Annuario de Estatistica Demographo-Sanitaria, Rio de Janeiro, Brazil. By Dr. Sampaio Vianna. (For the year 1906, and published in 1907.)

This annual volume, like its predecessors, is a goodly-sized document of some three hundred pages, which sets forth the essential facts relating to the vital statistics of Rio de Janeiro with some summary tables for certain other of the more important cities of Brazil. These annual reports should be of special interest to students of vital statistics, as they contain facts pertaining to a large population located in the tropics and to a city which, in the immediate past, has had a bad reputation because of its high mortality from yellow fever and other diseases more or less peculiar to tropical climates.

A summary of the meteorological data for 1906 forms the first page of the report proper, and the second page contains a summary statement of the exact location, altitude, area, and geographical divisions of the federal district or greater city of Rio de Janeiro. This method might well be adopted by our own larger American cities, some of which do not clearly define in their health or other reports the exact limits to which the reports refer or give the areas of the subdivisions of the city, such as wards, assembly districts, etc.

The movement of the population of Rio de Janeiro is briefly discussed, and the more important facts relating to immigration and emigration are clearly set forth with distinction of nativity and whether the migratory movement was by railroad or by water. Some of these facts are illustrated by a graphic display, opposite page 15, by means of rings within rings and rings interlinked. This kind of graphics does not appeal to the writer as being the best suited to represent a sober fact or series of facts more clearly than figures can do. There are other offences of the same kind in the volume, and perhaps the most notorious are those given opposite page 59, where the comparative mortality rates of Rio de Janeiro and other important cities of the world are represented by mountain peaks. Artistic imagination, it seems to the writer, is out of place, when used in this way. The diagram opposite page 18 is not quite so bad as the others referred to, but the comparative statement of the marriages, births, and deaths could have been somewhat more clearly shown either by parallel vertical bars of even width and different colors or by the simple curves so familiar to students of statistics. A new form of diagram, unless distinctly better than an old one, should be avoided. A fine bit of color or an elaborate display of form in the figure often interferes with the essential function of the diagram. Emphasis is placed upon this important matter because such efforts are altogether too frequent in statistical reports, and graphics are too important an aid to statistics to warrant their prostitution by imaginative compilers of statistics. There are some very fine examples of diagrams and cartograms in the

volume here under discussion, notably the diagrams opposite page 66, which illustrate the comparative daily mortality from yellow fever in six different years, and the cartograms showing the distribution of cases of yellow fever, smallpox, pest, and diphtheria in Rio de Janeiro during the year 1906.

It would be impossible in a brief space to even allude to all of the interesting facts contained in this report. Among others, however, the following are of quite exceptional interest and importance. One chapter of six pages is devoted to a brief discussion of the still-births in Rio de Janeiro with some international comparisons. The proportion of the still-born to total births is quite high in Rio de Janeiro, or 70.2 still-births to every 1,000 total, against 28.5 for Budapest and 31.2 for Moscow. On the other hand, in Tokio the proportion in 1901 was 78.8, and in Paris in 1905, 84.1.

The general death-rate in the city of Rio de Janeiro during 1906 was 22.31 per 1,000 of population; in the suburbs it was 15.46; and in the federal district as a whole, 20.74. As recently as 1904 the general deathrate of the federal district was 28.66. The infant mortality (ages under one) in Rio de Janeiro seems to compare favorably with that of other large cities. The mortality by age and nativity can be worked out in detail from the tables presented in the report.

Of the causes of death the most important, locally, has always been yellow fever until as recently as 1902, when scientific efforts were first made to eradicate that scourge and with almost immediate good effects. Working on the mosquito theory, the present efficient local Board of Health has succeeded in almost clearing the city of yellow fever. In 1906, for example, there were but 42 deaths from that cause in the city of Rio de Janeiro, although the average annual number of deaths from that disease during the twenty-six years previous to 1903 was over 1,300.* The fight against smallpox is also showing good results, and there were only 9 deaths from that cause in 1906 against 3,566 in 1904, 1,414 in 1901, and 1,395 in 1899. These good results, judging from the weekly reports of the United States Marine Hospital Service, have continued during 1907.

It will be interesting to note whether the present progress in sanitation will be sustained in Rio de Janeiro. This will, of course, be necessary if the present conditions are to improve; and continued active efforts and great vigilance will be required to keep the city free from yellow fever and other contagious diseases. Malarial fevers also are still altogether too common, and progress in other sanitary directions, particularly in improved drainage, should result in a material reduction in the mortality from this class of fevers. The pest, or plague, and smallpox,

* For a very useful summary of progress in sanitation in Rio de Janeiro, see Part I of the Weekly Public Health Reports of the United States Marine Hospital Service, 1907, pp. 363 et seq.

if combated by the most modern and scientific methods, should ultimately be practically eliminated from the local mortality.

Containing, as it does, a considerable number of American residents, and, as one of the most important ports of South America, in constant communication with the ports of the United States, the health and sanitary conditions in Rio de Janeiro are of especial interest to this country. It is a fact deserving of sincere congratulation, therefore, that the present outlook for an at least normally healthful city is so bright in the metropolis and commercial emporium of Brazil.

F. 8. C.

Considerably more than a generation ago (in 1865), Dr. Farr brought the subject of Infant Mortality before the [Royal] Statistical Society, and frequently discussed it in his historic contributions to the annual reports of the Registrar-General's office. On December 19, 1893, Dr. Hugh R. Jones read before the Royal Statistical Society an exhaustive paper on "The Perils and Protection of Infant Life," which had the distinction of being the Howard Medal Prize Essay of that year. In the interim of more than forty years since Dr. Farr inaugurated the statistical discussion, so to speak, infant mortality has been a prolific subject in medical works and journals, has received perennial treatment in the reports of practically all bureaus of vital statistics, and the bibliography of the subject even up to ten years ago would constitute quite an impressive library, were all the papers on, and extended references to, this particular phase of human mortality assembled and properly indexed.

In a general way, however, it may be said that only within the last few years has the topic been presented in such a light as to attract serious attention at the hands of the public at large, the discussion up to the end of the nineteenth century having practically been restricted to medical men, government officials, and professional statisticians. To be sure, as early as 1876 a Society for Nursing Mothers was established in France, and pro