Town of Winthrop : Record of Deaths 1919-1921, Part 150

Author: Winthrop (Mass.)
Publication date: 1919
Publisher:
Number of Pages: 1192


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1919-1921 > Part 150


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23


1921


County


Suffolk


-


EXTRACTS


FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a stand- ard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died [defined so that it can be classified under the international classification of causes of death], where contracted, the duration of his last illness, when last seen alive by the physician, and the date of his death. . . . - Revised Laws, Chap. 29, Secs. 10 and 1, as amended by Acts of 1910, Chap. 322.


No undertaker or other person shall bury a human body . until he has received a permit from the board of health or its agent, . . . or . from the clerk of the city or town in which the person died; . no such permit shall be issued until there shall have been delivered to such board, agent or clerk, . . . a satisfactory written state- ment containing the facts required by law to be re- turned and recorded, which . . . shall be accompanied by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as herein- after provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, the chairman of the board of health, if & physician, or any physician employed by said board or by the selectmen for the purpose, shall upon application make such certificate as is required of the attending physician. If death is caused by violence, the medical examiner only shall make such certificate. ... The person to whom the permit is so given and the physician who certifies to the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require. - Revised Laws, Chap. 78, Sec. 38.


Medical examiners shall, in all cases, certify to the city or town clerk or to the city registrar in the place where the deceased died, his name and residence, if known, otherwise


a description of such person, as full as may be, with the cause and manner of his death, and shall make examination upon the view of the dead bodies of only such persons as are sup- posed to have come to their death by violence. - Revised Laws, Chap. 24, Sec. 8.


RULES OF PRACTICE


The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from in- jury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


STATEMENT OF CAUSE OF DEATH


Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) eaused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homi- cidal." " Asphyxiation by suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anæsthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."


If investigation shows the death to have been due to dis- ease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal gangloid) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"


DESCRIPTION (for unknown person).


NOTICE TO UNDERTAKERS : No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have come to his death by violence, until a permit in writing, signed by the Medical Examiner, has first been obtained. - Revised Laws, Chap. 24, Sec. 20.


THIS CERTIFICATE CONSTITUTES SUCH PERMIT


Calor


Feb. 23.1921


Mouse welt


R-302


The Commonwealth of Massachusetts


STANDARD CERTIFICATE OF DEATH


1648


(City or town)


Registered No.


(Place of death)


City or Town


.......


BOSTON


No. NEW! ENG. HOSPT


(If death occurred in a hospital or institution, give its NAME instead of strect and number)


2 FULL NAME


MASS.


(If in the


WANT HABof the United States, give rank, organization, etc.)


No.


20 CRESCENT


St.


(a) Residence. State.


(Usual placc of abode)


Length of residence in city or town where death occorred


years


months


days


How long in U. S., if of foreign birth?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


F


4 COLOR OR RACE


BLK


5 SINGLE, MARRIED, WIDOWED, OR


DIVORCED (write the word)


MAR.


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


JOHN H.


6 DATE OF BIRTH (month, day, and year) OCT. 13.1895


7 AGE


Years


26


Months


4


Days 10


If LESS than


1 day, ........ hrs.


or ....... min.


If STILLBORN, eoter that fact here


8 OCCUPATION OF DECEASED


(a) Trade, profession, or


particolar kiod of work


HOUSEWIFE


(b) Name of employer


9 BIRTHPLACE (city or town).


CHARLESTON.


(State or country)


S.C ..


10 NAME OF FATHER


JOHN SANDERS


PARENTS


11 BIRTHPLACE OF FATHER (city or town)


ORANGE


(State or country)


S.C.


12 MAIDEN NAME OF MOTHER PARALEE LOGAN


13 BIRTHPLACE OF MOTHER (city or town).


(Statc or country)


COLUMBIA


S. C.


14 Informant (Address)


MOTHER


15 MAR.


Filed


19


Registrar of city or town where death occurred


Filed March 26


(1921


Registrar of city er town where deceased resided


18 Where was disease contracted


if not at place of death ?


Did an operation precede death?


YES


FEB. 23. 1921


Was there an autopsy?


(VERSION & EXTRACTION)


What test confirmed diagnosis?


(Signed)


H. G. MYRICK


,19


( Address)


FEB . 24.


. M.D.


19 PLACE OF BURIAL, CREMATION, OR REMOVAL


MT.HOPE CEM.


DATE OF BURIAL


FEB.27


19


28 UNDERTAKER


G. H. P. GANAWAY


ADDRESS


9. 25,000


so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions on back


of certificate.


1 PLACE OF DEATH


County .......


SUFFOLK


State


MASS.


Registered No.


33


(Place of res lence) -


St., . Ward


VIVIAN WALKER


City or Town


16 DATE OF DEATH (month, day, and year)


FEB.23.


19 2 |


17


I HEREBY CERTIFY, That I attended deceased from


FEB. 23.


1921, to.


FEB. 23, 19 21.


FEB.23


19


21


ER


that I last saw h


alive on


and that death occurred, on the date stated above, at 6.05 Pm.


The CAUSE OF DEATH* was as follows :


* State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (Sce reverse side for additional space.)


POST-PARTUM HEMORRHAGE


(duration)


yrs.


mos.


.......


.ds.


CONTRIBUTORY


PLACENTA PRAEVIA


(SECONDARY)


(duration)


........ yrs.


mos.


ds.


carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms,


It


Feb 23.1921 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH [Approved by U. S. Census and American Public Health Association]


Statement of occupation. - Precise statement of occupa- tion is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irrespective of agc. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Compos- itor, Architcet, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on may form part of the second statement. Never return "Laborer,"


"Foreman," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer -Coal mine, etc. Women at home, who are engaged in the dutics of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write Nonc.


Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unquali- fied, is indefinite); Tuberculosis of lungs, meninges, peri- toncum, etc., Carcinoma, Sarcoma, etc., of ..


(name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection necd not be stated unless important. Example: Measles (discase causing dcath), 29 ds .; Broncho- pneumonia (secondary), 10 ds. Never report mere symp- toms or terminal conditions, such as " Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapsc," "Coma," "Convulsions,"""Debility" (“Con-


genital," "Scnilc," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Maras- mus," "Old age," "Shock," "Urcmia," "Weakness," cte., when a definite disease can be ascertaincd as the cause. Always qualify all diseases resulting from child- birth or miscarriage, as "PUERPERAL septicemia," "PUER- PERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS STATE MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to de- termine definitely. Examples: Accidental drowning; Struck by railway train - accident; Revolver wound of head - homicide; Poisoned by carbolic acid - probably suicide. The nature of the injury, as fracture of skull.


under the head of "Contributory." (Recommendations on statement of cause of death approved by Committee on Nomenclature of the American Medical Association.)


Cases for the Medical Examiners. - Under the provi- sions of chapter 24 of the Revised Laws deaths under the following conditions must be referred to the Medical Examiners:


1. Deaths following injury or violence, as Burns, Falls, Drowning, Gas poisoning, Suicide, Homicide, etc.


2. Deaths supposedly caused by violence, as Criminal abortion, Poisoning, Starvation, Suffocation, Exposure, etc.


3. Sudden deaths of persons not disabled by recognized disease, as A death upon the street, or one supposed to be due to Alcoholism, etc.


4. Deaths under circumstances unknown, as A person found dead, etc.


ADDITIONAL SPACE


FOR FURTHER STATEMENTS BY PHYSICIAN.


N. B .- Every itom of Information should be carefully suppiled. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain torms, so that it may be properly classified. Exact statement of OCCUPATION is very


important. See instructions on back of certificate.


1 PLACE OF DEATH


DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS


STANDARD CERTIFICATE OF DEATH


Township


Winthrop


State of


Massachusetts


Registered No. 37


[If death occurred in


Ward)


a hospital or Institution, give 'ts NAME Instead of street and number.]


2 FULL NAME


Frank.A. Rvan


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


White


5 SINGLE,


MARRIED.


WIDOWED,


OR DIVORCED


( Write the word)


Married


6 DATE OF BIRTH


March 22,


(Month)


(Day)


1 875


(Year)


7 AGE


45


yrs.


1.1mos.


5


ds,


or ___ min. ?


8 OCCUPATION


(a) Trade, profession, or


particular kind of work.


soldier


(b) General nature of Industry,


business, or establishment in


which employed (or employer)


Fate Bank


9 BIRTHPLACE


wille to alter


(State or country)


Massachusetts


PARENTS


11 BIRTHPLACE


OF FATHER


(State or country)


12 MAIDEN NAME


OF MOTHER


5


13 BIRTHPLACE


OF MOTHER


(State or country)


14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE


(Informant)


(Address)


15


Filed


Mar. 2. 1921


REGISTRAR


MEDICAL CERTIFICATE OF DEATH


16 DATE OF DEATH February 27, 1921 (Month) (Day) ( Year)


17 I HEREBY CERTIFY, That I attended deceased from Ech.10,1921 ,191 ....


, to.


Feb.27,1921.


, 191


that I last saw him. alive on


Feb.27.1921


191


---- , and that death occurred, on the date stated above, at .8:05 mP . M The CAUSE OF DEATH* was as follows: Pneumonia,Lobar left side


20 days


(Duration)


yrs.


mos.


ds.


Contributory. (SECONDARY)


(Duration) mos. ds.


- yrs.


(Signed) med mlnous


M. D.


Feb.27/21 191 ____ (Address)


Fort Banks, Mass


* State the DISEASE CAUSING DEATH, or, in deaths from VIOLENT CAUSES, state (1) MEANS OF INJURY ; and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL.


18 LENGTH OF RESIDENCE (FOR HOSPITALS, INSTITUTIONS, TRANSIENTS, OR RECENT RESIDENTS)


At place In the


of death


yrs.


mos. 17 __ ds. State


yrs.


mos.


ds.


Where was disease contracted,


If not at place of death ?


Shawmut Ave Poston,less


Former or


usual residence.


Showmut Ave Boston Lass


19 PLACE OF BURIAL OR REMOVAL


DATE OF BURIAL


3/2


1921


20 UNDERTAKER


¿9DRESS


11-3184 S. a. mowry


Health officer 2/28/20


244


or


Village


or


City


2


(No.


Farb Bunch Amputate


St .;


191


Mp 1€


County


Suffolk


10 NAME OF


FATHER


Under tollen


If LESS than


1 day, ____ hrs.


Feb.271921 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


[Approved by U. S. Census and American Public Health Association]


Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits ean be known. The question applies to each and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, c. g., Farmer or Planter, Physician, Compos- itor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement ; it should be used only when needed. As examples : (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The ma- terial worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," " Dealer," etc., withcut more precise specification, as Day laborer, Farm laborer, Laborer -- Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as Housewife, Housework, 0" .It home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, ete. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indi- cated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death .- Name, first, the DISEASE CAUS- ING DEATH (the primary affection with respect to time and eausation), using always the same accepted term for the same disease. Examples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal menin- gitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefi- nite) ; Tuberculosis of lungs, meninges, peritonaeum, etc., Car- cinoma, Sarcoma, etc., of .. (name origin; “Call- cer" is less definite; avoid use of " Tumor" for malignant neoplasıns); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The con- tributory (secondary or intercurrent) affection need not be stated unless important. Example : Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal condi- tions, such as "Asthenia," "Anaemia" ( merely symptom-


atic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion,""Heart failure," "Haemorrhage," "Inani- tion," "Marasmus," "Old age," "Shock," "Uraemia," "Weakness," ctc., when a definite discase can be ascer- tained as the cause. Always qualify all diseases result- ing from eliildbirth or miscarriage, as "PUERPERAL sept :- chaemia," "PUERPERAL peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS state MEANS OF INJURY and qualify as ACCIDENTAL, SUICIDAL, Or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples: Accidental drowning; Struck by railway train-accident; Revolver wound of head- homicide ; Poisoned by carbolic acid-probably suicide. The nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may be stated under the head of "Contributory." (Recommendations on statement of eause of death approved by Committee on Nomenclature of the American Medical Association.)


NOTE .- Individual offices may add to above list of nndesirablo terms and refuse to accept certificates containing them. Thus the form in use in New York City states: "Certificates will be returned for additional information which give any of tho following diseases, without explanation, as tho sole cause of death: Abortion, cellulitis, childbirth, convnisione, haemorrhage, gangrene, gastritis, erysipelas, meningitis, miscarriago, necrosis, peritonitis, phlebitis, pyaemia, septichaemia, tetanus." But general adoption of the minimum list suggested will work vast improvement, and its scopo can be extended at a later date.


11-3184


R-301


OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


(City or Town)


1 PLACE OF DEATH


City or Towa Stintelecon


State


No 145 to Lift are


St., ...


.. Ward


(If death occurred to a hospital oy Institution, give its NAME instead of street and number)


2 FULL NAME


(d) Residence. No. 145Cliff Cere


( Usual place of abode)


Length of resideoce io city or towo where death occorred


years


months


Ward.


(If non-resident give city or town and State)


days.


How long io U. S., if of foreign birth ?


years


months


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


Mai


(Day)


1921


(Year)


17 I HEREBY CERTIFY, That I attended deceased from 1 ,21


19


that I last saw h - alive on



19


.I.


and that death occurred, on the date stated above, at


10-302


.m.


The CAUSE OF DEATH was as follows:


If LESS thao 1 day, ........ hrs. er ... ... mio. Carcinoma of two


(duration)


.yrs


mos.


.........


ds.


CONTRIBUTORY ( SECONDARY)


(duration) mos ................ ds. .yrs ...............


18 Where was disease contracted if not at place of death ?


Did an operation precede death ?.


Date of.


Was there an autopsy ?


What test confirmed diagnosis ?.


(Signed)


.. , M.D.


(Address).


....


7 March 27


Rio


(Month) (Day) (Year)


14 Que Millie a Harm


145 Coliid ana Wentreal


....


15 Filed Mar 11/1921 (Month) (Day) (Year)


REGISTRAR


21 I HEREBY CERTIFY that a satisfactory stao- dard certificate of death was filed with me BEFORE the burial or transit permit was issued- I.G. Mowy


1


19 PLACE OF BURIAL, CREMATION, OR REMOVAL. Madison


(Cemetery)


(City or town)


DATE OF BURIAL Mar 4192,


ADDRESS 20 UNDERTAKER Mr. to Lordrich Lynn Les


Official Healthoffear of permit. position


Date of issoe 9/3/2/


Permit No. 2445


00.


4 COLOR OR RACE


White


5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) Married


5a If married, widowed, or divorced HUSBAND of (or) WIFE of


nellie a.


6 DATE OF BIRTH


Yeafs


71


Months 1


Days


23


If STILLBORN, enter that fact here


8 OCCUPATION OF DECEASED (a) Trade, profession, or particular kiod of work.


Karl Rond Clerk


9 BIRTHPLACE (City) .


(State or country)


Charlestown


masa


RE Benjamin Nammon


11 BIRTHPLACE OF


FATHER (City).


Eaton


(State or country)


12 MAIDEN NAME


OF MOTHERS


Elizabeth Jones


Lebanon


13 BIRTHPLACE OF


MOTHER (City)


(State or country)


me


County 3 SEX Male 7 AGE 10 NAME OF FATHER/ PARENTS instructions and extracts from the laws on back of certificate. in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH (b) Name of employer


The Commonwealth of Massachusetts


Registered No.


38


Benjamin Franklin Jarmon


(If in the Army or Navy of the United States, give rank, organization, etc.)


Date ...!


16 DATE OF DEATH


(Month)


1


Jaci: 6 1850 ( Month) (Day) (Year)


0 Mar. 1. 1921 REVISED UNITED STATES STANDARD CERTIFICATE OF DEATH


[Approved by U. S. Census and American Public Health Association]


.


Statement of occupation. - Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Tho question applies to cach and every person, irrespective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Plonter, Physicion, Compositor, Architect, Locomotive engineer, Civilengineer, Stationory firemon, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should he used only when needed. As examples: (0) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile foctory. The material worked on may form part of the second statement. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without inore precise specification, as Doy loborer, Form loborer, Laborer - Cool mine, etc. Women at home, who are engaged in the duties of the house- hold only (not paid Housekeepers who receive a definite salary), may he entered as Housewife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report spe- cifically the occupations of persons engaged in domestic servico for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATII, stato occupation at heginning of illness. If retired from business, that fact may he indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.


Statement of cause of death. - Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- brospinol fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of ...... ... (name origin; "Cancer" is less definite; avoid uso of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvulor heart disease; Chronic interstitiol nephritis, etc. The contrihutory (secondary or inter- current) affection need not he stated unless important. Example: Meusles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapso,""Coma,""Convulsions,""Dehility" ("Congenital,""Senilo," ete.), "Dropsy,""Exhaustion,""Heart failure,""Hemorrhage,""Ina- nition," "Marasmus," "Old age," "Shock," "Uremia,""Weakness," etc., when a definite diseaso can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL Septicemia," "PUERPERAL peritonitis," etc.




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