72 MR. J. BAXENDELL ON CHANGES IN 



diseases Avas 21 "6 per cent., which represents a saving of 

 63,886 lives. 



There is one disease which^ owing to the deaths caused 

 by it not averaging 2500 per annum during the last ten 

 years, has not been included in the list of those which 

 have increased in fatality, but which, I think, ought not to 

 pass without notice. This is nephria or Bright's disease. 

 In the ten years 1854-63 the deaths from it were 11,948 ; 

 but in the following ten years they were 23,802. The in- 

 crease in the death-rate from this cause therefore amounted 

 to 76-6 per cent., or more than double the rate of increase 

 of bronchitis. 



It is very commonly supposed that all the zymotic dis- 

 eases are preventible, or under the control of sanitary au- 

 thorities ; and it may be objected that I have taken only 

 the eight infectious diseases to test the utility of the sani- 

 tary measures which have been carried out during the last 

 twenty or thirty years. To meet this objection it may be 

 well to state that the total number of deaths from all the 

 zymotic diseases in the ten years 1854-63 was 973,248, 

 and in the following ten years 1,109,824. These numbers 

 give an increase of i'o8 per cent. ; and therefore, if sanitary 

 measures are to be tested by the impression they make 

 upon the death-rate from the whole class of zymotic diseases, 

 it is evident that the measures hitherto adopted have en- 

 tirely failed to produce any improvement of the public 

 health. 



The results which I have now laid before the Society, 

 though, perhaps, not so full and complete as might be de- 

 sired, are, it seems to me, quite sufficient to justify the 

 following conclusions : — 



(1) That sanitary measures, tested by their effect on the 

 diseases which are universally admitted to be infectious, 

 have produced a slight improvement in the public health, 



