Dr Marc d'Espine's statistical nosology.

THE BACKGROUND Nosologies, lists of diseases or causes of death, have been compiled from quite early times, usually in connection with medical research or teaching. The one illustrated and discussed here was constructed in Geneva by Dr Marc d'Espine during the first half of the nineteenth century for "statistical" purposes, that is, for the analysis of causes of death as registered in the Canton. In its time it was of some importance, for it was one of the two contenders for use as an international standard which were offered to the International Statistical Congress, which held nine meetings between 1853 and 1876. The other nosology was that presented by the Englishman William Farr. Jacob Marc d'Espine was born in Geneva on 29 April 1806,' but his family later moved to Odessa.2 From there he went in 1826 to Paris to study medicine, remaining until 1833.3 Afterwards he acknowledged his debt to two of the great Parisian teachers of the time: Gabriel Andral (1797-1872) and, more particularly, Pierre-Charles Louis (1787-1872). Indeed, in 1832, he was one of six Genevans among the thirteen members of Louis's 'Societe Medicale d'Observation'4 devoted to the study of disease by "numerical analysis". Farr, who was nineteen months Marc d'Espine's junior, was coincidently in Paris between 1830 and 1832 and mentions the same teachers. In the late 1830s both men were independently analysing information on causes of death; and in the first account of his work, each explained how he had found existing nosologies unsatisfactory and had to construct one for himself.5 At the time they were the only two men in Europe carrying out such a task and both continued to do it successfully for many years. Others had tried and failed. As early as 1764, Frederick II ofPrussia, prompted by Siissmilch,6 had such an exercise initiated, using fifty-six causes of