There is in all no very great decrease in the frequency of consumption, but what there is was evidently not due in any measure to the prevalence of malaria. The table on page 63 shows the comparative mortality for five years; also that for each year the aver age is 1,311, that for 1880, 1,327.

INFANTILE DEATHS.

The deaths of those under five, this year, are largely in excess of last year; more than half the increase over the mortality of last year is due to this class. The percentage to total mortality was 31.5, while in 1879 it was 28.3, an increase of over three per cent. This is largely due to climatic causes, the largest percentage is made up from cholera infantum, that is, of that part caused by disease. The effects of malaria in causing infantile debility and death are also to be seen here, and add their quota to swell the list. A large infantile death rate is an indication of anything but a good sanitary condition. The percentage this year, while larger than that of last year, is still not above the average, but the average shows a condition that should be improved upon. There is a small increase in all periods over last year, but slightest in the last, those from old age. The greater number of deaths too occur in summer, although from the protracted heated term, diarrheal diseases continued until late into the autumn, and early winter.

PNEUMONIA AND ACUTE LUNG DISEASES.

The frequency and mortality from pneumonia have increased rapidly for the last two or three years, but have not yet reached that of 1879, which was an exceptional year. As seen by the table, the deaths exceed the average for the last five years by 102. The rapidly transitional changes of the weather is doubtless one of the principal causes, still we find it extending into the early summer to an extent and degree quite unusual.

The increase in other acute lung diseases, while marked, is not as extensive as that in pneumonia. As stated previously, the increased mortality is largely due to climatic changes, as we have already discussed the causes of much more than half of the increase, and the causes have been principally climatic.

DISEASES OF THE NERVOUS SYSTEM.

The increasing ratio of deaths from nervous diseases is an interesting question for study in vital statistics. This has been marked for the last two years especially. Thus the deaths this year and

last, from insanity, are each double those in 1877, and more than three times those in 1876. The increase in other forms while regular and decided is not as great as in insanity. The great strain upon men in modern times to keep up in the race, to say nothing of excelling others, puts a great burden of care, worry, and anxiety upon the mind. The overtasked mind is not allowed sufficient rest, and recreation is a thing unthought of, hence comes the inevitable result, disease or a complete overthrow of the mental powers. The great cause of mental and nervous disease is overwork and anx iety, and of the two, worry is the most potent. Many men are hurried into wreck by the pressure of care and anxiety, so that any relaxation, to say nothing of west, or recreation, is out of the question, and indeed the word is well named, or the thing rather for which it stands, for it is indeed a re-creation to lay aside all anxiety and care and enjoy some form of amusement to the full. But to those that find no relief, even in sleep, from the load of care, the rest of death or madness comes at length.

DEFECTS IN REGISTRATION.

The following circular, describing the present greatest evils in obtaining correct returns, was issued and sent during the present year to the registrars:

BUREAU OF VITAL STATISTICS.

To the Registrars of Births, Marriages, and Deaths of the State of Connecticut.

GENTLEMEN;

As the general superintendence of the system of registration of Births, Marriages, and Deaths devolves upon this board, it therefore becomes our duty to call your attention to any measures that will improve this department, and to any features that require correction. Any suggestions that your experience may suggest will be welcome, and receive due attention. The law gives you ample power to compel complete returns, and, indeed, the accuracy and thoroughness of the record depends upon your zeal and fidelity to a very great extent. The following topics invite consideration at this time, arranged somewhat as to their relative importance. 1. The full name of the child in the birth records. 2. The returns from non-resident physicians. 3. The prevention of

improper use of the returns of Births and Deaths. 4. The safe keeping of the records. 5. The regulation of returns from sextons and those having charge of cemeteries and the registration of burials and removals in the records of cemeteries, and the enforcement of the law requiring removal permits.

The first is beset with the greatest difficulties. The law giving the registrar ten cents for every record of birth incomplete, in regard to the name of the child that he completes, has in some places increased the percentage of names to a great extent, but has not secured complete returns in this respect. It is suggested that in the smaller towns a postal card sent to the parents at the close of the year would, in most cases, secure a satisfactory reply. In view of this difficulty, the Board have issued Birth Blanks bound in book form, with a stub attached, to be retained by the physician and completed at any future visit he may make during the year. It also enables the physicians to preserve records of this part of their professional business with very little trouble. It also prevents waste, as the unused blanks are kept clean and are not readily lost. Registrars are requested to use every means in their power to secure complete returns of births. In some instances, a personal canvass through certain localities in the larger towns has increased the returns ten to twenty per cent. The compensation allowed the registrar in such cases amply repays the time thus spent.

The second difficulty is nearly as great. In some instances returns of births are made to the town in which the doctor resides, while oftener both births and deaths thus attended go unrecorded. The returns of births and deaths show this glaringly where towns are thus situated, the death rate from the returns being many times lower than the most liberal estimates of the greatest possible duration of life give, so much less as to show at once the incompleteness of the returns. The law, which was submitted to the legislature to correct this evil, provided for compulsory returns by letter, and payment of fees to non-resident physicians by letter by the registrars. Unfortunately, shall was changed to may, and the penalty for non-compliance stricken out, so no relief was afforded. It is, however, in the power of registrars to compel returns from such physicians, and postal card notifications of the law, and that it will be enforced, will be supplied registrars on application, to serve upon such physicians. If no regard be taken of such notice, we advise that the case be put into legal hands to secure compli

ance without suit, if possible, but to break up this persistent disregard of law, and secure this large percentage of births and deaths that now are unrecorded.

The attention of registrars is called to the improper use of the returns, in the publication of the names of persons that have died, in connection with the diseases of which they died, and of the number of deaths or births returned by physicians or midwives. Such abuse of the records should forfeit the right to use them, and registrars are hereby instructed to prevent such abuses by all means in their power, and in case of persistence, after due warning, to forbid such trespassers access to their books; furnishing always, to all, such data and information as are proper for publication or information. The number of births and deaths, and the number dying or born in any given period of time, or the number dying from each disease, are all facts that the public are entitled to know, also the number born or dying in any ward, street, or locality; but the names in connection with the disease, or the names of attendant physicians in connection with any statistical report, are matters of private, not public concern. Strict adherence to this rule is required.

In towns where no safe has yet been provided, the returns and records are often exposed to great risk of loss. Registrars are requested to use the greatest care in keeping their record books safely, and also in perserving the original certificates, which in case of a change in office should be transferred to the new incumbent intact. Attention is also called to the importance of filing a duplicate copy of the yearly abstract with the town clerk.

The importance of keeping a record of burials and removals at the office of the cemetery is obvious. The law in this respect is too often disregarded. Where such records are faithfully kept they are of the greatest assistance to the registrar in securing a complete numerical return of deaths, in addition to the relations of such records to the public welfare.

The registrar is the only person that can secure a due enforcement of the registration laws. Of course, it is the duty of every good citizen to obey the laws, and physicians are supposed to have a special interest in these returns. Unfortunately, these inducements cannot be entirely relied upon to secure satisfactory results; dependence then comes upon the public spirit and fidelity to duty of the registrar. This is a surer reliance than any of the others,

M

and while commending the efforts that have been made, and the results achieved, we suggest these topics for your careful consideration, and request your heartiest co-operation in making this service a model for all other states. Our laws and methods are now conceded to be among the best. It is our duty to see that the results shall be commensurate.

By Order of the Bureau of Vital Statistics,

C. W. CHAMBERLAIN, M.D.,
Superintendent.

ERRATA.

Page 11. The lines for Old Lyme and Preston are transposed all through after the population, so what reads as Old Lyme should be for Preston, and vice versa.

Page 14. The same for Norfolk and North Canaan.

Page 17. In the total deaths for Middlesex County, 5 dropped out. It should be 540, not 40, as printed.

Page 23. The total for Class IV should read 265 instead of 255, as printed.

Page 29. The total male deaths in Class III should be 55, not 54, as printed.

Page 40.

Watertown is printed Waterbury,