18 THE AMERICAN NATURALIST [Vol. LIV 



In the case of the first of these, item 151, 1 have ventured 

 to divide the total rate in roughly the same proportion 

 between the two subdivisions as exists in the United 

 States and England, namely f to premature birth and | 

 to congenital debility, etc. While this is admittedly a 

 hazardous proceeding, it seems to me less so than to omit 

 entirely so important a rate, which seems to me the only 

 other practical alternative. In the case of item 152 the 

 total rate is so small (3.3) that no particular difference 

 will be made whatever the basis of distribution used. 

 Consequently, I have again divided it roughly on the basis 

 of the American figures, calling § of the total due to 

 injuries at birth. 



Table III also includes data which in the International 

 Classification are distributed under three different gen- 

 eral heads. First, " General diseases"; second, " Non- 

 venereal diseases of the genito-urinary system and an- 

 nexa"; and third, ''Puerperal state." In the Interna- 

 tional List all cancers are included under "General dis- 

 eases." We have taken out for inclusion here the several 

 cancers of the primary and secondary sex organs, includ- 

 ing item 42, "Cancer of the female genital organs," and 

 item 43, "Cancer of the breast." Items 37 and 38, 

 "Syphilis" and "Gonococcus infection," are also taken 

 out of the class of "General diseases" of the Inter- 

 national List. The immediate reason for including these 

 diseases here is obvious, but particularly in relation to 

 syphilis the point at once needs further discussion. 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 there 

 included. The point well illustrates one of the funda- 

 mental difficulties in any organological classification of 

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

 practise 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- 



