40 TUBERCULOSIS, HEREDITY 



Edinburgh dispensary system there has been a rapid fall 

 in the death-rate from phthisis. Would it not be a grand 

 thing to be able to point to this and say : Here is the 

 great achievement which has resulted from this system 

 of limiting the infection-factor ? And this has been done ; 

 a recent writer asserts that this is true causation and not 

 association, and his conclusion is at once echoed through- 

 out the press. Well, Ladies and Gentlemen, I wish we 

 also could accept such teaching. But it is the old tale — 

 you take what statistics support your point and you 

 omit consideration of the rest. The argument from 

 statistics must always be by inter-comparison, and these 

 great medical authorities have wholly forgotten to com- 

 pare Edinburgh with other towns in which no such 

 system of dispensaries had been established. Associa- 

 tion, again, has been interpreted as causation. 



The Scottish statistics are very bad. Scotland has done 

 with her relatively small means such splendid scientific 

 work, that I hope she will pardon me when I say that 

 the data provided by her Registrar-General rank almost 

 at the bottom of European statistics. No age-corrections 

 are provided for the death-rates of special diseases ; up 

 to a certain date no allowances for extra-mural institu- 

 tion deaths have been made, and even now no allowance 

 appears to be made for intra-mural deaths of strangers. 

 Local officers give returns which differ from the 

 Registrar-General's, and complete confusion, amounting 

 often to a difference of 20 % — according to the treatment 

 of extra-mural deaths of natives and intra-mural deaths 

 of strangers — exists between various returns. I have 

 taken the Registrar-General's returns for Edinburgh, 

 but these are not corrected for age and not for 

 the deaths in the great Craiglockhart poor-house of 



