Far more valuable than a comparison of average rates of foreign countries is a study of the rates of each country for a series of years in order to discover whether they are decreasing or increasing and to compare such changes in the various countries. While it may be dangerous on account of different countries, no such source of error is attached to the comparison of rates in the same country for a number of years. The period 1900 to 1913 (or the latest year for which figures are available) is a very short one for a study of a change in death rates. It would have been far more interesting to study the death rates for a long series of years in each country, choosing a period beginning before the introduction of methods of asepsis. But such a study for the complete list of countries considered was not thought advisable, because of the difficulties caused by variations in classification of causes of death in the earlier years.
In order to study the rates for any increase or decrease occurring during the last 13 years, the rates per 1,000 live births will be used rather than those per 100,000 population. In several countries—Belgium, Hungary, Italy, Norway, Prussia, and Spain—the rate from childbirth per 100,000 population apparently has fallen during the period, while the rate per 1,000 live births has remained almost the same, or has risen. The cause of this inconsistency is the fact that in these countries the birth rate or the proportionate number of births to the number of inhabitants has decreased.
Number of deaths of women from 15 to 44 years of age in the death-registration area from each cause and class of causes included in the abridged International List of Causes of Death (revision of 1909),[[49]] 1913.
[49]. Except No. 25, diarrhea and enteritis (under 2 years), and No. 34, senility.
(Computed from figures in Mortality Statistics, 1913, pp. 338 to 349, in which causes of death are given according to the detailed International List of Causes of Death.)
| Abridged International List No. | Cause of death. | Number of deaths. |
|---|---|---|
| 13, 14, 15 | Tuberculosis of the lungs, tuberculous meningitis, other forms of tuberculosis | 26,265 |
| 31, 32 | Puerperal septicemia (puerperal fever, peritonitis) and other puerperal accidents of pregnancy and labor | 9,876 |
| 19 | Organic diseases of the heart | 6,386 |
| 29 | Acute nephritis and Bright’s disease | 5,741 |
| 16 | Cancer and other malignant tumors | 5,065 |
| 22 | Pneumonia | 4,167 |
| 35 | Violent deaths (suicide excepted) | 3,262 |
| 1 | Typhoid fever | 2,706 |
| 30 | Noncancerous tumors and other diseases of the female genital organs | 2,669 |
| 26 | Appendicitis and typhlitis | 1,620 |
| 36 | Suicide | 1,562 |
| 23 | Other diseases of the respiratory system (tuberculosis excepted) | 1,458 |
| 18 | Cerebral hemorrhage and softening | 1,398 |
| 24 | Diseases of the stomach (cancer excepted) | 940 |
| 27 | Hernia, intestinal obstruction | 854 |
| 28 | Cirrhosis of the liver | 598 |
| 9 | Influenza | 489 |
| 17 | Simple meningitis | 484 |
| 8 | Diphtheria and croup | 330 |
| 12 | Other epidemic diseases | 312 |
| 6 | Scarlet fever | 307 |
| 5 | Measles | 304 |
| 3 | Malaria | 250 |
| 21 | Chronic bronchitis | 184 |
| 20 | Acute bronchitis | 90 |
| 33 | Congenital debility and malformations | 24 |
| 11 | Cholera nostras | 18 |
| 4 | Smallpox | 16 |
| 7 | Whooping cough | 9 |
| 2 | Typhus fever | 2 |
| 10 | Asiatic cholera | |
| 37 | Other diseases | 11,688 |
| 38 | Unknown or ill-defined diseases | 458 |
A MUNICIPAL BIRTH CONTROL CLINIC. MORRIS H. KAHN, M. D., in New York Medical Journal for April 28, 1917.
Showing that large families among the poor are the result of ignorance of methods to prevent conception among the mothers.
The following studies were undertaken with a view to determining whether there was an actual need and demand for birth control education and whether such a demand, if it existed, could be supplied with any effect by a scientifically conducted clinic in the dispensaries of the Department of Health of the City of New York; we felt that it might be of scientific and sociological interest to publish a report and an analysis of the observations made, probably the first of their kind in this country. Section 1142 of our Penal Code was ignored in conducting this birth control study.
The social and economic status of the patients was fairly uniform, about the same as that of patients attending the other dispensary institutions in this city. A tabulation of the results was made under the following headings: Name and nationality; age; number of years married; number of living children and their ages; number of deceased children; number of miscarriages or abortions; contraceptive methods known or practised. More or less complete data were secured in 464 cases.