OBSERVATIONS On the BILLS of MORTALITY, In CARLISLE, for the YEAR 1779.

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THE advantages which may be derived from accurate regiſters of Mortality, are thus illuſtrated by an ingenious Philoſopher and Phyſician; "The eſtabliſhment of a judicious and accurate regiſter of the births and burials, in every town and pariſh, would be attended with the moſt important advantages, medical, political, and moral. By ſuch an inſtitution, the increaſe or decreaſe of certain diſeaſes; the comparative healthineſs of different ſituations, climates, and ſeaſons; the influence of particular trades and manufactures on longevity; with many other curious circumſtances, not more intereſting to Phyſicians, than beneficial to mankind, would be aſcertained with tolerable preciſion. In a political view, exact regiſters of human Mortality are of ſtill greater conſequence, as the number of people and progreſs of population in the kingdom, may in the moſt eaſy and unexceptionable manner, be deduced from them. They are the foundation likewiſe of all calculations concerning the values of aſſurances on lives, reverſionary payments, and of every ſcheme for providing annuities for widows, and perſons in old age. In a moral light alſo ſuch Tables are of evident utility, as the increaſe of vice or virtue may be determined, by obſerving the proportion which the diſeaſes ariſing from luxury, intemperance, and other ſimilar cauſes bear to the reſt; and in what particular places diſtempers of this claſs are found to be moſt fatal." Percival's Eſſays, vol. 2d.

CARLISLE is ſituated in Latitude 54.55 North, and is ſurrounded by a wall about a mile and a quarter in circumference. The ſituation is rendered exceedingly pleaſant by its vicinity to three beautiful Rivers, with which it is almoſt ſurrounded. viz. The Eden on the north eaſt ſide, Peterel on the ſouth eaſt, and Caldew on the north weſt. CARLISLE contains two Pariſh Churches, viz. St. Mary's and St. Cuthbert's, beſide two Preſbyterian, and a Quaker's Meeting Houſe. A very conſiderable Linen Manufactory is carried on in this City, and the Printing of Calicoes is ſtill more extenſive. The air about CARLISLE is pure and dry, the ſoil chiefly ſand and clay. No marſhes or ſtagnant waters corrupt the the atmoſphere; its neighbourhood to a branch of the ſea, and its due diſtance from the mountains on all ſides render the air temperate and moderate.

In July 1763, at the requeſt of the late Lord Biſhop of CARLISLE, the inhabitants were numbered with great care and attention by the Rev. Mr Richardſon, the Rev. Mr Simpſon, and Mr Alderman Hodgſon. There were at that time in the City and Suburbs, 1059 families, and 4158 inhabitants.

In January 1780, a very careful and accurate ſurvey was made by Mr Stanger and Mr Howard, under my own inſpection. When there were in the diſtrict before ſurveyed, 891 houſes, 1605 families, and 6299 inhabitants. For a more particular account of the ſurvey ſee Tables I. II. III.

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This aſtoniſhing increaſe of 2141 inhabitants, which is above half of the original number, in the ſmall ſpace of ſeventeen years, may in ſome meaſure be attributed to the eſtabliſhment of manufactories for the Printing of Calicoes. About the year 1761, Mr Brummel introduced this kind of manufactory; and notwithſtanding the many difficulties, which naturally attend any new inſtitution, by his activity, perſeverance, and abilities he ſurmounted them all, and the art is now brought to great perfection. Soon after, ſeveral other gentlemen followed his example. There are at preſent four companies who daily employ about eight hundred induſtrious poor, in this Manufactory.

This increaſe of population too has taken place, during that very period, in which Dr Price aſſerts the depopulation of Great Eritain to have been rapid and progreſſive. And what makes this increaſe more remarkable, CARLISLE has during the whole period alluded to, been conſtantly ſupplying the army, the navy, the metropolis, and even the diſtant regions of India with her hardy, active, and enterprizing ſons.

From Tables No. II. and IV. we can with pleaſure demonſtrate the extreme ſalubrity of CARLISLE even in a very unhealthy year; a year in which no leſs than 129 perſons were cut off by two epidemic diſorders, viz. the Small Pox and Scarlet Fever. By the Bills of Mortality publiſhed in different towns in England, as well as the Continent it appears on an average, that in Vienna about 1 in 19 and a half of the inhabitants die annually; in London 1 in 20 and three quarters; in Edinburgh 1 in 20 and four fifths; in Leeds 1 in 21 and three fifths; in Dublin 1 in 22; in Rome 1 in 23; in Amſterdam 1 in 24; in Breſlaw, 1 in 25; in Berlin 1 in 26 and a half; in Northampton and Shrewſbury 1 in 26 and a half; in Liverpool 1 in 27 and a half; in Mancheſter 1 in 28; in Cheſter 1 in 40; but in the year 1774 when the Small Pox were very general and fatal 1 in 27; and in the Pariſh of Sedburgh in the County of York 1 in 37 and a half; and in Blandford Forum in Dorſet, 1 in 39; in CARLISLE this year 1 in 30 and three ninths.

Tables No. III. and V. are of the utmoſt importance to the Phyſician, the Politician, and the Calculator of Annuities, and to every one who has the health and happineſs of himſelf and family at heart. They at one view ſhew what diſeaſes are moſt incident and fatal to particular periods of life. They clearly demonſtrate as far as one year's obſervation can have weight, what periods of life are the moſt healthy, what are the moſt obnoxions to diſeaſe.

Thus we ſee in CARLISLE one in 6 and nine tenths nearly, of all the inhabitants under 5 years old, die annually; betwixt 5 and 10 years old 1 in 64 and ſix ſevenths; 10-15, 1 in 119 and one ſixth; 15-20, 1 in 168 and three fourths; 20-30, 1 in 132 and four fifths; 30-40, 1 in 146 and one ſixth; 40-50, 1 in 95 and one third; 50-60, 1 in 58 and four fifths; 60-70, 1 in 24 and one third; 70-80, 1 in 13 and three fifths nearly; 80-90 1 in 4 and five ſixths; and between 90 and 100 years exactly 1 in 5. As no particular epidemic diſeaſe occurred laſt year which had any conſiderable effect on the lives of adult perſons, it is apprehended theſe calculations for the periods above 10 years old, will not be attended with much variation in other years.

That women in general live longer than men, is almoſt univerſally agreed, and the following obſervations tend much to confirm the truth of this opinion. During the laſt year 12 perſons died between 30 and 90 years old, 8 of theſe were females, and between 90 and 100, 2 died, both females. See Table IV. In Table III. we ſee two people are above 100 years old and theſe likewiſe are ſemales.

Table II. which contains the number of Huſbands, Wives, &c. Shews how inferior in number Widowers are to Widows. There are above four Widows to one Widower, an aſtoniſhing [3]diſproportion, in what manner is it to be accounted for? The following cauſes are conceived to operate conſiderably.

I. Men are in general more intemperate than women. II. They are expoſed to greater hardſhips and dangers. III. Widowers perhaps in general have greater opportunities of getting wives, than widows have of getting huſbands. IV. Widows have a greater propenſity to live in towns than widowers. V. and laſtly, The conſtitutions of males, as ſitted for more violent and laborious exertions, are firmer and more robuſt than thoſe of females; their muſcular and nervous ſibres, may therefore be ſuppoſed to become ſtiff, rigid, and incapable of performing the functions neceſſary to health and life ſooner than thoſe of females, both on account of their original texture, and the friction which muſt neceſſarily occur from laborious exerciſe. But from whatever cauſes the difference of longevity betwixt males and females may ariſe, the fact itſelf is ſufficiently aſcertained by Table IV. where we find that between the ages of 60 and 70, altho there are a greater number of wives than huſbands, yet 11 huſbands and only four wives have died, and of all different ages 29 huſbands and 16 wives.

The Table of Deaths and Diſeaſes No V. is as accurate as circumſtances and the ſituation of things would poſſibly admit. With reſpect to the Small Pox, and Searlet Fever, their ſymptoms and marks are ſufficiently evident to prevent any ambiguity. 24 have died of unknown diſeaſes, which is a great number, but which muſt ever be the eaſe at CARLISLE where many of the lower claſs (although they may have advice gratis) never call in medical aſſiſtance.

Only ſeventeen have fallen victims to Conſumptions, a number but ſmall, when compared with the number, which uſually die of that diſorder in other towns, and ſtill ſmaller when we conſider how many are employed in the manufactories of weaving and Calicoe printing*, where they continually breathe air by no means the moſt pure; and where they are ſubject to ſudden alterations of heat and cold. 5 perſons have died of this diſeaſe between 20 and 30 (ſee Table No V.) which conſirms the general obſervation, that during that period of life people are moſt liable to Conſumptions. It therefore behoves ſuch to be very cautious upon catching cold, leaſt by neglect and delay, a complaint which at the beginning might have been eaſily removed, ſhould gather ſtrength, and at laſt terminate in a fatal diſeaſe.

Three died of Dropſy (viz. Anaſarca) which in all was evidently occaſioned by exceſſive intemperance. Nervous and putrid fevers are not very frequent; no more than five have ſuffered by both theſe diſeaſes, which muſt appear ſomewhat aſtoniſhing to one who knows how many inhabitants there are of the loweſt rank, who are crouded in cloſe and ſmall apartments where they ſleep, eat, and prepare their victuals; whoſe food can not be the moſt nutritive; who ſeldom change their cloaths; and who pay but little attention to cleanlineſs. May not the ſtreams of water, which fortunately run near the moſt crouded parts of the town, tend to purify the air and prevent putrid fevers.

Agues or intermittent fevers are ſcarce ever known, a ſtrong proof that the effluvia ariſing from marſhes is the principle ſource of that diſeaſe.

In February, a poor girl either for ſome real, or imaginary complaint, was adviſed by an acquaintance as ignorant as herſelf, to take a large quantity of ſteel filings, which had been procured from a White Smith, or Watch-Maker. Not long after ſhe had taken them, ſhe [4]was ſeized with pains in her ſtomach and bowels, which ſoon increaſed to a moſt violent degree. Every remedy which could be ſuppoſed uſeful either in a ſevere cholic, or inflammation of the ſtomach, was fried, but in vain. She continued in the greateſt agony for two days and then expired.

During her ſickneſs ſhe was repeatedly aſked, if ſhe coud aſſign any cauſe for her diſorder, but ſhe always anſwered in the negative. Soon after her death, however, ſome ſteel ſilings were found in her room, and another ſervant in the houſe, on being examined, confeſſed that the deceaſed had taken three tea ſpoonfuls mixed with treacle, a few hours before ſhe began to be ill. Three tea ſpoonfuls of the filings which were found, weighed ſix drams and a half, and upon examining them with a magnet, I found a quantity of lead and ſome copper filings. Had the ſteel been pure, the quantity alone was ſufficient to have produced fatal effects, but here no doubt the lead and the copper would add conſiderably to its acrimony.

Let the death of this unfortunate young woman be a caution to others; and let Watch-Makers and White Smiths be careful to whom they ſell ſteel filings, eſpecially till they are ſeparated from every impurity by the loadſtone or ſome other method.

During this year two epidemics raged with uncommon violence, and ſwept off a great number of children, viz. the Small Pox and a ſpecies of the Scarlet Fever. As the Scarlatina Angiurſa or Scarlet Fever and Sore Throat is rather an uncommon diſeaſe, and not perfectly un [...]erſtood, it will not be improper to take notice of it in this place. The limits, however, of this ſheet, will by no means admit a thorough diſcuſſion of a diſeaſe, which has within theſe two years been ſo general and ſo fatal to children. I ſhall content myſelf with defining the Scarlet Fever and Sore Throat as it occurred at CARLISLE; afterwards attempt to point out its nature; the ſymptoms by which it is to be diſtinguiſhed from other diſeaſes; its terminations; and laſtly its method of cure. This epidemic made its appearance in July, was at its acme during September and October, and gradually abated till the latter end of December, when it almoſt entirely diſſappeared.

DEFINITION.

The Scarlet Fever and Sore Throat, is a contagious inflammatory fever. On the ſecond day of the fever, the throat becomes ſtiff and ſore, attended with ſome difficulty of ſwallowing; on the third, ſometimes not till the fourth, the face begins to ſwell and grows florid; this ſwelling and redneſs, ſoon become ſo univerſal, as to make the whole body reſemble a boiled lobſter in colour. On the ſeventh, or eighth day, the ſwelling and ſcarlet colour gradually abate, and the ſcarf ſhin becomes rough, and peels off in ſmall branny ſcales.

DIAGNOSTIC SYMPTOMS.

To an inaccurate obſerver, this diſeaſe may ſeem to bear a very near reſemblance to many eruptive fevers; the intelligent and attentive practitioner, will however, find no difficulty in diſcriminating it from all, but the Cynanche Maligna or Putrid Sore Throat, which eſpecially at the commencement of the Epidemic will be no eaſy matter. The diſtinction however, is extremely neceſſary, as the method of cure is almoſt diametrically oppoſite. We [5]ſhall therefore attempt it. Both diſeaſes are highly contagious; both attended with a fever; both with an affection of the throat; and both with an eruption of the ſkin. Yet each diſeaſe has its peculiar fever; peculiar ſore throat; and peculiar eruption. In the Cynanche (both for the ſake of brevity and perſpecuity we ſhall make uſe of the Generic term) the fever is conſtantly accompanied with a weak, quick, ſmall and unſteady pulſe. In the Scarlatina the pulſe is quick, full, but ſeldom hard. In the Cynanche the throat and fauces are full of creeping ulcers, covered with browniſh aſh coloured ſloughs. In the Scarlatina there are ſeldom any ulcers, but often whitiſh mucous ſloughs ſometimes extending over the whole tongue and inſide of the mouth, which may be eaſily waſhed off with a little wine and water. The eruption in the Scarlatina is florid, univerſal, ſmooth, ſeldom prominent, and always dry. In the Cynanche, neither ſo florid, nor ſo univerſal, and in general rough, prominent, and often moiſt. The Cynanche chiefly affects the weak and delicate; females, more frequently than males; whereas robuſt, and plethoric children are more ſubject to the Scarlatina. The Cynanche is almoſt conſtantly accompanied with a fetid breath, and an acrid corroſive humour is diſcharged from the mouth, noſe, and anus, which excoriates the ſkin. Theſe diſagreeable ſymptoms rarely occur in the Scarlatina. In the Cynanche, the colour of the blood is florid, its texture looſe and tender. In the Scarlatina it is firm and covered with a buffy coat. The Cynanche is cured by tonics and antiſeptics; bleeding, purging, and emetics, are univerſally hurtful. The principal remedies to be depended upon in the cure of the Scarlatina, are blood letting, emetics and the antiphlogiſtic regimen. Laſtly the Cynanche is highly putrid. The Scarlatina is inflammatory, as may be eaſily deduced from the following circumſtances, 1ſt. The robuſt and plethoric are more ſubject to it than the weak and delicate. 2d, There is a manifeſt ſwelling, redneſs and inflammation of the ſkin. 3d, The pulſe is full, and generally riſes after the firſt bleeding. 4th, The ſurface of the blood is covered with a firm buffy coat. 5th, In caſes, where the lancet was not freely uſed, ſuppurations ſometimes occurred in the throat. 6th, and laſtly, evident advantages were derived from bleeding.

TERMINATIONS.

The Scarlet Fever and Sore Throat ſometimes terminates in Dropſies, Deafneſs, Tumours and Suppurations in the Neck.

METHOD OF CURE.

From the definition already delivered, we learn that the Scarlet Fever and Sore Throat is a contagious diſorder. The occaſional or immediate cauſe muſt therefore neceſſarily be a peculiar kind of poiſon, of a volatile nature, readily mixing with the air. And many circumſtances render it probable that it is firſt applied to the mucus membrane which lines the mouth, noſe, fauces, ſtomach, &c. Emetics therefore are indicated, as remedies the moſt likely, to expel either the whole or a part of this poiſonous matter; and if they were uſed ſoon after the application of the poiſon, it is probable the diſeaſe might in many caſes be prevented. It is a certain fact, they have been employed with great advantage, and ought never to be omitted. The efficacy of Emetics does not however, by any means ſolely depend on their expelling the contagious virus; they unload the ſtomach, often gently move the belly, and have conſiderable effect in producing a copious ſweat, and in removing a ſpaſm of the ſmall veſſels on the [6]ſurface of the body, which is a part of the proximate cauſe of all Fevers. Emetic Tartar diſſolved in water appears to be the beſt vomit.

Of all the remedies made uſe of in this Epidemic, none were of more real advantage than bleeding, which was ſometimes repeated three or four times; ſo great was its efficacy, that I believe not one patient died, who loſt a ſufficient quantity of blood early in the diſeaſe. Many caſes however occurred where the mildneſs of the complaint rendered bleeding and almoſt every other remedy unneceſſary.

The Saline Mixture with a ſmall addition of Tartar Emetic, was of ſignal ſervice. It acted as a diuretic, ſudorific and gentle laxative. Immerſion of the feet and legs in warm water, often promoted perſpiration and a tendency to ſleep. A Gargle of red wine and water was uſeful in waſhing off any mucous ſloughs. The judicious application of theſe remedies, with plenty of diluents, and the antiphlogiſtic regimen ſeldom or never failed to produce the moſt happy effects.

Nearly about the ſame time, the Small Pox (ſee table No V.) began to rage with great violence. As the perſons affected with this diſeaſe were chiefly of the lower claſs, who ſeldom called in medical aſſiſtance, it is impoſſible to aſcertain the preciſe number: from the information however which I have had, it appears, that about 300, were during the laſt ſix months of the year, ſeized with the Small Pox in the natural way. Of theſe no leſs than 90 fell victims to its virulence. Hence near one in three died of all that were affected with the natural Small Pox, which while at the ſame time it ſerves as a melancholy proof of its fatal effects, points out the great and ſalutary advantages which are derived from inoculation. During the ſame period ſeveral hundreds were inoculated in the neighbourhood of CARLISLE, and it is a pleaſing truth, that not one of them died. Had thoſe 300 been inoculated it is more than probable that of the 90 not above 6 would have died, and even theſe not of inoculation but of other diſorders. Hence we ſee 84 perſons might have been ſaved to their parents and the public. Yet ſo great is the prejudice againſt the ſalutary practice of inoculation amongſt the vulgar, that few, very few, can be prevailed upon either by promiſes, rewards, or intreaties to ſubmit to the operation. No wonder that in rude, ignorant, and barbarous times, ſuperſtition hurried men into the groſſeſt abſurdities; when in a poliſhed and enlightened age; in an age too, when the experience of full twenty years has clearly demonſtrated the utility of inoculation, we ſee the bulk of mankind ready to ſacrifice their children and all that is dear to them, to a fooliſh prejudice.

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TABLE I.
 houſesfami.malesfema.Total of both ſexes    
Engliſh-Street2083196397321371Total within the wallshouſes 549families 870inhabit. 3504
Scotch-Street122197354437791
Fiſher-Street5382130194324
Caſtle-Street81143220307527
Abbey and Annet-Well Street77121173270443
The Abbey88173148
Botchard-Gate95202385457842total without the walls3427352795
Richard-Gate82177307356663
Caldew-Gate1653565926981290
New-Town1619405292total in the villages   
Harraby910314172   
Carleton30306667133   
Wreay17185658114   
Briſco3234107851922572671378
Botchardby2122465298   
Uprightby2021355489114818727677
Bleck-hill6364176178354   
Cummerſdale22226050110   
Morton-Head and Newby27275767124   
Total in the two Pariſhes11481872359141867677 Females exceed Males 595 Males to Females as 1 is to 1 and 1 ſixth nearly.

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TABLE II. Of the Number of Huſbands, Wives, &c.
 HuſbandsWivesWidowersWidows  
Within the walls53156946248Total of perſons who are or have been married3073
Without the walls48852245160Total of perſons who are married2489
In the villages1881911768Total of perſons who never were married4604
 12071282108476Total of umarried perſons5188
     Widows exceed Widowers368
     Widowers to Widows, as 1 is to 4 and 3 ſevenths nearly.

TABLE III. Of the number of Inhabitants of different ages.
 under 5 yearsbetw. 5 & 10 years10 & 1515 & 2020 & 3030 & 4040 & 5050 & 6060 & 7070 & 8080 & 9090 & 100100 & 105total
Within the City and Sub [...]rbs859731587543103073372949837516444516299
In the Villages17017712813229814412990632714511378
Total10299087156751328877858588438191581027677

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TABLE IV. Of Deaths, Ages, and Conditions.
Agesmalesfema.
Under 1 month67
Betw. 1-2 mon.2 
2-3 2
3-65 
6-924
9-12109
1-2 years old2112
2-31719
3-4108
4-5610
5-1077
10-1543
15-2022
Total of the above Ages9283

Ages.Batch.Huſb.widors.maidswiveswids.Total
20-3023 33112
30-40 3  3 6
40-50 4 2219
50-60142 2110
60-70 11114118
70-80 331 714
80-90 1311012
90-100   11 2
total of ages & cords32999161783
Total of ages under 20 years Males 92 
Total of ages under 20 years Females 83175
Total of all Ages and Conditions258

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Looſeneſs (57)3        1  4
Inſanity (63)     1      1
III. DISEASES of the HABIT.             
Weakneſs of Infancy (65)9           9
Decay of Age (66)        4611223
Dropſy (71)      1 2   3
Dropſy of the Head (72)  1         1
Dropſy of the Belly (75) 1   1      2
King's Evil (80) 1          1
IV. LOCAL DISEASES.             
A Diſcharge of Blood (102)      1     1
Coſtiveneſs (107)1           1
Tumour of the Stomach (113)       1    1
Ulcer (128)      1     1
Difficult Delivery    11      2
Unknown Diſeaſes6 1  222731 24
Accidents1 1 2       4
Total15014741269101814122258
* Cullen's Genera Morborum.

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TABLE V. Deaths and Diſeaſes of Perſons of Different Ages.
DISEASES.under 5 yearsbetw 5 & 10 years10 & 1515 & 2020 & 3030 & 4040 & 5050 & 6060 & 7070 & 8080 & 9090 & 100total
I. FERRILE DISEASES.             
Inflammatory Fever (G. 4*)3           3
Nervous Fever (G. 5, 6)1  1 11 1   5
Pleuriſy (G. 12)       11   2
Inflammation of the ſtomach from a largedoſe of Steel filings (G. 15)   1        1
Rheumatiſm Chronic (G. 22)         1  1
Gout (G. 23)       1 1  2
Small Pox (26)8621 1       90
Miliary Fever (29)    1       1
Scarlet Fever (30)314211       39
Thruſh (33)2           2
Conſumption (35)32115 23    17
Worm Fever24          6
II. NERVOUS DISEASES.             
Palſy (41)       1 1  2
Swoon or Fainting (42)      1  1  2
Indigeſtion (43)        1   1
Convulſions (48)2            

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TABLE VI.
Deaths inmales.femalesTotalTotal of Deaths in each Seaſon.
January,471133 Winter.
February.6410
March6612
April,63934 Spring.
May,71017
June,538
July,7714
Auguſt1451975 Summer.
September,202242
October,302353116 Autumn.
November,182038
December.101525
Total133125258

Chriſtenings,Males.femalesTotalN. B. The Chriſtenings are by no means accurate, many of the Diſſenters not being regiſtered.
 102109211 
Notes
*
Notwithſtanding the impurity of the air breathed by Calicoe Printers, and the ſudden changes of heat and cold which they are ſubject to, yet men following that buſineſs, are obſerved to be very healthy. May not this be owing to the acid ſteams continually exhaling in a Print Shop?
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TextGrid Repository (2020). TEI. 5544 Observations on the bills of mortality in Carlisle for the year 1779. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5C3C-B