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244
It was adopted in the early days of preventive medicine, and
can now only by courtesy be said to refer to seven diseases, as it
includes under one head—fever—diseases of such widely different
causation as typhus and enteric fevers together with other ill-defined
forms of fever of a debatable character. Its value as a practical guide
is greatly diminished also by the marked epidemic vagaries of some of
its component parts, such as measles and whooping-cough, but still
more by the inclusion of diarrhœa deaths.
The disease intended to be included in the zymotic death-rate
under the heading diarrhœa is undoubtedly an epidemic disease of a
specific character, but in actual practice numerous means are employed
by medical men to designate this disease in their death-certificates, all
of which have reference to one or more prominent symptoms of the
disease, and all of which may at times with equal justice be used to
express a diarrhœal disease, which is not of the specific nature of that under discussion.

During the present year an attempt was made by the Society of
Medical Officers of Health to estimate the methods adopted by each
individual Health Officer in the classification of diarrhœa deaths, in