Oldham, whereas it ranged upwards to 9.2 in Shef-
field and Hull, 10.1 in Salford, and 14.1 in Leicester.
The deaths referred to diarrhoea in these twenty
towns in the corresponding four weeks of 1878 and
1879, were respectively, 2,986 and 952; the 3,341
fatal cases in the four weeks of August last showed,
therefore, a marked excess not only upon the low
number in the cold August of 1879, but also upon
that returned in the same period of 1878. The 421
deaths from scarlet fever last month showed a fur-
ther decline from the numbers returned in recent
months; the largest proportional fatality of this
disease occurred in Sunderland and Norwich.
The deaths from measles were again propor-
tionally more numerous in London than in
the nineteen provincial towns. Whooping-cough
showed the largest fatality in Liverpool and
Hull. The 60 deaths from diphtheria exceeded
those in the previous month by 3, and included 40 in
London, 7 in Manchester and Salford, and 3 each in
Plymouth, Birmingham, and Leicester.
The 172
deaths referred to fever, mainly enteric, included 76
in London and 96 in the nineteen provincial towns,
which have a population nearly equal to that of the
metropolis; the most excessive death-rate from fever
in August occurred in Plymouth, Salford, Ports-
mouth, end Sheffield. Small-pox caused 15 more
deaths in London, but not one in any of the nineteen
other large towns; the deaths from small-pox in
London in the two preceding weeks were 51 and 14
respectively. The number of small-pox patients in
the metropolitan asylum hospitals, which had been
218 and 178 at the end of June and July, had further
declined to 128 on 28th August. The average
weekly numbers of new cases of small-pox, which
had been 41 in June and 21 in July, was 23 during
the four weeks of August. This slight increase in
the new cases during August, marks an interruption
of the recent steady decline in the prevalence of
small-pox in London.

tricts, including 19 new applications. Of these 216 cards, so many as 189 have been returned, and the statistical information thereon furnished is herewith published. The estimated population of the 192 sanitary districts for which we publish August statistics in the accompanying table, is about seven and a quarter millions of persons; and, including London and its outer ring of suburban districts, the aggregate population is nearly twelve millions, and little short of half the population of England and Wales. The birth-rate in those districts furnishing the information averaged 34.7 per 1,000, against 37.7 and 34.8 in the two preceding months; it was exceptionally low last month in Warminster, Saffron Walden, Westonsuper-Mare, Littlehampton, and Beccles. On the other hand, the birth-rate was excessively high, and exceeded 50 per 1,000 (suggesting an under-estimate of the population) in Altrincham, Walker-on-Tyne, Warrington, Harwich, and Wombwell.

The annual death-rate during August averaged 24.4 per 1,000 of the estimated population in the 192 urban sanitary districts, showing a marked increase upon the rates that prevailed in the two preceding months, which were but 18.9 and 18.7. The average death-rate during last month in the twenty large towns, including London, was, as before stated, 24.5 per 1,000; the rate during last month, in the 172 small towns, differed, therefore, but slightly from that in the larger towns, their general increase upon recent monthly rates being mainly due, as in the larger towns, to excessive diarrhoea fatality. The August death-rates were remarkably low, and under 10 per 1,000, in Littlehampton, Harwich, Warminster, Maidenhead, Newark, Trowbridge, Redditch, Toxteth Park, Pontypool, and Saffron Walden. The most excessive rates (those over 34 per 1,000) occurred in Redruth, York, Ashton-under-Lyne, Ilkeston, and Preston. The annual death-rate from the seven principal zymotic diseases in the sanitary districts averaged 7.8 per 1,000, against 2.6 and 3.4 in the two preceding months, and corresponding with the rate in the twenty larger towns. With very few exceptions, the increase in the zymotic death-rate was entirely due to the fatal prevalence of diarrhoea. In 19 of the 192 sanitary districts no death from any of the seven principal zymotic diseases was recorded, while the largest proportional excess in the rate from those diseases occurred in Altrincham, Bradford (Lancashire), Braintree, Ilkeston, Luton, Preston, Runcorn, Widnes, Willenhall, and York. A fatal case each in Cardiff and Huddersfield were the only deaths from

The fatality of diseases of the respiratory organs showed a further decline during August. The weekly number of deaths referred to these diseases in London, which had steadily decreased in the five preceding months from 254 in March, to 177 in July, further fell to 155 in August, but exceeded the corrected weekly average for the corresponding period in the ten years, 1870-9; they were equal to an annual rate of 2.2 per 1,000. The annual death-rate from lung diseases during August ranged in those of the nineteen large provincial towns for which the information is available, from 1.1, 1.7, and 1.8 in Ports-small-pox reported in the 192 sanitary districts. Measles mouth, Plymouth, and Newcastle-upon-Tyne, to 3.7 in Sunderland, and 4.0 both in Salford and Sheffield. In the outer ring of suburban districts round London (having a population of little less than a million persons) the annual death-rate from all causes during August did not exceed 18.7 per 1,000; the zymotic death-rate was, however, equal to 5.7 per 1,000, and was little less than that which prevailed in inner or registration London, where the rates from all causes and from the seven zymotic diseases were, as before stated, 22.6 and 6.4 per 1,000 respectively.

In the accompanying table we are able, through the co-operation of the Medical Officers of Health, to publish uniform August mortality statistics for 192 urban sanitary districts. The number of contributing sanitary districts had steadily increased during the preceding thirteen months from 36 to 188. On the last day of August, 216 post-cards were sent out to the Medical Officers of Health of as many sanitary dis

showed somewhat fatal prevalence in Hyde, Merthyr Tydfil, and Middlesbrough; and scarlet fever in Altrincham, Bolton, Bootle-cum-Linacre, Colchester, Reading, and Willenhall. Diphtheria caused three deaths in Aston, and two both in Burton-upon-Trent, and Leamington. Fever, principally enteric, showed the highest death-rates in Coseley, Crompton, Gloucester, Ilkeston, Lincoln, and Tredegar.

The annual death-rate from diarrhoea during August, which averaged 5.8 per 1,000 in the twenty large towns, including London, was equal to 6.0 in the 172 smaller urban sanitary districts contributing statistics to our table. Diarrhoea fatality in the smaller towns showed the largest excess last month in Barnsley, Bradford (Lancashire), Coventry, Goole, Luton, Penzance, Preston, Runcorn, Widnes, and York; the annual rate from this disease in each of these towns exceeded 10 per 1,000, and was equal to 16 per 1,000 in York.

The annual death-rate from diseases of the respi

The necessary information for these columns was for various reasons not supplied by the Medical Officers of Health, 4 The Statistics for these Sanitary Districts relate to four weeks, or 23 davS.

B. Anningson, M.D. F. Wacher.

I The Statistics for these Sanitary Districts relate to five weeks, or 35 days.

22.5

8.2 1.0

16.9

4.0

2.5