of Dr. J.H.  Rauch, Sanitary Superintendent of Chicago, manuscript records, hitherto unpublished, of its deaths from nervous disease, as well as the statement of each year’s total mortality; so that I have it in my power to show the increase of deaths from nerve disorders relatively to the annual loss of life from all causes.  I possess similar details as to Philadelphia, which seem to admit of the same conclusions as those drawn from the figures I have used.  But here the evil has increased more slowly.  Let us see what story these figures will tell us for the Western city.  Unluckily, they are rather dry tale-tellers.

The honest use of the mortuary statistics of a large town is no easy matter, and I must therefore ask that I may be supposed to have taken every possible precaution in order not to exaggerate the reality of a great evil.  Certain diseases, such as apoplexy, palsy, epilepsy, St. Vitus’s dance, and lockjaw or tetanus, we all agree to consider as nervous maladies; convulsions, and the vast number of cases known in the death-lists as dropsy of the brain, effusion on the brain, etc., are to be looked upon with more doubt.  The former, as every doctor knows, are, in a vast proportion of instances, due to direct disease of the nerve-centres; or, if not to this, then to such a condition of irritability of these parts as makes them too ready to originate spasms in response to causes which disturb the extremities of the nerves, such as teething and the like.  This tendency seems to be fostered by the air and habits of great towns, and by all the agencies which in these places depress the health of a community.  The other class of diseases, as dropsy of the brain or effusion, probably includes a number of maladies, due some of them to scrofula, and to the predisposing causes of that disease; others, to the kind of influences which seem to favor convulsive disorders.  Less surely than the former class can these be looked upon as true nervous diseases; so that in speaking of them I am careful to make separate mention of their increase, while thinking it right on the whole to include in the general summary of this growth of nerve disorders this partially doubtful class.

Taking the years 1852 to 1868, inclusive, it will be found that the population of Chicago has increased 5.1 times and the deaths from all causes 3.7 times; while the nerve deaths, including the doubtful class labelled in the reports as dropsy of the brain and convulsions, have risen to 20.4 times what they were in 1852.  Thus in 1852, ’53, and ’55, leaving out the cholera year ’54, the deaths from nerve disorders were respectively to the whole population as 1 in 1149, 1 in 953, and 1 in 941; whilst in 1866, ’67, and ’68, they were 1 in 505, 1 in 415.7, and 1 in 287.8.  Still omitting 1854, the average proportion of neural deaths to the total mortality was, in the five years beginning with 1852, 1 in 26.1.  In the five latter years studied—­that is, from 1864 to 1868, inclusive—­the proportion was 1 nerve death to every 9.9 of all deaths.