I have alluded above to a class of deaths included in my tables, but containing, no doubt, instances of mortality due to other causes than disease of the nerve-organs.  Thus many which are stated to have been owing to convulsions ought to be placed to the credit of tubercular disease of the brain or to heart maladies; but even in the practice of medicine the distinction as to cause cannot always be made; and as a large proportion of this loss of life is really owing to brain affections, I have thought best to include the whole class in my statement.

A glance at the individual diseases which are indubitably nervous is more instructive and less perplexing.  For example, taking the extreme years, the recent increase in apoplexy is remarkable, even when we remember that it is a malady of middle and later life, and that Chicago, a new city, is therefore entitled to a yearly increasing quantity of this form of death.  In 1868 the number was 8.6 times greater than in 1852.  Convulsions as a death cause had in 1868 risen to 22 times as many as in the year 1852.  Epilepsy, one of the most marked of all nervous maladies, is more free from the difficulties which belong to the last-mentioned class.  In 1852 and ’53 there were but two deaths from this disease; in the next four years there were none.  From 1858 to ’64, inclusive, there were in all 6 epileptic deaths:  then we have in the following years, 5, 3, 11; and in 1868 the number had increased to 17.  Passing over palsy, which, like apoplexy, increases in 1868,—­8.6 times as compared with 1852; and 26 times as compared with the four years following 1852,—­we come to lockjaw, an unmistakable nerve malady.  Six years out of the first eleven give us no death from this painful disease; the others, up to 1864, offer each one only, and the last-mentioned year has but two.  Then the number rises to 3 each year, to 5 in 1867, and to 12 in 1868.  At first sight, this record of mortality from lockjaw would seem to be conclusive, yet it is perhaps, of all the maladies mentioned, the most deceptive as a means of determining the growth of neural diseases.  To make this clear to the general reader, he need only be told that tetanus is nearly always caused by mechanical injuries, and that the natural increase of these in a place like Chicago may account for a large part of the increase.  Yet, taking the record as a whole, and viewing it only with a calm desire to get at the truth, it is not possible to avoid seeing that the growth of nerve maladies has been inordinate.

The industry and energy which have built this great city on a morass, and made it a vast centre of insatiate commerce, are now at work to undermine the nervous systems of its restless and eager people,[1] with what result I have here tried to point out, chiefly because it is an illustration in the most concentrated form of causes which are at work elsewhere throughout the land.

[Footnote 1:  I asked two citizens of this uneasy town—­on the same day—­what was their business.  Both replied tranquilly that they were speculators!]