An increase in the mortality from asthma, particularly in children, has been reported from Australia (Gandevia, 1967). the United States (Richards and Patrick, 1965), and Britain (Smith, 1966), and suggestions have been made that the increase is due to the introduction of new methods of treatment (Ford, 1966; Kessler and Geller-Bernstein, 1966; Greenberg and Pines, 1967). We have therefore examined the trends in mortality from asthma throughout the world and have sought evidence to account for the increase in England and Wales.

suggests that an upward trend in mortality may now be occurring (Gandevia, personal communication).We are grateful to the Registrar General of England and Wales for supplying many of the data, and for supplying them with minimal delay. We are grateful also to the Ministry of Health for information about the sale of aerosol bronchodilators; and to Miss A. Table I. In four instances no inquiries could be made as the name of the relevant general practitioner could not be ascertained. Two physicians did not respond to multiple inquiries, and one knew nothing about the patient, who had only just been entered on his list, and returned a blank questionary. In all, therefore, we obtained information relating to 96% of the deaths (177 out of 184). The forms were, in general, completed fully and carefully and many practitioners provided a great amount of detailed information. All the information requested was not, however, always available and some data refer to slightly smaller total numbers.Fifty-two deaths were recorded in hospital and letters were sent to 52 hospital consultants. All replied. Few could provide any information beyond that associated with the management of the terminal episode, and six of the question-

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