Relevant Quotes from William Farr
Humphreys, N.A. (Editor): Vital Statistics: A Memorial Volume of Selections from the Reports and Writings of William Farr. London, Sanitary Institute, 1885, p. 254-5. Reprinted for the New York Academy of Medicine by the Scarecrow Press, Inc., Metuchen NJ, 1975.
All the preceding diseases are modified, and some are induced, by external agents, but the present class comprises the evident results of physical and chemical forces acting on the organisation. Burns, asphyxias, wounds, poisonings, stings, are types of the several sub orders of the class.
Fire, asphyxia, mechanical forces, poisons, stings, induce specific diseases, which present a regular succession of phenomena, and should in all cases have names. Thus, as it is the "burn" and not the fire that is the cause of death, so it is the disease to which "arsenic" gives rise, rather than the arsenic, that we should register.
Human agency plays so important a part in this class, that it might be made the basis of the division into orders. Thus a man may die (1) a glorious death in battle (pro patria mori); he may die (2) by an act of homicide (murder, manslaughter); he may die (3) ignominiously on the scaffold (execution); or, (4) abandoning the post in which God has placed him, he may take away his own life (suicide); (5) he may die by a surgical operation; and (6) he may die by accident.
If this grouping be adopted, the mode in which death is produced by wounds, chemical injuries, poisons, asphyxias, and mechanical forces, would form secondary heads.
At the instance of the Registrar General, instructions have been prepared under the several heads of the Nosology, for the use of medical men and coroners in England. In the several countries of Europe similar instructions would be required, and might be modified so as to meet the peculiar circumstances of each nation.
The most important point to attend to in the instructions is the registration of the secondary diseases which intervene in the course of other diseases, and the record of the duration of every fatal disease.
To render the analysis of the causes of death complete, it will be necessary to subject a certain number of them to a second analysis: showing, for example, the various ways in which childbirth is fatal, the circumstances in which fatal accidents occur, the cases of measles that terminate in bronchitis or pneumonia, of scarlatina that pass into dropsy, and the duration of each fatal case. These analyses would be interesting chiefly to medical statists.
I have thus sketched in outline the classification of diseases from the statistical point of view, and have arranged them all under the five groups of Epidemic diseases (zymotici or demici), Constitutional diseases (cachectici), Local diseases (monorganici), Developmental diseases (metamorphici), and diseases that are the direct result of violence (thanati).
The general statist will gain a notion of the three first classes, by comparing them with the disorders arising in a most elaborate machine--from electrical, magnetic, or chemical action, and from the wear and tear of its particular parts. The fourth class is exemplified by defects of construction and by general decay. The fifth class is represented by the act of breaking the machine to pieces, disintegrating its parts, and putting an end to its movements, which when once stopped cannot be recommenced.
By studying the causes which are injurious and fatal to men in our countries and in our cities, statists will contribute to the removal of evils which shorten human life and to the improvement of the race of men, so that citizens of civilized States may be made to excel barbarians as much in strength as they do in the arts of peace and of war.
In the words of Bacon, "If physicians [and we may add governments] "will learn and use the true approaches and avenues of nature, they may "assume as much as the poet saith-
- "Et quoniam variant morbi, variabimus artes;
- "Mille mali species, mille salutis erunt."
- (16th Annual Report, Appendix, pp. 71-9.)