CRESSY L. WIIyBUR, M. D. 103 



would be quite impracticable in the country; but even in the 

 cities in this country at the present time more would be gained 

 by requiring the thorough enforcement of the registration of 

 all births within 5 days or 10 days after their occurrence than 

 by requiring prompter returns and permitting the repeated 

 violations of the law that now occur. 



Neither is it desirable to make any changes or additions in 

 the United States Standard Certificate of Death or in the cor- 

 responding Standard Birth Certificate. These blanks have been 

 officially adopted by the American Public Health Association, at 

 Richmond, 1909, for use during the next ten years, and are 

 used in the great majority of the States of this country. They 

 contain all that is necessary for the essential purposes of regis- 

 tration and it is extremely unwise to attempt to modify them 

 to secure special information. Information of this kind, such 

 as character of infant feeding, use of nitrate of silver to prevent 

 blindness, etc., can better be obtained in other ways. Much of 

 the imperfection of our vital statistics has resulted from the 

 absence of a uniform blank for the initial data, which we now 

 have in the Standard Certificates, and perpetual changes and 

 alterations in these blanks, however desirable from special 

 points of view, should be discouraged until they assume suffi- 

 cient importance so that the next general revision can include 

 them and all registration States adopt them at the same time. 

 We want no more tinkering with the forms in use until the time 

 arrives for a general change. 



At this point it is desirable that the distinction between the 

 mere notification of births and the complete legal registration 

 of births should be clearly understood. The notification of 

 births is much like the notification of sickness. Both are of 

 value for certain purposes and it is to be hoped that practicable 

 methods of birth notification and sickness notification may be 

 widely introduced in this country, and the notification of births 

 may be of service to the thorough registration of births and 

 the notification of sickness be of aid to the complete and satis- 

 factory registration of deaths, as well as supplying reliable 

 morbidity statistics, which are our most crying need after that of 

 complete birth registration. But the notification of births is in 

 no sense a substitute for the complete legal registration of births, 

 and sickness notification can never take the place of thorough 

 registration of deaths. The methods employed for notification 

 and registration are somewhat different, and any attempt to 

 combine them indiscriminately, or to modify registration laws 

 in blissful ignorance of the essential requirements of registration, 

 can only do serious injury to vital statistics and delay the day 

 when we shall have satisfactory records of infant mortality. 



