The act adopted in Great Britain has been modified and improved upon since then, and in the United States many of our cities and some of our States have been engaged in a similar effort. As yet we have no central bureau or collecting office for the nation; nor is this necessary, if each State would do its duty, or, at least, the general government in that event need only tabulate the returns of each of the States. The effort is now making, under the auspices of the American Public Health Association, to secure a uniform method of registration in all offices collecting vital statistics, by which the same name will be given to the same disease and the same facts recorded in each return made. This will cause a little confusion at first in those offices where statistics have been tabulated for a number of years, but the advantage will be so great as to fully repay any inconvenience at the first. If we desire to obtain the full benefits from the advance of sanitary science, we must see to it that in every State there is an efficient bureau of vital statistics, whether under the supervision of the State Board of Health or some other department of the State. The absence of such a bureau reflects upon the intelligence of the people or the integrity of the law-making power. Are there tangible results to warrant so sweeping an assertion? is a fair question, since at the time of the preparation of the census of 1890 New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Delaware were the only States collecting vital statistics, and since then but Maine and Michigan have been added. Before quoting figures, it must be premised that even now the returns only approximate accuracy; they were much more inaccurate at the first, and before the general registration was undertaken most of the statements are merely estimates, after the fashion of the geographer who gives the number of inhabitants in China, where a census never has been taken. It may happen that the benefits are not as great as the figures seem to show, but after making all allowance there is great improvement. [Illustration: LIVES SAVED BY PUBLIC-HEALTH WORK. _Comparison of death-rates in Michigan from scarlet fever and small-pox before and since the State Board of Health was established, and from typhoid fever before and since its restriction was undertaken by the State Board. (Compiled from the State Department’s “Vital Statistics” of Michigan.)_ ]