What was Killing Babies in 19th-Century Europe? Categorising Their Deaths Using ICD10h

This paper draws together the results from a set of complementary analyses of the causes of infant mortality in eight European port cities in the late 19th century. The deaths were all coded according to ICD10h, with granular codes and a bespoke categorisation for infant deaths. The paper assesses and improves the categorisation of the causes of infant death by considering age and seasonal patterns. We find that while there were similarities in the levels and trends of infant mortality there were also important differences which are ripe for investigation by further research. Cause of death patterns were dominated by a transfer from vague to more specific terms over time, but the vague terms used tended to differ by location, and in the speed of their disappearance. Seasonality analysis suggested that most commonly used vague terms, including convulsions and weakness, probably reflected a variety of different underlying causes and should not be combined with more distinct and coherent categories such as airborne disease or food and water-borne diseases. Although teething is commonly treated as a proxy for diarrhoea, this does not appear to have been universally the case. We illustrate how comparative exercises such as this can further understanding of particular historic terms and their use in different settings, and can produce improved cause of death categorisations. Even the improved categorisation produced here, however, does not free the researcher from the need to consider changes in medical provision, knowledge and terminology within a sensitive and historically informed interpretation.