and the birth-rate has fallen in almost exactly the same proportion. The
position of a nation in the scale of civilisation may almost be gauged
by its births and deaths. The order in Europe, beginning with the lowest
birth-rate, is France, Belgium, Sweden, the United Kingdom, Switzerland,
Norway, Denmark, Holland, Germany, Spain, Austria, Italy, Hungary, the
Balkan States, Russia. The order of death-rates, again beginning at the
bottom, is Holland, Denmark, Norway, Sweden, Switzerland, the United
Kingdom, Belgium, Germany, France, Italy, Austria, Serbia, Spain,
Bulgaria, Hungary, Roumania, Russia. These two lists, as will be seen,
correspond very nearly with the scale of descending civilisation, the
only notable exception being the low position of France in the second
list. This anomaly is explained by the fact that France having a
stationary population, the death-rate in that country corresponds nearly
with the mean expectation of life, whereas in countries where the
population is increasing rapidly, either by excess of births over deaths
or by immigration, the preponderance of young lives brings the
death-rate down. We must, therefore, be on our guard against supposing
that countries with the lowest death-rates are necessarily the most
healthy. In New Zealand, for example, the death-rate is under 10 per
1000, the lowest in the world; and though that country is undoubtedly
healthy, no one supposes that the average duration of life in New
Zealand is a hundred years. To ascertain whether a nation is long-lived,
we must correct the crude death-rate by taking into account the average
age of the population. When this correction has been made, a low
death-rate, and the low birth-rate which necessarily accompanies it, is
a sign that the doctors are doing their duty by keeping their patients
alive. If our physicians desire more maternity cases, they must make
more work for the undertaker. Large families almost always mean a high
infant mortality; and it is significant that a twelfth child has a very
much poorer chance of survival than a first or second. The agitation for