[From Causes of Consumption, 1899]

CHAPTER V.

PREVALENCE OF CONSUMPTION IN THE ISLE OF MAN.

Before the passing of the Registration Act, in 1876, it was impossible to ascertain with any accuracy the amount of phthisis in the Isle of Man. Nevertheless, there was a general impression, both among the laity and the profession, that the Manx death-rate from consumption was in excess of that in England. I have been at some trouble to get the opinion of our older and more intelligent farmers in various northern parishes, and there seems to be a remarkable unanimity on two points, firstly, that consumption is more prevalent here than on the mainland ; and secondly, that it is not as common now as formerly. On the other point, also, there was a marked agreement ; but as that refers to the cause of this prevalence, I shall reserve it for the next chapter. One would naturally expect then, that in due time the Reports of the Registrar-General for the Isle of Man would furnish statistics that would convert a popular belief into a proven fact. No one was, therefore, surprised, when in 1883, Dr. Haviland, in a lecture delivered in Douglas-his Excellency Spencer Walpole, Esq., Lieut.-Governor, being in the chair showed that the annual death-rate from phthisis per 10,000 living in the Isle of Man, was 31·63, whilst in England it was only 21·30 At the time of this lecture, however, Dr. Haviland's figures were restricted to the years 188o, 1881, 1882 ; and, therefore, the results arrived at cannot be accepted with the same confidence that they would he if they covered a longer period. Nevertheless they fully justify us in asserting that fifteen years ago the deaths from consumption, which in England amounted to a terrible rate per annum, were half as many again in the Isle of Man.

Dr. Haviland also published a phthisis mortality table giving the averages for each parish and town in the Island, and these figures he used to illustrate his theory that strong winds are a predisposing cause in the production of phthisis. Since this lecture was delivered, fifteen years have elapsed, and consequently more reliable statistics can be obtained than three solitary years could possibly yield. Below I give the total deaths from consumption for each year since 1883 in the Isle of Man :-

TABLE IX.-Deaths from Consumption in the Isle of Man.

If we divide the fifteen years into three periods of five years each, we shall be able to see the increase or decrease in the number of deaths from phthisis in each parish and town, and we can reduce the actual numbers to the annual average mortality per 10,000 persons living. In working out the ratio, I have struck a mean population between the 1881 and 1891 census.

TASLE X.

In order to facilitate a comparison between the results obtained on a three years' basis, and those on a fifteen years' basis, we place the two in parallel columns.

TABLE XI.-Annual Phthisis Mortality per 10,000 persons living.

We now see the serious discrepancies that arose in the 1880-2 calculations, discrepancies that the author was in no way responsible for, but arising out of the fact that very limited statistics were at his disposal. How the geographical distribution of phthisis in the Isle of Man, as based upon the more recent observations, will affect the deductions drawn by Dr. Haviland in support of his theory of causation, will be discussed later. To impress in a ready and forcible way this distribution of phthisis, and at the same time to aid comparison, I append two maps, the first one prepared by Dr. Haviland, and published by kind permission of Messrs. Brown, of the " Times," and the second prepared by myself.

In comparing the numbers who die from phthisis in the two sexes, we find that the females are more prone to the disease than the males, although the difference disappears to a great extent when we remember the preponderance of females over males in the total population. We will take the three quinquennial periods.

TABLE XII.-Male and Female Phthisis Mortality. Total Number of Deaths during

Let us now look at the phthisis rate for England and Wales for say 10 years :

TABLE XIII.-Phthisis Mortality Rate-England and Wales.

It is very evident that the amount of consumption in the Isle of Man is terribly in excess of that on the mainland, and although a marked improvement can be noticed in the 1883-1897 period over the 1880-1882 period-an improvement that comes out in an especial manner in the quinquennial periods in Table X---there still remains much to be done. The town of Douglas has made great steps in this direction ; the total deaths from phthisis in the 1883 calculation was 261, while in the 1898 calculations it was 213, in spite of the fact that the population had meanwhile increased by some 4,000 people.

It is high time that both the medical profession and the government of this beautiful little Island should fully realise the gravity of this canker that is eating out the very heart of a thrifty, intelligent, and honest little nation, and should endeavour to find the cause, and, if possible, apply the cure. We believe this can be done, for we possess, in an exceptional degree, those natural factors that will aid us in our efforts to stan-p out this insidious evil.

Any comments, errors or omissions gratefully received The Editor HTML Transcription © F.Coakley , 2006