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ON INTERNATIONAL STATISTICAL COMPARISONS 5 I
compared there must be a certainty that the registra-
tion process as to numbers is effective and complete in
each. This is not the case in all countries, and it is an
especially important matter in historical investigations
even.in the same country; the registration of births and
deaths in England, for instance, being notoriously de-
ficient until a comparatively modern period. Even a
great country like the United States is still most de-
ficient in this vital particular; there is no such thing as
a goo~ birth and death rate for that great country. In
Philadelphia some years ago a local report of the re-
gistrar of births, deaths, and marriages was put into
my hands, from which it appeared that the deaths ex-
ceeded the births. I learnt on inquiry that the explana-
tion of a fact which would have been somewhat startling
if true was simply the neglect of the laws or adminis-
tration in the matter of the registration of births. I do
not know whether there has been improvement since
in this particular city of the United States, but that
there is still a lack of a uniform and effective system of
registration throughout the country is most certain. It
is necessary then to reiterate again and again the neces-
sity for the utmost caution in the use of such common
figures as birth and death rates. Always when a writer
would make a comparison, let him see that his facts are
really comparable. He must not be content to take
them from a dictionary without inquiring.
These remarks hold good of other comparisons some-
times made, particularly as to the prevalence of certain
kinds of disease. I need not say to an audience of ex-
perts what difficulties arise in the definition of disease,
and how doctors, apart from mistakes as to what the
disease really is of which a man dies, may honestly vary
in their statement of the fact from the number of causes
themselves, one doctor giving a proximate and another
an ultimate cause. Before statistical comparisons can
be made, something must be ascertained as to whether
definitions and method of registration are substantially
the same in the two countries compared. In historical