While it is certain that the death-rates in the last century were greater than those of the present day, it is not possible to make precise comparisons. The record of deaths in the city of New York begins with 1804, and was necessarily very imperfect until the law of 1851, which required the registration of all deaths; but it shows a death-rate of 30.2 per 1,000 in 1805, which means that the true death-rate must have been between 35 and 40. At present, for a series of five years, it would be about 20, having been below 19 in 1899, so that the death-rate has been diminished by at least one-third. How much of this is due to improved sanitary conditions it is impossible to say. A comparison of the list of causes of death in 1805 with the list of causes for 1900 shows great differences, but much of this is due to changes in name and to more accurate diagnosis.
"Malignant sore throat" and "croup" were well known to anxious parents in 1800, but "diphtheria" caused no anxiety. "Inflammation of the bowels" was common and fatal, but "appendicitis" had not been heard of. "Nervous fever," "continued fever," and "low fever" were on the lists, but not typhoid, which was not clearly distinguished as a special form of disease until 1837, when Dr. Gerhard, an American physician, pointed out the differences between it and typhus, which also prevailed at the commencement of the century.
One hundred years ago the great topic of discussion in our cities on the North Atlantic coast was the means of preventing yellow fever, which had been epidemic in New York and Philadelphia for two years. Physicians were disputing as to whether the disease was contagious and imported, and, therefore, perhaps, preventable by quarantine and disinfection, or was due to some occult condition of the atmosphere (which was the view taken by Noah Webster in his "History of Epidemic and Pestilential Diseases," a work which appeared about the middle of the year 1800, although it is dated 1789). The discussions remind one of the remark that a certain patented form of electric light was surrounded by a cloud of non-luminous verbosity. For example, the Committee of the Medical Society of the State of New York reported that yellow fever may be produced in any country by pestilential effluvia; and Webster concluded that typhus and nervous fevers were due to a "conversion of the perspirable fluids of the body into septic [poisonous] matter"--all of which means that they knew nothing about it. Even now we do not know the cause of yellow fever, or the precise mode of its spread; but we are sufficiently certain that it is due to a specific micro-organism to be confident that its spread can be checked by isolation and disinfection properly applied--and Memphis and New Orleans are witnesses to the truth of this.