 70 to 80	" .	6	1	2	3		2	3		3	1	1	b	27
	' 80 to 90	" .		...	1	1			1		1	3		>)	<j
	' 90 to 100	It										0			2
	' 100 to 110	" .													...
Male			77	63	84	86	53	81	5b	47	72	45	51	92	806
Female			79	70	85	69	77	67	62	68	87	55	55	79	853
Monthly totals			156	133	169	155	130	148	117	115	159	100	106	171	1659 1659
Qu	arterly totals		458			433				391		377			
 
15
Table IV.—Mortality from Diseases of the Nervous System.
		Annual Aggregates.			Quarters of 1858.			
DISEASES.								
		1856.	1857.	1858.	1st.	2d.	3d.	4th.
Abscess of the brain ....		2						
Apoplexy ....		123	115	Ill	28	35	24	24
Chorea ....		2	1					
Catalepsy ....		1						
Coma		2	i					
Compression of the brain		8						
Concugsion of the brain			"i	"i		"i		
Congestion of the brain		177	201	241	44	58	97	42
Convulsions		603	556	609	157	150	172	130
Coup de soleil .		2	6	26		23	3	
Cramp		11	10					
Disease of the brain .		107	100	134	29	49	3b	21
Dropsy of the brain .		242	173	261	31	87	92	bl
Effusion of the brain		94	92	72	20	12	26	14
Epilepsy		24	18	2	2			
Hysteria		3						
Inflammation of the brain		329	306	815	72	72	114	57
" " tympanum .								
Irritation of brain and spinal marrow								
Mania or insanity ....		12	7	9	1	2	b	1
Mania a potu .....		43	62	85	21	20	31	13
Neuralgia ......		1		1				1
Palsy......		104	92	105	24	23	26	32
Softening of the brain		40	14	3	1	0		
" " spinal marrow .		2						
Teething......		29	17	12		1	10	1
Tetanus ......		13	11	13	"i	4	6	2
Trismus...... Totals......		2	2					
		1976	1791	2000	431	539	641	389
Puerperal convulsions		2	1					
" mania . . . . Totals...... Total mortality, exclusive of stillborn								
		1978	1792	2000 10162	431	539	641	389
		11722	1C338					
Per cent, of total mortalitj	'	16.87	17.33	19.58				
 
16
Table V.—Mortality from Diseases of the Organs of Nutrition.
	TUSKASKS		Annual Aggregates.			Quarters of 1858.			
			1856.	1857.	1858.	1st. 16 *3 3 1 1*2 18 6 89 18 1 "o '*8 8 49 80 17 17	2d. 3 69 8 12 2b (i 6 25 *3 "& 21 66 110 2 12 8	3d. 6 576 104 11 186 3 12 16 104 1 215 18 23 6 1314	4th.
Abscess " abdc " of t Cancer of t Cholera " infa " mor Cirrhosis of Colic . Constipatioi Consumptio Diarrhoea . Disease of 1 n Dropsy " abdo Dysentery Dyspepsia Gout . Icterus Ileus . Inflammatic a it Intussuscep Marasmus Obstruction Scrofula Tabes mese Tuberculosi Ulceration <	minal le liver ie stomach and ntum bus . the liver 1 n of the bowels he liver . stomach and minal n of the liver " periton " stomach tion . of the bowels uterica s )f the stomach a	bowels bowels eum . and bowels nd bowels	40 i 4 16 35 6 17 3 3 149 27 27 213 8 301 "i 21 1 39 68 184 6 484 9 61 36 15	35 "i 7 3 534 10 3 7 "5 119 41 17 239 6 198 2 5 11 25 56 299 4 506 2 61 44 "e	31 662 53 i 138 68 12 95 240 1 1 16 30 55 273 2 463 2 54 56				6 16 1 io 14 i'e 1 4 *4 11 54 1 68 "7 8
Totals...... Total mortality, exclusive of stillborn			2503	2236	2253	347	382		210
			11722	10338	10162				
Per cent, ol	total mortality	■	21.35	21.62	22.17				
 
11
Table VI.—Mortality from Diseases of the  Urino-Genital Organs.
		Annual Aggregates.			Quarters of 1858.			
DISEASES.								
		1856.	1857.	1858.	1st.	2d.	3d.	4th.
Albuminuria.....		9	7	1				1
Amenorrhoea		2						
Cancer of mamma		2	...					
" uterus		5	4		...		...	
Childbed ....		2	7	"i	1	...		
Chlorosis ....		2	1	...				
Convulsions, puerperal		2	1					
Diabetes ....			7	3		2	1	
Disease of the bladder		i	1	1				1
" kidneys		16	8				...	
" ovaries		1	2					
" prostate glai	d '. '.	1		...				
" uterus		5	2					
Dropsy, ovarian		1						
Fever, puerperal		69	49	36	1	17	13	5
Hemorrhage from uterus		7	5					
Inflammation of the bladder		8	9	3	2	1		
" " kidneys		7	7	7	2	1	2	2
" " prostate gland			"0	...				
" " uterus		15	8					
Mania, puerperal ....			...					
Rupture of the bladder								
" urethra			1					
" uterus			...		...			
Stone in bladder				"8	"6	2		
Strangury .			"3 2 1					
Suppression of urine Syphilis .		'*5 1		"3	i	"2		
Tumour, ovarian								
Ulceration of the uterus			1		13	25	16	9
Totals...... Total mortality, exclusive of stillborn		161	126	63				
		11722	10338	10162				
Per cent, of total mortality	j	1.37	1.21	0.62				
2 
18
Table VII.—Mortality from Fevers.
1	DISEASES			Annual Aggregates.			Quarters of 1858.				
				1856.	1857.	1858.	1st.	2d.	3d.		4th.
Fe	per . ' bilious ' cerebral . ' congestive 1 continued ' enteric ' gastric ' hectic ' intermittent ' malignant ' nervous ' pernicious ' puerperal . ' remittent . ' scarlet ' typhoid ' typhus ' " ioterodes " yellow			10 24 "3 0 2 14 7 69 22 992 229 49 5	3 25 2 5 2 2 4 2 5 "9 49 23 704 175 38	43 1 1 "2 i 36 17 241 197 71 16	"5 "i "2 i 2 120 51 21	3 1 1 17 3 68 29 15		ii 13 5 20 37 19 16	ii "5 7 33 60 16 132
Totals...... Total mortality, exclusive of stillborn				1428	1048	626	203	137	154		
				11722	10338	10162					
Pe	r cent, of total mortality		•	12.18	10.13	6.16					
Table VIII.—Mortality from Measles.
DISEASES.		Annual Aggregates.			Quarters of 1858.			
		1856.	1857.	1858.	1st.	2d.	3d.	4th.
Measles	......	141	56	28	1	7	11	9
 
19
Table IX.— Causes assigned for Death where the number is 90 and
                          upward.
~				Annual Aggregates.			Quarters of 1858.			
DISEASES.										
				1856.	1857.	1858.	1st. 28	2d. 35	3d. 24	4th. 24
Apoplexy ......				123	115	Ill				
Casualties ......				158	118	191	60	43	60	38
Cholera infantum ....				722	534	662	3	69	57b	15
Consumption of the lungs .				1501	1544	1659	458	433	391	377
Congestion of the brain				177	201	241	44	58	97	42
" " lungs				97	132					
Convulsions .....				603	556	609	157	150	172	130
Croup				268	256	292	105	57	33	97
Debility				430	378	457	120	88	133	116
Diarrhoea .				149	119	138	12	12	104	10
Disease of the brain .				107	100	134	29	49	35	21
" heart .				179	222	215	61	54	50	50
Dropsy				213	239	95	89	6		
" of the brain .				242	173	261	31	87	92	51
Dysentery .				301	198	240	13	25	186	16
Effusion on the brain				94	92	...				
Erysipelas				100	95					
Fever, scarlet				992	704	241	120	68	20	33
" typhoid .				229	175	197	51	29	57	60
Hooping-cough . Inanition .				114		153 91	22 21	49 20	69 34	23 16
Inflammation of the brain .				329	306	315	72	72	114	57
«' " bronchi				250	179	100	24	30	24	22
" " lungs .				379	504	562	134	147	114	167
" " stomach and bowels				184	299	174	49	66	104	54
Marasmus......				484	506	463	80	110	215	58
Measles				141						
Old age Palsy				172	195	358	56	122	98	82
				104	92	105	24	23	26	32
Smallpox Stillborn Unknown Drowned				390 612	557	535	152	134	114	135
				257 105	291 134	183 127	48 14	52 38	55 57	28 18
 
Table X.—Deaths, with the Sexes, for each Month in the Year, and the Number at Sixteen Distinct Periods of Life, with the
   Percentages to  Total Mortality, Exclusive of (he  Stillborn—also the Stillborn  Children for  each Month, and their Sexes.
Months.	Stillborn.				"3 a oj	o CO	3	U 0) •O !►. d_-	o	O C4	o ©	«5 O O	o K5	o CO O o CN	©	0	0 CO 0 0 0	d 0 0 CD	d GO O e	d 0 0 CO	§' 0 0 05 1	0'	0	2 Eh 722
	M.	F.	3 o Eh 42																					
January	31	11		392	330	228	173	194	116	38	22	13	18	89	68	48	35	35	31	14				
February	32	22	54	387	359	208	190	186	96	56	23	11	26	77	92	48	35	45	28	20	2	1		74<;|
March	31	25	56	526	467	282	248	248	113	89	39	14	27	112	90	68	61	49	49	22	11	1		9931
April	25	19	44	437	371	218	199	199	85	66	31	13	23	87	75	64	44	52	43	22	4			808 i
May	24	15	39	390	342	214	144	193	57	60	16	11	21	92	72	59	44	47	35 23		2	1		732
June	31	20	51	580	464	322	253	303	105	99	28	9	31	102	100	76	56	56	39 j 33		7	...		1044]
July	18	15	33	708	602	486	410	584	145	95	28	22	22	99	81	59	57	49	43 ' 20		5	1		1310
August	18	12	30	632	569	443	374	516	156	69	17	19	40	95	57	74	52	45	37 1 22		1	1		1201
September	27	24	51	566	459	305	247	305	116	61	16	18	36	119	99	81	62	39	4 b 22		5	1		102b
October	25	17	42	303	299	151	149	173	51	40	12	13	11	65	68	54	47	31	20 10		7	...		602
November	24	20	44	327	298	160	144	174	55	51	9	5	10	76	62	46	38	45	33 ; 11		8	1	1	62 b
December	23	26	49	468	421	229	203	231	78	68	15	13	27	94	87	80	67	37	53 i 31 1		8		... ' 889	
Totals Per ct. •» of totals J	309	226	535	5716	4981	3246	2734 25.62	3306 37.25	1173 11.54	792 7.78	256 — 2.52	1G1 1.57	292 2.86	1107 10.89	951 757 598 530 9.35|7.45 5.88 5.21 1 ! 1				1 456 250		'61 0.60	6	1 j10697	
				53.45	46.55	30.35													4.48 2.46 1			.05	.009	
 
21
  Table I. The whole number of deaths returned  for the year has been
10,697.  This amount indicates a falling off of 201, or nearly 2 per cent.,
from the  deaths of 1857.  Fixing  the  population at 600,000, which, I
believe, is a fair estimate, the death returns furnish  a favourable indication
of the health of our city, and give one death  to  every 56 of its inhabit-
ants.
  Of the deaths recorded, 5,H5  were  males and 4,982 females, presenting
an excess of  deaths in the male sex  equivalent to 14.70 per cent.  For the
last ten years the mortality records of Philadelphia give an excess of male
deaths equal to 15.58 per cent.   The average  of  deaths for each quarter of
the year is 2,6745 for each month 891-,%;  for every day  29|.
   According to the seasons of the year, so are the rates of death determined
for each quarter.   The first quarter furnished 2,461, the second 2,584, the
third 3,536, and the fourth 2,116. The second or spring  quarter yielded, an
increase of 5 per cent, over those of the first quarter, embracing two of the
winter months.  The third quarter, which rates the highest in mortality,
and includes the summer and autumn in  part,  gave 36.76 per cent, more
than the second quarter, and 43.60 per cent, than the first quarter.   The
fourth or last quarter, in which  the deaths were reduced to 2,116, showed
a decrease of 40.15 per cent, from those in the third.  A large proportion
of the increase of  mortality in the  third quarter may be safely charged to
the  diseases of the organs of nutrition, embracing many of  the  zymotic
class.
   Appended to this table will be found the number of deaths returned from
the  almshouse, or Blockley Hospital; they amount to  573.   Also the mor-
 tality among the coloured population, which  was 611.   The number of in-
 terments in  the city burial-grounds of bodies brought from other counties
 and States amounted to 52.  I make these statements from the record, but
 their  accuracy is very doubtful.   From a more  reliable source I learn that
 while there has been an annual increase of the inmates of the Blockley Alms-
 house—our  great  pauper establishment—the rate of mortality shows a
 reduction from 21.89 per cent, in 1854 to 14.50 per cent, in 1858.
   In  order to arrive at a safer estimate of the deaths from diseases alone,
 it seems proper to deduct those in the table registered under external causes,
 as well as those from debility, malformation, old age, unknown causes, still-
 born  and those from the country, amounting  in all to 1,967, or 18 per cent.
 of the whole.   By this calculation we reduce the  deaths from certified dis-
 eases to 8 730.  Taking this as  the correct standard of deaths from disease
 during  the year, and it gives lis only 1 death in  every 67 of the popula-
 tion.

   Table II  presents the deaths returned to the health office from those dis-
 eases to which the lungs and air-passages are liable. They amount to 3,092, 
22
or 30.43 per cent, of the entire number of deaths for the year.1   This per-
centage is higher by 2.30 per cent, than the preceding year, and shows an
increase of deaths from this class over any former year, in proportion to the
annual mortality.
   The deaths from croup have increased 14 per cent, over those for 1857,
and amount to 292, or 9.44 per cent, of the mortality from diseases of the
air-passages.  The deaths in the first and fourth quarters, which  include the
winter months, more than double those for the second and third  quarters of
the year.  The steady increase of croup, according to the tables of mortality
for this city, cannot have escaped  the attention of the Fellows of the Col-
lege.  It is one of those diseases peculiar to childhood,  and most prevalent
between the  ages of one and five years;  it is not often met with in early
infancy, although during this year 110 of the deaths were under  one year of
age.   Boys  are said to be more liable to croup than girls, according to the
known statistics of writers.   The present year fully confirms this opinion.
160  of the  deaths were boys and 130 girls, showing an  increase of 23k
per cent, of the former over the latter.  The distinct character of the disease
causing death, whether pseudo-membranous or catarrhal  croup,  is rarely
designated in the certificate, and hence it is impossible to ascertain the com-
parative mortality of the two  forms of this frequent and too  often fatal
disease among children.  A more complete system of classification of dis-
eases, as well as of registration of deaths, would, if practically carried out,
supply a necessary want in our mortality statistics of this as well as other
diseases.
   The deaths from dropsy of the chest present an increase of  191.13 per
cent, above those recorded for 1857.   This augmentation will be  found to
belong to the last half of the year, and occurred principally among adults.
The cause in all probability may be looked for in the unusual prevalence of
inflammatory affections of the bronchial passages and lungs, the result of a
catarrhal epidemic influence in the atmosphere.
   This  catarrhal disease  furnished  140 deaths, or  4.52 per cent,  of the
mortality assigned to this class.
   Inflammation of the lungs  contributed 562, or 18 per cent., of the deaths
in this table, and inflammation of the bronchia 100, or 3 per cent.   Only*
two deaths are ascribed to inflammation of the pleura, one to inflammation
of the chest, none  to that of the  larynx or trachea.   This is an unusual
occurrence.
   Hooping-cough will be seen to have  supplied more deaths than for the
two previous years combined, viz., 153, an increase of 200  per cent,  over
those for 1857.
   The extreme prevalence of catarrhal  diseases in our city during the last

  1 It will be understood that the calculations in these tables having reference to
the entire mortality are prepared by excluding the  stillborn, unless otherwise ex-
pressed. 
23
four months of the year, amounting almost to an epidemic influenza, may
in some degree account for the increase of deaths as indicated in the table.

   Table III.  In this table I have set apart the  deaths  from consumption
of the lungs which have been recorded during the year.  I have also desig-
nated the sexes, and have shown the total of deaths for every decennial
period.
   The annual mortality from this dreaded scourge of the human family is
placed at 1,659.   Of this  number, 806 were males and 853 females;  the
excess of deaths among females is  peculiar to  all mortality tables in all
places.   In the present instance it was equal to  about 6 per cent.
   The deaths from this disease contribute more than half of those classed
with diseases of the lungs and air-passages,  while they furnish 16.33 per
cent, of the total mortality.
   The  increase of the deaths  from consumption  above those for 1857 is
equal to 7.45 per cent.
   Estimating the population at 600,000, the ratio of deaths to population
was as 1 to every 361.66,  or 2.76 in every thousand.
   According to this table, and it does not differ materially from others that
I have prepared for this  region, the decennial period in which the deaths
from consumption of the  lungs are most frequent is that between 20  and
30  years.   The  next in  frequency is between  30 and 40.  This result
would confirm the opinions of Sir James Clark and of Louis on  this point.
   There is no period of life, however, even from infancy (which  interesting
season  is thought to be very prolific of consumption) down  to extreme old
age, in which there will not be found recorded, deaths from the ravages of
this hereditary  pestilence.  In the accompanying  table you will find  9
deaths under 1 year, and 2 over 90 years; while the intervening periods
gave larger* proportions, marking a gradual increase up to 30 years, when
they as gradually declined.
   The highest monthly mortality was in December, 171; the next March,
 169; the next September,  159.   October and November furnish the lowest
 number__100 in the former, and 106 in  the latter.

   Table TY. contains the numerical estimate of  the deaths during the year
 from diseases appertaining to the nervous  system.  They amount to 1,990,
 or 19.58 per cent,  of the entire mortality.
   Under the separate titles of  convulsions and  congestion,  dropsy, inflam-
 mation, and disease of the  brain, will be found 1,560 deaths.  These diseases
 belong peculiarly to children,  and we may safely infer that 78 per cent, of
 the deaths from affections of  the nervous system are contributed by our
 infantile population.
   Convulsions, by itself, gives  a large proportion, equal to 609, or 6 per
 cent. 
24
   Twenty-six deaths are noticed from coup de soleil, or sunstroke.  Twenty-
 three  of the deaths occurred in June, and  of these, twenty-one were  in
 the last week of the month; during this terra, the thermometer stood at
 its highest point for the year, 96£ on  the  28th.   These deaths were the
 result of the extreme heat of the season.
   The deaths from mania-a-potu were 85, an increase of 37 per cent, above
 those for 1857, and a larger annual mortality  than for several years back.

   Table V. enumerates the deaths for the year from diseases peculiar to the
 organs of  nutrition, amounting to 2,253, and  equal to  22.17. per cent,  of
 the entire mortality.
   Under this head is placed cholera infantum, a summer disease of infancy,
 confined principally to the crowded suburbs  and badly-ventilated districts
 of our large cities and towns.   The third quarter of the year, embracing
 July, August, and  September, together with  the month of June, furnishes
 almost the entire mortality.  The whole number  for  the  year  was 662,
 equivalent  to  about 14 per cent, of  the deaths for the year,  in children
 under five years of age.
   Marasmus(?).—Under this term will be found 463 deaths;  the months
 of June, July, August, and September furnishing 262 of this number.  This
 also is one of those  diseases—or, more properly, results of disease—pecu-
 liar to children, and found prevailing extensively in large cities during
 the warm  season.   It seems to be a favourite name with many physicians,
 and an easy mode of certifying  to deaths of  a chronic form  in children
 where doubt exists in the mind as to the real  nature of the case.  I believe
 it to be the sequel of several varieties of  disease of the organs of nutrition
 in children; and, with that understanding, the numerous deaths ascribed
 to marasmus obviously belong to those affections, and axe placed to their
 account.
   The third quarter of  the year, which includes almost the entire warm
 season, contributes a large portion  of  the  deaths under this head.  It
 will be seen, also, that the increase is from those affections which  are gene-
 rally classified with the  zymotic or epidemic.  The entire number for the
 quarter is 1,314, constituting 58 per cent, of the deaths in this class;  while
 the epidemic diseases alone, in the quarter, are  1,093,  or 48 per cent.

   Table Yl.  Here  will be found  the deaths  assigned to those diseases
 which belong to the kidneys, bladder,  and the organs of generation.  They
 consist, this year,  of a limited percentage when compared with  the  whole
 mortality.  There is a falling off of one-half  from those of last year; they
 number 63. Of these, puerperal  fever deaths make 36,  or more than half.
 In 1857 the largest proportion of deaths from this fever were in the first
 quarter, the coldest period of the year.   This year, almost the entire mor-
tality was in warm weather. 
25
  Table VII.  The mortality from fevers during 1858 is shown in this table.
  A comparison with the fever table of 1857 is the best evidence of the
exemption of our city in 1858 from the destructive influence of this class
of diseases upon its citizens.  The former year they numbered 1,048, in the
latter 626, presenting a decrease equal to 40  per cent.  In 1856 the pro-
portion of deaths from fevers to the entire mortality was 1 in 8; this year
(1858) they are only 1 in 16.
  This  great  difference is  explained  in part by the falling off in the
deaths from scarlet fever.   In the two years preceding 1858 they amounted
to 1,696; during this year they were only 241.
  To the entire mortality,  fever deaths rate only 6 per cent.
  Typhoid and typhus fevers have increased in the number of their deaths
since 1857 at the rate of 25 per cent.
  If the record of  deaths be considered a fair index, our city has been
peculiarly exempt from the ordinary forms of autumnal  fevers.   The few
cases I have observed invariably partook of  a  mild  type, and were easily
managed.   Intermittent fever  and its varieties,  considered as of miasmatic
origin, which were exceedingly prevalent, a few years ago, in the urban as
well as in the suburban districts during the fall months, were neither fatal
nor numerous.  It has been remarked that this  more common type of fever
seemed to be gradually disappearing from our  vicinity as an  endemic, or
to be yielding in form to those of an asthenic character, as the typhoid or
enteric.
   After an  experience of thirty-four years,  and a somewhat  familiar ac-
 quaintance with the endemics of the county, I have never known the outer
 districts of our city to have enjoyed a  larger share of health than during
 the past year, especially as regards the  ravages  from fever.  The com-
 mon bilious fevers have been few in number; and when found, their active
 inflammatory  type  was doubtful, and features  were  presented, which cor-
 responded with those above alluded to,  of an enteric character.
   One of the local causes of this comparative immunity of the  suburban
 districts of the city from miasmatic fevers, in addition to the  meteoro-
 logical  or  climatic changes  may be  found, especially  during   the past
 two years, in the  almost entire  suspension  of those rapid and  extensive
 improvements which for years have been in progress along  the  outskirts
 of  the  city.  In the prosecution of these  changes, streets were opened
 and graded,  which required the digging down of embankments  and the
 filling up of excavations; the removal of earth was needed also from cellars
 dug for new buildings, and in the levelling of lots.
   The great amount of loose and new earth, thus exposed to the influence
 of heat and moisture, and the decomposition  of vegetable remains contained
 therein, in  connection with numerous  collections of stagnant water, could
 not do otherwise  than give  rise to  the exhalation of malaria, which,
 with other causes, highly favoured the  appearance and extensive prevalence 
26
of fevers.  When the money panic of 1857 swept over the country, our
city experienced its prostrating influence; business suddenly declined, pro-
perty depreciated in value, building improvements at once ceased, and with
these  reversions an abatement of miasmatic fevers followed.
  Sixteen deaths are recorded from typhus icterodes.   As far as I could
obtain correct information, these deaths were from undoubted cases of yel-
low fever.  They all occurred in the months of August and September.
  About the middle  of July there was  considerable anxiety in  the  com-
munity, in consequence of the arrival  and detention at quarantine of a
number of vessels from ports in  the West Indies, where yellow  fever was
prevailing at the time of their sailing.   Several of these vessels  had cases
of the fever on board in a most  malignant form, when  they dropped their
anchors opposite the lazaretto.  They received a visit from the  physician
at the station, Dr. L. S. Filbert, and the sick were immediately removed
to the hospital. Other vessels had lost several of their seamen with yellow
fever on the voyage, at sea, or in foreign ports, while others again arrived
with their crews in health, having  had no sickness during the voyage, but
were  detained for purification.  In a few days, cases of yellow fever were
received into the hospital from some of  these vessels.
  Every sanitary precaution was  strictly observed by  the  officers  at the
station, to prevent the  spread of the disease among the crews  of the fleet
riding quarantine, and to preserve the health of those  persons remaining
on board the infected vessels.  These were moored  at some distance north
and east of the others, which were detained, not on  account  of sickness,
nor because they came from infected ports, but because it  was according
to law.
  Dr.  Filbert received  into the hospital from  time to time,  in all, twenty-
seven cases  of yellow fever.   Four of these died; two within ten  hours
after admission.  Two of the four had black vomit.  This was a mortality
of only fourteen per cent, to cases, and shows a result more favourable than
is usual.  The treatment followed by the  doctor  in  these cases he has
had the  kindness to forward me,  which I herewith transcribe  in his own
words.
  " The treatment, which I am happy to say has proved very successful in
my hands, was  as follows :   As  soon as the patients (except the two who
arrived in a dying condition)  were  received into the hospital, I had  them
immersed in a  hot mustard-bath, after which, upon  being wiped dry, they
were put to bed, well covered with blankets, and bottles of hot water placed
around their bodies and lower extremities, with the intention of producing
diaphoresis.   Entire rest in the  recumbent  position was strictly enjoined,
and maintained throughout the treatment.   As early as possible  I admin-
istered the following remedies: R.—Hydr. chlor. mit. gr. vj; sulph. quin.
gr.  v;  pulv. nitr.  potas. gr. v;  pulv. ipecac, gr. ^.   This  prescription
was repeated every three hours.   The  treatment  had the desired effect of 
27
producing  copious perspiration.  In  from three to four days  the  fever
abated.
  "My object was to give a  sufficient amount of calomel to move the
bowels without the addition of other purgatives, at the same  time to lay
a mercurial foundation at  the  start.   It may not be out of place to say,
that in no  instance did my patient give me trouble where mercurial action
could be produced in due time.  In those cases where there was much gas-
tric distress, I applied mustard to the epigastric region.  Ice was allowed,
as much as the patient desired."
  The great solicitude felt by the lazaretto  physician, for  a faithful dis-
charge  of his  duties under the trying circumstances  in which he found
himself  placed, and his unremitted attention to  the sick, were calculated to
depress the energies of his nervous system; while his frequent visits to the
infected ships from day to day, in order that  those left on board might
have his protection, exposed him to the influence of a poisoned atmosphere,
and he  contracted the fever, which proved to be a mild case.   He con-
valesced on the sixth or seventh day of his sickness.
   Unfortunately two infected vessels escaped the vigilance of the officers at
the lazaretto, and either evaded the laws or the restrictions of the Board of
Health, or else through  a misunderstanding,  had received permits to leave
and thus found their way to the city,  where they discharged their cargoes
and their crews.   In a few days after  their arrival, several cases of yellow
fever made their appearance among the persons employed about these ves-
sels, and in the vicinity of their moorings.
   It has not been possible to ascertain the true number or exact locality
of cases of yellow fever that were under treatment during its limited appear-
ance in  our city.   The Board of Health, as I learn, preserved no record of
the cases reported to them, and, besides, there were instances of the disease
that never came  to their knowledge.
   From the most reliable information, there were between thirty and thirty-
 five cases.  A number of  them occurred in the vicinity of South and  Front
 Streets.   Several were in Kensington ; while a few were under treatment
 in one or  two of our public hospitals.  Many of these cases could be traced
 to direct communication with the atmosphere of the vessels that had reached
 our wharves, coming directly from yellow fever ports, without having under-
 gone quarantine; while with others  no satisfactory information could be
 obtained as to the origin  of the disease.
   Twenty-five of  these cases of fever were under the care  of Dr. John
 Ge"-an  of South Front Street.   His first case  occurred two days after the
 arrival  of the first vessel  at Lombard Street wharf, in a baker,  residing in
 Lombard Street near Front, who told the doctor  he had  been about the
 wharf for several days  previous to his sickness.   Five of the cases under
 the care of  Dr.  Gegan  died-a mortality of twenty per cent.   All  of  his 
28
cases, with the exception of the night inspector of one of the above infected
vessels, were in houses east of Second and south of Lombard Streets.
  It becomes, therefore, a  difficult  question  to  decide upon the origin of
these cases of yellow fever.   Were they the offspring of  a foreign poison,
introduced by vessels  from the West Indies, or  are they  to be regarded as
the production of domestic causes ?   Were they the result of epidemic or
endemic influences ?  That they were of sporadic or accidental origin, will,
perhaps, be admitted.    That the disease neither lasted until a frost should
banish it from our midst,  nor spread to any extent, are  facts well known.
The hygrometrical and the  thermometrical  conditions of the atmosphere
were by no means favourable to its production,  or administered  to its
extension; hence, the activity of the cause, whatever it might be, was soon
exhausted for the want  of these and  other propitious circumstances.

  The extensive prevalence of scarlet fever in our city for a number of years
past, the fearful ravages it has committed by death in that portion of the
population which, of all others, is the most interesting while it is the most
cherished, and the increased attention that  has  been bestowed  upon it of
late by writers on medicine, would seem to claim for it, at our hands, rather
more than an ordinary notice.
  For this purpose I have  taken  the trouble to compile, from the mor-
tality records, the following  table, which  gives us the deaths from scarlet
fever in our  city for  a period of twenty-eight years, from 1831 to 1858,
inclusive, with the ages and sexes for each decennial period:—
TEARS.	S	"3 a &H	o CO	3	© co a >> t>rH	o	©	MS © i-H «3 rH	§3 CO 0 0 >o © 15 '25 1626 25 33 56 84 1	0 0 CO :-K	0 CO 0 0	c 0 1 1	0 0 © 1 1	0 Eh 2004 2585 3475 8064
From 1831 to 1840, ten years " 1841 to 1850, ten " " 1851 to 1858, eight "	968 1267 1740 3975	1036 1318 1735 4089	945 1255 1712 3912	1010 1284 1707 4001	181 249 329 759	353 461 687 1501	915 1216 1574 3705	433' 68 545 52 7221 82 1 1700 192 1		14 4 12 0 17 4 43 U	0			
  During the twenty-three years preceding 1831, beginning with 1807,
when the first annual statement of deaths in our city was published by the
Board of Health—as prior to this event we have no authentic account of
the mortality—there were only 162 deaths from scarlet fever.  Within this
interval of time there was a series of years, from 1812  to 1818, that a death
from scarlet fever was unknown  to the record;  and from 1807 until 1812,
only 13 deaths are to be found on the register.
  In 1830 the deaths increased to 40, from 9 the previous year, and from
the following year, 1831,  when, as the above table indicates, they run up
to  200, we  may date the  advent  of this wide-spread and severe exanthe- 
29
matous fever.  Not only has  it prevailed extensively, and with  marked
fatality,  but during each  successive decennial period it has  steadily in-
creased, provided the increased ratio of deaths be taken as the  index of its
prevalence.
  All writers agree that no period is fixed for the duration of  scarlet fever
when  it makes its appearance in an epidemic form, and it would not be an
assumption of authority to assert, that the past twenty-eight years have
proved a memorable epidemic cycle, especially when contrasted with  the
preceding period of twenty-three years, during which term only 162 deaths
from this disease were returned out of  56,000 deaths.  It has  been conjec-
tured  by Dr. Emerson  that  in the period of exemption  referred to, there
may have  been  deaths from scarlet fever reported under the  title of sore
throat, which in all probability was the case.  Making every allowance,
however, for the 355 additional deaths thus recorded, it would not, in my
opinion, change the proportional mortality between the two periods—since
the like conjecture, for the returns of deaths from scarlet fever during the
epidemic visitatiori, by other and vague terms, would far  exceed  those of
the former period.
   A careful inspection of the table will reveal several  points  of interest
involved in the history and character of this dreaded malady.   That it is a
disease of infancy  and childhood, scarce a  doubt need be entertained.   Of
the 8,064 deaths which have occurred  in this city since 1831,  7,665, or 95
per cent, were under ten years of age.  Of the deaths recorded beyond
 20 years, or in adult life, there were 151,  not quite 2 per cent.  Eight of
 these were between 50 and 60, one between 60 and  70, and  one between
 70 and 80 years of age, proving that the disease may  attack the aged and
 terminate fatally.
    Some diversity of opinion has been expressed as to the influence of scarlet
 fever upon the sexes.   While  one author decides that  girls are more liable
 to it than boys, another claims the influence for the  boys; while a  third
 believes that under  puberty, sex exerts no influence whatever, but beyond
 that age it is most frequently found among females.
    It  may be thought impossible, with our  present imperfect and limited
 means of observation, to decide correctly this question.  Should it never be
 settled, it is not one of vital importance.   Nevertheless, I am of opinion
 that females are more subject  to the disease than boys.   The evidence for
 this opinion will be found in the accompanying table, unless it can be satis-
 factorily shown that the result there given of the excess of female deaths,
 was occasioned by a less resistance  to a fatal termination of the disease,
 owing to  their greater delicacy of conformation.
    Of the deaths recorded in this table, 4,089 were females, and 3,975 were
 males, presenting an excess  equal to 3 per cent,  of female deaths over those
 in the  male sex.  This result, while it may conflict with the  estimate of a 
30
number of  able writers, is in accordance with the experience and decision
of the Registrar-General of England.

   Table VIII.  For several years a separate table has been prepared for
measles, smallpox, and varioloid.  The falling off in the deaths from small-
pox and varioloid since 1855 has rendered a distinct notice unnecessary.
Only seven deaths are registered from smallpox during the entire year, and
of these victims, five were  children.  Not a  death took  place  from vario-
loid.   For measles the table has been continued, although it might with
propriety be dispensed with, in the present instance, as the deaths from this
exanthem have reached  only 28 during the year.   No epidemic of measles
has prevailed, and the few isolated cases which made their appearance were
generally mild in character.   The  last two  quarters of the year show an
increase in  the deaths, the disease no doubt having been complicated with
catarrhal inflammations, which were quite prevalent.

   Table IX. In this group are those only, in which the deaths have ex-
ceeded ninety for the year.
   A glance at the table will  indicate a change in favour of  1858, as to its
comparative health, with the results of the previous years appended thereto.
   Consumption of  the lungs produces the highest mortality.   Cholera in-
fantum is the next in the scale.
   Disease of the heart,  which in all probability stands for a variety of dis-
tinct  morbid affections, the true diagnosis of which has either been  over-
looked through indifference, or waived in the absence of a knowledge of
exploration according to modern investigations, numbers 215 of the entire
mortality from diseases of the organs of circulation, which  were 248.
   The remarkable increase of deaths from old age, seen in this table,  num-
bering 358,  when  compared  with  those  in former years, will  not escape
attention.  They more than double the number for either  1855 or 1856,
and nearly double those for 1857.   I  shall not  attempt any explanation,
as it may be  purely an accidental occurrence, although  it might serve as
an argument in favour of an approximation towards a higher average of
human life in our city.

   Table X.  This is a useful table for the  statistician.   It presents at first
sight an analysis of the annual mortality, numerically arranged.  The still-
born, with the sexes for each month, are given.   The deaths per month at
each of the fifteen  distinct periods of life,  with the sexes, and the number
of boys and  girls under twenty years of age, are also enumerated.  A cal-
culation of percentages of deaths for each month to the whole number has
been prepared, as well as for the several designated periods of life,  all of
which will be found available in making up comparative tables. 
31
  The stillborn children amounted to 535, which would be equal to 5 per
cent, of the entire mortality for the year.  This is a more favourable com-
parison than was presented last year, or for the seven previous years.  The
male  stillborn  exceeded the  female by 36.72 per  cent.  This fact of the
excess of stillborn males is noticed in the statistics of other cities.
  The largest number of stillborn occurred in March—viz., 56; the lowest
in August—viz., 30.  The coldest months yielded the  greatest amount of
stillborn children.1
   The  mortality in children, or those deaths which have  occurred  before
the twentieth year of life,3 exclusive  of stillborn, were  5,443, and make up
53.38 per cent, of the deaths.  Those under one  year, deducting the still-
born, amounted to 2,767, equivalent to 27.25 per cent, of the mortality,
and constitute more than half of all the deaths under  twenty years.
   The deaths under five years amounted to 4,731, or 46.40 per cent, of the
annual mortality.   Between five years and twenty they were less than 7 per
cent.
   The mortality in infancy and childhood in our city will compare favour-
 ably with that of other  large  cities; still, the large number of deaths  at
 these interesting periods of  life demand a far greater share of attention
 from  the medical profession and the corporate authorities than they now
 receive.   It is  a fact, and cannot be denied, that the  prevalent causes for
 this heavy mortality in  early life are preventable.  The improper hygienic
 management of children, with regard to their diet, dress, exercise, and  air,
 together with a neglect by the civil  authorities of the  enforcement of sani-
 tary police measures, are mainly the agents that lay the foundation for the
 existence of infantile  diseases, and  thus invite this early harvest of death.
  "  In adult life, that decade between 20 and 30 gave the highest mortality;
 it was equal to 10.89  per cent.  The deaths beyond  this  period gradually
 declined, up to extreme  old age.   Two hundred and fifty deaths,  or 2.46
 per cent'., took place in the  decennial period between 80 and 90, sixty-one
 between 90 and 100, and seven died in their centennial term, one of whom
  was beyond 110 years.
    The proportion of deaths in advanced life, when compared with the total
  mortality and with the like proportion in former statistics, shows that the
  probabilities of life have been increased during the year.   In the previous
  vear (1857)  although the mortality was greater in amount than this year,
  vet the aggregate ages were only 221,327 years, which made the  duration
  of life 20£ years; whereas this year (1858) the sum of the ages amounted
  to 238,585, which would increase the average existence of life to 23* years.

    . No estimate can be formed of the nnmber of stillborn to the births in onr city,
  as the Board of Health have failed in secnring the birth statutes for several years
   t the tables these  deaths are classified as minors, and those above twenty as
  adults.