under the head of "country." The actual result, however, is far
otherwise, as will be noticed opposite most of the diseases. In
the totals it is nearly equal, showing that the mortality in the
densely populated' city localities was, in the aggregate, nearly
twice as great as in the more sparsely inhabited country districts.
A reference to the various diseases, will exhibit what particular
causes of death have visited the cities with undue fatality.
♦
For each of the three periods, viz., the year 1849, the eight
latter months of 1848, and the seven previous years, we have
also computed the per cent, which the deaths, from each of the
several named diseases, bore to the whole number of deaths from
specified causes in their respective periods. Among the first ob-
jects which attract notice in this table, (XVII, p. 80,) we observe
the large proportional number of deaths which have occurred
during the later periods. If we omit the returns from Boston,
there will remain, for the twenty months of this Report, about 40
per cent, as many deaths as occurred during the seven previous
years. This is owing in part to more full returns of late, and in
part to actual greater mortality. By reference to particular dis-
eases or classes, we shall ascertain what particular causes have
lately been so fatal. Of deaths from all specified causes, the
proportion which those within the twenty months (including
Boston for 1849) bore to those of the seven years before, was as
49.57 to 100. Or, in other words, the former was 49.57 per cent,
as much as the latter; while of the first class, {zymotics,) the
deaths of the twenty months was 71.79 per cent, as much as those
of this class during the seven years. And, still further, we find
that, of the dysentery, nearly twice the number died within
twenty months as during the whole seven years, there having
been only 2413 in the seven years period, and 4590 in the twenty
months period. The commencement of the epidemic character
of this disease appeared in the summer of 1847, and came in the
• The exact proportion it for city, 33.13 per cent. 5 country , 66.87 per cent.
Digitized by VjOOQIC
ANALYTICAL OBSERVATIONS. 106
last (seventh) Registration Report for the year ending with April
30, 1848. During that year, 1074 died of this disease ; the an-
nual average number during the six previous years was only 223 ;
the number during the twenty months since, as stated above,
was 4590. Making all due allowance for the additions from
Boston, and the result is still startling.
Ztmotic Diseases. — Those diseases are classed under this gen-
eral head, which prevail (a) as Epidemics, that is, become very
frequent at particular times, in particular places, as cholera, dys-
entery, and several forms of fever; also, (6) Endemics, or those
that are peculiar to certain defined localities, and arise from some
hidden or obvious cause ; and (c) ContagioiLS diseases, as small
pox, measles, &c.
It will be observed in Table XVII, that the deaths from
zymotics, in the seven years prior to May 1, 1848, were only 27
per cent, of the deaths from all specified causes during that period ;
while in the eight remaining months of 1848, this class of dis-
eases produced 40 per cent, of the deaths. But as observed be-
fore, several diseases are seldom severe, except during the heat of
summer, while the results of others are more equally distributed
over the year ; and consequently we cannot take the per cent, of
any one disease or class oi diseases, during the eight months pe-
riod, as an index or safe representative of what that disease or
class was during the whole twelve months. In 1849, the per
cent, of deaths from this class of diseases was 38.70. The in-
crease was confined principally to that contributed by cholera,
dysentery, measles and scarlet fever.
Cholera. — All deaths from cholera morbus have been classed
under this head. When cholera morbus assumes a malignant and
epidemic type, it is termed cholera, and sometimes Asiatic cholera.
Most of the deaths in 1849, under this head, were of this latter
character, and were in particular localities ; about four fifths, or
80 per cent, of them, will be found in the division of cities, and
a very large majority of these were in Boston and Lowell.
The cholera exhibited a preference, also, for particular classes
of citizens, or those subjecting themselves to particular habitudes
of life. Of the 707 who are reported to have had it in Boston,*
* Report 00 Cholera.— Cs<y Document, No. 66, 1849.
14
Digitized by VjOOQIC
106 EIGHTH REGISTRATION REPORT.
672 were foreigners, 460 of these being natives of Ireland ; and
only 136 were born in this country, 42 having been born in
Boston, and 42 more in other parts of this State. 396 were be-
tween the ages of 20 and 46. Of the whole number (262) of
patients in the temporary Cholera Hospital, in Boston, 164 were
known to be intemperate, and 108 supposed to be temperate.
The epidemic seemed to present the same characteristics in other
places in the State, and in other cities of the country. Over 6
per cent, of all the deaths, from stated causes, in 1849, were from
this epidemic malady, whereas former periods show less than one
half of one per cent.
Diarrhcea^ which so intimately accompanies cholera, was also
quite fatal in 1849. It was not so severe, however, in this State,
in proportion to the cholera, as it appears to have been among
some of our transatlantic neighbors. " Prom the Registrar Gener-
al's Return, we learn that the total number of deaths in England
and Wales, in the year 1849, was, from cholera 63,293, from
diarrhoea 18,887."* In Massachusetts, the total number, in 1849,
was from cholera 1188, (944 of these were in the division of
cities,) and from diarrhosa 209, (158 of which were in cities.)
Dysentery has prevailed in an epidemic form, preceding the
cholera, and produced a heavy mortality within the last three
years, as has been already observed. In its late visitations it dif-
fers as much, or more, from the ordinary type of that disease, as
cholera differs from cholera morbus, or as typhus does from the
plague of former times in older countries. The years 1848 and
1849 were particularly noted by the terrible mortality from this
destroyer. For six years previous to 1847, the annual average of
deaths from dysentery was only 236, but in 1847 it rose to 1074,
and during the succeeding twenty months, which are embraced
in this Report, it numbered 4690, of which 2465 were in 1849.
By far the most fatal year was 1848, immediately preceding the
visit of the cholera. In the latter eight months of that year,
2135, or nearly a fourth part (23.53 per cent.) of all deaths in the
State, occurred from it, besides those in the city of Boston, to
1847 and 1848, this epidemic was principally confined to cities in
♦ Report of the General Board of Health on the Epidemic Cholera of 1848 and 184«, pre-
sented to both Houses of Parliament by command of Her Majesty.
Digitized by VjOOQIC
ANALYTICAL OBSERVATIONS. 107
the eastern part of the State, but in 1849 it appears to have
chosen more rural localities, 67.63 per cent, being in the country
districts, and only 32.47 per cent, in cities.
Typhus fever has apparently somewhat diminished. This is
owing in part to the fact, that several other diseases have for-
merly been classed under this head. We have eliminated some
of them, but could not all, from the preceding reports.
Measles prevailed in the spring of 1849 more extensively than
at any other time since the Registration Act went into force, in
1842. It was mostly confined to Suffolk County, which had not
previously made full returns.
Scarlet fever produced about one half as many deaths during
the twenty months,, as during the seven years previous, as indi-
cated by the former reports. We find, however, that some of this
disease have hitherto been ranked with other causes of death.
Of the 1143 deaths from it in 1849, more than one half (632)
were in the cities.
Small pox also appears to be on the increase. It caused 114
deaths, or .59 per cent., in the year 1849, and only 106, or .19 per
cent, during the whole of the seven years previous to 1848.
Sporadic Diseases. — ^AU diseases not zymotic, that is, not epi«
demic, endemic or contagious, are termed, for the sake of distinc-
tion, Sporadics, and are divided into several classes, according to
the parts of the system they usually attack. First we have those of
Uncertain Seat, or those which occur sometimes in one portion
of the body and sometimes in another, or affect the general system.
This class causes about one tenth of the deaths, and in 1849 quite
a major part of them were in cities ; this is especially true of
infantile diseases, which were more fatal than any others of this
class. Mortification has apparently decreased, for reasons noted
above, in connection with typhus and scarlatina.
Diseases affecting the Nervous Organs, produce about one
death in every twelve. These are mostly from inflammation of
the brain, convulsions and hydrocephalus, or " water on the brain."
The two last named diseases are scrofulous, and principally con-
fined to those in early life. The cities always furnish an undue
proportion of them. Many diseases of this family, or class, seem
to be as severe on country as on city life,
Digitized by VjOOQIC
108 EIGHTH REGISTRATION REPORT.
The Respirative Oroaks are subject to a class of diseases,
which furnish the records of mortality with nearly one fourth of
their number, and far more than any other class, except the epi-
demic group. Pulmonary consumption and pneumonia, or in-
flamation of the lungs, contribute nearly all of this class. Of all
the agents of death, which afflict our race by their mortal visita-
tions, consumption secures the greatest number of victims in this
climate.
Of the 102,696 cases of death recorded in this State (including
the city of Boston) within the last nine years, and whose diseases
were specified, (besides those who died by violence,) 22,342 are
stated to have been from consumption of the lungs ! that is, a
little more than one out of every five deaths, (21.78 per cent.)
This may be confidently stated as very near the general law, or
degree of relationship, which this formidable terminator of human
life bears to the aggregate of all other diseases in this Common-
wealth. Besides these from consumption, 488 per cent, of all
deaths, of known diseases, were from inflammation of the lungs,
making 26.66 per cent., or somewhat more than one quarter of
the mortality from these two common diseases of the lungs alone !
Diseases of the heart have increased, causing 379 deaths in
1849, which would show a very high comparative per cent, were
it not for the unprecedented number from dysentery and some
other causes.
Those classified under Digestive Organs have also constantly
increased of late. The year 1849 shows three times the annual
average of deaths, from this class, when compared with the seven
years period. Teething, and those returned as having died of
inflammation of the bowels and disease of the bowels, furnish, by
far, the largest part of deaths from this class. The diseases above
named, like others which are particularly severe among children,
are found to have been the most fatal in the cities.
The next four classes are comparatively small, and cause but a
limited number of deaths. Childbirth exhibits the larger part of
the deaths from all these classes combined, and a large majority
pf the deaths from this cause were in the cities, being to the rest
pf the State, in 1849, as 133 to 79. Of these, 66 were in Boston.
Peathji by Violence, in various forms, were nearly double their
Digitized by VjOOQIC
ANALYTICAL OBSERVATIONS. 109
average during the twenty months. Accidents were unusually
frequent, and were the most so in 1848, (aside from those returned
from Boston in 1849.) But the greatest increase is exhibited in
the number who are recorded as having had their existence cut
short by heat. In 1849 one life was legally terminated by the
executioner^ which was the first in the history of our State regis-
tration, and TEN persons were rmirderedy which is just half as
many as returned during the whole eight years previous.
A terrible and fatal case of hydrophobia occurred in Lowell, in
the early autumn of 1848, which was the first ever returned, and
three are reported to have taken place in the State in 1849. SuU
cides have averaged a little over five a month, during the period
of this Report, and 33 a-year in the former period.
Sex suggests an interesting item for consideration. It has been
observed (p. 95) that among the births, we find a majority are
males. We here notice that a majority among the deaths are
females. This is true in reference to the mortality of the whole
State. In the country districts alone, however, the preponderance
of female mortality is so much greater than it is in the whole
State, that it casts the balance on the other side in the cities.
If we knew the per cent, which the number among the living of
each sex, bears to the other in the cities and in the country, this
might perhaps be accounted for in part or whole. It is to be
presumed that the female sex predominates in the State, and to a
greater degree in the country than in the city. This is to be
inferred from the fact, that although, in 1849, among the births,
52.06 per cent, were males and 47.94 per cent, females in the
State, among the deaths under five years of age, 53.82 per cent,
were males, and 46.18 per cent, only were females ; and that more
males than females resort from the country to the city residence,
while the proportion of the sexes between those who leave the
State and those who enter it, is probably such as to afford no great
effect in this particular.
The following statement will show the proportion existing
between the sexes in several particulars, for the year 1849 : —
Digitized by VjOOQIC
110
EIGHTH REGISTRATION REPORT.
TABLE
E.
Births.
Dcathf under At* yeua.
Whole number of Deaths.
LoeaUdes.
Namber.
ProportioD.
Number.
Number.
Proportion.
M. F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
f.
State,
City,
Country,
1332ai2273 52.06 47.94 41693577 53.82
5344 51001 51.14 48.862117 1875 53.03
7985' 7167152.70 47.302052 1702' .54.66
46.18'l0019|l0208 49^50.47
46.97 4710 4617 50.50 49.50
45.34 5309 5591 48.7051.30
This abstract shows that the great excess of male mortality
occurs in the earlier ages. Had we taken those who died under
one year old, the excess would have been still greater. The dis-
parity will be seen as follows : —
TABLE L.
Stati.
Cnr.
Coratar.
Number.
Proportion
Number.
Number.
Deaths under one ? Males,
year of age, ^ Females,
1994
1558
56.13
43.87
996
610
55.14
44.86
998
748
57.16
42.84
Excess of males,
436
12.26
186
10.28
250
14.32
The excess of males was, in every 10,000
In the whole State,
BirOM,
412
1226
764
dMllu.
— 94*.
In the Cities,
228
1028
606
100
In the Country,
540
1432
932
—260*
There are various causes of death which press with unequal
force upon the sexes. Those which seem to be the severest
upon the male, are diseases of brain, except insanity, diseases of
the lungs, except consumption, diseases of the heart, liver,
most forms of fever, and the various causes of death by violence-
The mortuary tables of the last and former years also indicate
quite clearly that those diseases which are more or less peculiar
to the young, such as cholera infantum, croup, hydrocephalus
or water on the brain, infantile diseases, and ulceration or can-
ker, select a major part of their victims from among the male pop-
ulation. The majority of deaths from cholera were males, while
those from dysentery and typhus were nearly equal as to sexes.
* Kzcess of females.
Digitized by VjOOQIC
ANALYTICAL OBSERVATIONS. Ill
The diseases which prove most fatal Bxaong females are anae-
mia or consumption of the blood, cancerous affections, consump-
tion, dropsy, measles and old age. Death produced by causes
connected with parturition, of course are confined to the female
sex. Diseases affecting the urinary organs are most frequent
among males, while those affecting the organs of generation
prevail most among the female sex.
A very great difference in the sexes is found in the deaths from
consumption. In the last five years and eight months there were
recorded 14,209 deaths from this disease, whose sex was stated.
Of these, 8463, or 69.49 per cent., were females, and only 6766,
being 40.61 per cent., were males. The excess of the former is
18.98 per cent. But, notwithstanding this great excess of female
mortality from this disease, in the aggregate, latterly a majority
of that portion of deaths from it who were under five years of
age were males.
Senility, or old age, seems to have found a larger number of
females than males.
The Seasons, also, exhibit an unequal distribution Of mortali-
ty — an undue proportion of the deaths occurring in the summer
months. The following table will show the number of each
sex that have died during the summer months of 1849, in the
State, and in the two divisions of " City" and " Country," togeth-
er with the proportion which each division bore to the other, and
the per cent, which each month sustained to the whole year, not
only in each of the divisions, but also in the whole State : —
Digitized by VjOOQIC
112
EIGHTH REGISTRATION REPORT.
I
i
s
s
g
8
d
I
i
I
^ CO CO CO CO cd r^ CO CO od CO CO *
cooi«»HCoaoi-«g|go^i^»ft»H
i^im^^mr
)n^eocoracDt>>oo
aoioi^c«cowiO"^cooioi«co
siliiiiiisii
COkO
>cos
>ot
J ^ 05 1^ Fi r* ^ ^ c
) CO t^ ^ ^ tfd 00 Is. 2
ssas^ssssa**-''
f-^<^QgOl!^QQpOrHOgOOCO
;iiiiii§§i3-
1 i i i i i i i i i i i T
I I I I I I I I I I i I I
I I I I I I I I ^ I
^ •
g ■
^ '
4 '
1^
^t
$
s
J
Digitized by VjOOQIC
ANALYTIOifL OBSERVATIONS. 113
The foregoing table shows most plainly that the summer
months are by far the most fatal in either of the divisions, and in
the whole State. In the latter, August and September present an
aggregate of 30.70 per cent., which is more than double the
amount shown by any other two contiguous months, and nearly
double the amount of any two selected months. The two
months above named show a difference from each other of only
the half of one per cent, in the State ; but in the divisions of
city and country it is much greater, and stands against August in
the former, and against September in the latter. In some of these
cities, isolated, it is still greater ; being in the city of Boston, for
instance, 19.94 per cent, in August, and only 10.88 per cent,
in September. Previous to 1840, September waa the most fatal
month in the mortality of Boston, and prior to 1820 it was in
October that the most deaths occurred. This change has taken
place gradative, as Boston has become more densely populated,
and more insalubrious to its residents, particularly the younger
portion of them. In the country districts, the abstracts show us
that September is at this time the most fatal of either of the
twelve months. Had time permitted us to have made the requi-
site abstracts from the records, it would most probably have been
demonstrated to us that the excessive mortality of summer in
cities, especially, was, to a very unproportional degree, sustained
by children. Of all who died in the city of Boston, in the months
of August and September, 1849, omitting the deaths from chol^
era, which mostly prevailed among adults, we find that 66.24 per
cent, were under five years of age.
Among the diseases which seem to prefer particular seasons of
the year, we observe generally that zymotics and fhpse which
are severe upon tender life, mostly select the hot weather of ad-
vanced summer. Dysentery in its epidemic type, as it has pre-
vailed of late, seems particularly to be almost confined to a short
period, while the arch disease, consumption, runs through all
seasons with nearly equal results. We subjoin the mortality from
these two diseases in tl)e State, during the different mouths of
the year 1849 : —
16
Digitized by VjOOQIC
U4
EIGHTH REGISTRATION REPORT.
TABL£ N.
COHSCMPTION.
MONTHS.
DYSSNTERT.
NOlfBIK*
Ptr
Nunsft.
Per
H.
P. , u.
Total.
IL
?.
u.
ToteL
Gent.
118 177
125 1S3
112. 175
130 175
1371 178
1191 166
125 158
145| 193
18l| 187
109 1ft)
123, 165
102 156
1
2
295
278
289
305
315
286
283
339
370
298
289
258
1
8.18
7.71
8.02
8.46
8.74
7.93
7.85
9.40
10.27
8.26
8.02
7.16
January,
February,
March,
June,
July,
August,
September,
October,
November,
December,
Unknown,
10
10
7
10
14
19
78
378
491
163
92
20
1
11
9
8
10
9
13
69
a53
480
196
36
14
1
1
1
li
6
3
1
21
19
15
21
24
33
147
742
977
362
58
35
1
.85
.77
.61
.85
.98
1.35
&00
90ii3
39.81
14.76
2.36
1.43
15262073
7 ! 3606
100.
Total,
1223
1208
24
2455
100.
With the exception of indicating a little larger proportion of
consumptives in September, the above gives a very correct index
of the proportional distribution of those two diseases during the
last five years, as we learn from mathematical demonstration.
The following abstract of deaths from dysentery, corroborates
the above remarkable results : —
August,
September,
October,
OXATHl rmOH DTSKNTXaT IN
1847. 1848. 1849. Total.
28 J 732 742 1756
452 708 977 2137
187 293 362 842
Total for the three months, 920
The nine other months, 125
Total of dysentery,
1045
2170
2455
4734
936
6670
The Ao^s are given in the following table, accompanied by
computations similar to those for the months, (Table M, page
112,) which show the relative degree that classes of the commu-
nity in the different periods pf life suffered by death in the year
1849:—
Digitized by VjOOQIC
ANALYTICAL OBSERVATIONS.
il5
I
04
Oi ^ lO* CO Ol
ud lA 01 CO o t^ CO u6 rC ad ;o 1-4
> cd ol CO o( th t^: u6 <^ oj f-4 * '
8
8
Eh
2i
s
g
o
I
^
SSS^8
$88g8{52gSSSS3R8S
>«aocOi-<
gOCO iiOliiHitiitiCO
2 '^^ ^ ^^ ^^ ^ •^ Cx Cv ^T TT ^H
J2SS8
I8JSS
5 ,-H — iO O
5Tf«C0 i-i
5-
00 lA
s§
S-^QOO
iS^S
o^coc
m
\%
j§^lpllii0l=s
«•
I 01 I 1 f 1 Ol
OOOI »-i CO fi9 CO 01 ol »-i
»HCO ^H »Q lO CO 01 1-i iH
§i§i§ii§sis^'^®
3
Si
S
s
O
J-^iH OI»HOl 01 \a
I » I I I t I "^
^
t^ t^ v^ w Ira ^ »^ «N c9 o) .H n
^
iiliiiss§SiS"§
05
o
o
• • « « < I 1 < « I I I I « 1
i I i I
JSSSS
I
Digitized by VjOOQIC
116 EIGHTH REGISTRATION REPORT.
We have had occasion before to allude to the fact, that death
presses heavily upon those in early life. In the most unmistaka-
ble language, the above table demonstrates this truth, and imparts
definiteness to it. But, as before intimated, in order to ascertain
the relative probabilities of living, or the '< expectation of life" at
any given period, we must not only know the number of deaths,
but also the number of the living at the different periods. Of
this, however, we cannot at present inform ourselves. It is a
point of much interest, and received attention a few years ago,
80 far as Lowell is concerned, with the following results in that
city, from 1841 to 1845: — The probabilities of surviving the
present period of life were the greatest between the ages of twen-
ty and thirty ; the next greatest between ten and twenty ; they
then followed between thirty and forty ; forty and fifty j fifty and
sixty ; under ten ; and the least over sixty. In Boston, during
the same period, the results were similar, commencing however
one decade earlier in life. There exists also a very wide differ-
ence iti the relative chances of life at the several periods. In the
former city, for instance, the statistics showed that the expecta-
tion of life between the ages of ten and thirty was seven times