From this calculation, I derived the general fact that, under the age of ten, more males die from scarlet fever than females; but that, above ten, the contrary obtains.

Having ascertained this preliminary fact, I looked at the question in its bearings on relative mortality in reference to relative population. It was very difficult to find data of any extensive kind to elucidate this relationship; but ultimately I got one district where population and special mortality admitted of being studied together.

In the districts of Kent, in the year 1843, there

were

Deaths from scarlet fever (205 were males at all ages, 413, of which 208 females

giving 3 females in excess.

The population of these districts, as obtained by the census taken rather more than a year before,

was

Total population in 1841, (232,228 were males) giving 4,657 females in 469,113, of which 236,885 females

excess.

Now, this last table is, it will be seen, quite contrary to the first two in its results; and separate writers, inclined to controversy, might, by referring to only one of these tables, baffle an adversary considerably. Considered, indeed, in their singleness, the tables might and would be made to convey the most incorrect ideas. But when the three tables given are viewed carefully, and with an unbiassed eye, their very differences are found to be of the highest value, inasmuch as these differences place before the mind the true state of matters. For, collectively, the cal

culations indicate that scarlet fever makes no selection as regards sex, but attacks more males, or more females, according to the relative number of males or females who are resident in any district where it is epidemical.

The last table illustrates this fact exceedingly well. There are more deaths from scarlet fever amongst females in a given portion of country than amongst males; and there are in the same portion of country, previous to the searlet fever epidemic, a larger number of females than of males in the population.

Again, the calculation given at page 58, which shows that scarlet fever is most prevalent in the first ten years of life amongst males, and that after ten the preponderance passes over to the female side, illustrates the same law. For, in the child part of our population—using the word population in its general sense-males number most; but in the youth and adult population, there are more females than males, owing to the fact, that youths and men are exposed to more causes of mortality, and are drafted into other countries in larger numbers, than girls and women: so scarlet fever, as the results given above illustrate, follows this law of number; for our tables show, that whilst more males die under ten years from the disease than females, after the age of ten the mortality begins to take the lead on the female side, and to continue steadily in the same course as life advances.

Still more, our calculation from the 102,382 cases

with which we opened this argument, although it gives a slight excess on the male side, viz., 938, supports the same law. For the majority of these cases occurred in patients under ten years; in the period of life, that is to say, when the body is most susceptible of the disease, and when the male population is larger than the female.

I think I have put down sufficient now to show that sex has no influence, predisposing or otherwise, on scarlet fever; but that male and female are alike susceptible if they are alike exposed.

The influence of meteorological conditions in relation to scarlet fever is a next point of peculiar interest. In the years 1852-3, I made extensive inquiries touching this matter, with special reference to barometrical and thermometrical changes, the presence or absence of elasticity, the direction and force of the wind, the humidity of the atmosphere, and the effect of season on the course and prevalence of the disease.

The only reliable fact affirmative in kind, as bearing on the effect of meteorological conditions, was in relation to season only. Here I arrived at valuable information which bore out, in the strictest sense, the opinions of preceding writers. The concurrent testimony, in fact, of almost all writers on the disorder, teaches that it is most common in autumn, next so in the summer, next so in the winter, and least so in the spring. In three epidemics which I witnessed in different parts of this country, the disease always commenced in the summer, became

most violent in the last months of the year, continued into the new year, and died away with the spring. I believe, too, that sporadic cases are most common in autumn, although I have seen such instances in the month of April. Cases, however, occurring in the spring, even though of malignant character, seem to me more likely to recover than at the other

seasons.

Sydenham remarks that scarlet fever, though it may occur at other seasons, is most common in the. end of summer, when it attacks whole families, and children especially. Fothergill, in describing the malignant form of scarlet fever, observes:"Although it survives different seasons, and all varieties of weather to which we are exposed, yet it seems to show itself most frequently in the autumn, and in the beginning of the winter; at least I have met with more cases from September to December inclusive, than in all the other months together."

Cullen names the beginning of winter as the time when scarlet fever is most prevalent. Withering speaks of the winter and summer months as favourable seasons, and records the particulars of an epidemic which, commencing in summer, was temporarily checked in October, but recommenced, with extreme virulence, in November. The terrible epidemic of malignant scarlet fever that raged in St. Albans in 1748, is described by Dr. Cotton as occurring in the latter end of the year. The epidemic recorded by Peart in 1802, did not become violent and extensive

until the latter part of August, and in September. Willan remarks that the disease, scarlet fever, is most virulent during October and November. Haygarth entertained a similar opinion. Rayer observes that the disease is most common about the equinoxes. An epidemic of malignant scarlet fever, described by Chomel under the title of gangrenous sore throat, and which raged in Paris a hundred years ago, was most violent in the months of October and November. Dr. Nieuwenhuys, in his paper on "the scarlet fever in Amsterdam in the year 1834," remarks, "the disease first showed itself, in the epidemic form, in the month of June 1834, and its victims were-in June 22, in July 32, in August 50, in September 78, in October 136, in November 106, and in December 61."

Mr. Ryland, in describing the cases of scarlet fever which occurred under his care amongst the outpatients of the Birmingham Infirmary in the year 1835, states that in the first quarter of the year ending March 25th, he had 5 patients, in the second quarter 7, in the third quarter 35, and in the three last months 59, making 106 cases in all.

Finally (many other authors being omitted), Dr. Tweedie, in his essay on scarlet fever, states that the disease is most common in autumn, least so in spring.

Such are some of the conclusions to which general observers have come with reference to the prevalence of scarlet fever at the various seasons of the year; and when these conclusions are tried by statistical facts, their correctness is strikingly established.