In Report 54, Table 17, the annual death-rates from various causes per million of population are given, and arranged in groups of five years from 1858 to 1890. We have there a history of thirty years, and even in that time a notable change in this history is to be observed. I have arranged the greater number of facts given in Table 17 in the following table, so as best to bring out those points which we are discussing. In the first group of disease are those due to micro-organisms, and a diminution of these diseases to a marked extent is to be observed of late years. Phthisis and scrofula placed by themselves in this group share in this decrease. In the second group are diseases that are due in great measure to carelessness, want of management, neglect and ignorance, such as convulsions, diseases of dentition, parturition and registered accidents. These, too, as one would expect, diminish yearly in a country where surrounding comforts and a sense of responsibility are on the increase. When we turn to the third group, that of constitutional disease, where the hereditary tendency comes in, we find an increase in almost all the hereditary diseases. A tendency to an increase of neurotic affections is shown by an increase in the deaths from nervous diseases, suicide and intemperance. A large increase in the diseases of the respiratory system is due in part to the increasing number of tuberculous patients who, kept from inroads of microbes, nevertheless readily fall a prey to other affections: there is, too, an increase in diseases of the circulatory system, in cancer, diabetes and other constitutional diseases. Annual death-rates in England from various causes, per million persons living, in groups of years 1858–1890-- KEY A: Phthisis and scrofula B: Other diseases of micro-organisms C: Diseases of dentition, parturition, convulsions, accident and negligence D: Some constitutional diseases ------------------------------------------------------------------------- CAUSE OF DEATH. 1858–60. 1861–65. 1866–70. 1871–75. 1876–80. 1881–85. 1886–90. ------------------------------------------------------------------------- GROUP I. A 3304·0 3311·0 3300·2 2940·6 2816·8 2540·8 2322·2 B[17] 4403·9 4498·6 4677·2 4055·8 3233·6 2708·8 2417·0 GROUP II. C 2257·0 2262·0 2191·0 2077·2 1860·4 1678·6 1538·0 GROUP III. D[18] 6056·3 6311·4 6594·6 7199 7536·4 7531·2 7929·4 ------------------------------------------------------------------------- [17] These include small-pox, measles, scarlet fever, simple and ill defined fever, whooping cough, diphtheria, miasmatic diseases, cholera, diarrhœa, dysentery, erysipelas, puerperal fever and thrush. [18] Diseases of the nervous, circulatory and respiratory systems, cancer, diabetes and other constitutional diseases.