NA TURE 



145 



THURSDAY, JUNE 13, i{ 



THE ELEMENTS OF VITAL STATLSTICS. 



The Elements of Vital Statistics. By A. Newsholme, 

 M.D. (London: Sonnenschein, 1889.) 



DR. NEWSHOLME has written a book which, though 

 intended primarily as a guide to medical officers of 

 health and students preparing for the various sanitary 

 examinations, will be found by the general reader to form 

 a convenient compendium of useful facts and of the 

 conclusions deducible therefrom. For the writing of such 

 a book the author was well qualified, having been dis- 

 tinguished as University Scholar in Medicine, and 

 having had, in addition to the ordinary practice of a 

 medical man, considerable experience as a medical officer 

 of health, formerly at Clapham and recently at Brighton. 

 A work of this kind must necessarily consist largely of 

 information derived from the census returns, public 

 registers, and reports ; and an author's ability is shown in 

 the selection of the information, its arrangement, and 

 verbal presentation. 



Like many persons who have given attention to the 

 subject of vital statistics, whether for sanitary or financial 

 purposes. Dr. Newsholme attaches great value to a correct 

 and more frequent census, and to a complete and accurate 

 registration of births, marriages, and deaths, the cause of 

 death being in all cases carefully ascertained and recorded. 

 He also desires a systematic and extended registration 

 of sickness, its nature and duration ; urging that the 

 concurrent publication of informition furnished by such 

 registration, and involving the announcement of the 

 outbreak, the spread, and the subsequent contraction. of 

 epidemics, would lead to results of the highest public 

 benefit. 



The requirements of a good census from a sanitarian's 

 standpoint are said to be that the enumeration shall be 

 accurate and complete— to this we may say, of course — 

 and that it shall be simultaneous throughout the country, 

 in order to avoid the disturbing influences of migration — 

 again, of course. It is suggested that the particulars 

 demanded at the taking of the census should comprise 

 the following items as a minimum : name, sex, age 

 (children under two years stated in months), relation to 

 head of household, conjugal condition, calling, religious 

 persuasion, illiteracy, birthplace and nationality, language, 

 residence, infirmities, this last term meaning, we presume, 

 serious infirmities, such as those of the bhnd, the deaf, 

 and the dumb, and the several forms of insanity. We 

 ourselves do not see in what way a sanitarian is concerned 

 with the religious persuasions of the people, or with 

 language as apart from and independent of nationality ; 

 nor do we think a sanitarian, or any other student or 

 scientific worker, could extract any useful knowledge 

 out of the untested declarations of uneducated persons 

 relative to the ability or inability of themselves and their 

 families to read and write. We do not altogether agree with 

 our author in advocating inquiry on these points ; but we 

 entirely agree with him on the remaining points he men- 

 tions, to which, in the main, however, the country at large 

 may be considered already to have assented. We would 

 emphasize, with him, the desirability of taking the ages 

 Vol. XL.— No. 1024. 



of the youngest children in months ; at any rate, for 

 the first year of life. Considering the heavy mortality 

 prevailing during infancy — about one-fifth of all the births 

 being followed by death within two years — and considering 

 its rapid change from month to month, as the development 

 of the infant progresses, it is an obvious requirement of 

 this branch of the subject that steps should be taken to 

 ascertain the mortality for each succeeding month of a 

 child's life, and thus verify the estimates and partial 

 results that have already been published. We would also 

 emphasize, with our author, the desirability that the 

 calling or occupation of each person should be given 

 with sufficient definiteness to obviate confusion. At 

 present one experiences some difficulty in manipulating 

 the figures of the Registrar-General's Office ; a difficulty 

 arising not only from the classification of occupation, and 

 partly unavoidable, but also from the inclusion in one 

 figure of masters with workmen, and sometimes of those 

 who have retired from an employment with those actively 

 engaged in it. There is, as is self-evident, the greatest 

 difficulty in obtaining precise information from the 

 millions of an entire population ; but the Registrar-General 

 has, no doubt, turned his attention in the directions now 

 indicated with a view to future action. 



The Civil Registration Act was passed in 1837, but for 

 a long while the registration of births was defective, 

 it having been estimated that as many as 5 per cent, of 

 the births were lost sight of. This is a fact not to be 

 forgotten in dealing with earlier years. The registration 

 of births was made compulsory by the Births and Deaths 

 Registration Act of 1874; but the record gives neither 

 the age of the mother at the date of the birth of the 

 child, nor the order of its birth (first, second, third, &c.) ; 

 so that we can know neither the number of children 

 borne by mothers at each year of the mother's age, nor 

 the average number borne in the course of a mother's 

 lifetime. The birth-rate in a community is commonly 

 represented by the ratio of births to population, so many 

 per thousand ; but the basis of looo living, including, 

 as it does, a varying proportion of men, women, and 

 children, is not a perfect basis ; and, to get the true birth- 

 rate, the number of births should be compared with the 

 number of women between the ages of about 16 and 

 45. The population basis is, as a rule, however, ade- 

 quate for practical purposes, and tables, so constructed, 

 display, throughout Europe generally, a tendency in the 

 birth- rate to decline. In the United Kingdom the 

 decline has been fairly regular and continuous for some 

 years past, the decline amounting to almost 3 per 

 thousand in seven years. 



The chapter on births contains, under the head of " The 

 Malthusian Hypothesis," some remarks respecting the 

 famous essay on the theory of population published in 

 1798. As popularly understood, the hypothesis was to 

 the effect that the growth of a population must be 

 circumscribed by the means of subsistence. The remarks 

 are especially directed against the doctrine that " the 

 population is increasing in a geometrical progression, the 

 means of subsistence in an arithmetical progression ; and 

 unless wars, destructive epidemics, marshes, dense towns, 

 close workshops, and other deadly agents, carry off the 

 excess of the numbers born, . . . the whole people must 

 be exposed to a slow process of starvation." Our author 



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