Nomenclature of Diseases

NOMENCLATURE OF DISEASES, that is, a systematic list of names of diseases and pathological conditions, constructed on the basis of certain terminology and classification and having proper sanction for practical application, constitutes an important part of research in all branches of health statistics, where observation, accounting, and analysis of diseases are applied. In determining current morbidity of the population, in one-time accounting of pathological conditions of certain groups, in analyzing mortality by its causes, in the broad field of daily operational medical reporting, one of the prerequisites for statistical research is an established nomenclature of diseases. The N. of D. is sanctioned and regulated by local authorities—for local reporting and statistical work, by state authorities—for general summaries and reports, and by international agreements—for international comparisons, which ensures the dissemination and application of this nomenclature in all relevant institutions and organs and consequently the suitability of the material for summaries and comparative-statistical conclusions. It goes without saying that since diseases of people are complex phenomena, basically and decisively conditioned socially and having social significance, since health authorities applying statistics for regulation and control of their practical activity are a component part of the class state apparatus, therefore the N. of D.—this "strictly limited complex of specialized knowledge"—by no means is an "objective", neutral instrument. Its principles and content entirely depend on the socio-political and economic situation, on the class orientation, determining the general scope, limits and character of preventive measures—and the development of medical knowledge. The task of disease classification is to give as clear a system as possible of pathology of human collectives in order to, with its help, identify the main objects of social-preventive intervention, outline its current direction and verify it with a control instrument for evaluating its effectiveness. Naturally, fundamentally different health systems in capitalist countries and in a country of building socialism^, the fundamental difference in target settings, in the very principles and in the entire organization of health improvement for the working population, in organizational prerequisites (the planned nature of socialist health care and the anarchism of capitalist individual medicine) had to inevitably cause a divergence between the Soviet nomenclature of diseases and the so-called international one. Historical review. The question of a unified international classification and N. of D. arose at the first international statistical congress (Brussels, 1853). The English statistician William Farr and the Swiss Marc d'Espine presented their projects to the next two congresses (Paris, 1855 and Vienna, 1857). The resolution of the congress, recommending a somewhat modified nomenclature of d'Espine, led to no practical results—the stimuli for international communication were still weak. Only after 40 years at the session of the International Statistical Institute (Vienna, 1891) did Jacques Bertillon (head of the statistical bureau of Paris) again propose an international nomenclature of causes of death. The project he presented at the next session of the International Statistical Institute (Chicago, 1893) was approved and sent for information and discussion to the statistical bureaus of individual states. The energetic initiative of Bertillon was supported by the American association of physicians and hygienists, which at the all-American congress (Philadelphia, 1897) adopted a resolution recommending the international Bertillon nomenclature to the USA, Canada and Mexico with the condition of reviewing it, starting from 1900, every 10 years. To this were joined some states of South America and a number of European municipal statistical bureaus (1899). Christiania (Oslo) on the report of Bertillon adopted a resolution on the desirability of introducing a common nomenclature in all European statistical institutions. Finally in 1900 at a special international conference organized by the French government with the participation of 26 states of Europe and America, the Bertillon nomenclature was recognized as international. The following revisions of the nomenclature also took place in Paris (July 1909, October 1920 and October 1929). The international nomenclature received state significance in the USA, in all South American republics, Great Britain and its colonies, as well as in most other states of Western Europe. In 1924 the USSR also joined. In Germany the introduction of the international nomenclature into practice is planned for 1931-32. At the last conference of 1929, 82 delegates—representatives of 33 states and 5 international organizations (Bureau of Labor, Statistical Institute, Bureau of Public Health, League of Red Cross Societies, Health Commission of the League of Nations)—participated. At this conference the Soviet delegation actively proposed a fundamental revision of the N. of D. The Bertillon nomenclature included in its composition 3 nosological lists (detailed and abbreviated nomenclature), containing 161, 99 and 44 separate rubrics of causes of death. The availability of these causes gave statistical authorities the possibility to process the material in a more or less extensive volume depending on the quality of the material, the goals and objectives of the research, while remaining in all cases within the framework of comparability. Since the research of causes of death was organized according to the basic plan, only the most important diseases connected with danger of death, and "on the other hand" indications of other causes of death not accompanied by diseases (suicide, murder, etc.) had to be included in the lists. The Bertillon nomenclature divided all diseases into two unequal departments: "general diseases" and "local diseases". The first department in turn contains subdivisions: "epidemic diseases" and "other general diseases". The list of epidemic diseases is very brief—only 12 forms, among which we find scurvy, malarial fever. The last rubric—the 13th—contains "other epidemic diseases" of undetermined composition. "Other general diseases": next to pyemia, glanders—relapsing fever, remittent fever, tuberculosis by organs, scrofula, syphilis, cancer by organs, rheumatism, diabetes, alcoholism, lead poisoning, other chronic professional poisonings (total 23 rubrics). The department "local diseases" breaks down into 13 classes, of which 8 by systems of the body and organs—diseases of the nervous system and sensory organs, circulatory system, respiratory organs, digestive organs, urogenital diseases, diseases of pregnant and puerperal women, skin and subcutaneous tissue (here are included erysipelas, gangrene, soft chancre, anthrax, scabies, etc.); the 3rd class in connection with the age development of the organism and its fading—developmental defects, diseases of newborns, old age. The last class—diseases from external influences. Addition—undefined diseases. The general construction of the Bertillon nomenclature can be characterized mainly by two positions. First, that the basis of the list of diseases is the principle of their distribution according to patho-anatomical signs and by localization in areas and systems of organs of the human body. The etiological factor—external dependencies of social origin of diseases—is not given significance: to the share of diseases from external influences remains the last and weakest place in the list; alcoholism, lead poisoning, other chronic professional poisonings receive equal places in that motley mixture which represents the group "other general diseases". The second feature of the nomenclature is that the main importance belongs to individual forms of diseases, which actually represent the basic units for studying morbidity leading to death, while the grouping of diseases in essence expresses no classification at all. In the nomenclature of the second order, abbreviated, the same division is maintained as in the detailed one. The brief one contains only enumerations of individual rubrics outside any classification. These features fully correspond to the views which guided Bertillon in planning his work. "The main task is not to create for statistics everywhere the same counting units of diseases... Statistics cannot be guided by nosological classification. The progress of science often changes doctors' ideas about the nature of diseases, while sta-

"46", "NOMENCLATURE OF DISEASES"

546 "A nomenclature of diseases should be changed as rarely as possible. That is why one should avoid grouping different diseases together as much as possible, as is done, for example, with the grouping of professions. What can the diseases 'entetic', 'dietetic' mean now, which V. Farr, an enlightened physician and statistician of the first rank, proposed to the congress of 1855? Now, records of the former 'dietetic' diseases would be of no interest to any of us. However, diseases such as gout, anemia, cancer, senile gangrene (which were part of this strange group of Farr) still retain very closely their former meaning, which they had in 1855. From this follow two consequences: V. Farr's proposal to group diseases by their localization is preferable to that of M. d'Espine, who proposed to distribute them according to their nature; in a brief nomenclature, only the main diseases should be listed, completely discarding the others, but not reducing all different diseases to more general sums. A group of diseases that seems most natural for a given time quickly loses its meaning and therefore cannot be applied in statistics. On the contrary, vocabularies of diseases change much more slowly." In 1909, the N. b. underwent only minor changes. The most additions were made to the classification 'diseases from external influences': food poisonings, bites of poisonous animals, cases in fires, accidental gunshot wounds, injuries from cutting instruments, injuries from falls, injuries in mines, injuries caused by machines, crush injuries (on railroads, during house collapses), etc.; murder by firearms, murder by cutting instruments, other murders. In the department 'general diseases' were added: acute miliary tuberculosis, rickets, beri-beri; tetanus was also transferred here (from the class of nervous diseases); in other classes, additions were made: angina, neuritis, ankylostomiasis, salpingitis; the name of the class 'diseases of the urinary organs' was supplemented-venereal diseases. When reviewed in 1920, the nomenclature 'also preserved its former structure (15 classes, 206 rubrics in the detailed and 38 rubrics in the brief nomenclature). The department 'general diseases' was divided into two classes: 'epidemic, endemic and infectious diseases' and 'general diseases' (except those mentioned above). In some individual parts, additions and rearrangements were made in accordance with the progress of medical-scientific knowledge. Thus, among infectious diseases were included: paratyphoid, Malta fever, acute poliomyelitis, infectious jaundice, a new, recently described disease-encephalitis lethargica. Scurvy, pellagra, beri-beri were classified in the group 'other general (non-infectious) diseases'. Influenza was subdivided into complicated and uncomplicated; for dysentery, subdivisions were introduced-amebic, bacillary, without specification; for plague-bubonic, pulmonary, septic, without specification; for tbc, a more detailed division than before was adopted. Into the class 'other general diseases' were included diseases of the brain appendage, parathyroid glands, thyroid gland (from the class of diseases of the respiratory organs), diseases of the spleen (from the class of diseases of the digestive organs). Instead of the previous rubrics-'lead poisoning, other chronic professional poisonings, other chronic poisonings'-two rubrics were adopted: 'chronic poisonings by inorganic and organic substances'. Into the rubric-'other diseases of the respiratory organs'-were included sub-rubrics 'chronic interstitial pneumonia, professional diseases of lung tissue and diseases of the mediastinum'. In the class 'diseases of the digestive organs', diseases of the pancreas and ulcer of the duodenum were isolated; the rubric 'intestinal parasites' was subdivided by the type of worms; cirrhosis of the liver was divided into alcoholic and cirrhosis with other etiology. In the class 'external influences', suicide by inhaling poisonous gases and by taking caustic substances were isolated into separate rubrics. Rubrics 'death from wounds and injuries received in war' and 'execution of non-military personnel by warring armies' were added. The reviews of 1909 and 1920 did not introduce a substantial (organizational or fundamental) restructuring into the Bertillon nomenclature. Its foundations remained unchanged until 1929, when at the 4th regular International Review the question was raised about the need for a fundamental revision. Until this moment, its development proceeded mainly in the following direction: a) expansion of the concept of infection, b) reduction of undefined categories of morbidity (general diseases, virulent, etc.), c) breakdown of undefined large groups into smaller and specific ones.-Among other nomenclatures that did not go beyond local application, mention should be made of the fundamental English one (1896), which represented a model of academic completeness (1146 rubrics) and was constructed on the principle of anatomical localization; of the Virchow Berlin nomenclature (1888)-138 rubrics, and of the Vienna nomenclature, which occupied an intermediate position and was based on the etiological principle. The development of classification and N. b. in Russia is connected with the history of zemstvo medicine, which reflected the peculiarities of tsarist Russia at the end of the 19th century-a period of struggle between the dying landlord-feudal relations and the rapidly growing capitalism. Russian pre-revolutionary classifications of diseases, created exclusively by public health organizations without the assistance of government agencies, often in opposition to departmental classifications, from the very beginning placed the principle of etiology and the service of practical public health needs in the foreground. 'While the English classification is academically dispassionate, exhausts the full list, and is indifferent to all diseases that humanity suffers from, our classification is tendentious and bears on its banner a clear motto-the study of important moments of population morbidity in social relations,' wrote P. I. Kurkin in 1895. A special commission of physicians from the Moscow zemstvo (Osipov, Tseskov, Repman, Orlov, Tolstoy) compiled 'A Project of a Nomenclature of Diseases for Zemstvo Medical Practice', which received the sanction of the provincial congress of physicians in 1876. In the following years, this classification, revised and expanded, spread to other zemstvo provinces of Russia under the name 'Moscow'. It was supposed to 'satisfy scientific requirements, follow clear and definite terminology, and at the same time serve for practical work in sanitary research, for elucidating the etiology of diseases of the population and for combating high morbidity.' In the expanded second edition (1886), the Moscow nomenclature consisted of the following ten classes and twenty-two groups, breaking down into 318 rubrics. Class I. Infectious diseases (except syphilis), epidemic and endemic. Class II. Syphilis and venereal diseases. Groups-syphilis, venereal diseases. Class III. Parasitic diseases. Groups-animal parasites, plant parasites. Class IV. General nutritional disorders. Class V. Local diseases. Groups-diseases of the nervous system, blood and lymphatic systems, smell and respiration, digestion, urinary organs, male sexual organs, female sexual organs, visual organs, hearing organs, bones, joints and muscles, skin and subcutaneous tissue. Class VI. New growths. Groups-benign, malignant. Class VII. Traumatic injuries. Groups-traumatic injuries of soft parts, bones and joints, traumatic injuries of vital organs, foreign bodies in open cavities of the body. Class VIII. Thermal and chemical injuries. Class IX. Poisonings and deprivation of vital factors. Class X. Developmental defects and deformities in general. Groups-diseases of development and senescence in general, consequences of diseases. In the mid-90s, the statistical organization of the Pirogov Society of Physicians raised the question of coordinating sanitary-statistical research in zemstvo Russia for the creation of an all-Russian nomenclature of diseases and causes of death. Scientific medical societies, universities, medical congresses, sanitary statistics bureaus, and individual specialists were involved in the work; the main foreign materials (Bertillon's, Virchow's, English, Austrian nomenclatures) were used. The report of the Commission (Dyakonov, Korsakov, Kurkin, Popov, Shervinsky) was presented to the VII Congress of Physicians (Kazan, 1899), at which this first all-Russian, so-called Pirogov, nomenclature was approved for use in the next ten years (until the Review). The Pirogov nomenclature, in terms of principles and content, was based on the program of the Moscow zemstvo, differing from the latter by greater coherence and systematicity, careful development of details, and a decisive transition to the terminology of the living language. It entered the practice of Russian public health statistical institutions, but in one essential direction it did not achieve its goal: due to resistance from the state apparatus, its implementation in official reporting was not carried out."

In the structure of the new classification, diseases were divided into 6 sections, based on vegetable and animal parasitism, external physical, electrical, and chemical effects on the body, development of new growths, general nutritional and metabolic disorders, developmental defects, and predominant lesions (instability) of individual organs and systems (local diseases). From these points of view, the entire system of diseases was systematized in the form of 20 classes of diseases, comprising 458 rubrics of individual forms. These classes are: I. Vegetable parasites. II. Animal parasites. III. Injuries. IV. Deprivation of air. V. Thermal, electrical, and local chemical effects. VI. Poisonings. VII. New growths. VIII. General nutritional and metabolic disorders. IX. Developmental defects. X. Diseases of the nervous system. XI. Diseases of the circulatory and lymphatic systems. XII. Diseases of the organs of smell and respiration. XIII. Diseases of the digestive organs. XIV. Diseases of the urinary organs. XV. Diseases of the male sexual organs. XVI. Diseases of the female sexual organs. XVII. Diseases of the skin. XVIII. Diseases of the organs of hearing. XIX. Diseases of bones, cartilage, joints, and muscles. XX. Diseases of the foot and subcutaneous tissue. Addition: diseases not introduced into the classification. Undetermined pathological states of health. The Pirogov nomenclature of 1900 functioned for more than 20 years; its next review was delayed by the imperialist war. Preparatory work proceeded in the direction of further development of its details on the basis of accumulated corrections and comments. The review was carried out only after the October Revolution during 1920-23 under the leadership of the Scientific Medical Council of the People's Commissariat of Health. The main work was done by the United (People's Commissariat of Health and Central Statistical Administration) statistical sanitary commission of the statistical department of the People's Commissariat of Health (presidium of the commission: Bogoslovsky, Kurkin, Kuvshinnikov, Chertov). In 1923, the People's Commissariat of Health received the new text of the international nomenclature (revision of 1920) with a proposal for the USSR to join it. On the instructions of the Scientific Medical Council, the nomenclature commission revised the previous project on the basis of coordination with the international one (1920). The project went through discussion at the Sanitary-Statistical Conference of the statistical department of the People's Commissariat of Health and the Scientific Medical Council. In July 1924, it was approved by the People's Commissariat of Health. In the historical sense, this was the first Russian state classification of diseases. The structure of the Soviet classification in comparison with the international one appears as follows: Soviet edition 1924. International edition 1920. I. Diseases epidemic, endemic, and infectious. Gr. 1. Epidemic and endemic diseases. Gr. 2. Infectious diseases (non-epidemic). I. Diseases epidemic, endemic, and infectious. II. General diseases (except those mentioned above). Gr. 1. New growths. Gr. 2. General nutritional, metabolic, and internal secretory disorders. Gr. 3. Alcohol poisoning. Gr. 4. Chronic poisonings. Gr. 6. Other general diseases. II. General diseases (except those mentioned above). III. Diseases of the nervous system and sensory organs. Gr. 1. Diseases of the nervous system. Gr. 2. Diseases of the organ of vision. Gr. 3. Diseases of hearing. III. Diseases of the nervous system and sensory organs. IV. Diseases of the circulatory organs. V. Diseases of the respiratory organs. VI. Diseases of the digestive organs. VII. Diseases of the urinary and sexual organs and their appendages (of non-venereal origin). Gr. 1. Diseases of the urinary organs. Gr. 2. Diseases of the male sexual organs. Gr. 3. Diseases of the female sexual organs. VIII. Diseases of pregnancy and the puerperium. IX. Diseases of the skin and subcutaneous tissue. X. Diseases of bones and organs of movement. X. Diseases of bones and organs of movement. XI. Developmental defects. XII. Diseases of newborns. XIII. Old age. Soviet edition 1924. International edition 1920. XIV. Diseases from external causes. Gr. 1. Suicides. Gr. 2. Acute poisonings. Gr. 3. Burns. Gr. 4. Deprivation of air. Gr. 5. Traumatic injuries. Gr. 6. Deprivation of air and food. Gr. 7. Thermal and chemical injuries. Gr. 8. Murders. Gr. 9. Injuries to bones and joints. XV. Undetermined diseases. XVI. Diseases not included in the list. The additional groupings adopted in the Russian classification are an extension of the main sections of the International List. The contemporary Soviet nomenclature. Although the zemstvo and Pirogov nomenclatures originated from the need to interpret morbidity from the point of view of etiology, during the period of zemstvo medicine, etiology of diseases was understood almost exclusively as a complex of 'objective' scientifically established regularities and connections outside the perspectives and direction of practical public health. Since the possibility of mass social prevention was narrowly limited by the framework of the feudal-capitalist system, and since the statistical research of the zemstvo intelligentsia was actually doomed to sterility—purely statistical, abstract existence—these studies could not have a sharply defined direction. All causes of diseases were equally significant, as long as they were objectively established and scientifically proven; in the absence of the possibility of mass practical health-improving action, it was impossible to differentiate causes of diseases according to their social significance, the order of necessary intervention, and the direction of the latter. The different fundamental principles and conditions of Soviet public health, its organic connection with the developed victorious socialist construction, and the clear class orientation of Soviet public health inevitably led to a radical revision of the N.b. The occasion for this was the invitation to participate in the Paris conference of 1929 on the fourth regular revision of the international nomenclature. On the instructions of the Soviet government, the People's Commissariat of Health and the Central Statistical Administration organized in late 1928 a Nomenclature Commission at the Institute of Social Hygiene (presidium: Batkis, Bogomolets, Kuvshinnikov, Kurkin, Mol'kov, Smulevich, Shevelev). The latter put forward on behalf of the USSR a special project, the main distinctive feature of which was the attempt to put the classification and N.b. at the service of health-improving practice, with a clear orientation, taking into account the relative significance, order, and pace of resolving the tasks facing this practice. Therefore, from the broad field of etiology, the Soviet project puts in the first place elements of the external environment, i.e., the complex of domestic and professional conditions under which diseases develop; it breaks down the causes of diseases according to their specific weight, and by highlighting key moments, it takes into account the accessibility of socio-hygienic intervention, considers the circumstances in which the disease occurs, because these accompanying conditions of the disease course may acquire predominance over the preceding etiology in the narrow sense (e.g., the introduction of Koch's bacillus and the conditions of the course of tbc); finally, it has in mind the nature of the necessary prevention. Unlike symptomatology, localization, pathological anatomy, narrow etiology, which form the basis of other systems, the Soviet project puts forward as the basic principle of classification etiology in the broad sense, i.e., the aggregate of essential concretely conditioning factors of the disease, its outcome, and significance. The Russian scheme of disease classification for presentation at the conference was designed as follows. Three major sections of diseases are established. 1. Diseases and conditions with a definite external etiology, the factors of which are taken as infectious agents, physical and chemical effects of the environment in connection with working and living conditions, violations of external nutritional conditions. 2. Diseases with unknown etiology: tumors, diseases of metabolism, diseases of the endocrine glands, diseases of the blood-forming organs, blood, and spleen; further (7 groups) by system and organ. 3. Diseases and conditions of particularly vulnerable age-sex groups: diseases and developmental defects, diseases of newborns, diseases of pregnancy and childbirth, senile decay; lastly—insufficiently defined diseases and inaccurate diagnoses. The position of the Soviet delegation at the Paris conference of 1929 was formulated in a statement made on behalf of the Soviet delegation. The Soviet delegation proceeded from the fact that 'the basis of the next revision of the international nomenclature should be not only the verification of individual details of the existing scheme, but also a critical evaluation of the scheme itself from the point of view of its correspondence to the achievements of modern medical science, the interests of social hygiene, and the practical tasks of public health, which everywhere in the world has gone significantly ahead compared to the era in which the foundations of the existing international classification and nomenclature of causes of death were laid.' Without considering the Soviet project for minor formal reasons, the Paris conference of 1929 limited itself to some improvement in the external structure of the international nomenclature, without satisfying the deeper demands for a radical revision of the outdated fundamental principles.'

The Nomenclature Commission of the Institute of Social Hygiene, based on the report of the delegation regarding the conference work, recognized that in subsequent Soviet works, 'the principles laid as the foundation of the Russian project must remain fully effective, as must its basic content. In accordance with the obligations given by the USSR delegation regarding taking all possible measures to achieve maximum comparability of our nomenclature with the international one, to carry out a detailed re-analysis of the project and to introduce the necessary changes to achieve maximum comparability of both nomenclatures. To consider international cooperation in this area as highly desirable in the future, however, on the condition of preserving the principles of our project. To use the time until the next conference to develop a classification and nomenclature of diseases as the initial link in the general problem of the statistical study of social health; to take timely initiative in this area. To bring the current opinion of the commission to the attention of the government through the People's Commissariat of Health of the RSFSR and the Central Statistical Administration of the USSR'. Thus, at the end of 1929, the Nomenclature Commission was once again tasked with establishing the final text of the N.b. for use in the USSR on the aforementioned bases. The work was completed by the end of 1930, along with additional and explanatory lists of diseases, an alphabetical dictionary, instructional guidelines, as well as introductory essays of a theoretical and historical nature; the nomenclature received approval from the economic-statistical sector of Gosplan for use in the USSR from 1931. At this time, the major departments of disease classification outlined in the 1929 project (definitions of external etiology, unspecified etiology) received one additional addition, which was given a place at the very beginning of the nomenclature—'diseases and conditions related to the process of population reproduction', which includes the groups 'diseases of pregnancy and childbirth, diseases of newborns and congenital developmental defects'. In the department of 'insufficiently established etiology', the groups 'diseases of metabolism', 'diseases of the endocrine system', 'diseases of the blood and blood-forming organs' are now detailed. The relationship between the Soviet 1930 classification and the international 1929 classification in their current form is visible from the table (see art. 552). The three main departments of the Soviet classification do not have exact analogues in the international nomenclature of diseases. However, Department I (diseases related to reproductive processes) can ultimately be formed from entirely taken classes XI, XIV and XV of the international nomenclature. The same formation of results for Departments II and III is hindered by the excessive complexity of the structure of class III of the international nomenclature, which contains groups (8, 10, 11) that are part of both departments of the Soviet classification. Among the group subdivisions, the detailed groups of trauma (4, 5, 6), alcoholism and malnutrition (7, 8) of the Soviet nomenclature find no comparison. All other groups, especially those of local diseases, are extremely close to each other in both lists. The group of infectious and parasitic diseases is somewhat richer in the Soviet nomenclature (due to the inclusion here of lobar pneumonia, acute articular rheumatism, acute infectious osteomyelitis, and skin infections). The Soviet classification places in the forefront groups of diseases that should primarily be addressed by planned socialist prevention; it highlights in separate rubrics phenomena of special social significance (e.g., artificial abortion); it consistently highlights diseases with established external etiology, fighting against the remnants of their dissolution in the mass of diseases arranged according to the anatomical-physiological principle (e.g., transferring a skin abscess to the infectious group of Department I); it decisively fights against the class tendency of bourgeois nomenclature to obscure the well-established social roots of large areas of social pathology (for example, instead of the motley category of violent and accidental deaths—in the Soviet nomenclature, three clear groups: intentional injuries, industrial injuries, non-industrial injuries—accidental and of undetermined nature); it isolates drug addiction from the group 'chronic poisonings by other organic substances', classified in the international nomenclature according to a 'neutral' technical-chemical principle, and strives to make the disease classification a precise instrument placed at the service of the practice of socialist healthcare. Details can be traced through the attached texts of both lists (see also Morbidity, Mortality, Statistics - sanitary statistics).

P. Kurvyn, G. Lpfshits, L. Syrkip. International Nomenclature of Diseases, Causes of Death and Disability (as revised in 1929). I. Detailed Nomenclature. I. Infectious and parasitic diseases. 1) Typhoid fever. 2) Paratyphoid. 3) Typhus. 4) Relapsing fever. 5) Melioidosis. 6) Smallpox, variola, unspecified. 7) Measles. 8) Scarlet fever. 9) Whooping cough. 10) Diphtheria. 11) Influenza, with complications of the respiratory organs, without complications. 12) Cholera. 13) Dysentery: amoebic, bacillary, unspecified. 14) Plague: bubonic, pulmonary, septicemic, unspecified. 15) Erysipelas. 16) Acute poliomyelitis and poliomyelitis encephalitis. 17) Lethargic encephalitis. 18) Cerebrospinal meningitis. 19) Glanders. 20) Anthrax. 21) Rabies. 22) Tetanus. 23) Tuberculosis: of the respiratory organs, 24) of the meninges and central nervous system, 25) of the intestines and peritoneum, 26) of the spine, 27) of the bones and joints, 28) of the skin and subcutaneous tissue, 29) of the lymphatic system, 30) of the genitourinary organs, 31) of other organs; 32) disseminated-acute, chronic, unspecified. 33) Leprosy. 34) Syphilis: congenital, acquired, unspecified. 35) Gonococcal infection and other venereal diseases. 36) Purulent and putrefactive infections (non-postpartum): septicemia, pyemia, gas gangrene. 37) Yellow fever. 38) Malaria: malarial fever, malarial cachexia. 39) Other diseases caused by protozoan parasites. 40) Hookworm disease. 41) Echinococcosis: of the liver, of other organs. 42) Other helminthic diseases. 43) Mycoses. 44) Other infectious and parasitic diseases. II. Neoplasms. 45) Cancer and other malignant neoplasms: of the mouth and pharynx, 46) of the digestive organs: esophagus, stomach, 12-finger intestine, rectum, kidneys and bile ducts, pancreas, peritoneum, other digestive organs; 47) of the respiratory organs; 48) of the uterus; 49) of other female genital organs; 50) of the breast; 51) of male genitourinary organs; 52) of the skin; 53) of other organs. 54) Benign neoplasms: of female genital organs, of other organs. 55) Neoplasms without specification. III. Rheumatic diseases, nutritional diseases, diseases of the endocrine glands and other general diseases. 56) Acute articular rheumatism. 57) Chronic rheumatism, osteoarthritis. 58) Gout. 59) Diabetes mellitus. 60) Scurvy, Barlow's disease. 61) Beriberi. 62) Pellagra. 63) Rickets. 64) Osteomalacia. 65) Disease of the pituitary gland. 66) Diseases of the thyroid and parathyroid glands: goiter, Basedow's disease, myxedema, tetany, other diseases. 67) Diseases of the thymus gland. 68) Diseases of the adrenal glands (Addison's disease). 69) Other general diseases. IV. Diseases of the blood and blood-forming organs. 70) Bleeding disorders: purpura, hemophilia. 71) Malignant anemia, others. 72) Leukemia, true aleukemia. 73) Diseases of the spleen. 74) Other diseases of the blood and blood-forming organs. V. Chronic poisonings. 75) Acute and chronic alcoholism. 76) Other chronic poisonings by organic poisons, professional and others. 77) Chronic poisonings by inorganic poisons, professional and others. VI. Diseases of the nervous system and sensory organs. 78) Encephalitis (not epidemic), brain abscess, others. 79) Meningitis. 80) Tabes dorsalis. 81) Other diseases of the spinal cord. 82) Apoplexy due to hemorrhage, embolism or thrombosis of cerebral vessels, hemorrhage, unspecified. 83) General paralysis. 84) Early dementia and other psychoses. 85) Epilepsy. 86) Infantile convulsions. 87) Chorea. Neuritis. Paralysis agitans. Multiple sclerosis. Other nervous diseases. 88) Diseases of the visual organs. 89) Diseases of the ear and mastoid process. Otitis. Other diseases. VII. Diseases of the circulatory organs. 90) Pericarditis. 91) Acute endocarditis. 92) Chronic endocarditis and valvular lesions. 93) Diseases of the myocardium: acute myocarditis, chronic myocarditis, degeneration of heart muscle, unspecified. 94) Diseases of the coronary arteries and angina pectoris. 95) Other diseases of the heart: functional, others and unspecified. 96) Aneurysms. 97) Arteriosclerosis. 98) Senile gangrene, others. 99) Other diseases of the arteries. 100) Diseases of the veins: hemorrhoids, varicose veins, phlebitis. 101) Diseases of the lymphatic system, lymphangitis, others. 102) Anomalies of blood pressure (idiopathic). 103) Other diseases of the circulatory organs. VIII. Diseases of the respiratory organs. 104) Diseases of the nasal cavity and accessory sinuses. 105) Diseases of the larynx. 106) Bronchitis: acute, chronic, unspecified. 107) Bronchopneumonia and capillary bronchitis. 108) Croupous pneumonia. 109) Pneumonia, unspecified. 110) Pleurisy. 111) Pulmonary edema, embolism, hemorrhagic infarction, thrombosis. 112) Bronchial asthma. 113) Emphysema of the lungs. 114) Other diseases of the respiratory organs, chronic interstitial pneumonia and professional diseases of the respiratory organs, other diseases, including gangrene of the lungs. IX. Diseases of the digestive organs. 115) Diseases of the mouth and its accessory organs, pharynx and tonsils. 116) Diseases of the esophagus. 117) Stomach ulcer, duodenal ulcer. 118) Other diseases of the stomach. 119) Diarrhea and enteritis under 2 years of age, 120) from 2 years and older. 121) Appendicitis. 122) Hernias, intestinal obstruction. 123) Other diseases of the intestines. 124) Cirrhosis of the liver: alcoholic, of other origin. 125) Other diseases of the liver. 126) Gallstones. 127) Other diseases of the gallbladder and bile ducts. 128) Diseases of the pancreas. 129) Peritonitis, unspecified. X. Diseases of the genitourinary organs. 130) Acute nephritis. 131) Chronic nephritis. 132) Unspecified. 133) Other diseases of the kidneys, renal pelvis and ureters, pyelitis. 134) Stones of the urinary tract: of the kidneys, bladder, unspecified. 135) Cystitis, other diseases of the bladder. 136) Urethral stricture, other diseases of the urethra. 137) Diseases of the prostate. 138) Diseases of the male genital organs. 139) Diseases of the female genital organs: ovaries, fallopian tubes, parametrium, uterus, breast, others. XI. Diseases of pregnant women, parturients and puerperal women. 140) Miscarriages with sepsis. 141) Miscarriages with hemorrhage. 142) Extrauterine pregnancy. 143) Other complications of pregnancy. 144) Hemorrhages during labor: placenta previa. 145) Puerperal fever. 146) Postpartum albuminuria and eclampsia. 147) Other toxicoses of pregnancy. 148) Thrombosis, embolism, sudden death during labor. 149) Other complications of the act of labor. 150) Other diseases of pregnant women, parturients, puerperal women. XII. Diseases of the skin and subcutaneous tissue. 151) Furuncle. 152) Phlegmon, abscess. 153) Other diseases of the skin and subcutaneous tissue. XIII. Diseases of the bones and organs of movement. 154) Acute infectious osteomyelitis. 155) Other diseases of the bones, 156) Diseases of the joints (except tuberculosis and rheumatism), other diseases of the organs of movement. XIV. Congenital malformations. 157) Hydrocephalus, meningocele, spina bifida, congenital heart defects. Malformations. Others. XV. Diseases of newborns. 158) Congenital weakness. 159) Premature infants. 160) Consequences of the act of labor in cases of cesarean section, in other cases. 161) Atelectasis, jaundice of newborns, sclerema, other cases. XVI. Old age. 162) Senile marasmus, complicated by senile dementia, other cases. XVII. Violent and accidental death. 163) Suicide by taking poisonous substances, 164) inhaling poisonous gases, 165) strangulation and hanging, 166) drowning, 167) by firearm, 168) by cold weapon, 169) by falling from a height, 170) crushing, 171) other suicides. 172) Infanticide: immediately after birth, later. Homicide: 173) by firearm, 174) by cold weapon, 175) other. 176) Bites by poisonous insects and animals. 177) Food poisonings. 178) Accidental poisonings by poisonous gases. 179) Others. 180) Cases in fires. 181) Accidental burns. 182) Mechanical suffocation. 183) Drowning. 184) Wounds by firearm, 185) by cold weapon. 186) Injuries from falling and crushing. 187) Injuries from earthquakes and other natural disasters. 188) Injuries inflicted by animals. 189) Hunger and thirst. 190) Effects of cold, heat. 191) Lightning strike, 192) electric shock. 193) Other accidents: foreign bodies, others. 194) Violent death of unknown origin. * 195) Wounds in war. 196) Executions of civilians by warring armies. 197) Death penalty. XVIII. Insufficiently defined causes of death. 198) Sudden death. 199) Insufficiently defined causes of death. P. Nomenclature of diseases. ^ The nomenclature of diseases differs from the detailed nomenclature of causes of death only in that some categories have subdivisions (subcategories), indicated by bold type (A, B, C, etc.). These categories are as follows. 34) Syphilis: A. Congenital; B. Acquired: 1) primary, 2) secondary, 3) tertiary. C. Unspecified. 35) Gonococcal infection and other venereal diseases. A. Gonococcal infection. B. Other venereal diseases. 43) Mycoses. A. Trichophytosis and favus. B. Other mycoses. 87) Other diseases of the nervous system. A. Chorea. B. Neuritis. C. Paralysis agitans. D. Multiple sclerosis. E. Hysteria, neurasthenia, clericalism. F. Others. 88) Diseases of the visual organs. A. Conjunctivitis (including trachoma). B. Keratitis. C. Iritis. D. Cataract. E. Inflammation of the retina. F. Glaucoma. G. Others. 115) Diseases of the oral cavity. A. Diseases of the teeth and gums. B. Others. 123) Other diseases of the intestines. A. Diseases of the anus and anal fistulas. B. Others. 149) Other complications of labor. A. Normal labor. B.

Complications of childbirth. 153) Diseases of the skin, its appendages, and subcutaneous tissue. A. Alopecia. B. Scabies. C. Others. 158) Congenital weakness. A. Infants discharged healthy from hospitals. B. Congenital weakness. 194) Other injuries. A. Foreign bodies. B. Dislocations (without specification). C. Sprains (also). D. Fractures (also). E. Scars. F. Others. 200) Undetermined diseases. A. Insufficiently defined. B. Emaciation. C. Simulation, continued observation of the patient.

- III. Abbreviated nomenclature of causes of death. I. Diseases and infectious parasitic diseases. 1) Typhoid and paratyphoid. 2) Typhus. 3) Smallpox. 4) Measles. 5) Scarlet fever. 6) Whooping cough. 7) Diphtheria. 8) Influenza. 9) Dysentery. 10) Plague. 11) Tuberculosis of respiratory organs. 12) Tuberculosis of other organs. 13) Syphilis. 14) Purulent and putrefactive infection (of non-postpartum origin). 15) Malaria. 16) Protozoan and helminth diseases. 17) Other infectious and parasitic diseases. * Under the headings starting from 'food poisoning' to 'violent death of unknown origin', a special subdivision must be made according to the following table: 1. Accidents in mines and quarries. 2. Accidents from machines. 3. Accidents on transport: a) railroads and trams; b) automobiles and motorcycles; c) other types of land transport; d) water transport; e) air transport. 567 II. Cancer and other new growths. 18) Cancer and other malignant new growths. 19) Non-malignant and undetermined new growths. III. Rheumatic diseases, nutritional diseases, diseases of endocrine glands, and other general diseases. 20) Acute articular rheumatism. 21) Chronic rheumatism and gout. 22) Diabetes mellitus. 23) Avitaminoses. 24) Diseases of the thyroid and parathyroid glands. 25) Other general diseases. IV. Diseases of the blood and blood-forming organs. 26) Pernicious anemia and others. 27) Leukemia, aleukemia and other diseases of the blood and blood-forming organs. V. Chronic poisonings and intoxications. 28) Acute and chronic alcoholism. 29) Other chronic poisonings. VI. Diseases of the nervous system and sensory organs. 30) Meningitis (simple). 31) Tabes dorsalis. 32) Cerebral hemorrhage, embolism and thrombosis. 33) General paralysis. 34) Early dementia and other psychoses. 35) Epilepsy. 36) Other diseases of the nervous system. 37) Diseases of the organs of vision, hearing and their appendages. VII. Diseases of the circulatory system. 38) Pericarditis. 39) Acute endocarditis. 40) Chronic endocarditis and lesions of the heart valves. 41) Diseases of the myocardium. 42) Diseases of the coronary arteries and angina pectoris. 43) Other diseases of the heart. 44) Aneurysm (excluding the heart). 45) Arteriosclerosis and gangrene. 46) Other diseases of the circulatory system. VIII. Diseases of the respiratory organs. 47) Bronchitis. 48) Pneumonia. 49) Pleurisy. 50) Other diseases of the respiratory organs (excluding tuberculosis). IX. Diseases of the digestive organs. 51) Ulcer of the stomach and duodenum. 52) Diarrhea and enteritis (under 2 years). 53) Diarrhea, enteritis, ulcers of the intestines (2 years and older). 54) Appendicitis. 55) Hernia, intestinal obstruction. 56) Cirrhosis of the liver. 57) Other diseases of the liver, biliary tract, including gallstones. 58) Other diseases of the digestive organs. X. Diseases of the urinary and sexual organs. 59) Nephritis. 60) Other diseases of the kidneys, renal pelvis, and ureters. 61) Stones of the urinary tract. 62) Diseases of the bladder (excluding new growths). 63) Diseases of the urethra. 64) Diseases of the prostate gland. 65) Diseases of the sexual organs of non-venereal origin. XI. Diseases of pregnancy, childbirth, and the puerperium. 66) Complications of pregnancy. 67) Bleeding during childbirth. 68) Postpartum septicemia and infection. 69) Toxicoses of pregnancy: albuminuria, eclampsia. 70) Other diseases of puerperal women. XII. Diseases of the skin and subcutaneous tissue. 71) Diseases of the skin and subcutaneous tissue. XIII. Diseases of the bones and organs of movement. 72) Diseases of the bones, organs of movement (excluding tuberculosis and rheumatism). XIV. Congenital malformations. 73) Congenital malformations (excluding stillbirths). XV. Diseases of newborns. 74) Congenital weakness. 75) Premature birth. 76) Consequences of the act of childbirth. 77) Other diseases of newborns. XVI. 78) Old age. XVII. Violent or accidental death. 79) Suicide. 80) Homicide. 81) Other accidents. 82) Other cases of death of unknown origin. 83) Victims of war. 84) Death penalty. XVIII. Undetermined causes of death. 85) Unknown and undetermined causes of death. ГУ". Abbreviated nomenclature of causes of death. I. 1) Typhoid and paratyphoid. 2) Typhus. 3) Smallpox. 4) Measles. 5) Scarlet fever. 6) Whooping cough. 7) Diphtheria. 8) Influenza. 9) Plague. 10) Tuberculosis of respiratory organs. 11) Tuberculosis of other organs. 12) Syphilis. 13) Malaria. 14) Other infectious and parasitic diseases. II. 15) Cancer and other malignant new growths. 16) Benign and undetermined new growths. III. IV and V. 17) Chronic rheumatism and gout. 18) Diabetes mellitus. 19) Acute and chronic alcoholism. 20) Other general diseases and chronic poisonings. VI. 21) Tabes dorsalis and general paralysis. 22) Cerebral hemorrhage, embolism and thrombosis of cerebral vessels. 23) Other diseases of the nervous system and sensory organs. VII. 24) Diseases of the heart. 25) Other diseases of the circulatory system. VIII. 26) Bronchitis. 27) Pneumonia. 28) Other diseases of the respiratory organs (excluding tuberculosis). IX. 29) Diarrheas and enteritis. 30) Appendicitis. 31) Diseases of the liver and biliary tract. 32) Other diseases of the digestive organs. X. 33) Nephritis. 34) Other diseases of the urinary and sexual organs. XI. 35) Septicemia and postpartum infections. 36) Other diseases of pregnancy, childbirth, and the puerperium. XII and XIII. 37) Diseases of the skin, subcutaneous tissue, bones, and organs of movement. XIV and XV. 38) Congenital weakness, congenital malformations, premature birth, and others. XVI. 39) Old age. XVII. 40) Suicide. 41) Homicide. 42) Violent or accidental death from other causes. XVIII. 43) Cause of death is unknown and undetermined. The second Soviet classification and nomenclature of diseases and causes of death (according to the revision of 1930) (approved by Gosplan). Department I. Diseases and conditions related to the process of population reproduction. Group 1. Diseases of pregnancy and childbirth. Complications of pregnancy: ectopic pregnancy, other complications. Eclampsia and albuminuria of pregnant women and puerperal women. Other toxicoses of pregnancy. Artificial abortion. Premature birth. Natural abortion. Bleeding during childbirth. Thrombosis, embolism, sudden death during childbirth. Other complications of the act of childbirth. Septic 560» diseases after childbirth; after artificial abortion. Postpartum diseases of the mammary gland. Other postpartum and post-abortion diseases. Group 2. Diseases of newborns and congenital malformations. Premature birth. Consequences of the act of childbirth. Congenital malformations: hydrocephalus, cerebral hernia, spina bifida, congenital heart defects, deformities, others. Congenital weakness. Other diseases of newborns: atelectasis, jaundice, others.

'Section' II. Diseases with established external etiology. Group 3. Infectious and parasitic diseases. Typhoid fever. Paratyphoid. Typhus. Recurrent fever. Melioidosis. Smallpox. Measles. Scarlet fever. Whooping cough. Diphtheria. Influenza. Cholera. Amebic, bacillary, and other forms of dysentery. Plague. Erysipelas. Carbuncle. Furunculosis. Phlegmon and abscesses of the skin. Acute infectious osteomyelitis. Septic and pyemic diseases. Lobar pneumonia. Acute articular rheumatism. Acute poliomyelitis and poliomyelitis encephalitis. Lethargic encephalitis. Cerebrospinal meningitis. Anthrax. Rabies. Tetanus. Glanders. Leprosy. Tuberculosis of respiratory organs, meninges and central nervous system, intestines and peritoneum, spine, bones and joints, and other organs (skin, lymphatic system, urogenital apparatus, etc.); disseminated (acute miliary, chronic, without specifications). Syphilis congenital, acquired (primary, secondary, tabes dorsalis, general paralysis of the insane, etc.), without specifications. Gonococcal and other venereal diseases: gonorrhea, blennorrhea, etc. Malaria. Yellow fever. Other protozoan diseases. Ancylostomiasis. Echinococcosis. Other helminthic diseases; trichinosis, etc. Mycoses: actinomycosis, tinea capitis, favus, etc. Other infectious and parasitic diseases; scabies, trachoma, etc. Group 4. Intentional injuries. Infanticide. Murder: by firearms, cold weapons, by strangulation, by poisoning, during war, of civilian population by warring armies, capital punishment, other murders. Suicide-by asphyxiation, by firearms, by cold weapons, by poisonous and caustic substances, by other means. Violent death of undetermined nature. Group 5. Industrial injuries. Mechanical injuries, foreign bodies in the eye, etc. Asphyxiation, drowning. Acute and chronic poisoning by inorganic and organic substances. Frostbite and other injuries due to low temperature. Injuries by electric current. Other industrial injuries. Group 6. Non-industrial, accidental, and undetermined injuries. Injuries caused by means of transport: railroads and trams, automotive transport, etc. (land transport, water transport, air transport). Mechanical injuries, foreign bodies in organs and body cavities. Asphyxiation, drowning. Food poisonings. Burns and other injuries due to high temperature, radiant energy, and chemical substances. Frostbite. Injuries by electric current. Injuries during fires. Injuries caused by animals. Bites of venomous animals. Lightning injuries. Injuries as consequences of natural disasters. Other injuries. Group 7. Alcoholism and other drug addictions. Acute poisoning by alcohol and its surrogates. Chronic alcoholism and other drug addictions. Group 8. Diseases from inadequate nutrition. Scurvy. Beriberi. Pellagra. Rickets. Starvation. Thirst. Other diseases from inadequate nutrition. Section III. Diseases whose external etiology is insufficiently established. Group 9. Neoplasms. Cancer and other malignant neoplasms of the oral cavity and pharynx, digestive organs and peritoneum (esophagus, stomach, duodenum, rectum, liver and bile ducts, pancreas, peritoneum, other digestive organs), respiratory organs, uterus and other female genital organs, mammary gland, male urogenital organs, skin, other organs. Benign neoplasms of female genital organs. Neoplasms without specification of nature. Group 10. Diseases of metabolism. Chronic articular rheumatism. Gout. Diabetes. Osteomalacia. Other metabolic diseases. Group 11. Diseases of the endocrine system. Diseases of the thyroid and parathyroid glands: goiter, Basedow's disease, myxedema, cretinism, tetany, other forms. Diseases of the thymus gland. Diseases of the adrenal glands. Diseases of the pituitary gland. Other diseases of the endocrine system. Group 12. Diseases of the blood and blood-forming organs. Hemorrhagic diatheses-hemophilia and others. Anemia, malignant anemia. Leukemia, aleukemia. Diseases of the spleen. Other diseases of the blood and blood-forming organs. Group 13. Diseases of the nervous system and sensory organs. Encephalitis. Meningitis. Diseases of the spinal cord. Arteriosclerosis of the brain. Hemorrhage, embolism, thrombosis, hemiplegia. Early dementia and other psychoses. Epilepsy. Infantile convulsions. Chorea, neuritis, paralysis agitans, multiple sclerosis, hysteria, other diseases. Diseases of the visual organs-conjunctivitis, keratitis, iritis, iridocyclitis, cataract, retinitis, glaucoma, etc. Diseases of the organ of hearing and their consequences. Group 14. Diseases of the circulatory organs. Pericarditis. Endocarditis acute, chronic, valve defects. Myocarditis. Sclerosis of the heart vessels. Angina pectoris. Aneurysms. Arteriosclerosis. Other arterial diseases. Diseases of veins. Diseases of the lymphatic system. Group 15. Diseases of the respiratory organs. Diseases of the nasal cavity and its appendages. Diseases of the larynx. Bronchitis. Bronchopneumonia. Pneumonia without other specifications. Pleurisy. Emphysema of the lungs. Bronchial asthma. Pulmonary edema. Embolism. Hemorrhagic infarction, thrombosis. Other diseases of the respiratory organs- bb Group 16. Diseases of the digestive organs. Diseases of the oral cavity, pharynx, tonsils. Diseases of the teeth and gums. Diseases of the esophagus. Stomach ulcer. Duodenal ulcer. Enteritis, colitis. Appendicitis. Typhlitis. Hernia. Intestinal obstruction. Cirrhosis of the liver. Gallstones. Other diseases of the gallbladder and bile ducts. Diseases of the pancreas. Peritonitis. Other diseases of the digestive organs. Group 17. Diseases of the urogenital organs. Acute nephritis. Chronic nephritis. Nephritis without specifications. Other diseases of the kidneys, renal pelvis, ureters. Kidney stones and urinary tract. Other diseases of the bladder. Diseases of the urethra. Diseases of male genital organs of non-venereal origin, of the prostate gland. Diseases of female genital organs (not postpartum or of venereal origin): ovaries, tubes and parametrium, uterus, mammary gland and other organs. Group 18. Diseases of the organs of movement. Diseases of bones. Diseases of joints and other organs of movement. Group 19. Diseases of the skin. Diseases of the skin and subcutaneous tissue. Section IV. Insufficiently defined diseases and causes of death. Group 20. Senile debility. Sudden death (without other specifications). Other inaccurate and undetermined diagnoses.