The statistics of all our large towns demonstrate the great and unnatural destruction of life that takes place in these centres of civilization, where the highest medical skill is found, and placed freely at the call of poor as well as rich. The natural death-rate at present is 17 per thousand--_i.e._, that under the most favourable conditions as amongst the upper classes in our healthiest cities, in the healthiest country districts, 17 out of every thousand persons die each year all the world over, a lower mortality being exceptional; but the following was the death-rate of our chief cities (1868) instead of the natural rate of 17 per thousand: Bristol, 23; London and Birmingham, 24; Dublin, 25; Edinburgh, 27; Liverpool, 29; Glasgow, 30; Manchester, 32. That means that in London alone, in a year of no special sickness, more than 21,000 were killed who ought to have lived. In the British Islands an army of over 176,516 lives were swept off unnecessarily. This is not all: a much larger proportion of the population is always ill at one time; about 78,000 in London is reckoned, of whom one-third are suffering from preventable diseases. This calculation does not take into account those feeble, ailing persons who are never more than half well, who lack strength and energy for the daily fulfilment of duty. It is shown that in the whole of England the people have only a mean life-time of forty-one years--not half the term of life that seems to belong naturally to our race. Of those who died within the year, over 134,000 were in ripe manhood; but yet more noteworthy are the deaths under the age of twenty-five: over 242,000 perished in childhood and youth. The wholesale slaughter of children in our civilized country is truly appalling. Out of 233,515 deaths at all ages, 94,804, or 40·60 per cent., were those of children under five years of age. To understand fully the grave import of these records three facts must be noted: first, that the death-rate of a country is always under-stated; second, that town populations increase at a much more rapid ratio than country populations; third, that the death-rate increases in direct proportion to the density of the population. In proof of these three propositions let me quote from recent testimony of our most eminent statisticians: