stages of the manufacture, and especially in wool-combing and cloth dressing. Shoddy grinders, that is, persons employed in mills where old woollen rags are torn to pieces by a machine for the purpose of being manufactured, with the addition of new wool, into yarn, are also exposed to the inhalation of dust, and suffer in consequence from a complaint known as the shoddy fever, and characterised by headache, sickness, dryness of the throat, difficulty of breathing, cough, and expectoration. It is stated by Thackrah that the operatives in these departments are subject to chronic bronchitis and asthma. The male exceeds the female death-rate in all the places, excepting Halifax, where the female is higher than the male death-rate, and Stroud and Huddersfield, where the sexes die at an equal rate from pulmonary diseases. With the single exception of Melksham, the differences in the mortality of the sexes are inconsiderable in the chief seats of the woollen manufacture. Beyond the fact already noticed, that the adult male pulmonary death-rate is excessive in Leeds, nothing as to the influence of the woollen manufacture on health can be deduced from the present series of facts. Possibly, a minute investigation of the death-losses at the several periods of life in the other places might have furnished more positive results.

(b.) Silk Manufacture. The great diversity in the death-rates of the sexes is the first circumstance in the pulmonary death-rates in several districts of silk manufacture. The male is higher than the female pulmonary death-rate in Norwich, Derby, and Coventry; the female much higher than the male pulmonary death-rate in Leek and Macclesfield. The male death-rate in each place being considered as 100, the female death-loss would be 86.6 in Coventry, 93.6 in Norwich, 99-0 in Derby, 116-3 in Macclesfield, and 1190 in Leek. Silk and ribbon are the special manufactures of Derby, but the proportion of operatives employed in them is not large. In Norwich more men are employed in shoemaking than in the silk manufacture. The number of operatives employed in the latter form of industry is indeed too small to produce any great effect upon the general death-rate, even supposing the manufacture of silk to be prejudicial to health. Watch-making employs a considerable number of the men of Coventry, but a very large proportion both of the men and women are employed in the manufacture of ribbons and silk. Macclesfield and Leek, next to Coventry, are the two districts in which the largest proportion both of men and women are employed in the silk manufacture; they are therefore the districts in which we should expect most obviously to observe the influence of silk manufacture on health. In both places a considerable number of females. are employed in the prevalent occupation, and in both places also the female considerably exceeds the male death-rate. The excess for the whole of life is nearly equal in the two districts; but it is greatest in adult life among the women of Macclesfield, where a much larger number are engaged in this industrial employment. In Leek the pulmonary death-rate of adult women exceeds that of adult men in the proportion of 82 per 100,000. In Macclesfield the pulmonary death-rate of women exceeds that of men in the proportion of 148 per 100,000. The general death-rate of children is high in both places, and the pulmonary mortality under five years of age is in accordance with the high death-rate from all causes. The high deathrates of children show the existence of unhealthy influences which affect the entire population, but the excess of the female death-rates also shows that the women are acted upon by some special cause of ill health.

(c.) Linen and Flax Manufacture.-There are among the selected districts none in which the linen and flax manufactures occupy so prominent a position in the industrial occupations of the people as that held by woollen manufactures in Bradford and Melksham, or by silk in Leek and Macclesfield. A small proportion of the operatives in several places, as for example, in Leeds, are employed in the flax or linen manufacture, but this is so intermixed with other industrial employments, and is in itself so small in amount, as to render it impossible to estimate the influence of the occupation on health. The injury to health sustained by operatives in flax has long been known, and arises from the same cause as the asthma of lead miners and the grinders' rot, the inhalation of an atmosphere charged with dust, which irritates the bronchial membrane, leading to bronchitis and its consequences, emphysema and bronchial phthisis. Knaresborough and Pateley Bridge are the only two places amongst those to which the inquiry has extended in which the flax and linen manufacture forms a prominent feature in the occupations of the people, and the proportion in both is too small to afford any trustworthy conclusions. The high male pulmonary death-rate of Pateley Bridge is probably to be ascribed quite as much to the circumstance that 9.5 per cent. of the adult men are employed in lead-mining as to the fact that upwards of 15 men in each 100 are engaged in the flax manufacture. The natural position of Pateley Bridge is salubrious, it is remote from ordinary urban influences, and the people, chiefly of the agricultural class, are sparsely distributed on the surface of the earth, at the rate of only 70 to a square mile. Probably the pulmonary mortality of Pateley Bridge would have been small but for the influence exerted on its public health by the occupations of the inhabitants. This example may serve at least to show that other influences act on the public health, besides those which have been, not perhaps too prominently, but certainly too exclusively, put forward as the alpha and omega of sanitary requirements.

(d.) Cotton Manufacture. The pulmonary death-rates of seven towns and of one rural district in which the cotton manufacture forms the staple industrial employment of the people have been investigated. The mortality in Garstang is moderate, but nearly two-thirds of the adult men are employed in the cultivation of the earth, and the proportion either of men or women employed in factory labour is exceedingly small. The deathrates are high in all the other places. Although it has a larger proportion of agricultural labourers, and a smaller proportion of urban residents among its population than several places where the death-rates are lower, Preston stands next to Manchester in respect of pulmonary insalubrity. The aggregation of the inhabitants of Preston upon the surface of the soil is much less dense than that of Chorlton and Salford, but the proportion of paupers in the population of Preston is greater than in either of the other places. The female exceeds the male death-rate in Wigan and Blackburn, and is scarcely appreciably less than the male death-rate in Preston. A larger per-centage of women are employed in the cotton manufacture in these three towns than in any of the others in the table. Including the women employed in the woollen and silk manufactures of Manchester, as well as those employed in the cotton manufacture, 20.5 per cent. of the adult females of Manchester are engaged in the special manufactures of that city. This is by no means a large proportion, yet on comparing the pulmonary death-rates of the sexes in Manchester with those of Birmingham and Liverpool it is found that the difference between the pulmonary death

rates of adult men and women is less in Manchester than in either of the other towns. The difference in the death-rates of the sexes is very considerable in Liverpool, where the women follow no special occupation; less in Birmingham, where 7.1 per cent. of the adult women are employed in the manufacture of metals; least in Manchester, where 20.5 per cent. of the adult females are employed in manufactures. Assuming the adult male pulmonary death-rate of each place to be 100, the adult female death-rate of Manchester would be 85'4, of Birmingham, 77.3, and of Liverpool, 72.7. Another fact tends also to the conclusion that factory labour is unfavourable to health. It is, that whilst the pulmonary mortality of Manchester is, in both sexes, lower than the pulmonary mortality of Liverpool for the whole of life, it is higher in both sexes for adult life. Here again the influence of female occupation seems apparent, for the excess of the adult female deathrate of Manchester from pulmonary affections over that of Liverpool is very much greater than the excess of the male adult death-loss. Thus, whilst both Manchester and Liverpool sustain a high pulmonary mortality, the causes of this mortality fall with unequal severity upon the different periods of life. The exciting causes of the high pulmonary death-loss of Liverpool seem common to all ages, and therefore act with proportionably greater force upon the delicate and feeble constitution of young children. In Manchester, although probably similar causes are in operation, they are less powerful than in Liverpool, for the infantile pulmonary mortality as well as the infantile mortality from all causes, is less than in Liverpool; but other influences are also at work among the adult population of Manchester which aggravate the pulmonary mortality at a more advanced period of life.

(e.) The Manufacture of Hosiery and Lace.-Most of the places in which hosiery and lace are manufactured sustain a high pulmonary mortality. The female exceeds the male pulmonary death-rate in Belper, Basford, and Radford. In Hinckley, where about an equal proportion of men and women are employed in the manufacture of hosiery, the male is somewhat higher than the female death-rate. In Leicester and Nottingham the male very considerably exceeds the female death-rate. Nottingham and Leicester must in fact, as regards the proportion of deaths caused by chest affections, be classed amongst unhealthy places. The population of both places is dense, and the proportion of agricultural labourers small. There are, however, other town districts as purely urban in character in which the density of the population does not differ materially from Leicester and Nottingham, but which present a lower pulmonary death-rate. The population of Hull is rather smaller, that of Norwich somewhat larger, than the population of Nottingham and Leicester. The density of the inhabitants of Hull measured by their distribution upon the face of the earth is very considerable, but not quite so great as prevails in Nottingham, but the density both of Hull and Norwich is greater than the density of Leicester, yet the pulmonary death-rates of Hull and Norwich fall considerably below the pulmonary death-rates of Nottingham and Leicester. Coventry, Derby, Portsea, and Worcester, are other urban districts which likewise contrast favourably with Nottingham and Leicester as regards their death-rates from pulmonary affections.

7. MANUFACTURE OF SHOES.

The three districts, Wellingborough, Northampton, and Stafford, are remarkable for the large number of men employed in the manufacture of

shoes. The occupation is sedentary, and when too closely followed it is conducive to gastric affections, but it does not appear to be particularly injurious to the lungs. These three towns hold an intermediate position between the purely agricultural and the smaller manufacturing towns, as regards the proportion of mortality from pulmonary diseases. Notwithstanding that few females are employed in the special manufacture, the death-rates of the two sexes differ but little in Northampton and Stafford. In Wellingborough, where 20-2 per cent. of the women are employed in the manufacture of lace, the female very considerably exceeds the male pulmonary death-rate. I have already had occasion to remark the high female death-rates from pulmonary diseases in districts where the women are employed in the manufacture of lace, whilst the men are chiefly engaged in the cultivation of the earth. Here, then, is another example of the like kind, excepting that, instead of being engaged in the cultivation of the earth, a large per centage of the men of Wellingborough are employed in a special industrial occupation. It is, indeed, most remarkable that the female so frequently exceeds the male pulmonary deathrate in places where the women are much employed in special forms of

manufacture.

B.-CONTAGIOUS DISEASES.

(a.) Small-pox.-The death-rate of small-pox varies in different districts from a small fraction up to 145 per 100,000 persons of both sexes and all ages. The highest proportion of deaths occurs in certain districts of the south and west of England. The male exceeds the female small-pox deathrate in England and Wales, in the several great registration divisions, and, with the exception of Worcestershire and Monmouthshire, in which the male and female death-rates are equal, in the several counties to which this investigation has extended.

Taking England and Wales as the standard of comparison, the deathrates are below the standard in five and exceed it in six of the great divisions. The male mortality is highest in London, but the mean mortality in both sexes is highest in the south-western counties. The lowest mortality is presented by the eastern counties, where the small-pox death-rate is very nearly 50 per cent. below the small-pox death-rate of England and Wales.

The mortality in the counties varies to an even greater extent than that of the larger divisions. The death-rates of Staffordshire, Durham, and Cornwall, from small-pox, are more than four times as high as the deathrate of Lincolnshire. Lancashire, which among the counties presents the highest general death-rate, has a lower small-pox death-rate than either Cambridgeshire, Cumberland, North Wales, or Cornwall, in each of which the general-death-rate is considerably lower than the general death-rate of Lancashire. The mortality in some of the registration districts is exceedingly small, in several it is very large.

The male death-loss during the seven years was higher in proportion to the relative numbers of the two sexes resident in each place in 79 districts; the female was highest in 21 districts. It is, perhaps, not unimportant to note than in 10 of the districts in which the female exceeds the male mortality from small-pox, the female are also higher than the male death-rates from pulmonary affections. Of the 11 remaining districts, several are places in which the mortality either was remarkably small or was chiefly limited to one or two years. It may, therefore, be inferred that, excepting under

peculiar circumstances, small-pox is normally more fatal to males than to females.

Of all diseases, small-pox is perhaps that the mortality of which is the most certainly under the control of art. In the practice of vaccination we possess a means of prevention, the universal employment of which might indeed fail altogether to extirpate small-pox, but would at least, as has been well said, "render deaths by small-pox among the rarest entries in the register." The irregular and inefficient manner in which this important sanitary precaution is often performed may be learnt by comparing the mortality of Plymouth, Penzance, Portsea, Merthyr Tydfil, Redruth, and other places, which present a high death-rate from small-pox, with the mortality of Newcastle-on-Tyne, Liverpool, Nottingham, Northampton, Birmingham, Manchester, Tynemouth, Salford, and Chorlton, in each of which the number of deaths in proportion to the population is considerably less than half, in several instances less than a third, of the small-pox deathrates of the former places. There can be no doubt that the regular and efficient performance of vaccination on every child would almost entirely annihilate the mortality occasioned by small-pox, even in those places in which the mortality is smallest. The loss of life by small-pox is indeed small in comparison with what it was prior to the introduction of vaccination, but during the seven years comprised in the present inquiry upwards of 36,400 deaths were produced by small-pox in England and Wales. Most of these deaths would have been prevented had there been a perfect system of vaccination.

(b.) Measles and Hooping-cough often prevail at the same period, very frequently follow each other immediately in the same subject, and, when fatal, are each most commonly so from pulmonary complication. Measles is most fatal in the male sex in England and Wales, and in 10 of the 11 great registration divisions. The difference in the mortality of the sexes is usually small, being largest in London, where the deaths in each 100,000 males of all ages being 50, the female deaths, also in each 100,000 females of all ages, are 42. The female exceeds the male death-rate by 1 death in each 100,000 of either sex respectively in Monmouthshire and Wales. Out of 23 registration counties for which the death-rates have been computed, the male death-rate produced by measles exceeds the female death-rate from the same disease in 17, is equal to the female death-rate in 3, and inferior to it in the remaining 3. The male death-rate being considered as 100, the female death-rate in England and Wales would be 95. In London the male death-rate being 100, the female would be 84. Staffordshire and Lancashire among the counties present the highest death-rates from measles. Herefordshire, North Wales, and Bedfordshire present the lowest death-rates. The death-rates of Lancashire and Staffordshire from measles are each more than three times as much per 100,000 persons as the deathrates of Bedfordshire and North Wales, and more than four times as much as the date-rate of Herefordshire. The widest difference in the deathrates of the sexes occurs in Herefordshire, the healthiest county, and in Gloucestershire, also a healthy county. The male death-rates of each county being assumed to be 100, the female death-rates of the following counties would be-Staffordshire, 98; Lancashire, 93; Bedfordshire, 88; Herefordshire, 83; Gloucestershire, 81. Hooping-cough is more fatal to females than to males in England and Wales, in all the great registration divisions of the country, and in each of the 23 selected counties. The