MORTALITY BRITISH ARMY, AT HOME, AT HOME AND ABROAD, AND DURING THE RUSSIAN WAR, AS COMPARED WITH THE MORTALITY OF THE CIVIL POPULATION IN ENGLAND. Alustrates by Gables and Diagraniis, | Reprinted front the Report of the Royal Commission appointed to enguire into the Regulations affecting the Sanitary State of the Army] LONDON: PRINTED BY HARRISON AND SONS, ST: MARTIN’S LANE 1858. "SAONVHD GACAAN ONILNAWSIdWI OLNI AUYLSINIW YVM SHL JUNSSAdd OL NOINIdO DITGAd JO ASN ALVYSHITAG ,SYAWHOSSY AHL 4O LYVd SV GSHSITENd SVM LATHdWVd 3HL ‘S49C4M QNV SAIIYID CAY¥O0T1O9 30 SNVAW Ad FINVI9 V LV AWOH NS3ATYC 3Y3aM “3SI7T TIAID 430 LVHL ATdNOd ONIAG SHOVYNVEA NI ALITWVLYOW FHL SV HONS “SLOV4 JWOD -TAMNMQ ‘COHLAW SIHL GSLNSANI GVH AHS GAaASITSd JIVONILHDIN JONSAYOTS GASGNI ‘SLUYVHD TVIYNOLDId 40 SNVAW Ad SLOVA IWOITLSTLVLS 40 NOILVLNSASSYd SHL 40 SADNVLSNI LSSITYVS JHL 4O JNO SVM LATHdWVd SNOWANONYV SITHL THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES GIFT OF HH 4 iQ ~Q faa za = - es) WY) faa} = Q Z < pd A MORTALITY OF THE BRITISH ARMY, AT HOME, AT HOME AND ABROAD, AND DURING THE RUSSIAN WAR, AS COMPARED WITH THE MORTALITY OF THE CIVIL POPULATION IN ENGLAND. Jllustrated by Cables and Diagrams, [Reprinted from the Report of the Royal Commission appointed to enquire into the Regulations affecting the Sanitary State of the Army.] LONDON: PRINTED BY HARRISON AND SONS, ST. MARTIN’S LANE 13 5:8. CONTENTS. Description of Diagrams of the Mortality in the British Army INDEX TO THE TaBuns. Table A & B. Mortality of the British Army at Home Table C—a. Average Strength, Deaths, and Rate of Mortality sek year, 1839—1853, of tle be ‘i Home and Abroad, compared with that of the Civil Population : Table C—O. Excess of Deaths among Non-Commissioned Officers and Men over what there ould ie if the Army were as healthy as the Civil Population in Country Districts Table D. Showing the same with the General Population in England and Wales . Table E—a. Two Life Tables showing the number of English Soldiers and of Bees rng val dead between the ages of 20 and 40 Table E—6. Table showing the Strength, Deaths, and Annual vee of Mortality i in the Atty serving at Home from 1839 to 1853, as compared with the Mortality at the Army Ages in healthy Districts and in England and Wales Table F—a. Showing the Annual Loss from Le and Death among 10, 000 Reames hetwont the ages of 20 and 40 : Table F—8, Strength and Invaliding in the ung serving : Hom fre om 1839 6 185 3 Table F—c. Proportion per 1000 of Troops serving at Home, who died or were invalided in ties septennial periods F j ; : ; ; . ‘ ; é Z Table F—d. Showing the number of effectives, distinguishing young soldiers from veterans, remaining out of 10,000 Recruits annually. 1, in the Army as it is; 2, in the Army in an improved state Deaths and Annual Rate of Mortality per 1000 living oti different Sistas of Dieaes among the English Male Population, 15—45 ds of age, and among the ae of the Line serving at Home . : Table H—a. Mortality in the Army of the East in ijeptal dinae ox years, Ao i, 1854, és June 30, 1856 Table H—8. Annual Rate of Mortality per sank rote different asia of Disonse in Hospital | in the Army of the Hast, and in the English Male Population, of 15 to 45 years of age Table K. fig. 1. Estimated Average, Monthly Strength of the Army in the East, and the Deaths and Annual Rate of Mortality per 1000 in each month, from April 1854 to March 1856, from Zymotic Diseases, Wounds, and Injuries; and all other Causes . Table K. fig. 2. Annual Rate of Mortality per cent. on the Sick Ate at Scutari, October 1, 1854, . June 30, 1855 General Return. Of the Primary Admissions, Deaths, and Diseases | in the Hospitals of the Avitiy § in the East, from April 10, 1854, to June 30, 1856, arranged according to Dr. Farr’s pro- posed new Classification ; J : Table Z. Density of Population in the O inttaraciek Gensel’ Plans for Bical sioute as com- pared with that in Town Districts in England eS iio J Sem alnpamae NE SN SRS NS SN sth y Diagram A. Diagram B. Diagram C. Diagram D. Diagram E. Diagram F, Diagram G. Diagram H. Diagram I. Diagram K. Diagram K. fig. 2 Diagram Z. INDEX TO THE DIAGRAMS, Representing the Relative Mortality of the Foot Guards, and of the English Male Popula- tion at corresponding ages. Representing the same comparison for the Army at Home. Representing the Relative Mortality of Males of the Soldiers’ Ages in Healthy Districts and in the Army at Home and Abroad. Representing the same comparison as regards the Male Population of England and Wales. Shewing the number, living and dead, at the several ages from 20 to 40 among, 1, English Soldiers. 2, Englishmen. 3, Englishmen in Healthy Districts. Representing the loss by Death and Invaliding, 1, in the Army at Home in its present state. 2,in the Army at Home in an improved state. Representing the Relative Annual Mortality from all causes, Zymotic Diseases, Chest and Tubercular Diseases, and other Diseases in the English Male Population, aged 15—45, and in the Infantry of the Line, serving at Home. Representing the Relative Mortality, from different causes, of the Army in the Hast in Hospital, and of the English Male Population, aged 15—45. Representing the Annual Rate of Mortality per 1000 in the Hospitals of the Army in the East for each month, from April 1854 to March 1856, compared with the Annual Rate of Mortality in Manchester. Representing the Relative Mortality from Zymotic Diseases, Wounds, and all other causes in the Hospitals of the Army in the East for each Month, April 1854, to March 1856. Showing the Annual Rate of Mortality per cent. on the Sick Population at Scutari, from October 1, 1854, to June 30, 1855. From the difficulty of introducing a sheet, of sufficient size, to represent such a Mor- tality into the folio, this figure has been projected on a tenth part of the scale of the other figures in the Diagram. Had it been on the same scale the longest Radius, repre- senting the Mortality in the Hospitals for Februay 1855, would have projected 40 inches from the centre of the circle ! Mllustrating the Relative Density of Population in London, in East London, and in the Quartermaster-General’s Plans for Encampment. Description of Diagrams of the Mortality in the British Army. DIAGRAMS are of great utility for illustrating certain questions of vital statistics by conveying ideas on the subject through the eye, which cannot be so readily grasped when contained in figures. This aid has therefore been called in to give greater clearness to the numerical results in the body of the Report and in the Appendix. Diagrams have been prepared illustrative of the comparative health of men of the army ages in England and of soldiers in Barracks on Home Stations. Likewise diagrams showing the same comparison for the whole army at home and abroad. These several diagrams give the comparison of the life of the soldier with the life of the civilian at the same ages in time of peace. There is another set of diagrams showing the same comparison in time of war. Two other diagrams exhibit the chief classes of disease in both sets of diagrams. We are thus enabled better to understand how far it is within the power of preventive science to diminish the risks to which the soldier is exposed, whether at home or in the field. Diagram A shows the relative mortality of the Foot Guards and of the English male population at the corresponding ages. It must be remembered that the Guards are, physically, the very select out of the population. Any impediment or disease is enough to prevent a man being taken for military service. And none but the strongest and best looking recruits are accepted by the Guards. The young Guardsman is, in every sense, a “picked” life, and would be considered as a first-class life by any insurance office. As soon as the recruit enters the service he is placed under the entire control of educated officers : his diet, cleanliness, personal habits are strictly attended to: he is lodged in barracks which have cost the country far more than was the relative cost of the house in which he was brought up: he never leaves the country in time of peace, but passes from his town-quarters in London to his country-quarters at Windsor or at Chichester, and whenever he suffers from the slightest ailment his medical adviser is instantly beside him: he has hospital accommodation, medicine, attendance, and every necessary comfort immediately. One would say that of all men a soldier in Her Majesty’s Guards was the most likely to enjoy perfect health and long life. The men that were rejected when the Guardsman was selected have passed back into civil life. The civil population has lost a certain proportion of its good life which has gone into the army, and it has received back those lives which were not good enough for the army. The civil population has had all the loss, the army all the gain. Let us now see how the Guards die off under the, apparently, very favourable circumstances mentioned. Diagram A consists of alternate black and red lines of different lengths. The black lines show the proportion of deaths per annum among 1,000 of the civil population for each 5 years from 20 to 40. The red lines show the proportion of deaths per annum among 1,000 Guards for the same ages. The excess in length of the red line over the black line in each pair of lines shews the excess of deaths among the Guards. There is however an important difference between the relative value of the black and red lines which must be noticed, otherwise the mortality in the Guards, great as it is, might appear less than it really is. The black line exhibits all the deaths in the civil population which occur between the ages of 20 and 40, but the red line does not exhibit all the deaths which occur among the men who had been selected for the Guards. very year between the ages of 20 and 40, men are rendered unfit for service by organic disease, and are discharged to die among the civil population and to raise its rate of Diagram A. Table A & B. i TOE SEE TDA TAD A AE a ee pe CLE, a otheio O ial ETE ROR Din ei Areata i a Diagram B. TableA & B. Diagram C. Tables C—a, C—O. Diagram D. Tables C—a, D. Diagram EH, Tables E—a, H==6: mortality. These are included in the black line, and are consequently not shown in the red line. These deaths are in fact deducted from the length of the red line and added to the length of the black line, so that in the comparison the Guards have a double advantage from their men who die invalided. The Guards, though the most unhealthy corps in the home service, is not the only one which suffers a great excess of mortality. All the army on home service suffers, though in a somewhat less proportion. This is shown in Diagram B, where the black lines again exhibit the mortality among the general English population, and the red lines the mortality among soldiers on home service. The excess of length in the red lines shows the excess of mortality among the troops, subject to the same correction.as to invaliding as has been already mentioned for the Guards. The whole army, like the Guards, consists of carefully picked lives. To show the full bearing of this fact in any comparison between the health of the army and that of civilians, it is necessary to state that, of the civil population at the recruiting age, a certain part is unable from illness to present itself to the recruiting officer: that deaths among that part go to raise the civilian mortality : that of those who do present themselves for recruits, a third part at least, though probably a much larger proportion, are rejected as unfit for service: that of those rejected at least a fourth part are suffering from diseases which shorten life. The lives rejected are thrown back into the general population; but notwithstanding this process of selection and the apparently favourable circumstances under which the troops are placed, we have from some cause or other the extraordinary results exhibited by these diagrams. The wide extent of the British Empire, and the great variety of climates it presents, as well as the topographical peculiarities of our various colonies and possessions scattered over the whole earth, would lead us to expect a higher rate of mortality among soldiers born in the British Islands, when these soldiers are sent on service abroad, than would exist among the home population at the same ages. This difference is represented in Diagram ©, which exhibits the mortality among English- men of the army ages, living in healthy districts, and the mortality of the whole army at home and abroad for the same period, subject to the same correction for invaliding. Diagram D shows the same fact with regard to the army and the general male population of England at the army ages. In some years it will be found that the mortality in the troops is from 5 to 6 times greater than it is in civil life, as represented on Diagram C. These facts are represented in another way in Diagram HE, each parallelogram of which represents the total sum of life among 10,000 men, between 20 and 40 years of age, entering the army, and remaining on home-service, and among the same number of Englishmen taken, first, all over the town and country districts, and, secondly, in the healthy districts at home at the same ages. The left-hand line of each parallelogram shows that all start alike ; but the black wedge, which represents the progress of death among the various classes, it will be observed, has a very different slope in each separate parallelogram. The proportion of death increases and that of life diminishes, ina very different ratio and to a very different extent in each. The mortality is greater and its progress more rapid among the English male population generally than among that in healthy districts. The general population has lost a third more by the time it arrives at the age of 40, than the healthy population has, while the soldiers have lost above a third more of their numbers than the general population, and more than twice as many as the healthy population. Each parallelogram also represents the total money value of 10,000 men between the ages jof 20 and 40, as well as the loss of value from loss of life at each succeeding year between the two ages. It further shows the relative value of the amount of life in the army as contrasted with that of two classes of civil population, passing on from 40 years to the succeeding period of life, from which it will be seen that while among healthy civil populations about 8,500 lives out of 10,000 survive the wear and tear of the ages between 20 and 40, and thereafter add their quota to the wealth of the community, only 6,900 of the army lives are available for the same purpose. It may be said that the nation loses the money value of the excess of mortality existing in _its general population over that of the population in healthy districts. : In the case of the army, the country incurs great expense in educating the soldier for his duties, and it is difficult to estimate the value of a good soldier, for he can hardly be jreplaced. In the present state of sanitary knowledge, it may be fairly stated that the whole excess of money loss between that in healthy districts and that in the army, as represented by the difference in area of the black wedges, might be saved to the tax-payers of the country. 3 The general community incurs a still further loss of productive labour, because it will be seen that the number of lives at 40 years of age returned into the general civil population (supposing that the average age of discharge from service is 40 years), is much smaller in the army than the proportion which survives in the healthy civil population : and the productive power of the country is further taxed for the support, by poor-rates and otherwise, of a large proportion of men, temporarily or permanently disabled by diseases contracted in the service. The loss from invaliding has been already referred to as a serious cause of inefficiency in the army not shown in any of the preceding diagrams. Diagram F has been constructed from Tables F—a, F—b, F—c, and F—d, to bring under one view the whole loss sustained. This is shown in No. I. on which the black wedge represents the deaths, the yellow wedge the loss from invaliding, and the two wedges conjoined the total loss from both causes in an army of 200,000 men between the ages of 20 and 40. No. II. represents what the loss would be if the army were as healthy as the civil male population, and by comparing the red areas of both diagrams the great loss of efficiency in the army in its present state becomes more apparent. Under the present system No. 1, 10,000 annual recruits would be required to sustain a force of 141,764 men, while under the improved conditions as to health indicated on No. I, 10,000 annual recruits would sustain an army of 166,910 men. These diagrams then show the loss of life, of service, and of money valve entailed on the country by the neglect of sanitary measures in the army in time of peace. It is in the highest degree important to show the classes of disease from which the great losses in the army in time of peace arise, for it is in this way alone that we can ascertain whether, and to what extent, we can mitigate or prevent these diseases by known sanitary precautions. The two parallelograms on Diagram G represent the classes of mortality from disease most prevalent in the Infantry on home-stations, as compared with the extent of the same types of disease incivil life at the same ages. re The excess of length in the army parallelogram shows the total excess of mortality in the Infantry over that in the civil population. We are at once struck by the remarkable fact that more than seven-ninths of the mortality in the Infantry are due to two classes of disease alone,—namely, to zymotic diseases, such as fevers, cholera, diarrhoea, and to chest and tubercular diseases, such as consumption, Sc. In fact the mortality from chest and tubercular diseases alone, in the Infantry on home » service, exceeds the total mortality from all causes among the civil population at the same ages ; while the deaths from zymotic disease are above double what they are in civil life. Again, chest and tubercular affections are the scourge of the civil population, and yet the civil population suffers less than one-half the mortality from these diseases that occurs in the Infantry, while the deaths from zymotic disease in the Infantry nearly equal the total deaths from chest affections in the civil population. It is necessary here also to repeat that while the area in diagram G representing the mortality of the English male population exhibits all the deaths from each class of diseases, the area representing the Infantry mortality does not. It takes no account of men discharged by reason of chronic, tubercular, and chest diseases, whose deaths taking place after discharge among the civil population, go to swell the mortality from these diseases, such as it is shown in the area which represents the civilian mortality. These diagrams, then, exhibit clearly the frightful mortality continually going on in the British army, and the classes of disease to which this mortality is to be attributed. The first question which arises on looking at these diagrams is,—what can be the cause of all this? By what possible procedure can it be that the élite of the British working popula- tion can be so guided as that such a result shall follow? Is there anything in the food, clothing, duties, habits of the men to which it can be attributed? Are the army medical men less skilful in their profession than those in civil life? To every such query we must reply that there is, on the contrary, everything in the soldier’s favour in these particulars, except perhaps that he is not sufficiently worked. His barrack accommodation has cost the country enough of money. There has been no expense spared in that. Can there be anything there to occasion such fearful annual loss of life ? Let us see what sanitary experience teaches as to the causation of the diseases from which the soldier suffers . Ist. Consumption and diseases of that class are the result of breathing foul air contami- nated by the breath of other persons. It is air polluted in this way which appears to be the special agent which predisposes people to consumptive diseases. How is such a state of the air chiefly produced? Very easily :—simply by crowding too many people into unventilated rooms, especially into sleeping-rooms. If barrack-rooms are crowded and unventilated, and if the atmosphere is close or foul during the hours of sleep when the system is more peculiarly predisposed to its effects, then you Diagram F. Tables F—a, F—b, F—c. F—d, Diagram G. Table G. 4 have the elements of consumption and tubercular disease. If you want to develop the seeds into activity, all you have to do is to take the men out of such an atmosphere which they have been breathing night after night, and expose them on guard to wet and cold, and the disease will soon develop itself. But mark,—exposure to wet and cold alone will not do it. The Crimean experience proved this ; and so it is found to be daily and nightly, in night trades and occupations, except in the case of the soldier. To know whether the conditions requisite to produce consumption and tubercular disease exist in barracks, it is only necessary to read the disgusting evidence given before the Barrack Committee, and the statements in this Report on the subject, or simply to consult the tables in the Appendix showing the amount of cubic space allowed to the men in barracks, and to the sick in military hospitals. It would be difficult to frame conditions more likely to generate such diseases than those to which soldiers are exposed in barrack-rooms. They are in fact the self-same conditions as have been determined by direct experiment to be necessary for the production of tubercular disease in animals. When a sufficient cause is found it is not necessary to look for another. 2nd. Zymotic diseases, namely, fevers, diarrhea, cholera, dysentery, &c., are known in civil life to be most intense in their activity where certain local conditions are present— First in prominence amongst these conditions, we have again overcrowding and defective ventilation,—the repeated breathing, in fact, of air already breathed, such air being further contaminated by moisture and exhalations from the skin. Next we have emanations proceeding from animal excretions, or from decaying vegetable matter together with moisture. The want of drainage and the foul state of the latrines and urinals in many barracks, as described in the Report, are sufficient illustrations of this class of causes. There are others of minor importance which need not be mentioned. Those enumerated are quite sufficient to account for most of the excess of zymotic mortality from which the army on home-stations suffers. If men returning from foreign service happen occasionally to be more susceptible to the operation of such causes, they will of course suffer more severely ; but allow- ance is made in the diagrams for even this contingency, as they do not exhibit any deaths occurring for the first six months after men have returned from foreign service. The next query is one which it is almost superfluous to put. It is whether there be any known means of diminishing this excessive mortality; and whether there be any hope of reducing the lines of disease and mortality among the troops, as exhibited in these diagrams, to the same length as the lines for the civil population ? The reply is, that the line of the soldier’s mortality on home service should, to say the least of it, never have been longer than that of the civil population, and that it might be shorter. The parallelogram showing the mortality and disease among the civil population on Diagram G, is the very one, towards the reduction of which to smaller dimensions the whole sanitary procedure under every sanitary Act of Parliament is directed. It was the large dimensions of such parallelograms that led to the agitation which ended in the Legislature giving a sanitary code to England. And it is hardly credible that it should be necessary at the present day to advocate similar measures for the army. There is no reason why with proper sanitary measures the general health of the population should not be raised to the standard of the most healthy districts of the country, as indeed it has been in certain marked instances. And why should the health of the army on home service be any exception, seeing that the personal conditions of the soldier are so much more favourable ? If this were done, and if our home army consisted of 100,000 Guards, we should save nearly 1,500 good soldiers per annum, who from all experience in other cases are as certainly killed by the neglects specified as if they were drawn out and shot. By referring back to Diagrams C & D, which represent the army mortality at home and abroad, as compared with that of an English population at the same ages, we cannot fail tu be struck with the immense loss of life entailed on the army, and the corresponding cost to the country from foreign service. This loss is much less than it was in former times. It has been diminished by various sanitary means; and there is no reason whatever, why, if intelligent inquiry were instituted, and proper sanitary precautions taken, all the lines of army mortality on those melancholy tables might not be materially shortened. __ Unfavourable as those diagrams are to the sanitary system, or rather want of system, in the British army, they exhibit results which might be considered as in the highest degree favourable when contrasted with the mortality from disease among the British troops in time of war. It is at such times that the excessively defective state of sanitary science and practice in the army becomes pre-eminently remarkable, and leads to the most disastrous results. It is right, however, to state that such defects are not confined to the British army. All armies during war have suffered from the neglect of very ordinary hygienic precautions, and some vgickaaiuaninionenin vues eee eee . armies have been all but destroyed in consequence Nearly six-sevenths of the vast army with which Napoleon the First invaded Russia had perished, or ceased to be effective before the setting in of the fierce cold which destroyed the remainder. The actual losses in battle form a very small part of the calamities ofa long war, so much so that if the excess of mortality caused by disease could be cut off, the loss in action would be hardly worthy of remark in the comparison. The facts connected with the disastrous Walcheren expedition, as well as the ignorance and absence of the most ordinary precautions which led to so great a loss of life, are matters of history. But up to the present time the experience of that expedition appears to have led to no beneficial result, so far at least as can be gathered from the still more disastrous Crimean war. The linear Diagram H_ gives the comparative results of the mortality amongst the English male population of the army ages, and amongst the soldiers of the British army in the East. The first short black line gives the mortality from all causes among the English population. The second long red line, nearly twenty-three times the length, gives the mortality in the army. For every Englishman of the army ages who died at home, nearly twenty-three died in the Kast. The proportion of deaths from wounds, exclusive of those killed on the field, during the war, was thirty times greater among the soldiers than among the civil population ; but even at that rate the mortality in hospital from wounds did not exceed 3 per cent. of the force, while the deaths from all causes were nearly 23 per cent. of the force in the field. When we examine the cause of this great mortality, the eye is arrested at once by the second long red line marking the zymotic deaths. The short black line immediately above it shows the corresponding mortality from zymotic diseases among the home male population at the same ages. We learn from these two most instructive lines, that for every man of the ages and numbers who died at home from zymotic maladies, 93 died in the army in the Hast! The remaining diseases shown in the diagram are not worth notice. Ifthey were all expunged, and the deaths from wounds taking place in hospital expunged with them, the fact would remain that the army in the Crimea almost perished from zymotic disease. The awful mortality i that noble army is shown still more strikingly by Diagram I. For the sake of comparison, the town of Manchester, one of the most unhealthy in England, and one very subject to zymotic diseases, has been selected. The small black disc in the centre shows what would have been the mortality of the Crimean army, had it had been as healthy as Manchester. Now contrast with this the great black bat’s wing on the right-hand of the diagram. The whole of that black area outside the small innermost circle shows the excess of mortality in the army over that of one of the most unhealthy towns in England. The diagram is in two parts. The right hand part shews the mortality of the army during the first twelve months of the War from April 1, 1854, to March 31, 1855. It shows how healthy the army was when it landed in the Hast. By comparing the dates, it will be seen that, immediately on the army reaching Varna, sickness and death began to increase, showing the sudden exposure of the troops to some very unusual causes of mortality. It will be seen, that the whole time the army was in Bulgaria, it suffered severely—that the mortality declined when it left that pestiferous region for the Crimea—that from the moment it broke ground before Sebastopol, in a comparatively healthy district of country, the mortality began to rise during October—that it progressed with frightful rapidity during November and December, attaining, during January 1855, an amount greater than the maximum of the mortality of the great plague of London in September 1665. The diagram gives a pictorial representation of that great Crimean calamity during the first year of the war. LHExcept, perhaps, in one or two of the medizval epidemics, no pestilence of which we have any record would form such a picture for eight consecutive months. The left-hand diagram gives the mortality of the second year of the war. It was great, as will be seen by contrasting its black irregular surface with the small Manchester circle, but when compared with the first year’s mortality it is insignificant. It will be seen that for the last three months (but in reality for the last six months, January to June 1856 inclusive) the mortality retires within the Manchester circle and all but disappears. We have here ata glance the vital statistics of the Crimean war. The immense preponderance of zymotic diseases has been already referred to, and a glance at; Diagram K will show that these diseases were the cause of the whole catastrophe. The total mortality from wounds at Alma, Inkermann, and during five months in the trenches, exclusive of the killed in action, is all comprised in the small pink cone in the centre. The small black patch adjacent comprehends the total mortality from diseases not zymotic. The irregular blue surface, like the tail of a portentous comet, shows the zymotic diseases, the pests and scourges of camps and armies now, as they were of cities and towns in the middle ages, before the dawn of sanitary knowledge. Diagram H. Tables H—a, H—0. Diagram I. Diagram K. Table K, He. T: 6 The analysis of the second year’s mortality is given on the left-hand circle of Diagram H. It exhibits an immense reduction in the deaths from all causes except from wounds, the legiti- mate result of war ; but even to the end the zymotic mortality retains its preponderance, and only disappears when the army had arrived at its most healthy condition. : ee On comparing the total mortality as shown on Diagram I. with the zymotic mortality in Diagram K., it will be seen that the very first diseases from which the army suffered (as shown by the dates) in Bulgaria were zymotic diseases. They were principally fever and cholera, brought on by neglect of sanitiry precautions chiefly in the first bad selection of camp sites. The first outbreak began to subside only in September, and continued to decline until the army sate down before Sebastopol. Another and far more terrible invasion of zymotic disease followed that event. The men were hard worked, but hard work by itself never induced zymotic disease. We must look for other causes, and these causes once existing, fatigue would co-operate powerfully with them. The men had no sufficient shelter. .They were in want of clothing suitable to the weather. They suffered from wet and damp. ‘They were exposed to the elements at all times and seasons. ‘Their food was not sufficiently nutritious nor varied. ‘They had no proper means of cooking, and little or no fuel, and they could not eat their rations. What wonder, then, if their very blood got into a disordered state, and zymotic maladies broke out among them? Scurvy and scorbutic diseases appeared at a very early period. Fever, cholera, diarrhea, dysentery increased,so as to threaten the total destruction of the force. The requirements of hygiéne had been disregarded, and these diagrams show the natural results. During the summer of 1855, as shown on the left-hand diagram, zymotic diseases still prevailed, though to a comparatively insignificant degree. Sanitary defects in draining, cleansing, and ventilation, and over-crowding were then the prevailing causes of attacks. During the winter of 1855—56 all the previous causes of disease had been removed. The men were well clothed, fed and sheltered. Their huts were properly drained and ventilated, and nuisances had been removed. ‘The hard work had also ceased. Compare, then, the right with the left-hand diagram from the months of September to April ; and no more instructive lesson on army hygiene could be given. The men were the same, the conditions only had been altered. The requirements of nature had been disobeyed in every particular during the first winter, and she has left on that diagram an everlasting vindication of her broken laws, During the second winter, nature had been more perfectly obeyed, and the stigma of her displeasure has almost ceased to appear. In discussing the causes of the terrible mortality of that fearful winter, we must not over- look another important point, namely, what chances a sick man had of proper care and. treatment. The medical staff, it is known, exerted itself to the very utmost, and incurred a large proportionate mortality among its members in consequence. But the accommodation for the sick in camp was for several months most defective. There were no proper hospitals, and no suitable beds or other appliances. The suffering from exposure among the sick was perhaps greater, considering their diseased state, than among the army generally. The transport-ships were most defective at first, over-crowded and badly ventilated, and moreover, many cases were shipped in an unfit state for removal, particularly cases of choleraic disease. There was a great mortality on board the ships in consequence. During the period of 45 months from the landing in the Crimea, to the end of January 1855, out of 13,093 sick shipped for Scutari, 976 died on a passage of only 300 miles, which is 75 per 1000. In January 1855, there were actually lost on the passage 10 to every 100 received alive. Of those who landed, two were lost out of every five treated in the Hospitals of the Bosphorus, during the month of February, and one out of every two at Koulali, the worst of all the Hospitals ; for, when the sick arrived they were crowded into buildings which had undergone no sufficient sanitary preparation for their reception. The drainage, ventilation, lime-washing, and other arrangements were so defective that the buildings were little better than pest- houses, and the result was, an enormous and neédless mortality among the sick, which went to swell the losses of the army, and to raise its proportionate rate of mortality. The Scutari mortality was in fact a separate problem and must be considered by itself. It was the case of thousands of sick removed 300 miles from the causes which had occasioned their disease, and exposed to another class of risks in the buildings into which they were received. ‘The buildings were spacious and magnificent in external appearance ; far more so indeed than any military buildings in Great Britain; and several of them to all appearance were better suited for hospitals than any military hospitals at home. The mere external appearance was, however, fatally deceptive. Underneath these great structures were sewers of the worst possible construction, loaded with filth, mere cesspools in fact, through which the wind blew sewer-air up the pipes of numerous open privies into the corridors and wards where the sick were lying. of ~The wards had no means of ventilation, the walls required constant lime-washing, and the number of sick placed in the hospitals during the winter was disproportionately large, aaa when the bad sanitary state of the buildings is taken into consideration. — The Ea eee the hospitals was increased, not only without any sanitary precautions having been taken, but while the sanitary conditions were becoming daily worse, for the sewers were getting more and more dangerous, and the walls more and more saturated with organic matter. Some os improvements were made in the beginning of March, 1855, but it was not till the 17th id effectual means were put into operation for removing the causes of disease in the buildings. By t 4 end of June the improvements were nearly completed, and the proportion of sick had fallen of. The small diagram (fig. 2) on Diagram K. shows the whole history of that frightful ee calamity. It exhibits the annual rate of mortality per cent. on the sick population of the hospitals. It will be observed that even from the very commencement of the occupation of these buildings in October, 1854, and before the sufferings of the winter had begun, ta mortality was very high, although the number of sick was small, indicating tne io y state of the buildings from the very first. Nothing was done to improve them even im only fresh ship loads of sick were passed into them. The mortality of course LA Gece advance. Still nothing was done. Then came the great Crimean catastrophe, and ship after ship arrived with sick in so susceptible a condition that the foul air of these hospitals was almost certain death to them, and accordingly, as the diagram shows, they died, in the month of February, at the rate of 415 per cent. per annum. In 12 months at such a rate the whole sick population of the hospitals would have perished four times. ee ; | The reduction in the mortality after the sanitary works were begun is most striking, anc it falls eventually in June 1855 to less than a sixth part of what it was when the Barrack and General Hospitals were occupied together in October, 1854, and to a nineteenth part of what it was in February 1855. Our General Hospitals have been so deplorably us Managed in all our wars that the question has been raised as to whether it would not be better to do without them altogether The experience of Scutari, as shown on the diagram, proves that General Hospitals may become pest-houses from neglect, or may be made as healthy as any other buildings. ae ; fa cs The question of these zymotic diseases is of infinitely greater importance ee war ce during peace, for no weapons are so destructive of armies In the field as they — 1€ slaughter of battles and sieges is cast into the shade by that of pestilence, which during long wars is the real arbiter of the destinies of nations, for it exhausts their resources more completely than all other losses in the field. . : ¢ In a country like ours with a limited population, an entirely voluntary system 0 te - ment, and colonies and possessions in all climates and latitudes, the question oe a itary hygiene is rapidly becoming a question of vital importance to the interests of f 1€ ee Upon the British race alone the integrity of that empire at this moment dae to depen The conquering race must retain possession. Hxperience has shown that 4 Wee nse information and skilful application of the resources of science in preserving hea 2 the pe on our home population must exhaust our means. The introduction, therefore, of a proper sanitary system into the British army is of essential importance to the public interests. The Crimean experience has proved the whole case, both as regards the disastrous ae 8 of defective administrative arrangements, and the possibility of foreseeing and obviating simular evils in future. And it has, moreover, shown that, with troops like ours, whose bravery and uncomplain- ing endurance of hardships the most severe and fatal, have been the admiration of vee nae England has nothing to dread but the results of her own inexperience and want of foresight. Diagram K. Table K, fig. 2. DIAGRAM Z. Illustrative of the Quartermaster-General’s Regulations for Eneampments. Diagram Z is introduced to illustrate an important sanitary principle in camping troops, Diagram Z. viz., the relative density of the population of a camp according to the number of tents pitched Table Z. on a given area of ground. The Quartermaster-General’s “ Regulations for Encampments” of 11th May, 1853, con- tain three plans for encamping a battalion 850 strong. | 3 In plan No. 1, 60 tents are arranged in 10 lines of 6 tents toa line. Four of the lines are double, and there are two single lines. 3 Plan No. 2 shows a “ compressed” order in which the tents are arranged in 10 double lines of three tents to a line. Plan No. 3 has the tents arranged in 10 equidistant lines of six tents to a line. Fifteen men are allotted by the regulations to each tent. The occupied area in Plan No. 1, measured from the outer margin of the tents, is 210 x 36=7560 square yards. In plan No, 2, it is 220 x 18=3,960 square yards. In plan No. 3, the area occupied is the same as in No. 1, viz. 7,560 square yards. In all the plans the areas given include the spaces between the tents, and they correspond to what are called the “ built” and “ unbuilt” areas in towns. Plans Nos. 1 and 2 are so arranged that each double line of tents corresponds to the “built” area of a town, and the intervening spaces would represent the “ unbuilt” area. In plan No. 1 the area absolutely covered by two lines of tents, six in a line, and 2 yards between the lines is, yards 14 x 86=504 square yards. | In plan No. 2, six tents in two lines touching each other, cover aspace = 12x18 216 square yards, The following, on these data, would be about the population on the area of the camps reduced to a common unit :— Plan No. 1 = 348,000 per square mile. = 664,000 = 347,000 The occupied areas alone, without the open spaces intervening between the rows of tents are as follows :— Plan No. 1 = 1,044,820 per square mile. 39 39 2 aad 1,290,000 39 99 Sanitary principles of great importance are involved in the question of density of popula- tion upon a given area, and the whole subject has accordingly attracted considerable attention, more especially as it has been found that, other things being equal, the sickness and mortality among given populations bear a certain ratio to the density. The most densely peopled towns and districts are generally the most unhealthy. The prevailing diseases are fever, cholera, diarrhoea, consumption, and other diseases connected with atmospheric pollution. The air circulates less freely in densely populated districts, and the amount of organic refuse to be removed is, of course, much greater in proportion to the area where the population is more densely crowded than where such is not the case. Enquiries into the density of town populations have shown that the densities vary from 10,000 or 12,000 inhabitants per square mile on the “ built” and “unbuilt” area to 175,000 per square mile. In certain districts the population on the “ built” area greatly exceeds these estimates. Diagram Z shows the comparison between the density of population on the built and unbuilt area of the whole of London and on the Quartermaster-General’s plans. Each point represents a human being; the angular spaces the area allotted to each in the different densities, and the blue lines the distance from person to person. It will be seen that the least crowded of the Quartermaster-General’s plans affords about a twentieth part of the area per man allotted to each inhabitant of the metropolis ; that it is about half the amount of that in the most densely peopled part of London; and_ that the population on the occupied area of the camp is above 50 times more crowded than the population of London. If the metropolitan area were equally crowded as the camp No. 3 on the diagram, it would contain 42,000,000 of people.* If crowded as No. 2, it would contain 81,000,000. And if the metropolis were as crowded as the occupied area shown in the diagram, it would hold 127,000,000 or about four times the population of the three kingdoms! These comparisons will be sufficient to show the great importance of this element of over- crowding to the health of camps. z batiritey Total of the umbers Tagoo : Foot British aie Household Guards and of Glide Army at in 8ol, Cavalry. Dragoons. | the Line. Hoine: 1L9L1 90 99 157 50,387 588 38,242 22,099 293 10,005 84 3,638 49 67 136,277 1,498 1,818 2,545 2,776 co op) bo Smallpox ... Measles Scarlatina ... Quinsey Cephalitis ... Apoplexy ... Paralysis... Se Insanity (Dementia) Erysipelas ... Epilepsy : Phlebitis ... an ena Tetanus Typhus (and continued ) Cephalalgia Fever)... ae Neuralgia ... Carbuncle ... oe ne Ophthalmitis Influenza ... at as Otitis Dysentery ... Diarrhoea ... Cholera Ague soe ee He t Remittent Fever ... me : Order 2. Rheumatism (Acute and April Speirs 82,252 SDA EROS SO = 35,473 June aaa eee 38,863 Vly rete a 42,647 August 45. sca79 44,614 September... 47,751 October ses 46,852 November 3 87,858 December ass 43,217 January .. . 44,912 Pebruary oc 43,485 Warchcc Gk 46,140 — bo OMwWIoskaAPoohr Jao) ~T bo ©9 COP OO OH et pany EBwDoDmHaontwaans A Chronic) ... Be : Pericarditis ae Deaths: under i : ees ec) me he eee Sees Aneurism ... nder the head of ‘“‘ Wounds and Injuries,” comprise the following causes :— Heart Disease Luxatio, Sub-Luxatio, Vulnus Sclopitorum, Vulnus Incisum, Contusio, Fractura, Ambustio, and ORDER 2. | Varix Concussio Cerebri. Palpitatio .., Syphilis Hydrophobia Order 3. ORDER 3. Epistaxis . TaBLE K.—Figure 2. . | Privation ... ree ae } ye | Laryngitis... : Purpura and Scurvy Bronchitis ... (see above under Dy- 2,096 Pleurisy Annvat Rate of Mortraurry per Cent., on Sick Population at Scurart, from October Ist, 1854, sentery) ... Pneumonia es to June 30th, 1855. ce Alcoholism (includes ier | Asthma and Dyspnoea Delirium Tremens,other 281 Other Lung Diseases cases not returned) Annual Rate of Mortality per Cent. OrpER 4. ; Order 4. Scabies... es Si Gastritis Woorms=< ee ies Enteritis Dracununeculus ... ee Peritonitis ... 1854 October Ist to October 14th .. 148 Ascites eee we October 15th — Novemberllth .. 101 Uleeration-of Intestines ... November 12th — December 9th .. 121 : Orver 1. pee Goncipaie aL se Q a 10th — January 6th es 202 Rae ee a a | Intussusception very 7th — January 31st . Dropsy__... = ae Stricture of Intestines February Ist —- February Sth eons Cancer et Tumores ia Fistula : February 25th — March Pith 3 Mortification =e a Dyspepsia ... March 18th — April ees CE ae April 8th — April 28th 3. nee eas April 29th — May 19th .. : ORDER 2. H Pancreas May 20th — June Oth 5 Hepatitis ... June 10th — June S0th = ss Scrofula... a i Jaundice oH : Phthisis ... si Se | Other Liver Diseases Hydrocephalus... a Spleen Disease * No admissions or deaths were returned under any of these heads. Cla ss. Causes or Drarn. Admissions.| Deaths. | Class. Causzs or Dnata. Admissions.| Deaths. —_— | ——__ Se ey tenes st | Order 5. : Order 1. Nephritis (and Nephria) ... Gelatio (Frostbite) Ischuria_... ote ie Pernio (Chilblain) Nephria (see above) an i Sunstroke ... Diabetes... aes an Asphyxia ... ss Stone ay aa he i Poisoning ... oe oS pe oH Other violent Deathst ystitis ... 4 a ‘J r ? r deiuhice of Uscihee = DENSITY OF POPULATION. Hy drocele .3. se vegan cask Ee Order 2. ' Varicocele ... | Tassz Z. A few Districts of Great Density—consisting of Built Area and Streets. (It is not stated that all ‘these wounds and injuries Order 6. | were incurred in fizhting, Persons to a | but, there being no means s - Be “Mile (Not applicable to the of distinction, they have Districts and Towns. Square Mile, Army.) all been referred to this i 1841-50.* f Order.) . Luxatio : a so e Order 7. Subluxatio... ae ae East London oe a 5 175,816 Vulnus Sclopitoram a 2 | Strand ne ee £6 Ae 161,556 Arihratie’ oo ape ee pace NCIS 55S Hae Le St. Luke : 151,104 Ostitis and Periostitis ... Contusio ... Se ah 1 ; wie oa we ae ; a aes Joint Disease ce Se Practura —.:. re we 1h Holborn sce Bs ee pes i ce Exostosis ... Sas ae Ambustio ... aa Ree St. James’, Westminster .. sy tee 144,008 Necrosis, Caries, &e. —... Concussio Cerebri... = i Liverpool .. ws ae ie vee 69,368 Birmingham ; j a ; 37,504 os il Leeds vy e ee ssi “4 28,965 Order 8. : Order 3. Bristol pes p ae 8 22,606 Phlepinonens se pe Homicide... .... ce Nottingham : — ae ey 19,082 Uleer ae Re oS : East Stonehouse .. se ; ; 18,028 Skin Diseases... as h Lonpon .. ‘ ae cs ies 17,678 : we i Plymouth .. : Fe Se 17,368 Orders 1—38, Suicidet ... = ii Hall oo. a ve os 16,082 Manchester é ; ie = 10,664 (Not applicable to the Army.) Order 5, Execution ... Order 4. Punishment Atrophy and Debility ... Causes not Specified Quarter- Master General’s Plans for Encampments. * No admissions or deaths were returned under any of these heads. + These are not properly returned, but appear under the collective head of “ Accidental, Sudden, Ebrietas, and t : 9 9. } No. 2 . ° 664,000 Cold,” &e. N Occupied and Unoccupied 348 000 t Unsuccessful attempts at suicide were, apparently, not recorded. a oF Area. 2 sae § This case was returned simply as hanging. i No. 3 347,000 Norz.—The names of certain Orders as well as those of certain specific Diseases are omitted, as not applicable to the ; Army. Occupied Area... ie a eS 1,044,820 * The number of persons to a square mile in the districts and towns of England, calculated on the mean population of 1841 and 1851, has been taken from the Registrar-General’s Sixteenth Annual Report, Supplemental Tables, pp. 150—153. (G6-GFST) Adel, vl ystjsuy wos usyvy st ‘sose oaoqge oyy 4v ‘uoNendog sey ysiysuy oy9 Jo AzI[eyOTY, OUT — ALON ‘QSNOFT JOSIaWOYg “VdIO IoysISoy [elousy “ep ‘sIMAT SUNVE "sprvn4y) 4007 OV-SE ‘UOTULYSIL Sug ‘sparen 4004 ‘sparen 4004 a0 £4) WYSTLSUgy (SEE ey eee | ‘Spren4y) 400,7 sR i EAS FE SS TS 2 CTO SLRS I IO ETE CE-06 “WOULYS ISU aS SERA EEE ETT TS , } “MOULYST SU “SUIAT] 000T 0} A[TenuUy Sieguey@ i SHILVUC ‘soby buspuodsassoo yo voryetndog ee ysT[suy ay2 fo puv sprenyg 400,q a2 fo hyynpropy aarqnpagyy ayy buruasaudagy ‘(€E-6PS81) SqeL, OT yst[Suge wos uoyeq st ‘sade oaoge og) 4v ‘uoyvndog epepT ysipougq eyy jo Aqpeqtop, OY T—"aLON ‘Tap ‘SIMG'T SAV _. ERE SS SSS SSS SSS SSS SSS SS SS SS SSS SSS SS SSS SSS SSS ‘SOIp[OG YsTsugy 6-61 ‘MOULYST[SUAL ‘STOIPPOS YsTsug, ‘WOULYSIL SU ‘STOIPOS YstPsuy. “MOULYSTpSugy ‘STOIP[OS YsIpsug “HOULYST[ SURAT SHIVa ‘BUIAT] OOOT 0} AT[enuuy syyvoqg ‘saby buipuodse.t.oo gn woyeindog aeyAl ysI[suny oy7 fo pun emo 3e Away a2 fo hyyojvopy aaynpayy ayn Duajuasaudoy of the Non-Commissvoned Officers and Men and Colonial ¢ Ors, 1839 — 1853. 1... .. Modes in Healthy Iistricts . Sbldiers Mates ir Health y lhsirics SUMS ... Mates in Healthy Iisiricts ..., Soldiers Males in Healthy Districts SAMLES Males tn Mealihy Mhsiricts SAMS . Mates n Healthy Districts . Soldiers . Males in Healthy Districts Soldiers . Males in Healthy nstricts . Soldiers . Males in Llealthyy Lhstricts _ SHAT S .. Males in Healthy Districts . Soldiers .. Males wi Healthy Distruets . S0lMLEPS . Mates in Healthy Ihstriets .. doldiers .. Males in Healihy Districis ie asrae SAMLEPS .. Males ur Healthy Districts . Soldiers _ Males in Healthy Districts . Soldiers . Males i Healthy nstricts . Soldiers Fk We i RSENS” Harrison & Sons lith. St Martins Lame 8 represtiled as uniform we each of the YOUTS YIVOL the Lhugr ar CE) DHTAGRAM-— representing the relative Mortality of Males of the Soldiers Ages uring m Healthy isiruts ; and of the Non-Commissioned Officers and Man sirving ui te Arm y an oud and al home exclusive of Artillery, [toyad Ey queers, NestIndia, and Colonial ¢ OL08 1099 1850 Aroual Rate ot Mortality per 1000 DEATHS ..o.. .. Modes in Healthy hstrices _ Soldiers . Males tr Healthy Districts . SOMMIA'S .. Males in Healthy Nisiruts _ Soldiers _. Males in Healthy Districts SAMTTS : Males hdl Mealiny Mhsiricts SAMEAS ... Males in Healthy Disiricts . d0ldters _. Males mm Healthy Districts SOMMERS . Males in Healthy nstricts . soldiers . . Miles tr [lealtha Y lhstricts SHAT S SONS .. Males in Healthy Districts . Soldiers ... Males wi Healthy Districts ... d0ldiers Mates wr Healthy Ihstricts . doldierss Ky BS 8) XN SX mS oo . Males in Hedlihy Districts . SMES > SID Xs ~ .. Males in Healifvy Districts VIL 2 . Soldiers . Males ir Healthy Districts _. doldiers XN coo GIIF COMME : .. Males ir Healthy Districts GIG OF . Soldiers < Se Sy a NS EN or AE ot EE RE A ERNE eH ON CS Se a Flarrison & Sons ith. St Karting Lame NOTE. The Mortality of Males in the Healthy Distriets ts based on un average 9 Teurs and in this view ts represented as uniform ww each of the yeurs given wm the lhugram FT. Williams, dd.. General Reytster. UFtice Ly Wales, and of Ge Non - COMIRLSSLONCA. , Aa Colonia Corps, 7839 —I8 53, 0 Pe _....... Miles in Linyland & Wales ___. Soldters Pee ee ae .._ Males in Lingland & Wales 2 Soe rs : : ... . _Malesirn lkingland & Wales oe ee ee in Lingland & Wiles 6 ST ae, _Malesir Linglaund & Wiles See, wlinglind & Wales __ Sollrers _. Males wnLinglund & Wales _ soldrers Migs in Lingland & Wales __. Soldiers _ Males in Lingland & Wales ae Soldier. SS Males tr Lingland & Wales __ Soldlrers Males mLirnglind & Necles _ Moldiers Males nLingland & Wiles ape Soldiers Malesir Lr reglard & Wales See Soldier. 5% eo We: wn Lirgland & Wales _ Molders Males tn Lrgland & Wales we Soldiers _ . Merles tn Lirgland & Wales _._ _Solthers Leh. Ve nner rene ee Ee : ATA 2 : espe eae Fearrs NC of the Soldiers Ages i Lingland and Wetles. LHAGKAML - representing the relatwe Mortality of Males of the Soldiers Ages tving tn England and Wales, and of the Non - Commissioned Witcers and Men serving tr the Army, exclusive of Artillery, Royal Engineers West Irdia, and Colonial Corps, F839 S853. Ve ars. of Mortality ee eee DEATHS: - . ___ Males in England & Wales a eee _...Males in Lingland & Wales __ Soldters _. _Malesin Lingland & Wales _ Soldcers z __Soldrers 1843 o woe ro 8 a eee : ___Soldlers 13540 1S 47 IS#D sc : oe ee eee I 8 2 Malsmlingjglnd Was E46 : eee omen eae ee i pe _....Malesin Lingland & Wales | _. oldters IS HAT | : : wee EP it ee i SS : ~-........._... Males in Lingland & Wetes : eh eens zit peewee Lp OEe ___Solhers 1848 | : —n se t—(Ct 2 oe ees urea ec Sere 2 Sees as eee ge eee se __ .. Soldters _ soldiers , . one ce ee ee ee _--------.-Maks wnlingland & Wales : se | coe ee Malesin Lingland & Wales ee ee eee Se Oe ee | 7 _ Soldiers L097 P53 a : : a ee Males wn Lnglant & Wales : ae Solvers Average os, OTE a a OE EPR aes Meatles 72 Lingtand & Nacles TO3SP-SS eae cr eee er as Be 7a Lieers NODE. The Mortality of Mates.is based on an A verage of 3 Years and in this view is represented as tunitorm we cactr ok the years. givere in the Diagram. of the Soldiers Ages in See: CE.) DIAGRAM A Show ing lhe Numbers L wing and Lead al the Several Ages trom £0 —40; I-ENGLISH SOLDIERS. A ge. Ve sO) 30 SOOO 2000 3000 ee fOOO LIVING IOOO ‘0000 SOOO SOOO GOOO FOOO00O CAD, bar = NUMBEAS LIVING AND D 2. ENGLISHMEN. Age. oO Oo SOOO £LOO00O IOOO #000 IOOO 6000 7OOO SOOO I0OO S0000 : uy Q S Se S S S poe | S & jot x NOMB 38. ENGLISHMEN IN HEALTHY DISTRICTS. Age. O . Pe 30 SOOO 2000 IOOO zs FOOO 5OO0 LIVING 0000 FOOO SOOO IOOO LOO00 NUMBERS LIVING AND DEAD, Lhis:— the Lragram (L) shows Chat out of 10 000 Soldiers alive at lhe Age or £0, abou’ J000 are loving and 3000 are dead at the Ave £0. 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APRIL 1854 ro MANCHESTER. AYVNNVE 9S 91 EXPLANATION. The Diograms represent the ANNUAL RATE of Mortality par 1000 inthe Hospitals of the Army in the East for each Month from April 1654 to March 1656 The wine wrcle shows the Moriahiy. whach the Army would have experienced fit had been subject tothe same rate which prevaied in one of the unkealthiest Ceties of England (Manchester ).—The distances between the Conire anil the second, the stcond, and the third circles he. cath represent 100 deaths to 000 living. ___ The Anrual rate of Moriality in any particular Month is shown by the length of the radial tine extending from the centre inthe direction at te Month indicated on the ouier cree. Thus: in Jonwery 1855 the Annual voite of Mortality per 000 was M74: ahigher rate than tut which prevailed during the Morch (Sptember }when the Mortality was laghest tn the year of the Great Plague, 1665 43g0190 Harrison b Sons, Lith. 5é 1 OCTOBER eee mn Soe in I | | | f i 1859 ; TO MARCH 1854 S (black), _ APRIL AUSE (1) = D TA i DIC AGRA WSS representing the reoiive Mortality trom IXYpTIC DISEASES Glue). trom WOUNDS ke (rea), and trom ALL OTHER CAUSES ( blach),_ iN tHe HOSPITALS oF tHe ARMY in tHe EAST, APRIL 1855 TO MARCH 1856. FOR EA@E-MONTH FROM APRIL 1854 to MARCH 1856. APRIL 1854 TO MARCH 1855. JULY 4ugy, Su, SS, wR oS i NS 3 R00 eee ge a @ m | a Se = S - ~