tinghamshire, and Leicestershire, it would remain doubtful whether they were visited by the epidemic during this period.

The twenty-one counties distinctly attacked by Cholera. in the course of the four months, October, 1848, to January, 1849, inclusive, lie, with few exceptions, on the eastern coast, or at least in the eastern half of the country; while of the ten apparently not attacked before May, 1849, only one is situated on the eastern coast, the rest being southern, western, and midland counties. These facts, therefore, suggest the notion not only that the epidemic affected a few counties first, and gradually extended to others, but also that it did not, during the winter of 1848 and 1849, reach the south-western part of England; the sole apparent exception to this rule being the case of Cornwall, and the deaths registered there as due to Cholera having been but ten during the whole period.

There are other facts, however, which throw some doubt on this view of the matter. It may be shown, that even in the counties which presented no marked increase in the deaths from Cholera after September, 1848, and in which the deaths occurred singly in different towns or districts, or were almost entirely those of infants, the total mortality registered as due to Cholera during the last three months of the year 1848, and the first three months of 1849, was considerably above the normal amount. The data from which this conclusion may be drawn are, the number of deaths from the disease registered during the different quarters of the year 1848 and the first quarter of 1849, in the different counties, and the proportion borne in other years by the deaths during the first and the last quarter respectively to the annual deaths from Cholera, in London. It will be seen in the Table given at page 8, that the deaths from sporadic Cholera occurring in London in the last three months of the year have, according to the average of a series of years, amounted to only 10 per cent. of the annual mortality from the disease, and the deaths occurring in the first three months of the year to less than 4 per cent.; and that in no year in which

the mortality was at all considerable, was the proportion in the last three months above 16 per cent., or in the first three months of the year above 8 per cent. Now in the year 1848, 61 deaths from Cholera were registered in the ten counties named at p. 53, as those in which no decided outbreaks of the epidemic disease were noticed; and 17, or nearly 28 per cent., of these deaths occurred in the last three months. of the year. In the 13 counties, again, in which the appearance of epidemic Cholera during the winter of 1848-49 seemed on other grounds doubtful, 206 deaths from Cholera were registered during the year 1848, and 91 of them, or 44 per cent., in the last three months; while in the 21 counties. in which the effects of the epidemic during the winter of 1848-49 were most decided, the proportion of deaths in the last quarter of the year 1848 was less than 52 per cent. of the mortality of the whole year, namely, 519 out of 1005 deaths. These facts, then, afford grounds for the suspicion that the influence of the epidemic was exerted, though with different degrees of intensity, in nearly all parts of the country, in the course of the last three months of the year 1848.

In the first three months of the year 1849, the deaths from Cholera became less numerous, except in a few counties. But yet the mortality was generally much above the average ratio, or even the highest ratio of other years in London. In the 10 counties least severely visited, the deaths in the first three months of the year 1849 were equal to 18 per cent., instead of 4 per cent., of the total number of deaths in the previous year. In the 13 other counties where there were still no decided outbreaks, the proportion was 30 per cent. In those most severely visited, it was 74 per cent. (See the Table at page 56.)

There is a third series of facts also tending to the conclusion that epidemic Cholera extended throughout the country in the course of the winter of 1848-49. It is certain that during the whole period of the epidemic many deaths, especially of children, due to the same cause, though often

Table showing the number of Deaths registered as due to Cholera in the different Counties of England and in the Metropolis, during the

not presenting all the ordinary features of Cholera, were registered as deaths from diarrhoea. And it is most probable that a very considerable part of the great excess of deaths registered as caused by diarrhoea during the year 1849, was due to this circumstance.

It is true that, for nearly three years previous to the inva

whole year 1848, in the last three months of that year, and in the first three months of the year 1849.

sion of Cholera, the deaths from diarrhoea had been much more numerous than they had been previously. Other diseases of the epidemic class likewise had begun to be productive of increased mortality in London about the year 1846, and had continued very fatal till the year 1850, when, like diarrhoea, they again, in nearly every instance, declined in prevalence or in fatality. So that some condition favourable to the ncrease of such diseases would seem to have arisen in the year 1846, and to have ceased or abated at the end of 1849. Still it will be observed in the subjoined Table that the increase in the deaths ascribed to diarrhoea in the year 1849, was incomparably greater than the increase of deaths from the other epidemic diseases; and that, excepting dysentery, the diminution in the following year was also much more considerable.

These facts, therefore, on the whole, lend support to the view that a large part of the mortality ascribed to diarrhoea in the year 1849, was due to a new cause, namely, the cause * The data for the subjoined Table are derived from the summaries of the London Returns of Mortality for the several years.

The next Table shows, as far as the data serve, that the recent increase

in the mortality from Diarrhoea was not confined to London.

which produced Cholera; and if this were the case, it follows that a great excess in the number of registered deaths from diarrhoea in any part of the country may be taken as evidence that the cause of Cholera was there in operation. Now the number of deaths registered as due to diarrhoea in different counties of England and Wales during the last three months of 1848 is not known; but these data are available with respect to the different months of the year 1849. It is possible, therefore, to compare the actual number of deaths from diarrhoea in each county during the first three months of 1849, with the number that would have occurred in the same period, if the mortality from diarrhoea during the whole year had been the same as in the year 1848, and had been distributed over the different quarters of the year in the same proportions in the counties as in London*.

* This Table, with the exception of the last four lines, is extracted from the Eleventh Report of the Registrar-General, p. xxxii.

Deaths in London from Diarrhoea in each of the four quarters of the years

1840-48.