CRESSY L. WILBUR, M. D. 105 



case is seen or the child is born. Let them use postal cards, or, 

 in cities, call up by telephone. Only the very simplest statement 

 need be secured, such as the names of the parents and place of 

 birth. A statement as to the use of silver as a preventive of 

 ophthalmia neonatorum could be required, and also whether aid 

 of a district nurse would be desirable, could be obtained at the 

 same time. But do not let such attempts to secure immediate 

 notification of births interfere with the proper legal registration, 

 which cannot be made as rapidly in many cases, nor load up 

 the standard forms of certificates with items which have no 

 proper place upon the permanent legal records of births and 

 deaths. It is hard enough to secure the enforcement of regis- 

 tration laws without further embarrassment from well-meaning 

 but uninformed enthusiasts, who are prone to subordinate all 

 other considerations to their immediate purposes. 



DISCUSSION 

 DR. WILBUR 



The Committee on Birth Registration has not taken up in 

 its report some questions of very great importance in their rela- 

 tion to the prevention of infant mortality. Among these are 

 the more complete reporting of still births, and the sharp dis- 

 tinction that should be made between still-born and live-born 

 children. The causes of antenatal mortality are most impor- 

 tant, but, on the whole, it hardly seems profitable to attempt 

 greater stringency in reporting still births when so many births 

 of living children are not recorded. So also it is necessary that 

 greater precision shall be employed in the statement of the causes 

 of death of infants, and a uniform nomenclature of diseases, 

 from which, as from the nomenclature of the Royal College of 

 Physicians used in England, such indefinite terms as "maras- 

 mus," "atrophy," "inanition," and the like shall be stricken is 

 much to be desired. Such a nomenclature is now in course of 

 preparation by a special committee of the American Medical 

 Association, co-operating with committees of other national med- 

 ical organizations, and with the Bureau of the Census and other 

 Government authorities, so that the official nomenclature, when 

 published, shall be fully comparable with the International Clas- 

 sification of Causes of Death which is now in use for the mor- 

 tality statistics of the United States and many other countries. 

 Recommendations on this subject cannot be made until the work 

 of the Commitee on Nomenclature is completed. It is not neces- 

 sary, either, to dwell upon the absolute necessity of reliable vital 

 statistics, and especially statistics of births from which are de- 

 rived ratios of infantile mortality, for the benevolent purposes 

 of this Association. The evidence is before you in charts and 



