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Feature Christmas 2018: Time After Time

Consumption, flux, and dropsy: counting deaths in 17th century London

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5014 (Published 12 December 2018) Cite this as: BMJ 2018;363:k5014

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Counting deaths for paleo-epidemiological analysis

I greatly enjoyed the paper by Stahl-Timmins and Appleby, who analyzed causes of death, reported by John Graunt (1620-1674) in his renowned pamphlet “Natural and Political Observations mentioned in a following index, and made upon the Bills of Mortality” (1662) [1]. I agree with their conclusions on the problems of accurate data reporting and consistent classification of deaths in ancient (and modern) documents.

Recently, some scholars have started to apply modern statistical and epidemiological methods in analyzing ancient mortality registers, for understanding the prevalence of some diseases in ancient populations. This kind of analysis - known as paleo-epidemiology - may provide important information on the diffusion of diseases in past-times. For example, a recent paleo-epidemiological analysis has evidenced a high number of uterine cancers in a Northern Italian city at the beginning of the nineteenth century, probably due to poor hygiene and sexual promiscuity [2].

In conclusion, I suggest to the authors of this paper that they continue and deepen their analysis, applying modern statistical methods. I believe that the identification of actual number of inhabitants in London in the seventeenth century is determinant for this kind of analysis.

References

1. Appleby J, Stahl-Timmins W. Consumption, flux, and dropsy: counting deaths in 17th century London. BMJ. 2018;363:k5014. doi: 10.1136/bmj.k5014.
2. Riva MA, Conti S, Dimaggio L, Cesana G. Parish mortality registers in paleo-oncology. Lancet Oncology 2018;19:1288. doi: 10.1016/S1470-2045(18)30690-9

Competing interests: No competing interests

24 December 2018
Michele A. Riva
Assistant Professor of History of Medicine
University of Milano-Bicocca
via Cadore 48, 20900, Monza, Italy