No. 630] 



HUMAN MORTALITY BATES 



23 



Classification. Of these causes which have been brought 

 in from other parts of the International Classification the 

 first which demands attention is the second on the list 

 1 'Congenital debility, atrophy, marasmus." This is a 

 part of item No. 151 of the International Classification. 

 As already pointed out, that item includes "Premature 

 birth," which has in the present classification been placed 

 under "Primary and secondary sex organs" for reasons 

 already stated, and "Congenital debility, atrophy, ma- 

 rasmus, etc.," which is the part included here. The 

 reason for putting this portion of item 151 under the 

 present heading is the practical one that clinical expe- 

 rience shows that the vast majority of the deaths of in- 

 fants which are statistically recorded under this heading 

 "Congenital debility, atrophy, and marasmus" are actu- 

 ally due to deficiencies, functional, structural, or both, 

 in the alimentary tract. In probably more than 95 per 

 cent, of all cases "Congenital debility" of an infant 

 means that something is wrong with the alimentary tract 

 in its immediate metabolic functions. 



Item 50, "Diabetes," includes deaths from a disease 

 which, while diagnosed from a disarrangement of the 

 excretory function, is primarily an affection of the organs 

 which have to do with the initial or early stages of 

 metabolism (the liver, the pancreas, etc.). It therefore 

 seems to belong properly in the classification where it is 

 now placed rather than with the kidneys. In the Inter- 

 national Classification it is included with "General 

 diseases." 



Item 71, "Convulsions of infants," is in the Inter- 

 national Classification placed with "Diseases of the 

 nervous system." It is transferred from that location 

 to the present one in this classification because of the 

 well-known clinical fact that the vast majority of deaths 

 of infants recorded as due to convulsions are really due 

 to profound disarrangements of the alimentary tract, 

 which eventually lead to convulsions. Biologicallv, the 

 fundamental breakdown in such cases is of the aiimen- 



