D.~No. 1b

8

FURTHER CORRESPONDENCE WITH

rose to 1,229 ; in the four quarters of 1871 they were successively 4,903, 7,012, 4,612, and 6,380 ; las quarter they further rose to 7,720, which considerably exceeded the number in any quarter of the past 32 years, and were equal to an annual death-rate of I' 3 per 1,000 persons living. Of these 7,720 deaths last quarter, 1,179 were recorded in the three Ridings of Yorkshire, 1,C75 in the northern, 900 in the Welsh, 862 in the West Midland, and 831, in the Metropolitan Registration Divisions. The epidemic first became fatally prevalent in London and in the large Lancashire towns ; here the numbers of deaths have shown a steady decline in recent quarters. The next most important outbreak occurred in the northern counties, especially in Northumberland and Durham, and apparently reached its climax in the latter part of last year, as the fatal cases last quarter had considerably declined, although again exceedingly numerous in many town districts of those counties. The deaths from smallpox showed a marked and general increase in each of the eight other registration divisions, especially in South Wales. It will be useful briefly to note a few of the places in the different division in which the epidemic was most fatal, or in which new outbreaks occurred during last quarter. In the southeastern counties 67 deaths from this disease occurred in Dover, and 43 in Portsmouth, while they had declined in Alverstoke. In the south midland counties the most notable outbreak occurred at Northampton, resulting in 157 deaths against 47 in the preceeding three months; Bishop Storbford, St. Alban's, Bedford, Biggleswade, Cambridge, and Wisbeach also suffered from the disease. The 611 deaths in the eastern counties included 53 in West Ham, 91 in Yarmouth and Mutford, 273 in Norwich, and 18 in Thetford ; the fatality in Norwhich showed a considerable decline in the latter part of the quarter. In the south-western counties, Plymouth and the surrounding districts formed the principal centre of infection, in which 233 fatal cases were reported ; the epidemic also prevailed in Bridport, Rideford, Redruth, Bridgwater, and Yevoil. Of the 862 deaths in the west midland counties, 263 were returned in Wolverhampton, which was the first important centre of infection in the division; these showed a slight decline from the number in the preceeding three months, and the violence of the epidemic had considerably abated during March and the early weeks of April ; the other towns of this division in which the disease most severely prevailed where Walsall, Dudely, Stourbridge, Coventry, Wellington (Salop), and to a less extent Bristol and Birmingham. Nottingham was the principle centre of infection in the north midland counties, in which town 170 of the 588 deaths from smallpox occurred, showing a considerable increase upon the previous quarter; the epidemic also became fatally prevalent last quarter in the neighbouring districts of Radford, Basford, Mansfield, and Worksop; and also prevailed in Chesterfield, Belper, and Ashby-de-la-Zouch ; towards the end of the quarter and during April the disease became epidemic in Leicester. In the north-western counties the deaths from smallpox showed a general decline last quarter, which was most conspicuous in Liverpool, Uirkenhead, and Manchester. In the Yorkshire division the deaths from smallpox, which had been 69, 98, 129, and 708 in the four quarters of 1870, further rose to 1,179 in the first three months of this year; of these 893 occurred in the West Riding, including 430 and 88 in the boroughs of Sheffield and Leeds, and 63 in Doncaster, 60 in Wakefield and 48 in Pontefraci districts; of the 169 deaths in the East Riding, 118 occurred in the borough of Hull and 20 in York district; the 115 in the North Riding, included 38 in Scarborough, 36 in Malton, and 18 in Guisborough districts, respectively. In the northern division the fatal cases which had been 1,566 and 1,546 in the two preceeding quarters declined to 1,075 in the three months ending the 31st of March last, of which 781 occurred in the county of Durham, 262 in Northumberland, 32 in Cumberland, while Westmorland was the only one of the English counties in which no deaths from smallpox occurred ; in Durham county the epidemic although still fatally prevalent in the mining districts, showed a general decline, especially in Sunderland, South Shields and Gateshead, but in Auckland districts the fatal cases rose from 105 in the last three months of 1871, to 199 last quarter; in Northumberland the decline was general, but most marked in Newcastle and Tynemouth; the deaths from this cause in Cumberland were principally confined to Cockermouth and Wigton, and showed a decline upon those in the preceding three months. In the Welsh Registration Division including the county of Monmouth the fatal smallpox cases which had been 141 and 539 in the two preceding quarters, rose to 900 in the first thee months of this year ; of these, 334 occurred in Monmouthshire and 420 in Glamorganshire, so that the number in the rest of South and North Wales did not exceed 146 ; Bedwelty and Newport districts in Monmonthshire and Merthyr, Tydvil, Neath, and Pontypridd, in Glamorganshire, suffered most severely from the epidemic; in other parts of Wales the disease was prevalent in Crickhowell, Holywell, St. Asaph, and Carmarthen. The annual death-rate from smallpox in England and Wales during the first three months of this year was, as before stated, equal to 13 per 1000 of the estimated population, against l'l in the last quarter of 1871. In the 18 largest English towns the 2,585 fatal cases were equal to an average annual rate of I*6 per 1000, while in 50 other large towns 1,290 deaths from smallpox occurred, or equal to2'l per 1000. In England and Wales, exclusive of these 68 large towns, which are now estimated to contain a population of 8,893,299 persons, the deaths from smallpox last quarter were therefore, 3,839, or equal to an annual rate of nearly 1 per 1000 of a population of rather more than 14,000,000. The following are a few of the highest death-rates from smallpox per 1000 persons living during last quarter: — Among the 18 largest cities and boroughs, 135 in Norwich, 93 in Wolverhampton, 77 in Nottingham, 7'o in Sheffield; amongst the fifty other large town districts 128 in Northampton, 9-8 in Newport (Monmouth), and B'6 in Dover; in other town registration sub-districts, 240 in Bideford, 152 in Tredegar, 149 Bridport, 14-5 in Bishop Auckland, 140 in Cadoxton, 135 in Radford, 128 in Castleford, 124 in Malton, 12-0 in Yeovil, and 11-9 in Llantrisiant. With regard to the distribution of the fatal cases of the other zymotic diseases it may be briefly remarked that measles was proportionately most prevalent in London, Staffordshire, Lancashire, and the West Riding of Yorkshire; the districts of Bolton and Cardiff showed excessive numbers. Although the deaths from scarlet fever were less numerous than in recent quarters, the disease was more or less epidemic in many parts of Staffordshire, Lancashire, the West Riding of Yo"kshire, Durham and South Wales, Wolstanton, Stoke-upon-Trent, Bury Burnley, Tadmorden, and Whitehaven were among the districts which suffered from exceptional prevalence of this disease. The deaths from whooping-cough were exceptionally high la3t quarter and the disease was especially fatal in London,