The Natural History of Population by Raymond PearlReview by: A. Hardisty SellersCanadian Public Health Journal, Vol. 31, No. 1 (JANUARY, 1940), pp. 47-48Published by: Canadian Public Health AssociationStable URL: http://www.jstor.org/stable/41978008 .

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Books and Reports 47

was the medical diagnosis. The final results of the study will be published in two volumes at a later date.

The construction of a list of causes of illness is one of the first requisites in any morbidity study. The prepara- tion of the list presented in this publication was one of the main objectives of the original undertaking which was designed to aid in the promotion of morbidity reporting in New York City. The method adopted in arriving at the list in its present form is indicated in the text, the basis being the Standard Classified Nomen- clature of Disease, the most authori- tative statement of medical nomen- clature in existence.

The List is divided into fifteen groups with sub-headings totalling 443 items. This number appears to be small enough to be generally satis- factory and the scientific basis of selection of items for inclusion in the list guarantees a presentation of the essential data for those interested in hospital morbidity. Special groups with specialized interests will natu- rally desire greater detail in certain sections of the scheme.

If the principles involved in the drafting of the International List of Causes of Death are recognized as acceptable by those interested in morbidity statistics, it seems reason- able that the major groups should be retained and, unless absolutely contra- indicated, the diseases, conditions or injuries included within the various major groups should be the same. This is not uniformly true of the List reported upon although the exceptions are admittedly few.

This development is of particular interest to Canadians in view of the national morbidity classification pre- pared by a Committee appointed by the Dominion Council of Health and tabled in 1938. Tremendous strides have been made in the last three years in Canada in the securing of informa- tion on the causes of illness. The attention of readers is therefore drawn to this publication as an authoritative source based on the largest scientific

piece of work of its kind yet under- taken in America.

A. Hardisty Sellers

The Natural History of Population. By Raymond Pearl. Published by the Oxford University Press, Toronto , 1989. 416 pages. Price $3.25. The Natural History of Popu-

lation contains a refreshing and thoroughly scientific treatment of the subject by one whose valuable re- searches in this field deserve careful study. The real cream of the book comprises the essential findings of studies in human fertility which by Dr. Pearl's own admission have been a major object of his interest and effort for many years. No pretence is made that this text exhausts the subject or presents all the pertinent material which is available. Indeed, it is planned to supplement this publication with another one at a later date.

What are the chief changes taking place in population? What factors are at work and what is the relative importance of each? What relation have these factors to modern attitudes and present population problems? These are some of the broad general questions to which this book provides a material basis for at least tentative answers. It is; of course, futile for any one to express dogmatic opinions because of the multiplicity of factors involved but the presentation of a considered opinion based on scientific research is extremely valuable at this time.

From a thorough examination of available population data supple- mented by a rather unique and remarkable study of human fertility this broad conclusion emerges: "If it were not for the effect of contraceptive efforts and the practice of criminal abortion, together with correlated habits as to postponement of mar- riage, there would apparently be little or no significant differential fertility as between economic, educational, or religious classes of urban American married couples." This result is the

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48 Canadian Public Health Journal

more striking because it indicates "that in one population at least the existing fertility differentials do not rest upon deeply rooted, innate bio- logical differences. Instead, the responsibility for them appears to rest primarily, overwhelmingly, and di- rectly upon that body of doctrine and practice popularly called birth control."

In presenting the material in the text, the author has dealt in succession with the biological background of population, the biology of fertility and human and animal reproductive patterns. These three sections are followed by a discussion of the extent of contraceptive efforts in the Ameri- can population and the effects of these on natural fertility as indicated by research. In a final section the author summarizes the essential find- ings and offers some comment on world population - past, present and future. Appendices to the text con- tain the more detailed tables and a summary of the procedure in collect- ing the fertility data under discussion. An exhaustive bibliography is appended.

Students of population will welcome this book. It is indeed a valuable addition to the literature on the subiect.

A. Hardisty Sellers

A Pediatrician in Search of Mental Hygiene. By Bronson Crothers. Published by The Commonwealth Fund , New York. 271 pages . $2.00. This interesting book is divided

into three parts : Mental Hygiene in the Practice of Medicine, Men- tal Hygiene in the Teaching of Medi- cine, and Towards Meeting the Paediatrician's Responsibility. The purpose of the book is to explain the opportunities open to the paediatri- cian to utilize the advances of the mental hygiene movement in private practice. The author begins by describing his own efforts and then explains the difficulties which tend to confuse the doctor interested in mental hygiene. The status of

paediatrics as a specialty is discussed with emphasis on the important new field - the study of the mental or emotional factors of patients. In the author's view, a useful type of mental hygiene of childhood can be employed by the paediatrician in his practice, although there are other workers engaged in mental hygiene, viz. teachers, psychologists, the personnel of the mental hygiene clinics, the psychiatrist in private practice and the non-medical worker with a train- ing in child guidance.

In Part II the need for paying attention to the "art" as well as to the "science" of medicine is pointed out, for the latter has made more rapid strides than the former during the past 25 years. The study of the environment, social and housing con- ditions, and economic stresses of the sick patient has led to the develop- ment of the hospital social service department as an aid in treatment. In this way the value of the trained, medical, social service worker has been recognized. Similarly, the relation of behaviour to physical disease is becoming apparent and hence the importance of developing a skilled worker, without medical train- ing, but possessing a knowledge of psychiatry and social science.

The problem of the effective intro- duction of the study of behaviour in a children's hospital is discussed, since behaviour is certainly an element to be considered in many of the cases attending the clinic. A child guidance clinic tends to be isolated in the administration of a hospital and is apt to be used by outside agencies in the solution of school and social problems.

Part III suggests a scheme for the development of a "specific paediatric art" on the basis of a recognition of the psychiatric components of differ- ent case-groups. The results of an enterprising experiment at the Boston Children's Hospital are reviewed and Dr. Crothers is satisfied that educa- tion and medicine are both involved in paediatrics. Although the hospital is well-equipped for the examination

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