Within Ten Days from the hour of a BIRTH this form of Report must be filled out and returned to the BUREAU of VITAL STATISTICS of the BOARD of HEALTH. [Extract from Statutes.] From § 13, Chap. 74, Session Laws, 1866.-"It shall be the duty of the parents of any child born in said district (and if there be no parent alive that has made such report, then of the next of kin of such child born), and of every person present at such birth, within five days after such birth or death, to report to said Board in writing, so far as known, the date, ward, and street number of said birth, and for every omission to report a written copy of the same to said Board within ten days after any birth, any person guilty of such omission shall be liable to pay a fine of ten dollars, which may be sued for and recovered in the name of the Board. N. B.—This law is designed to secure a faithful report of birth from the Attending Physician, or some one of the persons who were present at the This law will be rigidly enforced, both as regards the Medical Attend birth. RETURN OF A BIRTH. To the Bureau of Vital Statistics, Metropolitan Board of Health, for the burial of such infants is granted, and for giving the requisite facts for permanent registration of the birth. Still-births are certified upon a form particularly designed to answer the double purpose of furnishing the evidence upon which permission Certificates of Causes of Death :-Mortality Returns.-Records of death have hitherto been made in accordance with the names of causes which physicians and sextons have been pleased to give in their certificates, and as the apparent design of such certificates has been to furnish a written warrant for obtaining permit to bury the deceased, there has been no studious regard for accuracy in stating the true causes of mortality. The claims of medical and sanitary science, the right of posterity to know the true causes that at any period have destroyed life, and especially the necessities of sanitary government in its attempt to deal with all the preventable causes of mortality, indicated to this Bureau the duty of adopting some practicable means for ascertaining the real and essential causes of death as understood by enlightened physicians. It is not enough that we are seriously informed by a coroner's or a physician's certificate that "bleeding," bleeding," as 157 deaths were certified in the year 1865, or "asphyxia," as nearly 100 others were certified, or debility," as nearly 1,000 other deaths were certified in that year, caused death. 66 To secure, as far as practicable, the needed precision and fullness in our daily returns and public registers of death the subjoined form for the physician's certificate was adopted: Physicians are required by the Board of Health to fill out this Certificate accurately. No Permit for Burial will be granted without a Certificate. CERTIFICATE OF DEATH. 1. Name of the Deceased (in full),... 2. Age, ....... years,. . . . . months, . . . . ......days. Color,. 3. Single, (Married,) (Widow,) or (Widower,) (Cross out the words not 4. Occupation.... 5. Birth-place, required in this line.) (And how long in the United 10. I HEREBY CERTIFY, That I last saw h..... on the..... day of......186 that.. died on the.. and that the cause of h.....death was [FIRST,] [SECOND, (Remote, or complicating.)]..... (Date,)..... (Undertaker,).. .day of... 186 Time from attack till Death. M. D. Medical Attendant. With the same objects in view, and to aid in attaining them and facilitating the bureau work and its statistical studies and correspondence, we adopted the nomenclature and classification for this branch of vital statistics that were prepared by Dr. Wm. Farr for the British Government, and have received the approval of the International Statistical Congress. The classification and nomenclature, together with suggestions and requests thereon to physicians, will be found in the Appendix of this Report. In this connection I must beg leave to bear testimony to the utility and convenience of the statistical nomenclature which this Bureau has adopted, in common with the chief authorities in vital statistics of other nations. I would also acknowledge the courtesy and co.operation of the medical practitioners in New York and Brooklyn, in efforts to secure full and accurate certificates of death. The Sanitary Code directs that all the permits received at the cemeteries shall be returned to the Bureau every Monday. Ferry and bridge masters, expresses, railway and steamboat offices, when receiving a corpse for transportation beyond the limits of either city, retain the coupon of the burial permit and return it to the Bureau.* A corpse in transit through either city from places beyond the Metropolitan District is registered, and a transit permit is granted, which accompanies the remains. Thus the public record of the deceased and all movements of their remains is rendered complete, and is readily accessible for reference. This system can be equally complete throughout all the towns of the District whenever the counties of Kings, Westchester, Richmond, and Queens provide means for their local registration. The voice of the medical profession and of leading citizens in all these counties seems to be unanimous for the immediate adoption of the entire system of registration of marriages, births and deaths. * Immediately upon taking possession of the public records, we issued instructions to all classes of persons who are concerned in the care, transportation, and burial of the dead. Every illicit, irregular, and unhealthful practice was, as far as practicable, brought under the surveillance and control of the Board of Health. Those instructions secured the prompt return of information and certificate of every death in the two cities, and a traccable record of the movement and destination of every corpse conveyed from or transported to or through either of the cities. In no other city in the world, did greater need of such systematic and rigid rules exist. I am happy to state that no opposition has been shown to this rigorous system, though until the Metropolitan Sanitary Board ordered it into operation, the City Inspector's permits were to be had for the asking-ready signed and in quantity-at the shops of various undertakers and medicine venders in the different sections of New York city. Such a premium on the daily violations of the statute relating to interments and the sanctity of human remains was not to be tolerated; the Board of Health and its Bureau of Vital Statistics could not allow that vicious system to continue for an hour. The Metropolitan Police quickly gathered up and brought to headquarters all those unguarded burial permits. There were other and very gross evils connected with the custody and registration of the dead, which were promptly corrected. This Permit must, in all cases, accompany the body to its Permission is hereby giben to remove the remains of. New York,... 1866. The Ferry or Bridge Master, or Transportation Agent, will please tear off and retain this Coupon of the Permit until called for officially. THE FIRST USES OF DEATH RECORDS BY THE SANITARY GOVERNMENT. able class of causes of death. There is a large class of the causes of death which so invariably depends upon local and immediately removable causes, that it becomes the duty of the duty of the Bureau of Vital Statistics instantly to inform the executive department of the Board of Health of the facts ascertained concerning every such death and its local cause. Cholera and typhus are types of this avoidAgain, whenever, or in whatever district, there is a marked excess or increase in the rate of mortality from all causes, or, from any class of causes, or from a particular cause, the death record serves as a "barometer of health and disease," the index on the mortality scale is studiously watched, the storm is foreseen, and all hands summoned to arrest impending dangers. To obtain accurate and prompt reports of death which should serve this purpose of quickly indicating the nature and true cause of deaths from day to day, and likewise to procure as complete a record as the permanent registration of death requires, the Board authorized the Bureau to adopt such improvements in the certificates and returns as would best serve these objects. The form for death returns as presented on page 48 has been adopted, and is now bringing in the desired elements of a record that at once aids the executive duties of sanitary government and insures the preservation of a permanent registry of facts that will hereafter serve important legal, social, and hygienic purposes. In order to procure the needed uniformity and definiteness in the designation of the causes of death, and likewise to bring our mortality reports into harmony with the chief Bureau of Vital Statistics in our own and other countries, it has been deemed expedient to adopt a classification and nomenclature that is most approved by medical men, and that will be in all respects in correspondence with the statistical nosology and plan of state registration of causes of death, prepared by Dr. WM. FARR for the Registrar General's office of England, and, in 1855, recommended by the International Statistical Congress at Paris. A copy of this classification, &c., with various notes, will be found in the Appendix of this report. A copy of this statistical nomenclature, with the names of the causes, in four languages, together with a circular of instructions to physicians, has been furnished to every medical practitioner in the two cities of the Metropolitan District. Upon the basis of this classification we are now in weekly correspondence with the chief centres of civic and national registration. But the most practical result of this effort at systematic grouping and uniform names of causes is exhibited in the daily and weekly study and mapping of the districts and wards of the city to show at a glance the locality and grouping of deaths from the zymotic and localized causes. The Board of Health and the Sanitary Superintendent during the past months of peril have thankfully borne witness to the utility of the system of registration and study of the causes of death adopted by the Bureau. In the words of Sir Sidney Herbert to Sir Alex'r Tulloch, upon the |