124 BIOLOGY OF DEATH 



As a cause of actual death, syphilis frequently acts 

 through the central nervous system, and the question may 

 fairly be raised why, in view of this fact, syphilis is not 

 tabled there. The point well illustrates one of the fun- 

 damental difficulties in any organological classification 

 of disease. In the case of syphilis, however, the difficulty 

 in practice is not nearly so great as it is in theory. As 

 a matter of fact, most of the deaths from the effect of 

 syphilitic infection on the nervous system are recorded 

 in vital statistics by reporting physicians and vital statis- 

 ticians as diseases of the nervous system. For example, 

 it is perfectly certain that most of the deaths recorded 

 as due to "locomotor ataxia" are fundamentally syphil- 

 itic in origin. The rate of 5.4 for the Eegistration Area 

 of the United States in 1906-10 for deaths due to syphilis 

 is far lower, as any clinician knows, than the number of 

 deaths really attributable to syphilitic infection. These 

 other deaths, due to syphilis, and not reported under that 

 title, are reported under the organ which primarily 

 breaks down and causes death, as, for example, the brain, 

 and will in the present system of classification be included 

 under the nervous system. After careful consideration, 

 it has seemed as fair as anything which could be done to 

 put the residue of deaths specifically reported as due 

 to syphilis under Primary and Secondary Sex Organs. 

 The rate, in any event, is so small that whatever shift was 

 made could not sensibly affect the general results to 

 which we shall presently come. 



Turning now to the consideration of Figure 30, which 

 gives the curves of specific mortality from breakdown of 

 the reproductive organs, we note at once the high specific 

 death rate of infants under one, recorded by the female 

 line. This rate is over 40 per thousand exposed to risk. 



