OBSERVATIONS On the BILLS of MORTALITY, In CARLISLE, for the YEAR 1779.
THE advantages which may be derived from accurate registers of Mortality, are thus illustrated by an ingenious Philosopher and Physician; "The establishment of a judicious and accurate register of the births and burials, in every town and parish, would be attended with the most important advantages, medical, political, and moral. By such an institution, the increase or decrease of certain diseases; the comparative healthiness of different situations, climates, and seasons; the influence of particular trades and manufactures on longevity; with many other curious circumstances, not more interesting to Physicians, than beneficial to mankind, would be ascertained with tolerable precision. In a political view, exact registers of human Mortality are of still greater consequence, as the number of people and progress of population in the kingdom, may in the most easy and unexceptionable manner, be deduced from them. They are the foundation likewise of all calculations concerning the values of assurances on lives, reversionary payments, and of every scheme for providing annuities for widows, and persons in old age. In a moral light also such
Tables
are of evident utility, as the increase of vice or virtue may be determined, by observing the proportion which the diseases arising from luxury, intemperance, and other similar causes bear to the rest; and in what particular places distempers of this class are found to be most fatal."
Percival's Essays, vol.
2d.
CARLISLE is situated in Latitude 54.55 North, and is surrounded by a wall about a mile and a quarter in circumference. The situation is rendered exceedingly pleasant by its vicinity to three beautiful Rivers, with which it is almost surrounded.
viz.
The
Eden
on the north east side,
Peterel
on the south east, and
Caldew
on the north west. CARLISLE contains two Parish Churches,
viz. St. Mary's and St. Cuthbert's,
beside two Presbyterian, and a Quaker's Meeting House. A very considerable Linen Manufactory is carried on in this City, and the Printing of Calicoes is still more extensive. The air about CARLISLE is pure and dry, the soil chiefly sand and clay. No marshes or stagnant waters corrupt the the atmosphere; its neighbourhood to a branch of the sea, and its due distance from the mountains on all sides render the air temperate and moderate.
In July 1763, at the request of the late Lord Bishop of CARLISLE, the inhabitants were numbered with great care and attention by the
Rev. Mr Richardson,
the
Rev. Mr Simpson,
and
Mr Alderman Hodgson.
There were at that time in the City and Suburbs, 1059 families, and 4158 inhabitants.
In January 1780, a very careful and accurate survey was made by
Mr Stanger and Mr Howard,
under my own inspection. When there were in the district before surveyed, 891 houses, 1605 families, and 6299 inhabitants. For a more particular account of the survey see Tables I. II. III.
This astonishing increase of 2141 inhabitants, which is above half of the original number, in the small space of seventeen years, may in some measure be attributed to the establishment of manufactories for the Printing of Calicoes. About the year 1761,
Mr Brummel
introduced this kind of manufactory; and notwithstanding the many difficulties, which naturally attend any new institution, by his activity, perseverance, and abilities he surmounted them all, and the art is now brought to great perfection. Soon after, several other gentlemen followed his example. There are at present four companies who daily employ about eight hundred industrious poor, in this Manufactory.
This increase of population too has taken place, during that very period, in which
Dr Price
asserts the depopulation of
Great Eritain
to have been rapid and progressive. And what makes this increase more remarkable, CARLISLE has during the whole period alluded to, been constantly supplying the army, the navy, the metropolis, and even the distant regions of
India
with her hardy, active, and enterprizing sons.
From Tables No. II. and IV. we can with pleasure demonstrate the extreme salubrity of CARLISLE even in a very unhealthy year; a year in which no less than 129 persons were cut off by two epidemic disorders,
viz.
the Small Pox and Scarlet Fever. By the Bills of Mortality published in different towns in
England,
as well as the Continent it appears on an average, that in Vienna about 1 in 19 and a half of the inhabitants die annually; in London 1 in 20 and three quarters; in Edinburgh 1 in 20 and four fifths; in Leeds 1 in 21 and three fifths; in Dublin 1 in 22; in Rome 1 in 23; in Amsterdam 1 in 24; in Breslaw, 1 in 25; in Berlin 1 in 26 and a half; in Northampton and Shrewsbury 1 in 26 and a half; in Liverpool 1 in 27 and a half; in Manchester 1 in 28; in Chester 1 in 40; but in the year 1774 when the Small Pox were very general and fatal 1 in 27; and in the Parish of Sedburgh in the County of York 1 in 37 and a half; and in Blandford Forum in Dorset, 1 in 39; in CARLISLE this year 1 in 30 and three ninths.
Tables No. III. and V. are of the utmost importance to the Physician, the Politician, and the Calculator of Annuities, and to every one who has the health and happiness of himself and family at heart. They at one view shew what diseases are most incident and fatal to particular periods of life. They clearly demonstrate as far as one year's observation can have weight, what periods of life are the most healthy, what are the most obnoxions to disease.
Thus we see in CARLISLE one in 6 and nine tenths nearly, of all the inhabitants under 5 years old, die annually; betwixt 5 and 10 years old 1 in 64 and six sevenths; 10-15, 1 in 119 and one sixth; 15-20, 1 in 168 and three fourths; 20-30, 1 in 132 and four fifths; 30-40, 1 in 146 and one sixth; 40-50, 1 in 95 and one third; 50-60, 1 in 58 and four fifths; 60-70, 1 in 24 and one third; 70-80, 1 in 13 and three fifths nearly; 80-90 1 in 4 and five sixths; and between 90 and 100 years exactly 1 in 5. As no particular epidemic disease occurred last year which had any considerable effect on the lives of adult persons, it is apprehended these calculations for the periods above 10 years old, will not be attended with much variation in other years.
That women in general live longer than men, is almost universally agreed, and the following observations tend much to confirm the truth of this opinion. During the last year 12 persons died between 30 and 90 years old, 8 of these were females, and between 90 and 100, 2 died, both females. See Table IV. In Table III. we see two people are above 100 years old and these likewise are semales.
Table II. which contains the number of Husbands, Wives, &c. Shews how inferior in number Widowers are to Widows. There are above four Widows to one Widower, an astonishing disproportion, in what manner is it to be accounted for? The following causes are conceived to operate considerably.
I. Men are in general more intemperate than women. II. They are exposed to greater hardships and dangers. III. Widowers perhaps in general have greater opportunities of getting wives, than widows have of getting husbands. IV. Widows have a greater propensity to live in towns than widowers. V. and lastly, The constitutions of males, as sitted for more violent and laborious exertions, are firmer and more robust than those of females; their muscular and nervous sibres, may therefore be supposed to become stiff, rigid, and incapable of performing the functions necessary to health and life sooner than those of females, both on account of their original texture, and the friction which must necessarily occur from laborious exercise. But from whatever causes the difference of longevity betwixt males and females may arise, the fact itself is sufficiently ascertained by Table IV. where we find that between the ages of 60 and 70, altho there are a greater number of wives than husbands, yet 11 husbands and only four wives have died, and of all different ages 29 husbands and 16 wives.
The Table of Deaths and Diseases No V. is as accurate as circumstances and the situation of things would possibly admit. With respect to the Small Pox, and Searlet Fever, their symptoms and marks are sufficiently evident to prevent any ambiguity. 24 have died of unknown diseases, which is a great number, but which must ever be the ease at CARLISLE where many of the lower class (although they may have advice gratis) never call in medical assistance.
Only seventeen have fallen victims to Consumptions, a number but small, when compared with the number, which usually die of that disorder in other towns, and still smaller when we consider how many are employed in the manufactories of weaving and Calicoe printing
Notwithstanding the impurity of the air breathed by Calicoe Printers, and the sudden changes of heat and cold which they are subject to, yet men following that business, are observed to be very healthy. May not this be owing to the acid steams continually exhaling in a Print Shop?
, where they continually breathe air by no means the most pure; and where they are subject to sudden alterations of heat and cold. 5 persons have died of this disease between 20 and 30 (see Table No V.) which consirms the general observation, that during that period of life people are most liable to Consumptions. It therefore behoves such to be very cautious upon catching cold, least by neglect and delay, a complaint which at the beginning might have been easily removed, should gather strength, and at last terminate in a fatal disease.
Three died of Dropsy
(viz. Anasarca)
which in all was evidently occasioned by excessive intemperance. Nervous and putrid fevers are not very frequent; no more than five have suffered by both these diseases, which must appear somewhat astonishing to one who knows how many inhabitants there are of the lowest rank, who are crouded in close and small apartments where they sleep, eat, and prepare their victuals; whose food can not be the most nutritive; who seldom change their cloaths; and who pay but little attention to cleanliness. May not the streams of water, which fortunately run near the most crouded parts of the town, tend to purify the air and prevent putrid fevers.
Agues or intermittent fevers are scarce ever known, a strong proof that the effluvia arising from marshes is the principle source of that disease.
In February, a poor girl either for some real, or imaginary complaint, was advised by an acquaintance as ignorant as herself, to take a large quantity of steel filings, which had been procured from a White Smith, or Watch-Maker. Not long after she had taken them, she was seized with pains in her stomach and bowels, which soon increased to a most violent degree. Every remedy which could be supposed useful either in a severe cholic, or inflammation of the stomach, was fried, but in vain. She continued in the greatest agony for two days and then expired.
During her sickness she was repeatedly asked, if she coud assign any cause for her disorder, but she always answered in the negative. Soon after her death, however, some steel silings were found in her room, and another servant in the house, on being examined, confessed that the deceased had taken three tea spoonfuls mixed with treacle, a few hours before she began to be ill. Three tea spoonfuls of the filings which were found, weighed six drams and a half, and upon examining them with a magnet, I found a quantity of lead and some copper filings. Had the steel been pure, the quantity alone was sufficient to have produced fatal effects, but here no doubt the lead and the copper would add considerably to its acrimony.
Let the death of this unfortunate young woman be a caution to others; and let Watch-Makers and White Smiths be careful to whom they sell steel filings, especially till they are separated from every impurity by the loadstone or some other method.
During this year two epidemics raged with uncommon violence, and swept off a great number of children,
viz.
the Small Pox and a species of the Scarlet Fever. As the
Scarlatina Angiursa
or Scarlet Fever and Sore Throat is rather an uncommon disease, and not perfectly un
erstood, it will not be improper to take notice of it in this place. The limits, however, of this sheet, will by no means admit a thorough discussion of a disease, which has within these two years been so general and so fatal to children. I shall content myself with defining the Scarlet Fever and Sore Throat as it occurred at CARLISLE; afterwards attempt to point out its nature; the symptoms by which it is to be distinguished from other diseases; its terminations; and lastly its method of cure. This epidemic made its appearance in July, was at its
acme
during September and October, and gradually abated till the latter end of December, when it almost entirely dissappeared.
DEFINITION.
The Scarlet Fever and Sore Throat, is a contagious inflammatory fever. On the second day of the fever, the throat becomes stiff and sore, attended with some difficulty of swallowing; on the third, sometimes not till the fourth, the face begins to swell and grows florid; this swelling and redness, soon become so universal, as to make the whole body resemble a boiled lobster in colour. On the seventh, or eighth day, the swelling and scarlet colour gradually abate, and the scarf shin becomes rough, and peels off in small branny scales.
DIAGNOSTIC SYMPTOMS.
To an inaccurate observer, this disease may seem to bear a very near resemblance to many eruptive fevers; the intelligent and attentive practitioner, will however, find no difficulty in discriminating it from all, but the
Cynanche Maligna
or Putrid Sore Throat, which especially at the commencement of the Epidemic will be no easy matter. The distinction however, is extremely necessary, as the method of cure is almost diametrically opposite. We shall therefore attempt it. Both diseases are highly contagious; both attended with a fever; both with an affection of the throat; and both with an eruption of the skin. Yet each disease has its peculiar fever; peculiar sore throat; and peculiar eruption. In the
Cynanche
(both for the sake of brevity and perspecuity we shall make use of the Generic term) the fever is constantly accompanied with a weak, quick, small and unsteady pulse. In the
Scarlatina
the pulse is quick, full, but seldom hard. In the
Cynanche
the throat and fauces are full of creeping ulcers, covered with brownish ash coloured sloughs. In the
Scarlatina
there are seldom any ulcers, but often whitish mucous sloughs sometimes extending over the whole tongue and inside of the mouth, which may be easily washed off with a little wine and water. The eruption in the
Scarlatina
is florid, universal, smooth, seldom prominent, and always dry. In the
Cynanche,
neither so florid, nor so universal, and in general rough, prominent, and often moist. The
Cynanche
chiefly affects the weak and delicate; females, more frequently than males; whereas robust, and plethoric children are more subject to the
Scarlatina.
The
Cynanche
is almost constantly accompanied with a fetid breath, and an acrid corrosive humour is discharged from the mouth, nose, and anus, which excoriates the skin. These disagreeable symptoms rarely occur in the
Scarlatina.
In the
Cynanche,
the colour of the blood is florid, its texture loose and tender. In the
Scarlatina
it is firm and covered with a buffy coat. The
Cynanche
is cured by tonics and antiseptics; bleeding, purging, and emetics, are universally hurtful. The principal remedies to be depended upon in the cure of the
Scarlatina,
are blood letting, emetics and the antiphlogistic regimen. Lastly the
Cynanche
is highly putrid. The
Scarlatina
is inflammatory, as may be easily deduced from the following circumstances, 1st. The robust and plethoric are more subject to it than the weak and delicate. 2d, There is a manifest swelling, redness and inflammation of the skin. 3d, The pulse is full, and generally rises after the first bleeding. 4th, The surface of the blood is covered with a firm buffy coat. 5th, In cases, where the lancet was not freely used, suppurations sometimes occurred in the throat. 6th, and lastly, evident advantages were derived from bleeding.
TERMINATIONS.
The Scarlet Fever and Sore Throat sometimes terminates in Dropsies, Deafness, Tumours and Suppurations in the Neck.
METHOD OF CURE.
From the definition already delivered, we learn that the Scarlet Fever and Sore Throat is a contagious disorder. The occasional or immediate cause must therefore necessarily be a peculiar kind of poison, of a volatile nature, readily mixing with the air. And many circumstances render it probable that it is first applied to the mucus membrane which lines the mouth, nose, fauces, stomach, &c. Emetics therefore are indicated, as remedies the most likely, to expel either the whole or a part of this poisonous matter; and if they were used soon after the application of the poison, it is probable the disease might in many cases be prevented. It is a certain fact, they have been employed with great advantage, and ought never to be omitted. The efficacy of Emetics does not however, by any means solely depend on their expelling the contagious virus; they unload the stomach, often gently move the belly, and have considerable effect in producing a copious sweat, and in removing a spasm of the small vessels on the surface of the body, which is a part of the proximate cause of all Fevers.
Emetic Tartar
dissolved in water appears to be the best vomit.
Of all the remedies made use of in this Epidemic, none were of more real advantage than bleeding, which was sometimes repeated three or four times; so great was its efficacy, that I believe not one patient died, who lost a sufficient quantity of blood early in the disease. Many cases however occurred where the mildness of the complaint rendered bleeding and almost every other remedy unnecessary.
The Saline Mixture with a small addition of Tartar Emetic, was of signal service. It acted as a diuretic, sudorific and gentle laxative. Immersion of the feet and legs in warm water, often promoted perspiration and a tendency to sleep. A Gargle of red wine and water was useful in washing off any mucous sloughs. The judicious application of these remedies, with plenty of diluents, and the antiphlogistic regimen seldom or never failed to produce the most happy effects.
Nearly about the same time, the Small Pox (see table No V.) began to rage with great violence. As the persons affected with this disease were chiefly of the lower class, who seldom called in medical assistance, it is impossible to ascertain the precise number: from the information however which I have had, it appears, that about 300, were during the last six months of the year, seized with the Small Pox in the natural way. Of these no less than 90 fell victims to its virulence. Hence near one in three died of all that were affected with the natural Small Pox, which while at the same time it serves as a melancholy proof of its fatal effects, points out the great and salutary advantages which are derived from inoculation. During the same period several hundreds were inoculated in the neighbourhood of CARLISLE, and it is a pleasing truth, that not one of them died. Had those 300 been inoculated it is more than probable that of the 90 not above 6 would have died, and even these not of inoculation but of other disorders. Hence we see 84 persons might have been saved to their parents and the public. Yet so great is the prejudice against the salutary practice of inoculation amongst the vulgar, that few, very few, can be prevailed upon either by promises, rewards, or intreaties to submit to the operation. No wonder that in rude, ignorant, and barbarous times, superstition hurried men into the grossest absurdities; when in a polished and enlightened age; in an age too, when the experience of full twenty years has clearly demonstrated the utility of inoculation, we see the bulk of mankind ready to sacrifice their children and all that is dear to them, to a foolish prejudice.
TABLE I.
 
houses
fami.
males
fema.
Total of both sexes
 
 
 
 
English-Street
208
319
639
732
1371
Total within the walls
houses 549
families 870
inhabit. 3504
Scotch-Street
122
197
354
437
791
Fisher-Street
53
82
130
194
324
Castle-Street
81
143
220
307
527
Abbey and Annet-Well Street
77
121
173
270
443
The Abbey
8
8
17
31
48
Botchard-Gate
95
202
385
457
842
total without the walls
342
735
2795
Richard-Gate
82
177
307
356
663
Caldew-Gate
165
356
592
698
1290
New-Town
16
19
40
52
92
total in the villages
 
 
 
Harraby
9
10
31
41
72
 
 
 
Carleton
30
30
66
67
133
 
 
 
Wreay
17
18
56
58
114
 
 
 
Brisco
32
34
107
85
192
257
267
1378
Botchardby
21
22
46
52
98
 
 
 
Uprightby
20
21
35
54
89
1148
1872
7677
Bleck-hill
63
64
176
178
354
 
 
 
Cummersdale
22
22
60
50
110
 
 
 
Morton-Head and Newby
27
27
57
67
124
 
 
 
Total in the two Parishes
1148
1872
3591
4186
7677
 
Females exceed Males 595 Males to Females as 1 is to 1 and 1 sixth nearly.
TABLE II. Of the Number of Husbands, Wives, &c.
 
Husbands
Wives
Widowers
Widows
 
 
Within the walls
531
569
46
248
Total of persons who are or have been married
3073
Without the walls
488
522
45
160
Total of persons who are married
2489
In the villages
188
191
17
68
Total of persons who never were married
4604
 
1207
1282
108
476
Total of umarried persons
5188
 
 
 
 
 
Widows exceed Widowers
368
 
 
 
 
 
Widowers to Widows, as 1 is to 4 and 3 sevenths nearly.
TABLE III. Of the number of Inhabitants of different ages.
 
under 5 years
betw. 5 & 10 years
10 & 15
15 & 20
20 & 30
30 & 40
40 & 50
50 & 60
60 & 70
70 & 80
80 & 90
90 & 100
100 & 105
total
Within the City and Sub
rbs
859
731
587
543
1030
733
729
498
375
164
44
5
1
6299
In the Villages
170
177
128
132
298
144
129
90
63
27
14
5
1
1378
Total
1029
908
715
675
1328
877
858
588
438
191
58
10
2
7677
TABLE IV. Of Deaths, Ages, and Conditions.
Ages
males
fema.
Under 1 month
6
7
Betw. 1-2 mon.
2
 
2-3
 
2
3-6
5
 
6-9
2
4
9-12
10
9
1-2 years old
21
12
2-3
17
19
3-4
10
8
4-5
6
10
5-10
7
7
10-15
4
3
15-20
2
2
Total of the above Ages
92
83
Ages.
Batch.
Husb.
widors.
maids
wives
wids.
Total
20-30
2
3
 
3
3
1
12
30-40
 
3
 
 
3
 
6
40-50
 
4
 
2
2
1
9
50-60
1
4
2
 
2
1
10
60-70
 
11
1
1
4
1
18
70-80
 
3
3
1
 
7
14
80-90
 
1
3
1
1
0
12
90-100
 
 
 
1
1
 
2
total of ages & cords
3
29
9
9
16
17
83
Total of ages under 20 years Males 92
 
Total of ages under 20 years Females 83
175
Total of all Ages and Conditions
258
Looseness (57)
3
 
 
 
 
 
 
 
 
1
 
 
4
Insanity (63)
 
 
 
 
 
1
 
 
 
 
 
 
1
III. DISEASES of the HABIT.
 
 
 
 
 
 
 
 
 
 
 
 
 
Weakness of Infancy (65)
9
 
 
 
 
 
 
 
 
 
 
 
9
Decay of Age (66)
 
 
 
 
 
 
 
 
4
6
11
2
23
Dropsy (71)
 
 
 
 
 
 
1
 
2
 
 
 
3
Dropsy of the Head (72)
 
 
1
 
 
 
 
 
 
 
 
 
1
Dropsy of the Belly (75)
 
1
 
 
 
1
 
 
 
 
 
 
2
King's Evil (80)
 
1
 
 
 
 
 
 
 
 
 
 
1
IV. LOCAL DISEASES.
 
 
 
 
 
 
 
 
 
 
 
 
 
A Discharge of Blood (102)
 
 
 
 
 
 
1
 
 
 
 
 
1
Costiveness (107)
1
 
 
 
 
 
 
 
 
 
 
 
1
Tumour of the Stomach (113)
 
 
 
 
 
 
 
1
 
 
 
 
1
Ulcer (128)
 
 
 
 
 
 
1
 
 
 
 
 
1
Difficult Delivery
 
 
 
 
1
1
 
 
 
 
 
 
2
Unknown Diseases
6
 
1
 
 
2
2
2
7
3
1
 
24
Accidents
1
 
1
 
2
 
 
 
 
 
 
 
4
Total
150
14
7
4
12
6
9
10
18
14
12
2
258
* Cullen's Genera Morborum.
TABLE V. Deaths and Diseases of Persons of Different Ages.
DISEASES.
under 5 years
betw 5 & 10 years
10 & 15
15 & 20
20 & 30
30 & 40
40 & 50
50 & 60
60 & 70
70 & 80
80 & 90
90 & 100
total
I. FERRILE DISEASES.
 
 
 
 
 
 
 
 
 
 
 
 
 
Inflammatory Fever (G. 4*)
3
 
 
 
 
 
 
 
 
 
 
 
3
Nervous Fever (G. 5, 6)
1
 
 
1
 
1
1
 
1
 
 
 
5
Pleurisy (G. 12)
 
 
 
 
 
 
 
1
1
 
 
 
2
Inflammation of the stomach from a largedose of Steel filings (G. 15)
 
 
 
1
 
 
 
 
 
 
 
 
1
Rheumatism Chronic (G. 22)
 
 
 
 
 
 
 
 
 
1
 
 
1
Gout (G. 23)
 
 
 
 
 
 
 
1
 
1
 
 
2
Small Pox (26)
86
2
1
 
1
 
 
 
 
 
 
 
90
Miliary Fever (29)
 
 
 
 
1
 
 
 
 
 
 
 
1
Scarlet Fever (30)
31
4
2
1
1
 
 
 
 
 
 
 
39
Thrush (33)
2
 
 
 
 
 
 
 
 
 
 
 
2
Consumption (35)
3
2
1
1
5
 
2
3
 
 
 
 
17
Worm Fever
2
4
 
 
 
 
 
 
 
 
 
 
6
II. NERVOUS DISEASES.
 
 
 
 
 
 
 
 
 
 
 
 
 
Palsy (41)
 
 
 
 
 
 
 
1
 
1
 
 
2
Swoon or Fainting (42)
 
 
 
 
 
 
1
 
 
1
 
 
2
Indigestion (43)
 
 
 
 
 
 
 
 
1
 
 
 
1
Convulsions (48)
2
 
 
 
 
 
 
 
 
 
 
 
 
TABLE VI.
Deaths in
males.
females
Total
Total of Deaths in each Season.
January,
4
7
11
33 Winter.
February.
6
4
10
March
6
6
12
April,
6
3
9
34 Spring.
May,
7
10
17
June,
5
3
8
July,
7
7
14
August
14
5
19
75 Summer.
September,
20
22
42
October,
30
23
53
116 Autumn.
November,
18
20
38
December.
10
15
25
Total
133
125
258
Christenings,
Males.
females
Total
N. B. The Christenings are by no means accurate, many of the Dissenters not being registered.
 
102
109
211