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of the ICD. The concluding section then draws some connections with how the list is used in practice and how it comes to inform policy downstream and locally. The solutions proposed here are generic ones commonly appearing wherever diverse information sources must be reconciled into categorical schemata. |
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Distributed Residual Categories |
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A first solutionspreading out garbage categoriesmight appear to be no solution at all, but rather a studied avoidance of the problem. It does, however, offer some interesting insights. Garbage categories include an array of categories where things get put that you do not know what to do withthe ubiquitous "other."
22 In mid-nineteenth century Paris, more than 10 percent of causes of death were ascribed to "other causes" (Bertillon 1906). In Berlin at the turn of the century, doctors were reluctant to provide valuable morbidity information. Thus one table gave acute bronchitis 1,571, chronic bronchitis 225, bronchitis, without any other qualifier, 12,844 (CH/experts stat/88 1929, 8). There were two general causes for the creation of garbage categories. The major subcategory "undefined diseases" was used "either because there was not enough information or because the disease was badly characterized or finally because the doctor failed to formulate a complete diagnosis" (Commission Internationale Nomenclature Internationale des Maladies 1910, 128). |
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It would be extremely difficult to envisage a time when there would be no need for these categories. Their management has been a constant thread throughout the history of the ICD. A major feature of this management has been their distribution throughout the list. Thus at the time of the first revision of the ICD, the U.S. representatives suggested getting rid of the categories "eclampsia" (nonpuerperal) and "children's convulsions," since they were ill-defined (pun unavoidable). The committee rejected the suggestion since it would lead to the attribution of too many "unknown causes . . . and this would discredit the statistics" (Commission Internationale Nomenclature Internationale des Maladies 1910, 62). Or again, the vague "hemorrhage" was kept with a view to "not overinflating the figures concerning badly defined diseases'' (Commission Internationale Nomenclature Internationale des Maladies 1910, 73). This distribution went to the lengths of distinguishing between two types: ''other diseases" and "unknown or badly defined diseases." "Proposed conclusion: Each of these two rubrics is very important. The latter in particular indicates what is |
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