DEATH-TOLL OF ENGLAND AND WALES. 127 



draw from them. Unfortunately, the returns of the Re- 

 gistrar-General cannot be relied upon for the species of in- 

 formation which he seeks to obtain from them. 



Even when it is required only to estimate the gross 

 mortality of various places, there are important limitations 

 to their usefulness, owing to the various nature of the 

 boundaries of the several registration-districts, the presence 

 or absence of hospitals, and the movements or relative 

 composition as to age &c. of the populations. Carefully 

 collated data on these several points are given in the later 

 reports ; and by dint of much labour some of the more 

 serious errors from these causes may be avoided ; but when 

 we come to the nosology of the tables and try to pick out, 

 as Mr. Baxendell has done, the causes of the mortality in 

 different years, we are at once foiled of accurate results by 

 the imperfections of the records and the impossibility of 

 verifying the causes of death. 



These drawbacks to the utility of the returns have often 

 been pointed out ; and in the early reports of the Registrar- 

 General, Dr. Farr himself complains of the imperfect no- 

 menclature of disease. Doubtless some improvement has 

 taken place of late years ; but such variations in the accu- 

 racy of diagnosis at once prevent any value from attaching 

 to a comparison between earlier and later records. Until 

 a very recent period the registration of deaths was not 

 compulsory at all ; and in the Report of the Medical Offi- 

 cer to the Privy Council for the year 1864 it is noted that, 

 out of 500 deaths registered in St. David's district, only 15 

 were recorded by properly qualified medical practitioners. 

 To the present time it is highly probable that the disease 

 Phthisis or Consumption is far too often recorded as the 

 cause of death in some districts in Wales, since it is made 

 to include many forms of disease that cause wasting before 

 they cause death. 



