from 1853 to 1857, to 21 in 1858, and 20 in 1,000 in 1859.

The

city of Boston shows an improvement in 1858 and 1859 over the annual rate of mortality of the five years' period. An improvement is also indicated in the records of the neighboring cities of Cambridge, Charlestown and Roxbury; though not in each of these, to an equal extent. Each of these four cities, there not only appears to be an improvement in the mortality of 1859 over that of 1858, but also a still greater improvement over the average annual mortality in the five years 1853-57. Had the rates of death, or proportion of deaths to the living been as great in these four among the principal cities of the Commonwealth, during the past two years, as during the five previous years, they would unitedly have sustained a loss of 1,137 deaths in 1859 and 755 in 1858 more than the numbers which appear to have occurred. This statement is the more reliable from the fact that in these very places the records exhibit more accuracy and completeness than those in most other parts of the State. But if we confine our attention to Boston alone, where the mortuary records appear to be faulty in no appreciable degree, the results are equally startling to say the least, for had the mortality in the metropolis been as great in the last two years as the average in 1853-57, there would have been 620 more deaths in 1858 and 816 in 1859. The saving of the lives of 1,436 human beings in a single city of the State in two years, is an item worthy of some consideration; and yet had the death-rate in Boston in the past two years been only 17 in a thousand, which is considered by men of the largest experience to be as high as any community under ordinary circumstances need suffer, and which is but a mere fraction below what the recordsof the entire State exhibit, there would have been a still further saving of 934 human lives in 1858, and 771 in 1859. It may be

Without affirming on physiological grounds that man was created to live a destined number of years, or to go through a series of changes which are only completed in eighty, ninety, or a hundred years, experience furnishes us with a standard which can only be said to be too high. Seventeen in one thousand is supplied as a standard by experience. Here we stand upon the actual. Any deaths in a people exceeding seventeen in one thousand annually, are unnatural deaths. If the people were shot, drowned, burnt, poisoned by strychnine, their deaths would not be more unnatural than the deaths wrought clandestinely by disease in excess of the quota of natural death; that is, in excess of seventeen deaths in one thousand living.-XXth Reg. Report (1857) England, page xxxviii.

safely said, therefore, that 1,700 human beings have been needlessly destroyed in the city of Boston alone during the past two years.* It is equally true that during the whole of the last ten years, there has been an average of over one thousand unnecessary deaths each year! Had but a modicum of this number of lives been destroyed by accident or by the unusual prevalence of any pestilential disease, it would have cast the intensest gloom over the city and country, and filled the public heart with the sadness of sorrow. But this is not all; the black cloud has its dark but less dense margin. The same causes which result in swelling the records of death, tend also to depress vitality and augment the degree and amount of sickness suffered by those who again recover. The amount of sickness in any ordinary community usually averages two persons constantly sick to every annual death. This indicates that in addition to the large number of unnecessary deaths, there has also been an average of twice that number of persons constantly sick, all of which might have been prevented by proper sanitary regulations on the part of the municipal authorities, together with a practical recognition, on the part of individuals, of the terms on which alone we enjoy health and life.

Avoidable sickness and death inflicts a large and unnecessary tax upon the community, where health and life would reward sanitary efforts with the means of adding largely to the physical and moral resources, and the material wealth and usefulness as well as happiness of the common stock.

To enlighten the public mind on these matters, and to effect a change which shall overcome the obvious physical, moral, and pecuniary evils now extant, is well worthy the attention of the

* The British Board of Health with the Earle of Carlisle (Lord Morpeth) at its head, say: "Parliament has legislated on the conclusion, submitted with an accumulation of demonstrable evidence, that the causes of epidemic, endemic, and contagious diseases are removable, and that the neglect on the part of the constituted authorities to remove such causes, as far as they are obviously within their control, is a punishable offence. The foundation which the legislature has thus laid for the physical, and consequently the moral improvement of the people is recognized. Half a century ago it was said by a great physician and philanthropist, (the late Dr. Rush, of Philadelphia,) that the time would come when the legislature would punish communities for neglecting the known means of preserving the public health, and that prediction the British Parliament has been the first to realize."

wise and the good. What richer field lies before the Christian philanthropist; what greater benefits are promised to the labors of the political economist; what higher or more valuable direction can command the attention of the enlightend statesman ?*

The city communities taken together present a higher rate of mortality than the rest of the State. This is in accordance with well established facts, that density of population is, as a general thing, accompanied with comparatively high rates of death. If the records are complete, it will be readily perceived by the foregoing table, that the relative amount of vitality or immunity from death between the inhabitants of the cities and those who reside in the rural districts, was almost exactly as five to seven in the five years, 1853-57; while that of the entire State upon the same basis would be represented by six.

In London, during the sixteenth century, the population lived about twenty years on an average, and 50 died out of 1,000 living; consequently the excess over 17 was 33. That this excess was not inevitable is now demonstrated; for with a great increase in number, the population now lives about 37 years, and the mortality has fallen to 25 in 1,000. Is the excess of 8 deaths a year in every 1,000 living inevitable? This cannot be admitted for a moment, if we regard only the imperfect state of those sanitary arrangements which the public authorities of London have within their power. Nor can it be admitted that the excess of 5 deaths-or 22 deaths instead of 17—a year in every 1,000 living is inevitable in England and Wales, with evidence before our eyes of the same violations of the laws of nature in every district.

"England is a great country, and has done great deeds. It has encountered in succession, and at times in combination, all of the great powers of Europe; has founded vast colonies in America; and has conquered an empire in Asia. Yet greater victories have to be achieved at home. Within the shores of these islands the twenty-eight million of people dwell who have not only supplied her armies, and set her fleets in motion, but have manufactured innumerable products, and are employed in the investigation of scientific truths, and the creation of works of inestimable value to the human race. These people do not live out half their days; a hundred and forty thousand of them die every year unnatural deaths; two hundred and eighty thousand are constantly suffering from actual diseases which do not prevail in healthy places; their strength is impaired in a thousand ways: their affections and intellects are disturbed, deranged, and diminished by the same agencies. Who will deliver the nation from these enemies? Who will confer on the inhabitants, the blessings of health and long life? Who will give scope to the improvement of the English race, so that all its fine qualities may be developed to their full extent, under favorable circumstances? His conquests would be wrought neither by wrong nor by human slaughter; but by the application of the powers of nature to the improvement of mankind." XXth Reg. Report, England,-1857. pp. xxxix-xl.

Similar characteristics prevail in other countries. The following arrangement will place in juxtaposition the results of the latest facts within our control:

In the foregoing statement the mortality in the city of Boston, which is given separately, is also included in the city communities. The facts from England are divided into those of city and rural groups-the former embracing "125 Districts and twentythree Subdistricts comprising the CHIEF TOWNS" [Cities]-and the latter group includes "the remaining districts and subdistricts of England and Wales, comprising chiefly Small Towns and Country Parishes." London is given a separate place, although its facts are also included in those under the head of "Principal Towns." The facts from Scotland are divided into three groups-one including the eight principal towns*-another including all other smaller towns, embracing over four thousand inhabitants and a third group which "includes the remaining portion, which may be properly denominated the country or rural population."

England has had a very complete system of registration since 1836, and doubtless presents more trustworthy records than places of less experience. The system commenced in Scotland in 1855, and perhaps the records of that country are less perfect, especially in the more sparsely settled districts. We can in no other way account for the wide difference in the death-rates of rural and town populations which is even greater than it is in Massachusetts. It is gratifying however to observe that 1859 seems to have been a comparatively healthy year in all the places of record.

The contrast in the rates of mortality in city and country is most striking and universal. How much of this excess in cities is unnecessary, because preventable, it is not possible with our present knowledge, to decide. But that great improvements can and ought to be made, there is not the shadow of a doubt. It is not so much the unusual prevalence of any epidemic, which is temporary, as the usual number of excessive deaths to which we have become accustomed, that in the aggregate, destroys the lives of such numbers of our fellow beings. No well-informed person can contemplate the lack of sanitary measures on the part of municipal authorities and individuals, so clearly manifest in all of our cities, without the most convincing evidence that a great work is yet to be done, for which nature offers as a premium, the salvation of thousands of human lives and relief from an un

Glasgow, Edinborough, Dundee, Aberdeen, Paisley, Greenock, Leith and

Perth.