ent law this collection is made most prominent and essential as relating to public health, since in the last 25 years their indispensable necessity as a part of health administration has been fully accepted. Hence the guiding law only speaks of them a Vital Statistics, yet incidentally they are of great value in legal evidence as to marriage, birth, death, age, pensions, life insurance and as establishing rights of property. Until two years since they were available for this purpose through the department of the Secretary of State; since then all searches are made and certificates given through this Bureau, all receipts therefrom being paid to the State Treasurer. All the older books of such records have now to be searched here, and much time is consumed.

VII.-What are the Immediate and Remote Benefits of a State System of Vital Statistics Records?

The immediate benefits are that the requirement of returns is a guard over life and against improper or criminal concealments, so that so far as deaths are concerned, as one expresses it, "it is a mild and useful form of coroner's inquest." As to records of births, they help to guard against improper attendance or destruction of infant life; and as to marriages, they help to deter from haste and such secrecy as is against the interests of families and of society.

As to mortality, local and weekly returns are secured and verified by means of a central system. These local returns often at once point to some local cause of disease and death, or to an unusual prevalence of sickness or of an epidemic in some one neighborhood or block of houses, and so lead to immediate removal of nuisances or such dealing with the inmates as limits the spread of the disease.

The remote benefits of such returns and of deductions made from

them are of still more consequence. We have already noticed how, by aggregation of the facts, in various localities for quinquennial, decennial or longer periods, and so representing larger numbers of people, errors which arise from too few numbers or from temporary influences are balanced. So facts are secured which point to social evils to be remedied, and which, as to diseases, show the causes and effective methods for their prevention. States and countries are now utilizing these statistics as never before, and modes of tabulation are being simplified. By means of a recent invention, it is possible to secure combinations of instructive tables as never before. The chief

embarrassment still is that there is expense in all such inquiries and in gathering all such facts, and that so few are appreciative of the value of the results secured. Yet no one can make a study of such treatises as the abstracts from Dr. Farr on Vital Statistics (1884), or Newsholme on Vital Statistics (1889), or the Cartwright Lectures (1889), J. S. Billings, M.D., LL.D., or can examine the work of the Registrar-General's office of Great Britain, or that now being done in connection with the 11th U. S. Census, under the direction of Surgeon J. S. Billings, U.S.A., without perceiving that no collection of statistics is more necessary for governments and states. It is a satisfaction to know that in the present census no State Bureau of Vital Statistics has been found superior to our own, and that the U. S. Government is largely availing itself of our records for purposes of study and comparison, and so making a copy of all death records for five years past.

VIII.—What are the Present Defects in Our System or in Deductions from it?

The chief are these:

Localities make too rapid deductions as to healthfulness or sickliness from the death-rate of a single year. The error of this is fully presented in our twelfth report.

Local Boards are not careful enough to study the weekly records to find just in what houses or blocks deaths have occurred, and especially those from diseases known to depend largely on local conditions. Also every death, from week to week and year to year, should be marked on maps or graphic charts, the color or shape of mark indicating the disease. Thus the abiding-places of disease and death can be studied and the causes removed.

Physicians are not always careful enough to state the cause of deaths, or the secondary cause if the primary is doubtful. Peritonitis, for instance, should state whether "Idiopathic," "Traumatic " or "Puerperal." Cancer should state where located; so as to many other diseases.

To show, however, what progress was made when the old law was replaced by that of 1878, we give the death return from the populous township in which the Secretary resided, as made by the Assessor for the year previous (1877). The population of the township was about 3,750. The deaths returned were thirteen, and the causes of death as follows: "Aneuris, common disey head, gastric fever, general

debility, perrallis, dopsy, inflamation of lungs, fitts, old age, hemredge of the liver, accident, marasman, heart disease."

Returns of births should be more complete, although each year marks improvement.

State vital statistics should be reported quarterly, but cannot be, because of delays of complete returns.

The annual tables should be more extended, and especially the quinquennial and decennial tables, showing a larger series of deduced facts illustrated by diagrams and analysis. This cannot be until a longer period has elapsed or the State sees fit to make appropriation for more extended work. Yet no one can study the eleven reports made without noting some lines of progress.

The desire of this Board is thus to emphasize the importance of these statistics, and to ask the earnest co-operation of physicians, of Local Boards, of city registrars and of assessors, in efforts, from year to year, to perfect these vital records.

1890.

We may illustrate the possibility and reliability of such statistics in this way John Noble early displayed a great interest in animals, and especially in horses. His father had large wealth and sought to restrain this passion, lest it should beget a fondness for the turf and result in spendthrift extravagance. But this fondness took a peculiar turn. At an early age the young man came into possession of very large wealth, and determined to make the study of horse life his avocation. His purpose was to know all that related to the life history of this animal, the natural age, the causes of imperfection or disease, so that through this knowledge might be secured the highest perfection, i. e. not only long life, but the greatest freedom from all that could lower vitality or restrain usefulness; for with horses, as with men, the value depends largely on the capacity for uninterrupted use and usefulness. Agents were appointed, registry-books opened and six thousand horses registered and marked, while yet colts of less than one year. One thousand of these were born and were to be reared and used only in cities; two thousand more were to be transferred to cities as soon as broken, and of these one thousand were to be returned to the country on the first chronic signs of decline. The other three

thousand were always to remain in certain townships and in country occupations. The life history of all these was studied, with all the details of work, kind of occupation, stabling, and everything relating to them duly recorded. Facts as to descent and progeny were ascertained. While various facts were published from time to time, it was only at the close of thirty years, and after there had been the most thorough and detailed study of all this multitude, that Mr. Noble presented the result and his analysis of them. The agents in the selected cities and townships had, from personal observation, filled out all his schedules with events as they occurred, and so the material for the life and death history of these six thousand animals was very abundant. As the life of horses is so much shorter than that of men, it was easy to trace a whole generation. Mr. Noble, with wonderful ability, and in accord with the laws of statistical study, combined his facts so as to show the effect of locality, rearing, food, open air and stable care, occupation, treatment, care of teeth, of limbs, of hair, modes of exercise; in fact, all that could influence effective force and vitality. The author had been much laughed at during his long years of collection of facts and analysis of them, but his treatise proved the most valuable guide to horse care ever published. It substituted facts for so-called guesses, and gave a basis of experience quite different from that of single observations. While any real experience has some value, all came to see that recorded facts and observation of this kind and degree, carefully secured, were of inestimable service.

Similar studies of human vital statistics give far more valuable results, since they deal with a higher order of beings and a class subject to more variations and diseases. Through these, life-saving principles and practice can be reached that can be secured in no other way. During the past year the United States Census Bureau, by permission of the State Board of Health, has made accurate copies of all certificates of death filed in the office from June 1st, 1885, to June 1st, 1890. Massachusetts and this State were the States chosen as furnishing the best records from which to compile a series of facts for analysis and for comparison with other facts obtained in the present census. This affords this Bureau an opportunity to avail itself of these statistics, in order to secure from them a few tables and deductions not possible under our State appropriation, but these will not be available until another year.

THE INFLUENZA EPIDEMIC:

BY EZRA M. HUNT, M.D., MEDICAL SUPERINTENDENT OF
VITAL STATISTICS.

During our statistical year we have been visited by a disease generally known as Influenza. The French call it "La Grippe," and the Germans sometimes call it "Blitz-catarrh" (lightning cold). While it has many other local names it is not by any means new. The Annals of Influenza (Sydenham Society, 1852) give records of some twenty epidemics, from the sixteenth century to the nineteenth. A full account of these epidemics, up to 1847 inclusive, will be found in the ninth report of the Register-General for England and Wales, by Dr. Farr. Dr. Peacock, of London, has furnished the details of the epidemic of 1847. Prof. Gairdner, of Glasgow, has given some details of the epidemic of 1837, and Sir Thomas Watson, of London, particulars of that of 1847. Most books on the practice of medicine treat of the disease, while the journals of the past year abound with the varied literature of the subject. The older epidemics were generally spoken of as characterized by their sudden onset, with chills and general aching pains; by sneezing, coryza and cough; by high ephemeral fever, with great depression and a tendency to various pulmonary complications. Attacks have generally occurred in the winter or early spring. It has often had a pandemic character, caring little for distance or seas, occurring both on land and water, without any apparent connection. Its progress has not been uniform, being often opposite to the direction of the winds, passing adjacent countries, and then returning to them.

It was once thought to follow the lines of travel and traffic, but this view is not sustained by the recent outbreak. The following will serve as a brief summary of its appearance:

"The first cases recognized in Europe were observed in St. Petersburg about October 15th, 1889, and by November 12th it had spread