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By Michael Rowland Alderson

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Scarlet fever. A WHO report (1954a) reviewed the trends over the first half of the century and noted that the 4th revision had moved puerperal scarlet fever from the specific scarlet fever category to infections during childbirth. This is a very small change and unlikely to have altered the general comparability of the rubric. Perhaps more important is the tendency with alteration in coding rules for complications of bronchopneumonia, nephritis, heart disease, and pleurisy to be coded to these latter conditions rather than the underlying scarlet fever.

Only by summing the two 30 causes of death are comparable rates to other Western countries obtained. Benjamin (1968) drew attention to the 10 per cent decrease in deaths from heart disease that occurred in 1940 after the change in the assignment rules. He also supported the suggestion of using broad groups when making comparisons and advocated that heart disease, other diseases of the circulatory system, intracranial lesions of vascular origin, nephritis and bronchitis should all be pooled together.

Neoplasms Many reports have been published examining the validity of mortality statistics for malignant disease over this century; two reviews from WHO (1952b, 1955a) have examined long-term trends. Greenwood and Wood (1914) examined this issue. They particularly looked at the trends in the end of the 19th and early 20th century for 'accessible' and 'inaccessible' sites. They concluded that it was incorrect to state that the recorded incidence of cancer was not a consequence of genuinely increased incidence (though referring to incidence, they are dealing with mortality data).

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