NOTES.

SECOND DECENNIAL REVISION OF THE INTERNATIONAL CLASSIFICATION OF CAUSES OF DEATH, PARIS, JULY 1-3, 1909.

The classification of causes of death is fundamental in the preparation of uniform and comparable tables of mortality. Many years ago, in the old International Statistical Congress, the attempt was made to formulate a classification of diseases that could be accepted generally throughout the world. For various reasons the effort was not successful, and up to within a comparatively recent period every nation, and in the United States nearly every State and city, had its own peculiar way of compiling statistics of causes of death. No one could be certain, on examining a statistical table of this kind, that the mortality from any disease was fully comparable with the data found in any other report.

The beginning of the solution of this problem may be found in the Proceedings of the International Statistical Institute at Chicago in 1893, when Dr. Jacques Bertillon, as reporter of a special committee of the Institute, submitted the system which has now become recognized throughout the world as the International Classification of Causes of Death. The recommendations of the committee for the adoption of this classification were not generally followed at first, and it seemed probable that the effort would meet the fate of many previous attempts at international uniformity. The turning-point, from which may be dated the ultimate success of this classification, came with its formal adoption by the American Public Health Association at Ottawa in 1898, this action covering recommendations for its practical use in the national, state, provincial, and city reports of the United States, Canada, and Mexico. The report of the committee of the association which recommended this action, and of which Dr. Cressy L. Wilbur, now Chief Statistician of the Census, was chairman, also suggested a revision of the classification then known as the Bertillon System, so that it would be in acceptable form for the census of 1900 and subsequent years, and provided also for a regular decennial revision, in order that the classification might be kept abreast of the progress of medical science.

These recommendations were approved by the International Statistical Institute. It may be noted, incidentally, that, according to a compilation of all of the recommendations made by the International Statistical

Institute since its foundation, the action relative to the International Classification has been the most completely and successfully carried out in practical statistics. The French government called the First International Commission at Paris in 1900, and the International Classification as revised by it has been used by the United States Census Office, all registration States, and nearly all registration cities in this country, since that date. Unfortunately, however, the registration officials and medical men who had contributed so largely to the adoption of the International Classification were not represented in the First Commission of Revision, and, as a result, some cities have failed to adopt the system and many offices have made modifications which have interfered more or less with perfect comparability.

In order to avoid this unfortunate condition and to secure full representation of the important interests practically engaged in the compilation and study of statistics of causes of death, it was planned early by the Bureau of the Census to include representatives of the organized registration officials of the United States and of the medical profession, whose co-operation in the reporting of causes of death is absolutely necessary for successful results. It is very gratifying, therefore, that Congress provided that the Director of the Census should appoint three commissioners to represent the United States in the Second Decennial Revision called by the government of France to meet at Paris, July 1 to 3, 1909, one to be chosen from the Census Office, one from the medical profession, and one from the organized registration officials of the United States. In accordance with this law, Hon. E. Dana Durand, Director of the Census, designated Dr. Cressy L. Wilbur, Chief Statistician for Vital Statistics of the Census Office, Dr. Frank P. Foster, chairman of the Committee on Nomenclature and Classification of Diseases of the American Medical Association, and Dr. Wilmer R. Batt, chairman of the Committee on Classification of Causes of Death of the Section on Vital Statistics of the American Public Health Association, as the Census Commission. At the last moment Dr. Foster was unable to sail, but Drs. Wilbur and Batt proceeded to Paris, and there were also present as official delegates of the United States Dr. Frank L. Pleadwell, surgeon United States Navy, Dr. H. D. Geddings, assistant surgeon-general United States Public Health and Marine-Hospital Service, Professor Walter F. Willcox, Cornell University, and Dr. William H. Guilfoy, registrar of records, city of Greater New York.

The meetings of the commission were held in the Ministry of the Interior, delegates from twenty-three countries being in attendance. A large amount of preliminary work had been done in other countries, as well as in the United States,* in the preparation and submission of suggestions which were printed for the use of the International Commission,

*See Mortality Statistics, 1907, p. 16.

constituting a pamphlet of 130 pages.* The meetings were harmonious, and a commendable spirit was manifested by those in attendance in the matter of subordinating the individual preferences of each country to the general good. It was recognized that international uniformity could be attained in this way only. A considerable number of American recommendations were approved, notably that providing for a rearrangement of deaths from violent causes, which will aid greatly in the proper presentation of the statistics of this important class of deaths.

The detailed results of the revision will be printed (Procès verbaux), and the revised version will be available, therefore, for the use of the United States Census, and all State and city registration officials, beginning with the year 1910. The opportunity of thus starting out with the mortality statistics relating to the actual census year, which affords the data of population with which the mortality statistics must be compared, is of the greatest value, and it is highly gratifying that the wishes of the United States for the advancement of the date of the International Revision from 1910 to 1909 were acceded to by the French government and the other countries participating.

In accordance with a resolution of the International Commission an official version of the titles is to be prepared in each language represented. The English translation is to be prepared by Dr. Wilbur, aided by the other American delegates and Hon. G. W. Knibbs, Commonwealth Statistician of Australia. This will provide precisely the same tabular list for all English-speaking countries that have adopted the International Classification.

The active interest of the United States in the promotion of international uniformity was accorded a very graceful recognition in the bestowing of the vice-presidency of the International Commission upon Dr. Wilbur, who was called upon to preside over one of the sessions.

The sessions closed on July 3, and on July 4 the delegates were received by the President of France and Mme. Fallières. They also participated in the sessions of the International Statistical Institute, which were held in the week following those of the Commission of Revision.

The next revision will be called in 1919 and under the auspices of the French government, unless other provision is made. It is to be hoped, however, in view of the great advancement of American vital statistics and the important part that this country has played in the extension of the International Classification, that the Third Decennial Revision will be called by the American government to meet at Washington.

C. W. D.

* Exposé sommaire des observations présentées par diverses autorités statistiques à la Commission Internationale chargée de la révision décennale de la Nomenclature Internationale des Maladies. Deuxième session, 1909.

THE NEED OF STATISTICS OF AREA IN THE

UNITED STATES.

The writer recently undertook a simple statistical study of population density in the rural districts of the State of Ohio. He was very much surprised to find that, while population figures for townships and "incorporated places" were, of course, available in the United States Census Reports, there were nowhere in the State any official statistics of the areas of these local units. Even in Cuyahoga County, which contains the metropolis of the State, the county surveyor had only recently obtained the data of township areas. He had done this by measuring with a planimeter the surveyed maps of the county. Taking a hint from this method, the writer got his own data for the larger part of the State by measuring on a map and reducing to square miles those townships rectangular enough to admit of it. Of course, the results were crude, the measurements being inaccurate beyond a quarter-mile. Becoming interested in knowing in how many States of the Union this lack of data existed, he sent a letter to each of the forty-eight secretaries of state, asking whether "there was any compilation, printed or unprinted, of (a) figures giving the total area of each township in the state (or of other similar division smaller than a county) (b) figures giving the area of each town and city."

To these forty-eight letters thirty-nine replies were received. One State, Rhode Island, sent the figures desired, which covered, of course, a rather small proportion of the whole country's area. The answer of the other thirty-eight was that they knew of no such compilation, official or unofficial. In about twenty-cases the question was referred to some other department of the State government or to some Federal Bureau.

One State surveyor said that he had long had such a work in mind, and hoped soon to get at it. Iowa offered to compile the data for thirtyfive dollars. In three cases the writer was referred to the United States Department of the Interior, whose lack had already been revealed when Ohio was investigated.

Professor Walter F. Willcox, of Cornell University, has gathered these data for New York State by the planimeter and map method mentioned above. But, as he did this as a purely private enterprise, it has not been included in this account of the status of public statistics of the subject.

This reveals again our woful lack in the United States of many of the most easily obtained and most elementary social statistics. It is exceedingly important, especially since we are coming rapidly to the end of our great free lands, that we should know more and more about the

quantitative relation of the population, particularly of the rural popuIation, to the soil.

The United States Census, it is true, takes up the question of population density, but in a rather general, extensive way. Any intensive study is impossible to one not having access to the complete data of the Census Bureau. If, however, we had the area of every township, parish, hamlet, village, town, and city, it would be easy for any statistician to take up this problem. The only reason for choosing these subdivisions (township, etc.) is that they are the "enumeration units" of the Federal Census.

The purpose, then, of this brief article is to suggest to those interested in statistical studies the need of this particular kind of data, and to urge that a concerted effort be made to have these figures of area obtained by the Thirteenth Census. It would not be an expensive item for the census, though decidedly too expensive for private enterprise.

C. E. GEHLKE.