AND ENVIRONMENT 41 



Edinburgh, which is outside the walls. Its inclusion 

 makes the returns less favourable by about 10% for 

 Edinburgh. But taken as they are, we see (Fig. IX) that 

 Edinburgh occupies a position very close to the eight 

 principal towns of Scotland, and that it would be worse 

 than those towns if we excluded Glasgow. We see 

 further that originally Aberdeen and Edinburgh fell in 

 close relationship, and that now Aberdeen, without any 

 dispensary system hke the Edinburgh one, is ahead of 

 Edinburgh. Again, although the total rate is higher in 

 Glasgow than in Edinburgh, as we should expect in a 

 town which collects large quantities of the general 

 labouring class, yet the fall in the phthisis rate in 

 Glasgow has been more continuous than in Edinburgh, 

 if you take the whole period of our knowledge.^ Aber- 

 deen could with equal logic claim that an absence of 

 the dispensary system had enabled it to produce a larger 

 fall than Edinburgh in its phthisis death-rate. We 

 must, I think, conclude that the fall that we find in 

 Edinburgh is not peculiar to Edinburgh, and that if the 

 dispensary system has produced this result there, some- 

 thing equally eifective has produced and is producing 

 the like effect elsewhere. The same story may be 

 read from Fig. X, which gives the ratio of phthisical to 

 all deaths. The fall in the phthisis death-rate in Scot- 

 land dates from long before the time of dispensaries or 

 sanatoria. From 1868 to 1875 it was as great as it has 

 been in the last 15 years. What logical right have we 

 to pick out one town and one period, and say it is due 

 to a certain treatment, whereas in other towns, where 



1 Note also (i) that the general death-rate in Edinburgh has fallen in much 

 the same manner as the phthisis death-rate, and (ii) that for ten years the 

 dispensary system produced no effect on the phthisis death-rate. 



