TABLE No. 21.

Mortality from Twenty Prominent Causes, 1884 to 1890, inclusive.

*Fever, bilious fever, and typho-malarial fever included.

+ Meningitis and cerebritis included. Classed with atrophy and debility.

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DIAGRAM No. 1.-SHOWING THE COMPARATIVE MORTALITY, BY ABSOLUTE NUMBER OF DECEDENTS, FROM TWENTY PROMINENT CAUSES OF DEATH DURING YEAR ENDING DECEMBER 31, 1890.

Consumption..

Pneumonia..

Heart disease.

Apoplexy and paralysis..

Old age..

Cholera infantum.

Cancer.

Accident and negligence... 217

Atrophy and debility..

Bronchitis

Cephalitis

Diphtheria

Typhoid fever.

Brain disease.

Debility, infantile.

Bright's disease..

Diarrhea and dysentery....

Innutrition

Influenza..

Convulsions

Table 21 gives a comparative view of the mortality from twenty prominent causes of death from 1884 to 1890, inclusive. This table together with the diagram that follows, is interesting in studying the relative positions of the more prominent causes of death from year to year. Consumption in this State, as well as in this and every other country within the pale of civilization, causes more deaths annually than any other disease. Next in order comes pneumonia, although it has not always held second position; in 1887 it was third, and in 1886 and 1884 it was fifth in order of fatality. Heart disease ranks third in 1890, has three times during the seven years given, held second place and once dropped to fourth. Apoplexy and paralysis have been fourth in order with the exception of two years, 1886 and 1885, when they were third. Old age has varied from the third to the fifth position, usually holding the latter place. Cholera infantum has steadily held sixth position and cancer, seventh. Accident and negligence is eighth in the list for 1890 and has varied from that place to the eleventh in 1884. Atrophy and debility, ninth in 1890, shows a large increase over the records of former years; in 1884 and 1887 it was eighteenth in order; in 1889, sixteenth; in 1886 and 1888, fourteenth; and in 1885, thirteenth. This advance is another evidence of the subtle influence of la grippe. Bronchitis was tenth in order in 1890, the highest place it has held during the seven years recorded. Cephalitis was eleventh in order and has not been subject to very great changes. Diphtheria was twelfth in 1890 as against eighth in 1889, ninth in 1887, tenth in 1886, thirteenth in 1884, fifteenth in 1888, and eighteenth in 1885. Typhoid fever has dropped from eighth place in 1886 to thirteenth in 1890, the lowest it has ever been. Brain disease is fourteenth in the list as against fifteenth in 1889, thirteenth in 1888, twelfth in 1886, eleventh in 1887 and 1885, and eighth in 1884. Infantile debility was fifteenth in the list of 1890, a material increase over any previous record, it being seventeenth in 1888, and from the eighteenth to twenty-third in other years. Bright's disease, sixteenth in 1890, was thirteenth in 1889, fourteenth

in 1884 and 1885, fifteenth in 1886 and 1887, and twentieth in 1888. Diarrhea and dysentery were seventeenth in order in 1890, and ranked as high as ninth in 1884. Influenza appears for the first time among the prominent causes of death, holding nineteenth place in the list, with a mortality of 94 as against 4 in 1889.

The long black line at the head of the diagram stands as an appalling sign of the fearful mortality from consumption. Year in and year out, it is accountable for more deaths than any other disease known to mankind. Even the terrible epidemics of cholera and yellow fever that rage in some parts of the world are not so destructive to human life as consumption is in the aggregate. In 1884, 865 deaths were reported from this disease; in 1885, 857; in 1886, 809; in 1887, 766; in 1888, 742; in 1889, 651; and in 1890, 825 cases, making an average of 787 deaths for the past seven years.

TABLE No. 22.

Mortality from Consumption from 1884 to 1890, inclusive.

The mortality from consumption, the percentage of the same to the total mortality, and the rate per 10,000 of the population, is shown in the above table, for the years 1884 to 1890, inclusive. It will be seen that there was a considerable diminution in the mortality from this disease between the years 1884 and 1889, but was largely increased in 1890. We have entertained the belief that an increased knowledge of the nature of consumption and the measures necessary to restrict and prevent it may have had some influence in causing this reduction. The increased mortality in 1890 does not weaken our opinion, and is to be accounted for, to a large extent if not wholly, by the climatic or other causes to which has been due epidemic influenza or la grippe. That this condition has been a very marked and important factor in causing the increased mortality from certain diseases, has already been shown; therefore we are disposed to attribute the large increase in the deaths from consumption in 1890, to the climatic conditions of this particular period.