Reporting death. The case of Austrian tuberculosis mortality registration--critique and consequences for historical epidemiology.

The purpose of this article is to introduce recent insights into methodological problems of medical diagnosis in history, historical denotations, and interpretation of historical disease nomenclature (causes of death) in the 19th century related to tuberculosis mortality in Austria. Comparing and discussing the main sources--church death records, death certificates and compiled statistics on the causes of death--the paper illustrates practices of documentation and their impact on the quality of the compiled data. As a consequence of the insufficient quality observed, the article argues that historical epidemiology has to be careful when comparing national statistics on the causes of death and that it is necessary to consider the different contexts of the sources' origin. The paper is divided into three sections: it begins with a brief introduction into the history of tuberculosis mortality in the late 19th century and the recent discussions on the problems of historical diagnosis in historiography. The second section gives an overview of registration practice, the different types of sources and describes their specific context of origin. By focusing on the terms Abzehrung/Auszehrung and discussing the practice of assignment, the third part demonstrates that in case of tuberculosis, mortality rates have been overestimated for the time up to 1900. Finally the article gives two examples to exemplify further problems, evoked by the change in registration of causes of death in 1873 and 1896. The paper concludes with a summary of the results and consequences for medical and demographic history.