The fourth table also relates to the last four years. It restricts itself to those various forms of acute disease--epidemic, endemic, and infectious, which occasion, most of all, the predominant mortality of particular districts or seasons; and which are susceptible, in the highest degree, of being mitigated or removed under an efficient sanitary system. In their general import these documents agree very nearly with last year’s record; though showing unfortunately a somewhat higher death-rate (23·62) and especially a larger proportion of fever. On former occasions I have examined, with great minuteness, all such facts as these tables set forth, and have offered you the best suggestions in my power for the mitigation of preventable disease. The sanitary condition of the City is now substantially the same as at the date of my last Report; and any comment which I might make on the present tables could be little else than a repetition of arguments already submitted to your notice. Therefore, as other topics[76] of importance to the health of the City press for more immediate consideration, I refrain from occupying your time by any further remark on the materials which I subjoin. [76] We were at this time closely occupied in considering the general questions of extramural interment for the City.--J. S., 1854. I have the honour, &c., &c. FIFTH ANNUAL REPORT. _November 29th, 1853._ GENTLEMEN, According to the practice of previous years, I lay before you, in the annexed tables, a brief digest of your death-register for the fifty-two weeks which terminated at Michaelmas last. The deaths there enumerated amount to 3040--being 24 fewer than in the last preceding similar period. Beyond these statistics of the past year, there are other facts which I have thought it well to tabulate for your information. They relate to the entire term of five years, during which I have kept record of your mortality. Midway in this quinquennial period--namely, in the spring of 1851, the general census happened to occur. The inhabitants of the City, then enumerated, may fairly be taken to represent the mean of your somewhat fluctuating population; and the five years’ mortality, compared with the numbers of this mean population, will express pretty accurately their habitual death-rate. The period mentioned is indeed short for the purpose of establishing an average; but ten years at least must elapse before even similar materials can again be given for calculation, and a still longer time before the statistical basis can be enlarged. I have therefore thought it desirable to make the best use in my power of such facts as were before me, for the construction of quinquennial tables; out of which, with sufficient accuracy for all practical purposes, you may draw your own inferences as to the health of that large population which is under your sanitary government.