3 Surgeon General's Office III \;1I1W^ "n'y ESENTED BY 'Y t. cSamL // / f//ic. jg Q O Q- 0 w CXVG x 0 O^D xXXDODl! U J O D£>DQ'0 0 "OOP £ REPORT VITAL STATISTICS UNITED STATES, MADE TO THE MUTUAL LIFE INSURANCE COMPANY OF NEW YORK. ^ YU^c BY JAMES WYNNE, M. D., ^\ MEMBER OP THE AMERICAN MEDICAL ASSOCIATION ; OP THE AMERICAN ASSOCIATION FOR THE ADVANCEMENT OP SCIENCE ; CORRESPONDING MEMBER OP THE AMERICAN ETHNOLOGICAL SOCIETY; OP THE NEW YORK LYCEUM OP NATURAL HISTORY, &c, &c, &c. i%}mLm NEW YORK: H. Bailliere, 290 Broadway. LONDON: 219 Regent Street. PARIS: J. B. Bailliere et Fils, Rue Hantefeuille, MADRID : C. Bailly Bailliere, 11 Oalle del Principe. 1857. PREFACE. The accompanying Report was originally made to the Presi- dent and Trustees of the Mutual Life Insurance Company, of New York, who, in the prosecution of an extended business, had long felt the necessity for a more full and exact knowledge of Vital Statistics upon which to base their operations than was attainable. They had, indeed, through their medical examiners and other officials obtained many valuable statistics from all parts of the Union, which, upon the selection of the writer to make this report, were placed by Mr. Winston, the President of the Com- pany, under whose auspices they were collected, in his hands, and together furnish no inconsiderable source of information. The statistical records of the General and State Governments, and the contributions of many individual statisticians, have like- wise supplied reliable data, of whose value the reader will have an opportunity of determining for himself. The deductions dr;iwn either from admitted or supposed premises, are so given IV preface. as to enable a comparison to be instituted between the facts upon which they are based, and the reasoning consequent upon them ; and while all mere speculations are avoided, it is hoped that the principles developed may be found a safe guide in the conduct of a business which involves a trust, so vast in a pecuniary point of view, and so sacred in its moral obligations, as that of Life Assurance. It may be proper to add, that the collection of Vital Statis- tics, upon a comprehensive scale, is a new subject in the United States; and although this Report embraces many points whose elucidation is tolerably well defined, yet a large number await the collection of those facts which the General or- State Govern- ments, or both, must sooner or later gather together. It is highly gratifying to be able to state in this connection, that in addition to the Company to whom the Report was originally made, all the Life Insurance Companies in the United States, with the exception of six or eight, have, with, great unanimity and much kind feeling, united in defraying the expenses of the present publication. This is the more pleasing to the writer, inasmuch as it not only evinces a desire on the part of those engaged in this important and highly intellectual depart- ment of business to secure the aid of science, but is at the same time an earnest that, in their esteem, his labors are not devoid of value. PREFACE. V The Companies above alluded to are— New York Life Insurance Company, of New York. United States Life Insurance Company, of New York. The Manhattan Life Insurance Company, of New York. Knickerbocker Life Insurance Company, of New York. Mutual Benefit Life Insurance Company, of New Jersey. Penn Life Insurance Company, of Philadelphia. United States Life Insurance, Annuity and Trust Company, of Philadelphia. American Life Insurance and Trust Company, of Philadelphia. Massachusetts Hospital Life Insurance Company', of Boston. New Encland Mutual Life Insurance Company, of Boston. Union Mutual Life Insurance Company, of Boston. The State Mutual Life Assurance Company, of Worcester, Mass. Charter Oak Life Insurance Company, of Hartford. American Temperance Life Insurance Company, of Hartford. Connecticut Mutual Life Insurance Company, of Hartford. International Life Insurance Company, of London. Liverpool and London Life Insurance Company'. VITAL STATISTICS. CHAPTER I. introductory remarks. By a wise provision of Providence, the period of death in any indivi- dual instance during a state of health, is always a subject of extreme uncertainty, and it consequently happens that, although human life has an expectation of continuance proportioned to its past duration, and the collateral circumstances by which it is surrounded, yet the span of its existence is liable to be severed at any one moment of its being. Were the circumstances affecting its duration always the same, the period of life in any particular case might be defined with much certainty; but as these are found to be ever varying, so the expectation insepar- ably interwoven with them, becomes a question whose solution depends in a great degree upon the doctrine of probability. It is impossible to determine whether any coming event will happen or . not. Yet it is possible to conjecture the number of cases in which it may occur, and of these, the number in which its occurrence is probable. Ma- thematically speaking the probability of an event, is the ratio of the favor- able circumstances likely to occur in its regard, and the proportion of those in which it is likely to happen to those in which it is not; thus, the proba- bility of throwing an ace with dice, is one in six. And again ; when two dice are thrown, the probability of any given number being uppermost, as t 10 introductory remarks. seven is likewise one in six; because, every one of the six numbers on one of the dice may combine with one of the six on the other so as to form the number seven; now, as the number of combinations is thirty-six, and there are six ways in which seven may occur, its chances of occurrence are six in thirty-six times, or one chance in six. The value of the information thus obtained is far from being lessened because of its dependence upon what at first sight appears to be vague and uncertain. How much the acquired knowledge possessed by mankind is exclusively due to this source, may not at first view be imagined. Upon it are based the actions and judgments which constitute the affairs of every day life—confidence in the succession of future events, and in part, at least, the almost miraculous power, by which the astronomer, following with his calculations the flight of the comet, long after it has disappeared from the field of his telescope—predicts the time of its re-appearance after a fixed and stated interval. But the problems of the mathematician used in these determinations are the mere instruments, delicate and polished though they may be, by which these questions are determined. The materials from which he fashions his work, are furnished by those statistical records of the movements of population—which enlightened governments have found it to their interest to collect and preserve; and here the researches of medicine become so intimately blended with those of mathematics, that their division is next to impossible, and seems to require that the prosecutor of the one should also be a proficient in the other. The practice of registering births and deaths, is of extremely antique origin. We are possessed of sufficient information in relation to the habits of the early inhabitants of Asia and Africa, to enable us to speak positively in regard to the fact that, among the more influential and polished nations of these countries, registers of this kind were kept. The practice was INTRODUCTORY' REMARKS. 11 continued by the Greeks and the Romans, but the records which contained the enumerations like those of the nations that preceded them, have unfor- tunately been destroyed; and their previous existence is only revealed by collateral testimony. The earliest continuous register of births, deaths, and marriages now extant, is that kept by the city of Geneva, in Switzerland, which dates back to 1549, and has been continued from that time to the present, with great care and accuracy. This city, which has attained to a high degree of refinement, furnishes in the improvement in the progression of its popula- tion and increased duration of life, a striking evidence in favor of the benefits of the adoption of this system. I have before me (remarks Mr. Shattuck) the results of an examination made by Edward Mallet, a very able work, published in the " Annates D'Hygiene." From this work it appears that human life has wonderfully improved since these registers were kept. The number of years which it was probable that every individual born would live, appears in the different periods as follows:— Period. Years. Months. Days. Rate of Increase. 1550 to 1600..... 8 7 26 100 1600 to 1700___,13 3 16 153 1701 to 1750 ..... 27 9 13 321 ■ 1751 to 1800.....31 3 5 361 1801 to 1813.....40 8 10 470 1814 to 183 3____ 45 0 29 521 Showing that the mean duration of life has increased more than five times during these periods! The progression of the population and increased duration of life has been attended by a progression in happiness. As prosperity advanced, marriages became fewer and later. The proportion of births was reduced, but a greater number of the infants born were preserved, and the proportion of the population in manhood became greater. In the early ages, the excessive mortality was accom- panied by an excessive fecundity. In the last ten years of the 17th century, a 12 INTRODUCTORY REMARKS. marriage still produced more than five children; the probable duration of life I attained was not 20 years. Towards the end of the 18th century, there were scarcely three children to a marriage, and the probabilities exceeded 32 years. At the present time a marriage only produces 2f children, and the probability of life is 45 years. Geneva has arrived at a high state of civilization. The real productive power of the population has increased in a much greater proportion than the increase in its actual number. The absolute number of the population has only doubled during three centuries; but the value of the population—the productive powers— has more than doubled upon the mere numerical increase. In other words, a population of 27,000, in which the probability of life is 40 years for each individual, is more than twice as strong for the purposes of production, as a popiilation of 27,000, in which the probability or value of life was only 20 years for each indi- vidual. This wonderful improvement is attributed, among other things, by M. Mallet, to the information obtained, rendering the science of public health better known and understood; to larger, better and cleaner dwellings; to more abundant and more healthy food; and to a better regulated public and private life. He cites an instance of the effects of regimen in the preservation of life, where 86 orphans had been reared in one establishment in 24 years, and one only of whom had died. They were taken from the poor, among whom the average mortality was six times as great. Most of the countries of Europe have systems of registration, more or less perfect; the oldest of which, however, do not extend back to a period beyond eighty years. That of England, which has been productive of I more important results than any other, dates from 1838, and is, conse- quently, of less than twenty years' duration. In the United States, although some laws were enacted in the New England States at an early period, yet no decisive action was taken until 1842, when Massachusetts, adopting in a great degree the plan of the English Registration Act, had the honor to furnish the nucleus, around which the registration system, so far as it has been adopted, has gathered. An Act for registration was enacted in New York, in 1847 ; in New Jersey INTRODUCTORY REMARKS. 13 and Connecticut, in 1848 ; in New Hampshire, in 1849; in Rhode Island, in 1850; in Pennsylvania, Virginia and Kentucky, in 1851; and in South Carolina, in 1853. The results of these various Acts, so far as they have been made public, are to be found in the Annual Registration Reports of Massachusetts, Connecticut, New Jersey, Pennsylvania, Rhode Island, Kentucky and Virginia. Some of these reports, and particularly those of the State of Massachusetts, are prepared with much ability, and con- stitute valuable contributions to vital statistics. Others, as those of Connecticut, are meagre, and less reliable. The wide difference manifest in the general character and value of the reports already made, clearly establishes the fact that the United States never can possess a system of registration which will correspond in uni- formity and value with those of the Governments of Europe, until the task and responsibility of executing it be confided to the General Government. What value is attached to this information by the enlightened states- men of other countries, may be deduced from the following remarks made by the Registrar-General of England:—" The census has been taken decen- nially with great regularity in the United States of America; and the ages are properly distinguished, but abstracts of the registers of deaths have only been published by the cities of New York, Philadelphia, Boston, and some of the more advanced towns where property has accumulated; and life is watched over with more care and facility than in the back settle- ments—scantily peopled with a fluctuating population. No correct life- table can, therefore, be formed for the population of America until they adopt, in addition to the census, the system of registration which exists in European States." " Since an English life-table has now been framed from the necessary data^ I venture to express a hope, that the facts may be collected and 14 INTRODUCTORY REMARKS. abstracted, from which life-tables for other countries can be constructed. A comparison of the duration of successive generations in England, France, Prussia, Austria, Russia, America, and other states, would throw much light on the physicial condition of the respective populations, and suggest to scientific and benevolent individuals in every country—and to govern- ments—many ways of diminishing the sufferings, and ameliorating the health and condition of the people; for the longer life of a nation denotes more than it does in an individual—a happier life—a life more exempt from sickness and infirmity—a life of greater energy and industry—of greater experience and wisdom. By these comparisons a noble national emulation might be excited; and rival nations would read of sickness diminished, deformity banished, life saved—of victories over death and the grave, with as much enthusiasm as of victories over each other's armies in the field ; and the triumph of one would not be the humiliation of the other, for in this contention none could lose territory, or honor, or blood, but all would gain strength." * In addition to the information collected under the Registration Laws, are the bills of mortality kept by most of the populous towns in the United States. This latter source of information is, at the present moment, so far as it goes, the most reliable; and were it on a sufficiently extended scale, might supersede the necessity for registration, as it obtains under the present State enactments; but it could never equal in exactness and value such a system as is in use in England, were it extended to the whole country, and placed under the control and management of the General Government. The census mortality returns, although far short of what could be desired, clearly show the ability of the government, under a proper regulated Fifth Annual Keport Register-General of England, p. 19. INTRODUCTORY REMARKS. 15 system, to collect and arrange mortuary registers, which shall equal in exactness and value, those of any country in Europe. In order to accom- plish this, or even to give the ordinary census returns an approximation to correctness, it is necessary that the office wotk be executed by those who, from peculiar adaptation and long experience, possess an especial fitness for the undertaking. " Unless there is machinery in advance at the seat of Government, no census can ever be properly taken and published. There is a peculiar education required for these labors which neither comes from zeal or genius, but is the result only of experience. They are the most irksome and trying imaginable, requiring inex- haustible patience and endurance, and baffling almost every effort after accuracy. Long familiarity can alone secure system, economy, and certainty of result. This office machinery exists in all European countries where statistics are the most reliable, but there has been none of it in the United States. Each census has taken care of itself. Every ten years some .one at Washington will enter the hall of a department, appoint fifty or a hundred persons under him, who, perhaps, have never compiled a table before, and are incapable of combining a column of figures correctly. Hun- dreds of thousands of pages of returns are placed in the hands of such persons to be digested. If any are qualified, it is no merit of the system. In 1840, returns were given out by the job to whoever would lake them. In 1850, such was the pressure of work, that almost any one could at times have had a desk. Contrast this with the English system, and reflect that one individual presided over the census of 1801, '11, '21 and '31. In Washington, as soon as an office acquires familiarity with statistics, and is educated to accuracy and activity, it is disbanded, and even the best qualified employee is suffered to depart. The government may rely upon paying heavily for the experience which is being acquired. Even the head of the office, whatever his previous training, must expect, if faithful, to learn daily ; and it is not going too far to say that a matter of one or two hundred thousand dollars is the difference between the amount which a census would cost, conductedby an office which has had the experience of a previous one, (even if partly or entirely in new hands, which might often be desirable, since the machinery, as in other offices, would be kept up,) and an office without such experience. This can be demon- strated if required. Half of that amount would sustain an office of several persona from census to census, and defray all of the expenses of an annual or biennial report 16 INTRODUCTORY REMARKS. after the closing of the regular one, which itself would be executed with despatch, with greatly less force, and with a more economical and wiser application of labor. The permanent force would have no other interest than the prompt execution of the work." In regard to the confidence to be reposed in the present mortality returns, the report makes the following candid statement:— " The federal census of 1850 furnishes the first instance of an attempt to obtain the mortality during one year in all the States of the Union, and had there been as much care observed in the execution of the law as was taken in framing it, and in the preparation of necessary blanks^ a mass of information must have resulted relating to the sanitary condition of the country, attained as yet in no other part of the world. This, however, would have been expecting too much. It was to take for granted, first, that the person interrogated in each family, whoever he might be, with regard to its affairs, would be able to recollect whatever death had occurred in. it within the period of twelve months; and, second, to give the true designation of the cause of such death. One would think it not unreasonable that the facts of actual deaths would be striking and impressive enough in every household to be remembered for a much longer period than a single year; yet the returns of the marshals have only to be examined with care, and deductions made from them, to satisfy the most careful observer that in the Union at large at least one-fourth of the whole number of deaths have not been reported at all. Making allowance for even this error, the United States would appear to be one of the healthiest countries of which there is any record. The varying ratios between the States, as drawn from the returns, show not so much in favor of or against the health of either, as they do, in all probability, a more or less perfect report of the marshals. Thus it is impossible to believe Mississippi a healthier State than Rhode Island, etc. For rural population the returns are no doubt nearer correct than they are for urban, and the old States are in general better reported than the new. So far as the educated are in question, the assigned causes of death on the returns, may be con- sidered sufficiently near the truth for popular purposes, though falling far short of the precision necessary in skillful scientific calculations; but among the large mass of the community, vagueness and inaccuracy may naturally be expected, even where the parties are disposed to speak the truth and make the best effort to do so. The physician's certificate of the cause of death is the only positively reliable evidence of the fact. INTRODUCTORY REMARKS. 17 " The other points and particulars of inquiry, such as the age, sex, color, con- dition, occupation and nativities of parties, the season of decease and duration of sickness, stand upon somewhat different ground, and are, from their character, no doubt as correctly answered as the inquiries of the census relating to the ages, pur- suits, etc., of the living. " Upon the whole, then, and we cannot be too emphatic on this point, whilst this publication of the mortality statistics of the census is disclaimed as of authority in showing the respective pretentions to healthfulness or the degree of unhealthful- ness of the several States, or of very great scientific worth in showing the specific causes of death, it may be considered of much value, notwithstanding, in giving with even ordinary claims to precision very minute phenomena relating to the deaths of about one-third of a million of people scattered over three millions of square miles of territory. The value of such a multitude of facts cannot but be very great, even although they do not constitute the whole of them. We are every day accustomed to draw deductions for the whole from a part, and to argue out the true and com- plete from the approximate and uncertain. " It may also be said in favor of the returns as published, that they constitute but a beginning, and are not, perhaps, further from the truth than were the first attempts in States having registration systems. The same improvement as in these States may be expected hereafter. The publication of this volume will stimulate investigation and lead to a better understanding of the importance of the subject." 2 18 TERRITORIAL LIMITS. CHAPTER II. TERRITORIAL LIMITS. The territory embraced within the present limits of the United States extends from N. latitude 29° to 49°, and from the Atlantic to the Pacific Oceans. This vast area contains two millions, nine hundred and thirty-six thousand, one hundred and sixty-six square miles, and embraces a more extended range of soil and climate than that of any other civilized country upon the globe. The opportunity afforded for marking the effects of dif- ference of climate, temperature, soil and social institutions, upon the same people, is without a parallel, and were the statistical data as exact and reli- able as those of the smaller States of Europe, the information would exceed in comprehensivness and value, that of any other country, because more extensive and general in its range, and involving questions of migration and the intermingling of races on a scale unknown elsewhere. The Alleghany and Rocky Mountain ranges divide the face of the country into the Atlantic plain and slope, which is washed by the Atlantic Ocean, and was the earliest settled portion of the United States, the valley of the Mississippi lying between the Alleghany and Rocky Mountain ranges, watered by the Mississippi river and its tributaries, and the Pacific slope, extending from the Rocky Mountains to the shores of the Pacific Ocean, and embracing the auriferous region of California. GEOGRAPHICAL DIVISIONS. 19 The annexed table gives the area of each great division and ratio to the total area of the United States: Territory. Area in sq. miles. Ratio of area of each slope to to- tal area of U. S. Pacific slope............................................................. Atlantic slope proper................................................514,416 Northern Lake region...............................................112,649 Gulf region....................................................,. •. 325,537 Atlantic, Lake and Gulf east and west of the Mississippi....................... Mississippi valley, drained by the Mississippi and its tributaries................. Atlantic, including Northern Lake................................... 627,065 ' valley and Gulf or Middle region..........................1,543,099 Total.............................................................. 766,002 952,602 1,217,562 2,936,166 26.09 17.52 3.83 11.09 32.44 41.47 21.35 52.55 This is divided into States and Territories, as follows State or Territory. Alabama.............. Arkansas........... California.......... Columbia, District of.. Connecticut.......... Delaware........... Florida............. Georgia............... Illinois.............. Indiana............. Indian Territory (south of Kansas......... Iowa............... Kansas............... Kentucky........... Louisiana........... Maine.............. Maryland........... Massachusetts......... Michigan............ Minnesota Territory... Mississippi.......... 50,722 52,198 156,980 60 4,674 2,120 59,268 58,000 55,405 33,809 71,127 50,914 114,798 37,680 41,255 31,766 11,124 7,800 56,243 166,025 47,156 1.73 1.78 5.32 0.15 0.07 2.02 1.98 1.89 1.15 2.42 1.73 3.91 1.28 1.40 1.08 0.38 0.26 1.91 5.65 1.61 State or Territory. Missouri.............. Nebraska Territory .. New Hampshire..... New Mexico Territory New York.......... New Jersey......... North Carolina...... Ohio................. Oregon Territory.... Pennsylvania ....... Rhode Island........ South Carolina..... Tennessee.......... Texas............... Utah Territory...... Virginia............. Vermorit............ Washington Territory Wisconsin.......... Total............ Va o a c » 8* KS ^s < cm3 67,380 2.29 335,882 11.44 9,280 0.32 207,007 7.05 47,000 1.60 8,320 0.28 50,704 1.73 39,964 1.36 185,030 6.30 46,000 1.57 1,306 0.04 29,385 1.01 45,600 1.55 237,504 8.09 269,170 9.17 61,352 2.10 10,212 0.35 123,022 4.19 53,924 1.84 2,936,166 r3i> 11 1 34 4 23 35 21 27 5 24 39 31 25 3 2 12 33 8 17 The interior valley of North America begins within the tropics and terminates with the polar circle, traversing the continent from south to north. Dr. Drake says: " Of the area of this great inter-mountain region 20 DISTRIBUTION AND it is not easy to speak with any precision. This valley cannot be estimated at less than three-fourths of the continental surface. Its northern half is, however, rendered nearly uninhabitable, by the state of its surface and climate; and, therefore, the portion which presents objects of immediate interest to the medical etiologist, does not exceed three millions of square miles, of which as yet not more than one-third has acquired even a sparse population." The Rocky Mountains, which constitute the western boundary of the great valley? are a continuation of the Cordilleras of Mexico; and acquire an elevation in some places of fourteen thousand feet. The physician who would understand the true character of the climate of the interior valley from south to north, cannot too strongly fix his attention on this lengthened and elevated chain which effectually cuts it off from the genial influences of the Pacific Ocean, and bestows upon it the characteristics of an inland and peculiar climate, differing altogether from any to be found on the western portion of the European continent. The entire population, according to the census of 1850, was 23,191,876. The estimated population for each succeeding year to 1860, is as follows:— Years. Aggregate. 1851, ..........................23,873,71V 1852, ..........................24,575,604 1853,..........................25,298,126 1854,..........................26,041,890 1855, ..........................26,807,521 1856, ..........................27,595,662 1857, ..........................28,406,974 1858, ..........................29,242,139 1859, ..........................30,101,857 1860, ..........................30,986,851 AGES OF POPULATION. 21 The distribution of the population of 1850, among the States and Ter- ritories, according to their respective ages, is given in the annexed table:— STATES ASD TERRITORIES. Alabama............ Arkansas..........., California........... Columbia, District of. Connecticut......... Delaware..........., Florida............. Georgia............, Rlinois............., Indiana............ Iowa.............., Kentucky........... Louisiana........... Maine............... Maryland........... Massachusetts ........ Michigan ........., Mississippi.........., Missouri............, New Hampshire...... New Jersey........., New York.......... North Carolina......, Ohio................ Pennsylvania........ Rhode Island......., South Carolina....... Tennessee........... Texas .............. Vermont............ Virginia............, Wisconsin ........... x f Minnesota....., .12 o S= ©3 •** la so so t- *■ D 476 183 22 1 6 688 5664 8710 1159 112 19 3 79 15,746 2080 6186 3131 397 71 13 3 2 67 11,950 426 1637 1533 734 120 42 7 1 56 4555 98 448 589 457 295 56 19 3 13 1978 30 137 281 321 206 146 24 9 2 1 15 1172 7 34 92 162 182 107 65 24 2 2 3 6 686 1 17 40 64 103 104 74 39 10 2 1 5 460 2 3 • 13 23 50 58 55 43 26 C 5 2 286 3 2 14 19 44 51 50 24 16 1 5 229 2 2 2 12 5 17 36 29 23 5 1 1 135 1 4 10 4 9 6 15 4 3 i 57 1 i 0 1 1 3 3 7 1 4 1 1 1 1 23 5 5 15 7 5 1 1 836 870 8788 17,375 6872 2294 1081 691 320 217 105 73 22 8 2 i 1091 38,840 IN NORTHERN AND SOUTHERN STATES. 93 AGES OP WOMEN. Ages Men. Whole No. Under 20. 20 to 25. 25 to 30. 30 to 85. 35 to 40. 40 to 45. 45 to 50. 50 to 55. 55 to 60. 60 to 65. 65 to 70. Orer 70. Unk'n. Under 20 614 520 167 15 5 1 4 20 to 25, 4732 2577 1822 238 48 13 4 3 27 25 to 30, 2331 988 1024 251 46 10 1 1 10 30 to 35, 894 267 389 142 71 10 4 1 4 6 35 to 40, 672 83 186 105 49 33 8 4 4 40 to 45, 296 30 90 * 52 61 36 21 3 i 2 45 to 50 200 8 46 39 33 39 17 5 9 2 2 50 to 55 148 11 21 29 23 24 17 22 2 1 2 55 to 60 77 2 7 10 7 16 10 15 3 5 1 60 to 65, 66 3 4 8 5 9 8 13 10 5 2 2 2 65 to 70 35 3 1 2 5 7 7 6 1 1 2 1 Over 70 29 3 1 2 2 6 4 1 4 5 5 Unknown 372 17 29 7 2 315 Total.. 10,166 4397 3791 900 362 199 104 68 29 17 8 10 376 And also a table, based upon similar results in Belgium, for the year 1841 :— TOTAL MAKRIAGES IN BELGIUM. Men. Women. Jnder 21, 774 2,831 21 to 25, . . 4,677 7,421 25 " 30, ■ . 10,067 9,082 30 " 35, . 6,527 4,928 35 " 40, 3,636 2,791 40 " 45, . 2,037 1,477 45 " 50, 934 753 50 " 55, 512 357 55 " 60, 310 126 60 " 65, 244 67 65 " 70, 112 28 70 " 75, 36 13 75 " 80, 8 2 80 and upwards, 2 — 29,876 The foregoing tables, showing the results of the marriages contracted 94 AGES OF FEMALES MARRIED in the States of Massachusetts and Kentucky, so far as the age of the parties is concerned, and adapted from the Belgium returns, exhibit in a concise and admirable manner, the age and condition of the persons who have contracted this relation. It is hardly possible to devise a tabu- lated form which shall express the facts so clearly and concisely as the one just given. From the Massachusetts Returns it appears, that of the 38,840 females who formed marriage relations, 8,788 were under 20, 17,375 between 20 and 25, 6,872 between 25 and 30, 2,294 between 30 and 35, 1,081 between 35 and 40, and 2,437 above that age. Of the males, 688 were less than 20, 15,746 between 20 and 25, 11,950 between 25 and 30, and 10,456 above that age. There are peculiarities which do not admit of tabulation, and yet are interesting. Dr. Curtis, in his remarks upon the marriages which took place in Massachusetts, mentions some of these :— " Age presents also quite an interesting topic for consideration. During the twenty months we find marriages among persons of all ages between 13 and 91. The youngest individual married was a female of 13 years, several instances of which occurred. The youngest male was 16, who mar- ried a female of 19 ; the youngest couple was a male of 17 and a female of 14 ; a male of 20 and another of 25 married each a female of 13 ; a male of 19, one of 21, and another of 27, married each a female of 14; two males of 25 each, two of 28 each, one of 30, one of 35, and another of 47, married each a female of 15 ; and a bachelor of 50 married a girl of 19. " Although the male was usually the eldest of the allied couple, yet many instances happened where the reverse obtained ; thus we find a male under 20 married a female over 40 ; a bachelor of 24 married a widow of 42 ; a bachelor under 35 married a widow over 60; and another bachelor IN MASSACHUSETT AND KENTUCKEY. 95 under 40 married a widow over 75. A female of 18 married the second time, and one of 59 married the fifth time. A male of 30 married the third time. One of 36 and another of 45 married the fourth time each. Among those at later ages in life we find a male of 81 married a female of 69; but the oldest couple married were Mr. Calvin Kilborn, of Princeton, and Mrs. Susan Saunders, at the respective and respectable ages of 91 and 70. He is a farmer in good health, of sprightly habits and good mental faculties, still remembering the scenes and "incidents of travel" which he ex- perienced in 1777, when he went as a fifer at the Bennington Alarm. It seems worthy of notice that in this office, and almost side by side, are the official records of Mr. Kilborn's enlistment in Capt. John White's company which marched to Bennington in July, 1777, and also of his marriage in November, 1848, more than threescore and ten years having intervened between these interesting events. He has always been able to do the work on his farm to the present time, with but little assistance. ;' The following statement will be found to possess interest by showing the number and proportion of marriages at the different ages of the sexes during the last five years and eight months, viz., since May 1, 1854, 7229 males and 7453 females, whose ages were not stated, have been omitted in the calculations :— CD "3 d Males, 401 10,115 7941 2430 1203 748 486 322 218 172 9ft 67 29 5 24,232 £ Females, 5871 11,313 3751 1329 723 450 260 174 99 47 38 14 4 1 24,(i78 o id o in io VO SO o Ages, o o o o o 3 o "c3 t> CM C>1 o CO 1Q CO o •S* o IO IO 1Q O so SO c m > O , o Eh ss "S Males, 1.66 41.74 32.77 10.04 4.97 3.08 2.01 1.33 .90 .69 .39 fl8 T> .02 100 i^ Females, 24.40 46.98 15.58 5.52 3.00 1.86 1.01 .72 .41 .19 .16 .06 .02 100. " The above abstract indicates, so far as can be illustrated by an analysis of upwards of 24,000 marriages, the- ages of parties to which were \ 96 AVERAGE AGE AT MARRIAGE. stated, that the probabilities of marriage under the age of 20 years are nearly fifteen times as great with females as they are with males, and that between the ages of 20 and 25 they are much nearer equal, though still somewhat in favor of the female; but after the age of 25, till death, the probabilities of marriage are about two to one in favor of the male. " Again we perceive above, that of all females married, the chances that this interesting event will take place prior to the age of 20, are about as one to four of all the probabilities that they will ever marry; that is, when a female arrives at the age of 20 years and is unmarried, one quarter of the probabilities of her ever being married are gone. If she passes to the age of 25 unmarried, nearly three quarters of her probabilities are lost, and if she is unmarried at the age of 30, she has passed nearly nine-tenths of her chances of ever becoming a wife. The case is different with males, more than one-half of whose marriages occur subsequent to the age of 25. But the period of life between 20 and 25 appears the most probable of all the quinquennial periods of matrimonial alliances to both sexes."* The returns from Kentucky show that of the 10,106 females who were married in 1852 and 1853, 4397 were under 20, and 3,791 between 20 and 25. From this it appears that of all the females whose marriages were re- turned, 43.24 per cent, were under the age of twenty, and 37.29 per cent. between the ages of twenty and twenty-five, or 80.53 per cent, under the age of twenty-five. In Massachusetts but 24.40 per cent, of the females were married under 20, and 46.98 per cent, between 20 and 25, or 71.38 per cent, under the age of twenty-five. These tables indicate a very marked difference between the Northern and Southern portions of the Union, in regard to marriage, if Massachusetts * 8th Massachusetts Registration Report, p. 99-100. IN DIFFERENT LATITUDES. 97 is to be considered a type of the former, and Kentucky of the latter, which must manifest itself in all the future movements of population, seriously affecting their births and deaths, and influencing in a very decided manner the relative probabilities of life among the natives of the one or the other sections of the United States. • A comparison, instituted by Mr. Shattuck, between persons contracting marriage in Massachusetts and Belgium, for the first time, from dates already given, shows the average age in the two places to be— Males. Females. Belgium, .... 29.47 27.43 Massachusetts, .... 25.84 22.69 The elements upon which this computation was made, are derived from the Massachusetts Returns for 1845, and those of Belgium for 1841. A similar one, based upon the Kentucky returns, shows the average age at marriage to be— Males. Females. 23.98 21.03 These tables show that in Belgium more men and women marry be- tween the ages of twenty-five and thirty, and in Massachusetts, between twenty and twenty-five,^than at any other period of life. In Kentucky, more women marry below twenty, and more men between twenty and twenty-five, than at any other age. Massachusetts is thus made to occupy an intermediate position between Belgium on the one hand, and Kentucky upon the other. The average age at marriage is found steadily to decline, so as to present the remarkable difference of 5.49 years among the males, and 6.40 years among the females, between Belgium and Kentucky. A natural deduction from these premises is, that as women marry earlier, the number of children will be greater, and the sum of those 12 98 PHYSIOLOGICAL LAWS IN Avho attain to maturity less than in those countries whose marriages are contracted at a more mature period. How far this result may be modified by a lower latitude, and a consequent increase of temperature, the means are not at hand for determining. The principle is well established in physiology, that the human body matures much sooner in warm countries than in cold, and that the female in the former reaches a physical development which enables her to assume the functions of a mother, at a much earlier age than in higher latitudes. In the tropical regions of Asia, for example, the female reaches a point of de- velopment at eight which in the more temperate latitudes of Europe and America is not attained until fourteen. A system of reasoning therefore, which would place the inhabitants of these extreme countries upon a parallel in this regard, would be fallacious, because as nature has in each surrounded the human species by a combination of circumstances, which are entirely different, the one from the other, so it-has doubtless established a series of natural laws to govern and regulate the movements of the human race in each different latitude, or variety of climate under which they may be placed. Were it not for this compensation man must necessarily have been restricted to one particular belt of the earth's surface, instead of covering it all with his footsteps, and claiming the whole for his dominion. A limit is thus defined to the animal and the vegetable kingdoms. The lion and the elephant are never found to inhabit the same latitude as the ox and the sheep, nor are the latter ever associated in companionship with the rein- deer and the Polar bear. The banana and pine-apple never flourish in a temperate region, nor do the apple and peach survive transplanting to the frigid zone. In this extensive department of nature, a particular place is assigned to each distinct species of either kingdom, admirably adapted to the wants of its being, or the purposes it is intended to subserve. WARM AND TEMPERATE LATITUDES. •*•' Man alone is endowed with a capacity for universal migration. Pos- sessing no natural covering of his own, he is enabled in each latitude to adapt to himself that which is best suited to the climate. In the frigid zone he invests himself with the skins of animals, covered with thiok fur; in the temperate latitudes, he fabricates a clothing from the wool of the sheep ; and under the influence of the intense heat of the tropics selects a light linen texture, or almost entirely dispenses with the use of external garments. These analogies are introduced for the purpose of exhibiting the great variety of circumstances under which man may be placed, and to serve as a caution against too hasty a generalization. It is true that the limits of the United States do not embrace the extremes of climate and temperature to which allusion has been made ; nor do the States of Massachusetts and Ken- tucky represent its extremes. It does, however, possess in this regard a range of latitude and variety of climate, not only more extensive than any other civilized country, but nearly equal to that of all the countries of Europe, whose governments possess a system of registration. Moreover, as the changes of temperature are much greater in the United States than in those European countries, a knowledge of the move- ments of whose populations are revealed through their population returns, it follows that the changes of climate from warm to cold, and the reverse, are reached in traversing a less number of degrees of latitude in the United States than in Europe ; and hence while Massachusetts has all the character- istics of a northern climate, without its greatest intensity, so Kentucky pos- sesses, in a modified degree, the climatic influences of a Southern latitude. It must also be borne in mind that the climate of Europe and the United States are so different as not to be represented by the same parallels of latitude, and it has hence been seen that notwithstanding their dif- ferences in this respect the South of France and Kentucky, as southern 100 IMPORTANCE OF localities, and Sweden and Massachusetts as northern ones, bear a marked correspondence with each other. If these observations have any force, they would lead to the belief that the striking differences which have thus far been seen to exist in the move- ments of the population of Massachusetts and Kentucky, are not accidental, but in accordance with the laws which regulate and control them respectively —that these laws have shades of variation as they are made to operate upon the inhabitants of various latitudes, and that similar results are not uniformly to be expected—that while nature has provided in the most wonderful manner for the maintenance of the species and the preservation of a just equilibrium among the sexes, it has adopted different formulas to accom- plish this "end for different circumstances. This is abundantly manifest in the difference of the rates of mortality between town and country populations, and the manner in which after a high mortality nature repairs the loss by an acceleration of the functions of reproduction, so that the number lost by death is compensated for by the number of births. Now, if these differences are developed under different circumstances in the same locality, it is fair to infer that they are more likely to be developed in places whose latitude and climate have little or no correspondence with each other. Nothing short of an accurate and uniform system of registration applied to every part of the United States, and continued for a period sufficiently long to correct the errors which, will unavoidably become associated with it can determine this question. In the meantime there is sufficient evidence to show that the laws which regulate the population of any given place in Europe, as Geneva, arc not more admissible of general application in the United States, than they are in Europe, although a single place might doubtless be found where the iden- tity of movement would be as exact as in those of the places already put in comparison with each other. EXTENSIVE OBSERVATIONS. 101 It is because these rules are not general in application, that whenever any considerable sum is at stake upon the expectation or value of life, observations are made from various points and comparisons instituted between them. Milne did not rest satisfied with the quiet little town of Carlisle, embosomed in the centre of rural life, in England, or the accurate observations of that excellent old gentleman who officiated as its medical man (Dr. Heysham), but extended his enquiries on the one side to Sweden, and on the other to the south of France, and after becoming enriched with the labors of Nicander and Wargentin, in Sweden, and Mourgue, De- parcieux, St. Cyran, and Duvillard, in France, and in his mathematical deductions by Euler, La Place and Halley, produced his valuable work on Annuities, which is chiefly important because its range of enquiry is general, and its deductions extensive. The ratio of marriages to the population is found to vary in dif- ferent places. The Massachusetts returns give an average of one marriage to every 102 inhabitants of the entire State. In Suffolk county, in which Boston is located, the number was one in 64; while in Worcester county the number was one in 104, and in Dukes county one in 151. The registration report of Kentucky, in alluding to the number of marriages which took place in that State, says: "It appears that there were 7,430 marriages in the State during the year 1852, of which 5,105 are returned by the assessors, leaving 2,325 or 39 per cent, unaccounted for. We had, therefore, one marriage to every 102.92 white persons in the State. The proportion varied very much in different counties. In Harri- son and Jefferson the proportion was one in 50.34, and 54.90 respectively; whilst in Simpson and Livingston, the proportion was one in 239 and 216 respectively.1'" The clerks of the respective counties in the State of Kentucky, as of 1st Registration Report of Kentucky, p. 105. 102 MARRIAGE RETURNS many of the other States, issue a license authorizing the contemplated mar- riage to take place, which certificate is presented to the clergyman who performs the marriage ceremony. A record of the issue of the certificate is always made in the clerk's office, by which means it is possible to determine the number of marriages which have taken place. In this instance it appears to have furnished a check upon the records of the assessors, and shows that they failed to return 39 per cent, of the marriages which actually took place. The correction, it will be observed, is confined to the white po- pulation, and properly, because all the marriages noted were among this portion of the population; the laws of the State of Kentucky, and indeed of all slave States, not recognising any legal ceremony, nor requiring any registration or certificate, in marriages among the colored inhabitants. Similar omissions, as to numbers, appear to have been made in the succeed- ing year, so that it is probable that the number of marriages which actually took place among the white population of the State, in two years, was about 15,996, or one marriage to every 100 of the white population. In regard to those marriages actually reported, there appears to exist no reason to doubt the accuracy of the returns as to age, or at least that they form as near an approximation as can reasonably be expected. As to the marriage returns embraced in the census for 1850, Mr. De Bow remarks : " The ratio of marriages is very nearly one person married to every two hundred persons, varying between the States from one to 316, as in Delaware, one to 150, as in New Mexico, as one in 192, as in Massa- chusetts, a sufficient proof of the incompleteness of the returns."* It was hardly to be expected that in this particular the census should afford perfectly reliable information, because the marshals whose duty it was to gather these statistics, entered upon their task, without previous guide or * Compendium of U. S. Census, 1850, p. 104. IN DIFFERENT STATES. 103 direction. The returns, as given below, although acknowledgedly incom- plete, are introduced as the best standard of comparison with those gathered in the several States at hand. States, &c. Married. i states, &c. Married. Alabama, . 3,940 New Hampshire, 2,613 Arkansas, 2,112 New Jersey, . . 3,719 California, New York, 31,465 Columbia, District of 373 North Carolina, . 5,275 Connecticut, . . 3,213 Ohio, 22,328 Delaware, 564 Pennsylvania, " . 19,858 Florida, 431 Rhode Island, . 1,327 Georgia, 4,977 South Carolina, . 2,005 Illinois^ . 9,183 Tennessee, 7,872 . Indiana, 12,423 Texas, . . 2,232 Iowa, .... . 1,824 Yermont, 2,653 Kentucky, 8,091 Virginia, . 8,163 Louisiana, . 2,890 "Wisconsin, 3,015 Maine, 4,886 m 'Minnesota, . 39 Maryland, . 3,703 ~New Mexico, . 916 Massachusetts, . 10,347 Oregon, 168 Michigan, Mississippi, Missouri, . 4,257 CP H L¥tah, . 404 2,774 . 6,989 T otal, . 197,029 Neither the marriage returns of Connecticut, which are included in the Registration returns, nor those of New Jersey, which are computed at 4,242, appear to be more reliable than those returned by the marshals, and included in the United States census, from which it will be seen by com- parison they differ largely. The returns of Massachusetts and Kentucky, as corrected, furnish toler- ably correct information as to the relative proportion of marriages to their respective populations. It would be just to apply them to the whole Union, 104 RATIO IN DIFFERENT COUNTIES. as fair representatives of distinct portions, which would give a ratio of one marriage to each 101 of the population. This proportion is much greater than among the populations of any of the European States, which have ren- dered returns, except Russia, to whose population in some respects that of the United States bears a strong affinity. " Our returns (remarks the Rhode Island report) are inadequate to show what has been the real proportion of marriages to the population. But those who are acknowledged and recorded as having been made happy in this way, are, (if we take the population from the census of 1850,) in the last seven months of 1853, at the rate of one for every 91.99 in a year, and in 1854, one for every 70.46. From the whole population, however, we ought, perhaps, to subtract that of towns which made no returns of marriages, so as to base our calculation on the 'represented* population.' Doing this, the ratio would be, for the last seven months of 1853, at the rate of one to 74.36 in a year, and for 1854, one person married in every 64.71. In the first report, it was one to 81.636. * In England, there were living to each marriage, . . . 131 persons. Austria, " " " " " ... 124 " France, " " " " " ... 121 " Prussia, " " " " " ... 113 " Russia, " " " " " ... 90 " * 2d Registration Report of Rhode Island, p. 23. STATISTICS OF MORTALITY. 105 CHAPTER X. MORTALITY. The statistics of mortality are much more palpable in their immediate results, to those who do not directly concern themselves with the move- ments of population, than either those of births or marriages, and they have consequently not only attracted a larger share of public attention, but have likewise induced a larger amount of municipal and State legislation. There is scarcely to be found a populous town, in any country, marked by a high degree of civilization, which does not preserve a record more or less perfect of the deaths which take place among its inhabitants. In most of the populous places in the United States, these mortuary registers cover a comparatively large number of years, and it is therefore no difficult task to ascertain the rate of mortality peculiar to each, and with some degree of precision the ages upon which this mortality falls. The outlets of human life, in the guise of various diseases, are likewise taken notice of, to a sufficient extent, to mark the influence of the locality, if any peculiarity exists, upon its inhabitants, and to determine the species of disease most fatal to its population. In country districts, previous to the establishment of the system of registration, so far as it at present prevails, as a general rule, no mortuary 13 106 MEANS OF DETERMINING MORTALITY records were kept, and there consequently existed no means of determining their mortality, or standard by which the relative value of life in town and country could be measured. The only information at present in existence concerning the number of deaths which take place in the rural districts of the United States, is to be found in the returns of the States which have adopted a system of registration, and the marshal's returns to the general government, included in the census for 1850. As to the first of these means of determining the rate of mortality among the rural population of the United States, it is perhaps sufficient to say that in but seven out of the thirty-one States comprising the Union, is this system of registration in operation at all, and in some of those in which it does exist the returns are so imperfectly made as to deprive them of much of their value. In regard to the enumeration, as made by the agents of the general government when taking the census of 1850, it is quite certain that it does not include all the deaths which occurred during the year prior to June 1st, 1850. This subject has already been alluded to, and some reasons have been given for fixing the number of omitted deaths at a certain increased ratio above those enumerated. In addition to the bills of mortality kept by the various cities in the United States, and which ^furnish an excellent means of determining the error in the census returns, and of correcting it, the registration returns of at least two of the States supply valuable data, and constitute excellent standards of comparison. There is no more reason for refusing credence to the facts connected with the deaths reported by the takers of the census so far as age, and name of disease are concerned, than there is to any other of the various departments of enquiry which came within their cognizance. In the collection of facts, as extensive as those of the enumeration of the popu- lation of a country embracing many millions of inhabitants scattered over IN THE UNITED STATES. 107 a vast area, or of the various incidents connected with this population, whether pertaining to industrial statistics, or the increase of their numbers by birth, and their decrease by death, extreme accuracy is not to be expected. A certain margin is always left to that inseparable incident to all human affairs and all human reasoning—probability, which it is the province of mathematics to bridle and reduce to subjection. Those fluctuations of population, which are affected by births and marriages, with much less reliable data than is furnished by the records of mortality within reach, have, it is thought, been determined with consider- able precision, and there exists no reason why similar results may not be obtained so far as mortality is concerned. The aggregate of all the deaths included in the mortality statistics of the census for 1850, distributed among the States in which they occurred, is given in the annexed statement:—■ Alabama..............I 4,812 Arkansas.. ........... 1,654 California............. 794 Columbia, District of.... 427 Connecticut............ 2,924 Delaware.............. 044 Florida................. 507 Georgia............... 5,176 Illinois................i 6,386 Indiana...............j 6,882 Iowa.................] 1,140 Kentucky.............| 7,983 Louisiana.............i 7,351 Maine................', 3,882 Maryland..............j 5,127 Massachusetts..........j 9,978 Michigan..............i 2,423 Mississippi........... 4,629 4,279 1,367 111 41!) 2,857 565 424 4,74'.l 5,2y3 5,826 904 7,050 4,605 3,752 4,494 9,426 2,092 4,092 Aggregate Deaths. 9,910 3,021 905 846 5,781 1,209 931 9,925 11,759 12,708 2,044 15,033 11,956 7,584 9,621 19,404 4,515 8,721 Missouri............ New Hampshire..... New Jersey......... New York.......... North Carolina...... Ohio............... Pennsylvania....... Rhode Island....... South Carolina...... Tennessee.......... Texas.............. Vermont........... Virginia........... Wisconsin.......... 1 Minnesota .. Terri- I New Mexico lories. ( Oregon..... J Utah....... 6,854 2,038 2,513 24,446 5,227 15,818 15,532 1,103 4,207 6,179 1,641 1,534 9,735 1,575 19 580 32 131 5,438 2,193 2,952 21,154 4,938 13,139 13,019 1,078 3,839 5,696 1,368 1,595 9,324 1,328 10 577 15 108 Aggregate Deaths. 12,292 4,231 6,465 45,600 10,165 28,957 28,551 2,241 8,047 11,875 3,057 3,129 19,059 2,903 29 1,157 47 239 Of the 323,023 deaths included in the foregoing abstract, 172,878 were males, and 150,145 females. The difference between the male and 108 MALE AND FEMALE MORTALITY female deaths being 22,733. The ratio per cent, of the male deaths to the males living being 1.46, and of the female deaths to the living females, 1.32:— To 100 deaths of both sexes. Whole No. Males. Females. Males. Females. 323,023 172,S78 150,145 54.02 45.98 The proportion of deaths would be as 1,000 males to 919 females, or a difference of 81 ; which corresponds tolerably well with similar observations made in different countries,—the difference in some cases being somewhat over, and in others below, that observed in the United States. This excess of male over female deaths is of almost universal occur- rence. The returns of some of the States, however, show nearly an equal number of deaths for each sex, or, as in the case of New Hampshire and Vermont, a preponderance of female deaths over those of the male sex. In the former of these States the aggregate number of deaths was 4,231, of which 2,038 were males and 2,193 females, and in the latter 3,129, of which 1,534 were males and 1,595 females. The returns of Massachusetts give an aggregate of 19,404 deaths, with a preponderance of male deaths. The registration report increases the number for 1849 to 20,423, of which 10,019 were males, 10,208 females, and 196 of unknown sex. The report, in commenting upon this peculiar fact, states: "We hear notice that a majority among the deaths are females. This is true in reference to the mortality of the whole State. In the country districts alone, however, the preponderance of female mortality is so much greater than it is in the whole State, that it casts the balance on the other side in the cities. If we knew the per cent which the number among the living of each sex bears to the other, in the cities and in the country, this might perhaps be accounted for in part, or in whole. It is to be presumed, that the female sex predominates in the State, and to a IN DIFFERENT STATES. 109 greater degree in the country than in the city. This is to be inferred from the fact, that although in 1849, among the births 52.06 per cent, were males, and 47.94 per cent, females, in the State, among the deaths under five years of age 53.82 per cent, were males, and 46.18 only were females; and that more males than females resort from the country to the city as resi- dents, while the proportion of the sexes, between those who leave the State and those who enter it, is probably such as to produce no great effect in this particular."* In the accompanying table the deaths which occurred under five years of age, and the aggregate for 1849, are so placed as to show the relative proportion of those who died under five years, and their sex, from which it would appear that although the whole number of deaths of all ages in- cluded a greater number of females than males, yet among those which took place in the first five years, the excess was among the males in the propor- tion, for the whole State, 53.82 per cent, to 46.18 of female deaths :— Localities, Births. Deaths under Five Years. Whole Number of Deaths. Number, Proportion. Number. Proportion. Number. Proportion. M. | F. M. F. M. F. M. F. M. F. M. F. State,............ 13,329 112.273 52.06 51.14 52.70 47.94 48.86 47.30 4169 2117 2052 3577 1875 1702 53.82 53.03 54.66 46.18 40.97 45.34 10,019 4710 5309 10,208 4617 5591 49.53 50.50 48.70 50.47 5344 7985 5106 7167 49.50 51.30 " This abstract shows that the great excess of male mortality occurs in the earlier ages. Had we taken these who died under one year old, the ex- cess would have been still greater. The disparity will be seen as follows:— State. City. Country. Number. Proportion. Number. Proportion. Number. Proportion. Deaths under one year of age, } Females,.... 1994 1558 66.13 43.87 996 810 55.14 44.86 998 57.16 748 ! 42.84 436 12.26 186 10.28 250 14.32 * 8th Registration Report for Massachusetts, p. 109. 110 MALE AND FEMALE MORTALITY " The excess of males was, in every 10,000— Births. In the whole State,........' 412 In the Cities,.............. 228 In the Country,......,..... 540 Deaths under Deaths under Total of one year. five years. . Deaths. 1226 764 — 94* 1028 606 100 1432 932 —260* " There are various causes of death which press with unequal force upon the sexes. Those which seem to be the severest upon the male, are dis- eases of brain, except insanity; diseases of the lungs, except consumption ; diseases of the heart, liver, most forms of fever, and the various causes of death, by violence. The mortuary tables of the last and former years also indicate quite clearly that those diseases which are more or less peculiar to the young, such as cholera infantum, croup, hydrocephalus or water on the brain, infantile diseases, and ulceration or canker, select a major part of their victims from among the male population. The majority of deaths from cholera were males, while those from dysentery and typhus were nearly equal as to sexes, "f The annexed table, which exhibits the relative proportion of the sexes at all ages for the year included in the estimate of deaths as given above, will enable a comparison to be instituted into the relative number of the living and the dead :— Ages. Females to 100 Males. Ages. Females to loo Males. Under 1, ..... 50 to 60, . 110.4 1 to 5, 98.2 60 to 70, . 118.3 5 to 10, . 99.1 70 to 80, . 128.5 10 to 15, . 97.7 80 to 90, . 146.4 15 to 20, . 114.0 90 to 100, . 199.4 20 to 30, . 106.4 100 and over, . 225.0 30 to 40, . 96.5 Unknown, 17.4 40 to 50, 99.8 * Excess of Females , Ibid. p. 110. IN DIFFERENT COUNTRIES. Ill Of all the 994,514 inhabitants of Massachusetts in 1850, 505,997 were females, and 488,517 males, being an excess of 17,480 females over males. The population of the District of Columbia consists of 18,494 males, and 19,447 females, or an excess of 953 females. The deaths which oc- curred in 1849, as taken from the Census Returns, were 846, of which 427 were males, and 419 females. For the purpose of enabling a more general comparison to be made, a table is presented containing a summary view of the progress of population in the Kingdom of Wurtemberg, which, like Massachusetts and the District of Columbia, contains a larger female than male population :— WUKTEMBERG.* Population. Deaths. Year. Males. Females. Total. Males. Females. 1833, 773,561 813,887 1,587,448 20,428 26,066 1834, 776,965 816,102 1,593,067 36,451 35,252 1835, 786,619 825,180 1,611,799 25,660 45,505 1836, 793,973 832,692 1,626,665 28,481 26,663 1837, 798,259 836,264 1,634,523 31,309 30,402 1838, 806,311 843,528 1,649,839 28,885 27,540 1839, 815,057 851,342 1,666,399 27,151 26,327 1840, 824,457 858,711 1,683,168 26,883 26,216 1841, 831,656 865,560 1,697,216 29,763 28,598 1842, 840,339 873,179 1,713,518 29,895 28,976 It will be seen, by an examination of these returns, that notwithstand- ing the fact that in Wurtemberg the female preponderates over the male sex, yet the largest number of deaths uniformly occur among the male por- tion of the population. From these comparisons it would appear that in Massachusetts, and in all probability in the contiguous States, a different rate of mortality affect- ing the relative proportion of male and female deaths occurs, from that * Count Beroldigen." 112 MALE AND FEMALE MORTALITY which is presented by the returns of the District of Columbia and the Kingdom of Wurtemberg, and which by comparison would probably be found more extensively to prevail. If no further data were offered, than that of the record of the deaths for 1849, it might reasonably be inferred that the enumeration was erro- neous and unworthy of credit; but the additional evidence furnished by the consecutive registration returns of twelve years, places this question beyond the possibility of a doubt. These returns invariably show that more female than male deaths occur in each successive year—thus of the 20,301 regis- tered in 1853, 7,942 were males, 10,201 females, and 149 of unknown sex, being a preponderance of 268 female deaths. An abstract of the deaths of five years, including 1849, already alluded to, and 1853 just noticed, shows that of 92,174 deaths, the sexes of which were known, 45,855 were males, and 46,319 females. Now, the uniformity of these results is too exact, and the period of time covered by the observations too extensive to admit of any doubt as to their correctness, and it remains to be seen upon what principle this apparent disparity can be reconciled. Mr. Shattuck has constructed a table for two years, which so admirably demonstrates this disparity, that it is inserted without comment:— To every 10,000 Males there were Females. Showing a difference op Born. Died. In 1844 .................... 9,508 9,744 11,241 10,978 1,733 1,234 1845..................... "It maybe asked," he remarks, "what becomes of this difference? The answer is principally to be. found in the greater number of males than IN DIFFERENT COUNTRIES. 113 females, which the State furnishes to people other parts of the Union, and to traverse the world. From the census of New York city, just published, it appears that 16,006 of its inhabitants were born in New England, and throughout all the Western States New England men are found. It would be an exceedingly interesting enquiry, how many emigrants have been fur- nished each year by Massachusetts. And if a good system of registration had been in operation, we should have been able to show how many have gone hence to spread the wholesome influence of the land of their birth in other States and Qther regions. If every 10,000 births furnish 1,250 emigrants, the 25,000 births which have been estimated to take place in the State annually would furnish over 3,000 to spend the remainder of their lives in other lands than that of their nativity."* The census for 1850 gives the birth-place of each white inhabitant of the United States, so far as they could be ascertained ; and that they have been arrived at with tolerable correctness is evidenced by the fact, that of 19,987,563 inhabitants, the places of birth of all except 39,146 are given. born in Massa- 894,818 695,236 199,582 11,366 16,535 18,495 11,888 15,059 ------- 73,343 In other States and Territories, . . . . . 126,239 * Letter of Mr. Shuttuek to the Secretary of State of Massachusetts, p. 81. 14 Of these, the whole number of persons chusetts is, .... . Residing in " " in other States, Of which there are in Connecticut, . " " " " Maine, " " " " New Hampshire, . " " Rhode Island, " " " " Vermont, f 14 EFFECT OF MIGRATION From these statistics, as well as those already given, it is evident that the population of Massachusetts has been affected in the most serious manner by the extensive emigration and immigration to which it has been subjected. There is probably not to be found upon record an instance of a population in which these two causes have so effectually combined to change the population of an entire State as that of the one under con- sideration. It is true, that in many of the States of the Union there exists a greater relative proportion of persons of foreign birth, than in that of Mas- sachusetts, as in Wisconsin, where the number of these is 34.94 per cent., or in California, where it reaches 24.15, or in the older State of New York, where it amounts to 21.04 of the whole population, instead of 16.18 per cent., as in the case of Massachusetts. But notwithstanding the immense emigration from New York, which has gone to swell the populations of Ohio, Michigan, Wisconsin, Indiana, Illinois, and the other free States in the valley of the Mississippi, or that from Virginia and North Carolina which has gone to people the new slave States of the Union, and which in many instances exceeds in relative proportion that of the emigration from Massachusetts, yet in no one has the combined effect of the emigration and immigration produced such palpable results in this latter State. How many natives of Massachusetts, in quest of a new home were males, and how many females, there is no means of determining. It is highly probable that many of those who changed their residence for that of neighboring States either went in families, or returned after a period to bring with them a partner who had engaged their affections before their migrations. Of these, the relative proportion of the sexes would doubtless be the same as was to be found in the State from which they emigrated. Aniono- those who selected for themselves a residence in States more remote from that of their birth, the proportion of males was doubtless greater than ON MASSACHUSETTS. 115 that of females, because the occupations and habits of life of the former fit them for more extensive migration than the latter, who for the most part are found to change their abode under the auspices of their male relatives, either as parents or husbands. Judging from the large number of marriages which occur among the residents of different States, as shown by the census returns for 1850, it is probable that comparatively few who were unmarried when they left home and made their residence in a remote State, ever returned to marry, and hence as the emigration from, is greater than the emigration to, most of the New England States, and doubtless embraces a larger proportion of males than females, the native female population must necessarily be in the ascendant. Now, what effect these circumstances have upon the direct question at issue, the relative proportion of deaths among the two sexes, as made manifest by the returns of Massachusetts, is left for each to determine for himself. It may be proper to state, that although no entire registration district in England exhibits a larger proportion of female than male deaths, yet single counties, in rural districts, as Northamptonshire and Bedford- shire, among the South Midland Counties; Suffolk, among the Eastern; Wiltshire and Dorsetshire, among the Southwestcvn ; and North Riding, in Yorkshire, are among those whose female deaths are more numerous than males. The Austrian Provinces of Illyria Corinthia, and Illyria Carniolia, as well as the Prussian Province of Westphalia, likewise show an excess of female deaths. This excess of female mortality, wherever it exists, is exclusively confined to rural populations. The returns from all populous places, in the United States, show, that large towns are more inimical to male than female life, and that the proportion of deaths to the living of each sex among males is greater than among females. In this respect the New England States, 116 COMPARATIVE MORTALITY where an excess of female mortality alone is found, do not form an excep- tion to the general rule. Another enquiry of equal importance with the one just discussed, is the relative proportion of mortality between the two sexes at different periods of life, for the purpose of elucidating which the following table is intro- duced, giving the number of males and females who died at each age throughout the United States, as returned by the census of 1850 : Under 1, 1 and under 5, 5 u " 10, 10 a " 20, 20 a " 50, 50 u " 80, 80 u " 100, 100 and over, Totals, .... 172,800 150,045 Although this table is freely admitted not to contain all the deaths which took place in the United States for one year, yet it is presumed to give a tolerably accurate account of those which come within the range of its observation. The omission is a general one, affecting some portions of the country more, and others less, as the marshals were more or less fortu- nate in procuring answers to their enquiries, or zealous in prosecuting them ; but in no instance have the whole number of deaths which took place in an entire State been included in their reports. The relative division of deaths into male and female, and their distribution among the respective ages, with the exception, perhaps, of those which took place in the earlier years, correspond so well with the observations made by the registers of the States where notice is taken of the deaths which occur among the rural population Males. Female* 29,569 24,696 36,349 32,364 11,549 10,172 13,760 14,485 48,773 41,734 26,511 20,840 5,152 5,020 173 190 AT DIFFERENT AGES. 117 and with those of other countries, as to lead to the belief, that they were returned, with tolerable accuracy, to the census bureau at Washington. This table shows, in the aggregate, a preponderance of male over female deaths, in each period of life included, except that from ten to twenty years of age, in which the excess shifts to the female side of the table, to return again to the male side at the next period of life, which unfortunately embraces a stretch of thirty years, from twenty to fifty, in the early part of which, if a division had been made, it would have been seen "that the female deaths were more numerous than the male. Mr. Quetelet has given a table of the proportion of male and female deaths at different ages, for the town and country of Belgium, from which it appears that for every female death, there occurs the following propor- tions of male deaths, at the ages respectively named :— Age. City. County. 1 to 2 years, 1.06 0.97 14 to 18 " . 0.82 0.75 21 to 26 " . . 1.24 1.11 26 to 30 " . . 1.00 0.86 30 to 40 " . ■ 0.88 0.63 40 to 50 " , . 1.02 0.83 50 to 60 " • 1.07 1.18 60 to 70 " . 0.96 1.05 70 to 80 " . . 0.77 1.00 80 to 100, . 0.68 0.92 From this it appears that at about two years the deaths in the two sexes are nearly equal; between the ages of 14 and 15, which is the period of puberty, the female deaths preponderate. Between those of 21 and 26 the male deaths are in the ascendant, from 30 to 40 the excess of mortality shifts again to the female side, and continues with them during the period of procreation. * Ouetixet, Sur L'Homme, vol. 1, p. 167. 118 MALE AND FEMALE MORTALITY L'influence des sexes est extremement prononcee dans tout ce qui con- cerne les deces; deja meme elle se fait ressentir avant que l'enfant ait pu voir le jour. Pendant les quatre annees de 1827 a 1830, on a compte dans Flandre occidentale 2597 morts-nes, dont 1517 de sexe masculin et 1080 du sexe feminin ; ce qui donne un rapport de 3 a 2 environ. Cette difference est considerable, et comme elle se reproduit dans les tableaux de chaque annee, elle doit etre attribute a une cause speciale. Du reste, cette mortalite n'affecte pas seulement les enfants males avant leur naissance, mais encore a peu pres pendant les dix ou douze premiers mois qui la suivent, c'est-a-dire a peu pres pendant le temps de rallaitenient.* During the decennial period from 1828 to 1837, the number of deaths in the Kingdom of Sardinia was ..... 1,203,250 of which . . . 603,185 were males and . . . 600,065 " females, being in the neighborhood of 195 males to 194 females, or in the propor- tion of 100, 52 of the former to 100 of the latter. " II sesso maschile par dunque predominare nelle morti come nelle na- scite, ma in ragion di gran lunga minore ; onde la popolazione maschile dello Stato viene crescendo con progrcssione piu rapida che la popolazione femminile; avremo anzi opportunita di vedere in altro luogo che, mentre ne' primi anni del decennio che consideriamo la popolazione femminile eccedeva la popolazione maschile negli Stati di S. M., il contrario avviene dal 1832 a questa parte; tuttavia si dee osservare, che le emigrazioni assai piu frequenti negli uomini che nelle donne, col diminuire il numero delle morti maschili avvenute in patria fan pur comparire minore del vero la ra- gione de' maschi a quella delle femmine nelle morti. " Questo fatto del predominio delle morti maschili non e ne eguale, n6 * Quetelet, Sur L'Homme, vol. 1, p. 163. IN DIFFERENT COUNTRIES. 119 costante in tutte le divisioni; esso ha luogo con diversa proporzione nelle quattro Divisioni che seguono, nelle quali si trovano : Moit. Divisioni. Maschi per 100 Femmine. Torino,........101 12 Alessandria,.......102 89 Aosta,........101 97 Nizza,........100 85 Nelle altre quattro divisioni succede il contrario, e si hanno : Morti. Divisioni. Maschi per 100 Femmine. Savoja,........98 22 Cuneo,........99 95 Novara,........99 98 Genova,........99 95. " Queste differenze cosi leggieri, ed ora in un senso, ora nell'altro, par che debbano attribuirsi acagioni accidentali, anziche aniuna legge costante come quella che si osserva nelle nascite. Ne si puo dire che la mortalita di ciascun sesso segua la ragione della rispettiva popolazione; poiche se cosi e infatti per le Divisioni di Savoja, Torino, Cuneo ed Alessandria, il contra- rio succede in quelle di No vara e di Genova, nelle quali muojono piu nu- merosamente, ed in quelle di Aosta e di Nizza, nelle quali muorono piu uomini, abbenche in esse il numero delle donne sia il maggiore. In gene- rale la ragione de' due sessi nelle morti dipende dalla ragion loro nella po- polazione, della legge di mortalita per eta che a ciascuno compete, dal nu- mero delle emigrazioni e delle immigrazieni, e daU'eta cui queste sogliono aver luogo. "Havvi tra le citta e le campagne una sensibile differenza nella ragion de' sessi nelle morti, essendo maggiore nelle prime la mortalita degli uomi- 120 MALE AND FEMALE MORTALITY ni, nelle ultime la mortalita delle donne. Fanno tuttavia eccezione le citta di Torino e di Genova, nelle quali le morti femminili di gran lunga supera- no le maschili, tuttoche in entrambe queste citta la popolazione maschile (comprendendo in essa la truppa di guarnigione, e per Genova la popola- zione del porto) grandemente superi la popolazione femminile; infatti m Torino la prima sta alia seconda come 128 al 100. Ecco le tavole su cui le precedenti osservazioni sono fondate : Morti. Maschi per 100 Femmine. Ne' Communi Kurali,.....99 74 Nelle cittti in complesso, ..... 104 87 A Torino,........94 13 A Genova,........95 66. * It thus appears, from the observations deduced by M. Quetelet, from the eastern portion of Flanders, that during the four years intervening between 1827 and 1830, the number of male still-born, as well as those who died in early life, was largely in advance of the female mortality. The female mortality, indeed, does not, according to the facts deduced by this distinguished authority, begin to approach that of the male until the age of fourteen, and is not in the ascendant prior to the age of from twenty-six to thirty. Although the observations made by the Royal Commission of Sardinia, just quoted, do not give the relative proportion of male and female deaths at particular ages, they yet furnish some valuable information in relation to the number of deaths in different places, from which it appears that while in SQme places, as in Turin and Alexandria, the female deaths were in the ascendant; in others, as Genoa, and Savoy, they predominated on the side of the males. The proportion of male and female deaths, in town and * Inform. Statis. dalla R, Comm. Sup., Torino, 1843 ; Movito. della Pope., p. 664. IN DIFFERENT COUNTRIES. 121 country, in Sardinia, appears to be particularly marked, being in the pro- portion of 99 males to 100 females, in rural districts, while it reaches 104 males to 100 females, in town. In this respect these observations corres- pond with those made in different parts of the United States, as well as the more northern countries of Europe. The annexed table of deaths demonstrates that although the excess of mortality, in Massachusetts, is uniformly on the female side, yet during the early period of life, it is largely on that of the male :— Years. 1852, u il 1853, u u 1854, u a 1855, n u Sex. Males, Females, Unknown, Totais, Males, Females, Unknown, Totals, Males, Females, Unknown, Totals, Males, Females, Unknown, Totals, Total. 8,978 9,396 108 18,482 9,942 10,210 149 20,301 10,710 10,558 146 21,414 10,285 10,386 127 20,798 39,915 40,550 530 80,995 Under 1. 2,026 1,641 83 3,750 2,248 1,807 120 4,175 2,321 1,786 81 4,188 2,416 1,937 89 4,442 9,011 7,171 373 16,555 Under 5. 3,719 3,101 94 6,914 4,192 3,595 125 7,912 4,337 3,637 105 8,079 4,267 3,694 106 8,067 16,515 14,027 430 31,072 20 to 30. 808 1,285 2,093 976 1,307 2,283 1,109 1,493 2,602 550 705 1,261 3,443 4,790 8,233 All othera. 4,451 5,010 14 9,475 4,774 5,308 24 10,106 5,264 5,428 41 10,733 5,462 5,987 21 11,470 19,951 21,733 100 41,78 Aggregate, Males, Females, " Unknown, Totals, 15 122 MALE AND FEMALE MORTALITY The general experience of Life Assurance Companies, in Europe and in this country, is in exact correspondence with the results of the above table, and there seems to be no reason why the law of mortality in this regard should not correspond in the United States with that found to obtain in different European States. The experience of the Gotha Bank, in Germany, is pertinent to this subject :— " Another feature which appears to characterise the class of persons who insure their lives, and results from Mr. Hopf's analysis of the Gotha statistics, is the much greater mortality of women at the earlier periods of life ; in mixed populations, the reverse holds good. Thus, in the quinquen- nial periods, 26 to 30, 31 to 35, 36 to 40, the mortality of men is respectively 0.77, 0.88, and 0.98 per cent, while that of women at the same periods of life is 1.66, 1.79, 1.92. After 40, the difference ceases, and at the most advanced periods the females acquire an advantage over males. The Gotha Bank do not insure pregnant women, nor have they ever succeeded in determining a case of fraud on the part of a female; and yet, as the author observes, the numbers before us clearly prove that 'females understood better than males to gain advantage in the assurance.' The following is his explanation of the fact:— ' 1 think we must seek the principal cause of it in the circumstance that women, from the greater haslifulness peculiar to their sex, frequently do not communicate all their bodily infirmities and irregularities to their physicians, much less to others, and feel themselves much less under obligation to give notice to the assurance office of what they consider then' own secret respecting the condition of their hody.' And again :— ' There is no doubt that a greater proportion of females who assure their lives at the younger years, die early. The deviation is too significant and too constant to be considered accidental. We are not able to explain it by any other supposition IN DIFFERENT COUNTRIES. 123 than by the circumstance that women feel internal hidden infirmities and defects in a higher degree than men, and have a presentiment of approaching danger in conse- quence of them, which impels them to assure their lives, or that they understand better and more skilfully than men to hide the true state of their health, and to deceive by it even their medical men.' " It is, however, to be observed that the greater mortality of females below the age of forty does not apply in England, where the mor- tality of the two sexes is equal at that period of life. Our own experience would tend to show that this great mortality among females before the climacteric, in Germany, is due rather to the greater fatality in childbirth, than to the hidden defects adverted to. We throw this out merely as an impression obtained by inspecting numerous returns of foreign agencies, than as a fact, since nothing but the comparison of extended statistics can serve to determine such a question. We should have no difficulty in accounting for the circumstance, if proved to be based in truth, from the much more frequent employment of midwives during labor, in Germany, even among the higher classes, than among ourselves. " We pointed out at the commencement of our remarks on the subject of life insurance, that insurers, as a class, present a much more favorable average duration of life than their uninsured compatriots. This, however, would not be the case, were it not for the surveillance exercised by the police of the insurance companies—their medical officers. " Persons who feel the taint of any disease that may sap their vital power, are even more likely than others to insure their lives, in order to secure a provision for their wives and children. Were they admitted at the ordinary rates, the favorable averages spoken of as peculiar to the insured would soon be reduced below the average of the general population. It can only be by careful and conscientious appreciation of all the injurious influences to which mankind are subjected, and by a deliberate weighing of 124 COMPARISON BETWEEN the circumstantial as well as the direct evidence bearing upon the health of an individual, that a medical examiner to an insurance company can completely fulfil the duties of his post. He has to guard against nervous anxiety in watching over the interests of his company, quite as much as against a laxity in examining the applicants for the benefits of the institu- tion. The shock to a person in average health on being declined on the ground of some imaginary predisposition, and the injury inflicted upon him by thus refusing him the benefits of assurance, not easily obtained elsewhere when once refused, are matters for the serious consideration of the medical officer of an insurance company.* The annexed table, prepared by Mr. Kennedy, late Superintendent of the Census Bureau, showing the per cent, of mortality in Massachusetts, Maryland, and England, among male and females, at each age, likewise illustrates this point:—Before introducing it, however, it may be proper to state, that as the officer upon whom the arrangement of the details of the census devolved, Mr. Kennedy bestowed much labor to perfect this new but important branch of statistical inquiry, and had the answers corres- ponded with the instructions in point of exactness, the information would have been everything that could be desired. Unfortunately, however, neither in the returns made by the marshals, nor in their collation after- wards, was the same care taken, as in the preparation of the forms adopted for their guidance. Nor is either he or Mr. De Bow to blame for the meagerness of the medical statistics which Congress felt so little interest in, as to order their publication after a tardy delay, on the sole condition of not exceeding 400 pages, instead of the elegant form originally contemplated by the officers in charge of the census office. * British and Foreign Medico-Chirurgical Review, No. 35, p. 112. MASSACHUSETTS AND MARYLAND. 125 ANNUAL DEATHS PEK CENT—1850. Massachusetts. Maryland. England—1841. Ages. Males. Females. Males. Females. Males. Females. 0 to 5........... 7.105 1.168 0.452 0.572 0.998 1.253 1.513 2.067 3.482 6.767 15.000 35.240 6.052 0.983 0.573 0.831 1.170 1.346 1.325 1.654 2.960 5.762 13.470 27 540 5.466 1.041 0.477 0.605 0.896 0.991 1.884 2.433 3.405 8.977 15.157 31.132 4.875 0.855 0.606 0.757 0.938 1.146 1.249 1.712 3.285 7.221 12.280 23.430 6.838 0.955 0.509 0.718 0.949 1.080 1.410 2.230 4.232 9.150 19.850 37.390 5.860 5 to 10............ 0.922 10 to 15............ 0.542 15 to 20............ 0.801 20 to 30............ 0.942 30 to 40............ 1.121 40 to 50............ 1.308 50 to 60............ 1.938 60 to 70............ 3.761 7o to 80............ 8.378 80 to 90............ 18.850 90 to 100............ 34.570 The mortality returns of many of the States would appear to indicate that a difference exists between the northern and southern States, in regard to the relative mortality of the sexes in the middle period of life, from thirty to forty, and that the relative proportion of female deaths to those of males, was greater at this particular period in warm than in cold climates. The facts are not sufficiently numerous or well defined, to give anything beyond a mere shadow to this suggestion; but if, hereafter, under a more careful collection and analysis of facts it assumes a visible and substantial shape, it will furnish the starting point for many curious speculations which naturally suggest themselves to the mind upon its mere supposition. Dr. Sutton, in order to exhibit the force of mortality upon the sexes, at different ages, formed a table, showing the number of persons of different sexes living in Kentucky, in each period of life, as designated by the census for 1850, together with the number of deaths, and the proportion of deaths to those of living at the periods given, as taken from the State Registration Returns for 1853. MALE AND FEMALE .MORTALITY Ages. Number ok Living. NUMIIKR ok Deaths. Deaths to Living 1 to A, Males. Females. Males. Females. Males. Females. Under 1 year, . 15,749 15,014 1,112 845 14.16 18.00 1 to 5, 71,938 65,981 974 867 73.85 76.10 5 to 10, . 77,138 74,7S1 371 341 207.96 219.30 10 to 15, . 77,713 65,196 224 236 316.93 275.88 15 to 20, . 54,881 55,957 250 306 219.12 182.86 20 to 30, . 89,336 82,782 507 620 176.20 133.52 30 to 40, . 56,162 49,648 240 389 234.00 127.37 40 to 50, . 35,567 33,011 224 263 159.22 125.52 50 to 60, . 21,197 19,567 188 22!) 112.75 85.44 60 to 70, 11,058 11,173 189 164 58.56 68.13 70 to 80, . 4,793 4,689 165 148 29.05 31.68 80 and over, 1,766 1,873 116 94 15.22 19.91 This table is best explained by the constructor of it, who remarks:— " By examining this table closely, it will be observed that for the first six periods, the totals of deaths are greater than the sums of males and females. This is caused by there being one or more deaths at those ages in which the sex is not stated. In the census are a certain number of per- sons whose ages are unknown; and the same is true of the persons who have died; but no connection is presumed to exist between those thus re- turned in the census and in the assessor's book, for which reason they are both omitted in this table. " This table shows an awful mortality during the first years of life—no i less than one in 15.64 (or 6 per cent, of all children born,) dying within the first year. If we reflect, too, that, of necessity, there must have been many deaths which were not returned by the assessors; and again, that these infants were more likely to be forgotten than older persons, we shall be satisfied that this mortality, great as it appears, is yet far short of the truth. We must observe, too, that in every 100 dying during the first year, about 57 are males and 43 females. After the first year AT DIFFERENT AGES. 127 the ' value' or ' expectation' of life is much greater. Thus, more died during the first year than during the next four. Doubtless the chances in- crease as the time from birth increases ; so that during the second period of four years, only one in 74.70 died; and the male excess is greatly reduced. During the third period, from 5 to 10, the chances of life have trebled from what they were during the second—the male excess rather increased. The fourth period, from 10 to 15, shows the greatest expectation of life—only one dying in 310. Here the chances of life have shifted, and the excess of mortality is among the females. From this time, the expectation of life gradually declines; until after the eightieth year, it is reduced to about what it was during the first year. The excess of mortality, too, continues with the females, until the tenth period, from 60 to 70, when it again re- turns to the males, and there continues to the end of the list. " Since constructing the foregoing table, and writing the comments on it, I have examined carefully a similar table prepared by the Registrar- General of England, and find that his table corroborates surprisingly both the general correctness of my table, in early life, and the remark made as to the number of infants whose deaths have been omitted. From that table, it appears that instead of one child dying under one year in every 16 born, or 6 per cent, in England, 20.51 per cent, males, and 15.44 per cent, females die within the first year; thus demonstrating the enormous mortality of that period; and by legitimate inference, the great number of deaths among infants which are not returned in our report. " In his table, as in mine, from births to the period " 10 to 15,' the excess of mortality remains with the males. In 10 to 15, and up to 30 to 40,' there is a very slight excess of male deaths; and through all succeed- ing periods, the excess remains with the males, and increases as age advances. Whether more extended observations will show an approxima- 128 MORTALITY STATISTICS COMPARED. tion of the proportion of ages and sexes to the English tables, we must leave for time to determine. " I have looked into the relative mortality of the two races in early life, and find that of the 3,812 which are returned as having died under 5 years, 2,674 were whites, being one in 284 of the white population, and 1.138 were colored, being one for every 195 of the colored population." ' The remarks which preceded Dr. Sutton's table, relative to the mor- tality of the two sexes, at the middle period of life, is not only corroborated by it, but extended beyond to a point which it is thought will not be sustained by more general observations. A comparison of the Swedish and Montpellier mortality tables will show that the difference in the relative mortality of the two sexes at this particu- lar epoch of life, which has just been alluded to, as a possible characteristic feature of northern and southern mortality in the United States, also exists in the northern and southern counties of Europe, so far as these tables are an indication of the value of life among their respective populations. The importance to be attached to these comparisons, between male and female life, cannot well be over-estimated, because it will be found that in proportion as the expectation of life increases in value, in like manner will the proportion of deaths between the sexes assimilate more closely to each other. Whatever cause tends to disturb these relations, as the hazards of early infancy, or the epidemics which prove fatal to later years, or the change of habit from a rural to city life, operates directly in abridging the span of human existence. A population whose aggregate age at death is large, is uniformly a population in which the relative number of deaths among each sex, in proportion to the living of that sex, does not differ materially ; on the other hand, a population which presents a low aggregate age at death, is one which exhibits a great disparity in the deaths of the different sexes. * 2d Kentucky Registration Report, p. 126-7. INFLUENCE OF LOCALITY. L29 CHAPTER XI. LOCAL INFLUENCES. The influence of locality in determining the rate of mortality, is made quite manifest by a comparison of the various registers kept in different places, and indeed is perceptible to most persons without this comparison. The various natural divisions of country into sea-shore and inland regions, extended plains and mountain elevations, fruitful valleys and rugged preci- pices, have each a very manifest influence over the health of those who in- habit them. Nor are those geological formations which divide the surface into alluvial and sandy regions, and scatter immediately beneath the soil which reposes upon them limestone, granite, sandstone, and other rocks, giving a whole belt of country to the one formation, and another belt to another, less potent in the development of the diseases peculiar to each, and which constitute the chief outlets of life. But apart from these natural causes which are incident to each parti- cular locality, and which spring from the surface of the earth, is that more potent one of climate, which often modifies those causes that give character to each especial district, and assigns to each latitude its particular type of disease. Hence the inhabitants of so vast a country as that of the United States, which embraces almost every variety of natural division and geological for- 16 130 INFLUENCE OF LOCALITY mation, and, although possessed of a temperate climate, is yet subjected upon its southern and northern limits, in a modified degree, to the influences of a tropical and frigid one, are, as may well be supposed, subject to a great variety of influences, which operate in determining the rate of mor- tality, and fixing the relative value of life. It is evident that these are not always the same, nor are they amenable to the same laws; and any standard of comparison which would assign a fixed rate of mortality to the whole United States must necessarily be de- fective and unreliable. It might reasonably be expected that in each great division of country the period of life upon which death made its heaviest demand, after the passage of the infantile one, would be. different; and indeed in infancy and the earliest years of childhood, the same result, in a more modified degree, might be expected. Among the diseases of maturer years, and especially those which fall with most intensity upon middle life, many are confined to certain well defined geographical limits, beyond which they rarely extend, so as to form a characteristic feature in the mortality of those localities placed beyond their confines. Thus the intense autumnal fever, with its biliary complications and con- gestive type which prevails along the southern tier of States, and gradually loses its characteristics and intensity as it extends northward, is never seen in the New England States, or in those which skirt the Canadian border. Nor is the typhoid fever, which prevails in the northern States, especially in cool weather, a frequent visitor to the warm latitudes of Georgia and Alabama. Both of these are so modified by a change of climate, as to develope themselves in an altered form, in the latitudes which intervene between these two extremes. Exposure to cold, which in a northern latitude would develope itself in inflammatory affections, intense in degree, but pure and UPON THE RATE OF MORTALITY. 131 simple in character, in a southern one, give rise to complications which seriously alter its character, and affect its mode of treatment and pro- bable result. An inflammation of the lungs or their investure, which in a northern latitude would constitute a simple pneumonia or pleurisy, as far south as Virginia, would become complicated with an affection of liver, giving rise to bilious pneumonia or pleurisy, which is a much more serious disease, and requires a different mode of treatment. These examples are sufficient to show the influence of climate and loca- lity in the development of diseases, and in the modification of the same disease, and naturally lead to the expectation that as the causes which operate in each are not always the same, and the circumstances under which disease is manifested are diverse, so the results as developed in the demand upon life, would be different A striking evidence of the effect of locality and climate, in affecting the rate of mortality, is presented by the returns of the British army, whose duties, in guarding the immense possessions of that government, have made them the inhabitants of every variety of climate. The annexed table of the annual average mortality among the troops of this kingdom, is given upon the authority of Dr. Balfour, at the time Assistant-Surgeon to the Madras army :— AVERAGE ANNUAL MORTALITY OF TROOPS AT DIFFERENT STATIONS, NATIVES OF BRITISH ISLANDS. . ,. ., Annual mortality Station. Authority. per 1,000 troopl New South Wales, . . . Marshall, 14.1 Cape of Good Hope, . . Reports, 15.5 Nova Scotia, .... " 18.0 Malta,..... " 18-7 Canada,..... " 20.0 Gibraltar, .... " 22,1 Ionian Islands, .... 28.3 132 STATISTICS OF THE ENGLISH Station. Authority. AllftiliU JI1LT1 per 1,000 ti Mauritius, .... Reports, 30.5 Bermuda, .... u 32.3 St. Helena, .... u 35.0 Tenasserium Provinces, a 50.0 Madras Presidency, . Quetelet, 52.0 Bombay,..... a 55.0 Ceylon, .... Reports, 57.2 Bengal,..... Quetelet, 63.0 Windward and Leeward Command, Reports, 85.0 Jamaica,..... u 143.0 Bahmas, .... u 200.0 Sierra Leone, .... cc 483.0* It must be borne in mind that these troops were natives of the British islands, and consequently exhibited a much higher rate of mortality than the natives of the respective countries in which they were stationed; yet with this reservation, the table demonstrates most emphatically the effect of climate upon general mortality. The difference in the rate of mor- tality between native and foreign troops is shown by the annexed table, exhibiting the mortality of troops serving in their native countries. Thus among— British regiments at home, Maltese at Malta, .... Hottentot corps in Africa, Native Bengal army, .... Native Madras army, . Native Ceylon army, .... Annual average of native troops per 1,000, Mortality per 1,000. 15.9 9.0 12.5 13.0 15.0 25.8 15.2 * Journal London Statistical Society, vol. 8, p. 195. AND AMERICAN ARMIES. 133 The annexed extract from the statistical report of the sickness and mortality of the United States Army, is introduced to develope the same proposition :— Regions. Coast of New England,............... Harbor of New York, ..............., West Point........................ North Interior, East.................. The Great Lakes..................... North Interior, West................. Middle Atlantic...................... Middle Interior, East,................ Newport Barracks, Kentucky, ...,..... Jefferson Barracks and St. Louis Arsenal Middle Interior, West,................ South Atlantic, .......,............. South Interior, East,................. South Interior, West................. Atlantic Coast of Florida,............. Gulf Coast of Florida................. Texas, Southern Frontier,............. Texas, Western Frontier,............. New Mexico,........................ California, Southern,................. California, Northern,................. Oregon and Washington,.............. Mean strength. 3,963 9,387 6,901 3,553 10,346 7,230 6,299 2,456 1,454 5,580 5,319 2,800 5,919 10,013 835 2,299 4,450 6,324 5,873 1,707 1,599 1,831 Number treated. Deaths. 6,935 36 31,397 183 31,635 28 6,426 39 22,784 140 16,707 77 14,262 117 6,373 36 3,670 59 19,587 263 20,804 107 6,870 58 17,426 234 35,312 228 2,408 21 10,262 70 15,693 235 23 051 174 11,738 139 3,200 30 5,420 70 4,253 29 RATIO PER 1,000 OF MEAN STRENGTH, 1,749 3,345 4,584 1,808 2,202 2,310 2,264 2,594 2,524 3,510 3.911 2,453 2,944 3,531 2 883 4,463 3,526 3,645 1,999 1,874 3,389 2,322 9.0 19.5 4.0--- 10.9 13.5 10.6 18.5 14.6 40.5 47.0 20-0 20.7 39.5-" 22.7 25.0 30.4 52.8-~ 27.5 23.6 17.5 43.7 15.8* Neither of the results obtained by the returns given above, are to be taken as a standard by which to measure the relative value of life among the resident populations of the locality where the observations were made, because in addition to the circumstance that the life of a soldier is exposed to influences peculiar to itself, all of those noticed in the British army, and the portion of those in the United States who were stationed at southern posts, resided in climates to which they were strangers, and in which they were subject to influences not felt by the native residents. It has been seen that the relative annual mortality of the different countries, which possess a record of the deaths that have taken place * Mortality Statistics United States Army, p. 494. 134 ARMY STATISTICS NOT ALWAYS APPLICABLE among their respective populations, under the influence of the natural causes to which allusion has been made, and such artificial ones as they have chosen to surround themselves with, is quite different—the empire of Russia showing one death to each twenty-eight of its inhabitants, while in England the mortality declines to one in each forty-five. A subdivision of each country shows that mortality is greater in some rural districts than others, and in all presents a wide difference between town and rural life. Hence the law of mortality prevailing in Liverpool and the metropolis is not applicable to the rural districts either of the north or south midland counties, nor is that which defines the limits to human existence at each period of life, the same in France and Sweden. In the United States, with the error of the census returns corrected, so as to give an annual mortality of one to each forty-eight of the inhabitants, a result is obtained which differs from each of the countries in Europe, in- asmuch as it presents a lower standard of mortality. This standard of mor- tality, which after all is based somewhat upon speculation, is not by any means reliable, and it will consequently be necessary to arrive at the law which governs it by an examination of its individual details. Parallelisms in different latitudes are not always to be expected ; but, inasmuch as they have been found to exist between different parts of the United States and Europe, corresponding in geographical position, in other portions of this enquiry, it is anticipated they will be found in this; and although the results of the observations in no single country in Europe may be found to correspond with this, yet different parts of the entire con- tinent may be selected, irrespective of the government under which they exist, which will assimilate to corresponding parts of the United States. The advantage of these comparisons has already become so manifest, that nothing further need be said in their behalf at the present time. There is one circumstance connected with the climate of the United TO CIVIL LIFE. 135 States, which would lead to the belief that the correspondence between different localities in Europe and this country, apparently similarly situated, might not always be sustained, or lead to analogous results. This is the greater heat of the American summer. The prevailing winds in Europe, as well as America, especially, during the summer season, are from the west. In that portion of the United States embraced within the limits of the valley of the Mississippi, as well as in that stretched along the Atlantic sea coast, the effect of these winds, whose course is for an immense distance over dry land, with no intervention of sea, is largely to elevate the temperature. In Europe, the wind fresh from the Atlantic Ocean produces a directly contrary effect, and modifies rather than elevates the temperature. This effect is strikingly manifested upon vegetation. There is no part of the United States where the heat of summer is not] sufficiently intense to ripen maize, and it consequently flourishes in the northern as well as the Southern States. In Europe, with the exception of the low latitudes, it is found impossible to bring this plant to maturity for the want of a summer heat sufficiently intense to ripen it. It is, therefore, reasonable to expect that in elevated latitudes, as well as in southern ones, the mortality, in July and August, when the period of intense heat culmi- nates, will be proportionably greater than in countries similarly situated in other respects in Europe. " The isothermal lines, first employed by Humboldt to measure the heat and cold of the earth, and to connect places having the same mean temper- ature, differ sensibly from the lines of latitude. We need not now enter into details how the earth's annual rotation and oblique motion, in relation to the sun, the centre of the system, fixes the tropical limits of the sun's apparent declination south and north of the equator, and produces alternate winter and summer on either side of the line, as it will be evident that the mean annual temperature obtained at different latitudes must decrease from 136 ISOTHERMAL OBSERVATIONS. the equator to the poles. Had the whole surface of the earth been uniform, presenting the like relations to radiant heat, unaffected by the unequal action of disturbing causes, the mean temperature of every point would have been in proportion to the radius of the parallel latitude. But the mean temperature of places, calculated according to Dr. Brewster's formula, from an equatorial mean of 81° 50' Fahr., differs considerably from the mean obtained by observation. The mean temperature is usually higher at the same latitude in the Old World than in the New, and in north latitude than in south. Thus the isothermal line of 59° Fahr. traverses the latitude of 46° in Europe, but descends to latitude 36° in America. The general causes which disturb the symmetrical distribution of temperature, are the annual variations of the upper equatorial and lower polar currents of the atmos- phere, the differences of its contained humidity, the unequal distribution of land and water in various countries, the peculiarity of the surface land, and its relative height above the level of the sea—all of which causes have more or less influence in determining the local temperature or climate of countries, and in fixing the isothermal lines that mark out the zones of disease."* * British and Foreign Medico-Chirurgical Review, No. XXXVIU., p. 243. GENERAL CONFIGURATION OF TERRITORY. 137 CHAPTER XII. NATURAL DIVISIONS OF THE UNITED STATES. It has already been stated (page 18) that the territory of the United States is physically divided into three distinct sections, separated from each other by lofty ranges of mountains, and containing peculiarities rendering an examination of each a matter of the highest consideration. The first of these great divisions is occupied by the Atlantic plain and slope, which ex- tends from the Atlantic to the crest of the Alleghany mountains, and is the oldest as well as the most populous section of the country. The second is embraced in the wide valley, bounded on the one side by the Alleghany, or Appalachain chain, and on the other by the Rocky Mountains, and is tra- versed by the Mississippi River and its tributaries. The third extends from the Rocky Mountains to the shores of the Pacific, and, with the exception of California, contains but a slender population, and is traversed by vast wastes of unexplored territory. The Atlantic plain and slope, stretching from the river St. Croix upon the north, to the coral reefs of Florida upon the south, presents south of Cape Cod an unbroken front, upwards of one thousand miles in extent, to the waves of the Atlantic, unrelieved by any of those bold prominences which destroy the tameness of landscape. After passing Cape Cod, whose 17 138 THE ATLANTIC PLAIN, shores are low and sandy, northward, the highlands near the ocean, and the numerous harbors of Massachusetts, New Hampshire and Maine, open upon the sea in the midst of bold and picturesque hills, which contrast agreeably with the tame and monotonous scene of the more southerly coast. Receding from the shore, this vast plain, at first level, becomes elevated into hills, which increase in boldness and diversity, until they finally rise into those lofty ranges of mountain peaks, which bound the Atlantic slope on its western side. The breadth of this plain is not in all places the same. Beginning in New England by a narrow line, confined almost entirely to the sea-coast and the subjacent islands, it gradually expands as it proceeds southward, until in the Carolinas the mountains recede two hundred miles from the sea. A well defined line of primary rocks, extending longitudinally through the whole length of this plain, from the New England States to North Caro- lina, marks the point of demarcation between the low and level plain skirting the sea shore, and the elevated land which finally loses itself in the lofty summits of the Alleghanies. This line of primary rock, which main- tains an average elevation of great uniformity of between 200 and 300 feet above the sea, presents a visible barrier to the flow of the tide, and is marked in almost every stream that crosses it, on its way to the ocean, by a series of waterfalls or turbulent rapids. The appearance of this chain of rocks clearly indicates that it once formed the shore of the ocean, and presented to the resistless beating of its waves, a long but not very elevated range of cliffs. The aspect of the plain, stretching towards the sea, is also strongly corroborative of this view. It is low, flat, sandy, and covered by an abundant series of alluvial deposits, and is furrowed out to the level of the tide in every part by a multitude of inlets which are not unfrequently associated with large patches of marsh, or salt-meadow land. AND SLOPE. 139 The upper part of the valley, divided by this line of rocks, is nearly of the same dimensions as that skirting upon the sea, and presents at the onset a range of gentle undulations which swell into bolder and bolder forms, until it sweeps over the blue ridge and rises into mountain peaks. It is principally composed of the older sedimentary and stratified primary rocks, and presents a fine hilly country, luxuriant in vegetation, rich in scenery, and possessed of a number of rivers, and a water-power of great value. Professor H. D. Rogers has called the alluvial range east of the line of primary rocks the Atlantic plain, and that west of it the Atlantic slope. Most of the principal towns on the Atlantic are built along this line of demarcation, clearly showing the powerful influence exerted by geological phenomena upon the distribution of population. This line of primary rock may be traced from the city of New York, in the falls of the Passaic at Paterson, the Rariton at New Brunswick, the Delaware at Trenton, the Schuylkill at Philadelphia, the Patapsco near Baltimore, the Potomac at Georgetown, the Rappahannock near Fredericksburg, the James River at Richmond, the Brandywine near Wilmington, the Congree at Columbia, and the Savannah at Augusta. The whole surface of the extensive territory limited by the Alleghany mountains, as well indeed as the greater part of the entire continent north of the Isthmus of Dareiu, is overlaid with a strata of earth and pebbles of evident diluvial origin, varying in thickness from ten to twenty feet, fre- quently leaving large surfaces of the rocky formation exposed, and as often burying them in an investure of thirty feet in depth. West of this mountain chain, which not only presents a variety and beauty of landscape as grand and attractive as the loftiest peaks of the Alps or the Pyrennees, and is rich beyond calculation in its treasures of coal, iron ore, and other minerals, the interior valley of the Mississippi spreads by a wide and continuous sweep to the Rocky Mountains on the west. 140 THE INTERIOR VALLEY These mountains, which are a continuation of the Andes of South America, and the Cordilleras of Mexico, obtain an elevation of fourteen thousand feet, rising into occasional peaks of upwards of sixteen thousand feet. This valley is traversed from north to south upwards of three thousand miles by the Mississippi river. This parent stream receives the waters from numerous tributaries coursing through every portion of the valley, and forming highways upon which an immense commerce is carried. Cities of considerable size have arisen upon the banks of these rivers in various parts of the valley to accommodate the traffic, and the bottom lands in their vicinity have become covered by a comparatively dense rural population. A very remarkable phenomena in the arrangement of this valley is the uniformity of its slopes. One of these reaches from the Alleghany Mountains to the Mississippi river, a second and larger extends from the Rocky Moun- tains to the same point, and a third gradually rises from the Gulf of Mexico to the head waters of the Mississippi, with so gradual an ascent as not to attain an elevation of more than 1,000 feet in the whole distance. The slope west of the Mississippi is regular, while that on the eastern side is occasionally broken into hills, and embraces the most fertile territory in the United States. This immense valley contains vast spaces covered by marshes, and small lagoons, and others of equal extent, especially near the Rocky Moun- tains, whose sandy and arid soil affords but a stinted and scanty vegetation. Beneath this variety of surface reposes the formations of every geological era, from the alluvion of the Gulf of Mexico to the primitive rocks of the more northern section. In all these varied formations the greatest order and simplicity are observed, and it is probably here, above all other sections of the globe, that the geologist can best read in its vast pages the history of the earth's OF THE MISSISSIPPI. 141 geological formation. The primitive and metamorphic rocks, it is true, are seldom seen, and are only exposed by upheaval from their natural positions, but the lower silurian, the upper silurian, the Devonian and the carboniferous strata, present themselves in unvaried regularity over wide districts of country. The extensive ranges of silurian rocks are, for the most part, composed of limestone, in every variety, from hard and dense, to soft and friable. That these geological characteristics exercise a considerable influence over health, is well known. Their connexion is too immediate and self-evident to the medical man to require examination in detail. The prevailing type of disease is dependant as much, and perhaps more, on the predominant rock of the country, than upon any other cause. Climate, temperature, hygrometic condition of the atmosphere, and prevailing winds, may have much to do in influencing the general peculiarities of maladies in particular localities ; but all these agents combined are incompetent to generate the cause which frequently dwells in the rocky formation. Where the sub- stratum is composed of clay-slate the country is level, and the soil is in an especial degree retentive of moisture, and consequently ponds and marshes abound, and intermittent fever prevails. A limestone formation, especially of a friable species, is characterized by a luxuriant vegetation, a picturesque landscape, and a high grade of autumnal fever. In the region of sandstones the surface is hilly, and frequently mountainous, arid, and less productive, the streams are pure and rapid, and stagnant water is unknown. This is the region characterized above all others for eminent salubrity. It will be seen that there is no section which does not possess local causes of salubrity and disease, entirely independent of the great geogra- phical divisions into which the country, as a whole, naturally resolves itself. When a sufficiently minute series of statistics are obtained, the effect of these local causes will furnish the medical etiologist with interesting subjects of 142 RANGE OF TEMPERATURE investigation. The Transactions of the American Medical Association contain some papers on local epidemics, which are valuable in this connection. In forming an estimate of climate in temperate latitudes, such concomi- tant circumstances as proximity to the sea, or large inland bodies of water exposure to winds and elevation, must not be overlooked. Thus, in high latitudes, the sea-coast is always warmer than the interior in winter, and cooler in summer. The mountainous regions of New Hampshire and Ver- mont, although but a comparatively trifling distance from the coast, are so much colder during the winter season, that it is the constant practice of valetudinarians to leave those elevated situations during this inclement season to pass the winter in Boston, or other portions of the sea coast. The following table, prepared under the direction of the Surgeon- General of the United States Army, is illustrative of this point:— S3 «S (VlNTER Spring. Summer. Autumn si 6- Dec. Jan. Feb. March. April. May. June. July. 1 Aug. Sept. Oct. Nov. 34.95 23.31 31.87 40.58 54.66 61.94 1 69.27 72.98 1 75.57 65.48 G6.75 54.45 37.90 42.24 27.15 1 34.73 42.35 53.15 59.00 1 67.25 73.16 1 71.39 58. 16 41.85 51.56 53.10 101. 88 10 0 111 88 30.04 34.71 52.39 51.50 71.60 70.6(1 52.61 55.59 West Point, New York, is on the same parallel of latitude, and distant one and a half degree of longitude from Fort Trumbull (New London, Ct.) The former is inland, whilst the latter is upon the sea coast. Here, proxi- mity to the sea, renders the winters 4.67° milder, and the summers 1° cooler, than at West Point. ON SEA-COAST AND INLAND. 143 This difference is still more manifest in that portion of the North American continent lying above the boundary of the United States. In Nova Scotia, which is nearly surrounded by water, the thermometer seldom indicates a temperature greater than 88° in summer, nor less than 8° below zero in winter; whilst in Canada, occupying the same parallels of latitude, the thermometer in summer rises as high as 97° and occasionally 100°, and the oppression is as great as in equatorial latitudes. In winter, a cold of 30° below zero, is frequent, and the thermometer indicates a range during this season of from 8° to 30° below zero. The report of the Surgeon-General contains the results of a variety of observations made at different places for the purpose of marking the effect on temperature by proximity to, or distance from the sea, from which it would appear that the winters are 8.38° colder, and the summers 6.99° warmer, in the inland than on the sea coast. It may be proper to remark that many of the inland military posts, are situated in the new country beyond the western border settlements, and are exposed to the bleak winds from the Rocky Mountains, which course with- out opposition across the open belts of prairie, forming so prominent a picture in this western landscape. Those who reside in these prairies believe, and perhaps justly, that the sun's rays obtain a greater intensity in their open and almost boundless fields, than where the scene is diversified by the green foliage and agreeable shelter of the thick forest. It is highly probable, therefore, that a comparison between localities less exposed, and in more cultivated regions, would not exhibit the same difference of tem- perature between the sea-coast and interior, as appears from the observations of the medical officers of the army. The small numerous islands which dot the surface of the ocean on the shores of South Carolina and Florida, are famed for their salubrity and uni- formity of temperature; while the interior in summer is parched beneath 144 CLIMATE OF THE GREAT LAKES. the intensity of a burning sun. The temperature here seldom attains a higher elevation than 80° or 83°, which, combined with the pleasant sea- breeze, almost continually playing over their surface, renders them delightful and healthy places of resort for the inhabitants of the main land. The immense chain of inland lakes on the northern frontier, comprising a larger collection of fresh water than is to be found elsewhere on the sur- face of the globe, exercises, as may be supposed, a decided influence on the temperature of the country in juxta-position with them. It is estimated that these lakes contain 11,300 cubic miles of water, about half the quantity of fresh water on the globe, and reach for a distance of 1900 miles, covering over 94,000 square miles with water. Their depth is proportionably great— in some places, as in Lake Michigan, the sounding line having gone to the depth of 1800 feet without reaching bottom. The effect on climate produced by proximity to rang es of mountains in the United States is very marked. The salubrity of those portions of Vir- ginia, Maryland and Pennsylvania, lying at the foot of the Alleghanies, is doubtless in a great measure induced by the immediate presence of this ex- tended chain of lofty mountains. The superior healthiness of this section of country is so famed, that large numbers of visitors from the lowlands and large cities, are in the yearly custom of resorting thither during the summer and autumn months, when the heat of town is most oppressive, and the malarial country most prolific of disease. It not unfrequently happens, however, that the protection afforded by mountains against the strong winds, operates unfavorably on the mainte- nance of a wholesome atmosphere, and hence we often find, deep valleys in the midst of high and precipitous mountains without a proper outlet, op- pressed by a degree of heat which is almost insupportabable. In those mountain gorges, on which the wind falls obliquely, and without sufficient force to sweep away the vapours arising from the surface, which constantly AND MOUNTAIN REGIONS. 145 arise, laden with exhalations from the soil, an unwholesome moisture is ever present, the air stagnates and looses its vital properties; even the water is supposed to loose its healthy qualities, and the situation becomes in the highest degree prejudicial to health. Positions of this kind are seldom in- habited in the United States, owing to the extent of its territory, and the facility with which even the poorest persons can change their abode. In Switzerland and Scotland the melancholy effects of such a locality are ren- dered too visible in the miserable race of beings inhabiting them, who are the constant and incurable victims of scrofulous and rachitic affections, and who drag out a bare animal existence of mental imbecility and bodily suf- fering, oppressed by evils which they have neither the ability nor the inclin- ation to cast off. Elevation above the level of the sea exercises a decided influence over the climate of any particular latitude. The temperature of the atmosphere is found to decrease in successive and regular gradation as it leaves the earth's surface, so that in the ascent of the lofty mountains, within the tropics, the traveller experiences every change of weather, from the oppres- sive heat of the summer's sun on the plain below, to the piercing cold of eternal frost, on the lofty summit above. The variation of temperature has been found, with occasional variations, to equal one degree for every three hundred feet in temperate climates. This subsidence of temperature with elevation is doubtless dependent on the extreme rarity of the atmosphere at a distance from the earth, and the consequent facility with which it is per- meated by heat, as well as the radiating powers possessed by the earth, which enables it to return the atmosphere a portion of the solar rays previously absorbed. The atmosphere is condensed in proportion to the force by which it is compressed, and expands in exact ratio to the diminution of that force. It follows that the superincumbent strata of air, being compressed Vith 18 146 EFFECT OF ELEVATION. greatest force in its most dependent part, and that dependent part being nearest the earth's surface, its density will there be greatest, and this density will diminish in exact proportion to the ascent of the column of air. Now, the air, when under a certain compression, has a certain capacity for latent heat, which is increased by a diminution of the compression, and diminished by its increase. If a column of aifi, at a certain distance from the earth, receive a certain number of sun's rays, and then be suddenly brought clown to a position where it will occupy a denser medium, its particles being com- pressed, a portion of the latent heat becomes sensible, and is given off to surrounding bodies. The following observations, made by Mr. Green, in an serial voyage, ex- hibits this declension of temperature :— " The thermometer at the earth's surface indicated a temperature of 74° At an elevation of 2,952 feet, of . . . . .72 7,288 " ...... 70 9,993 " . .... 69 " 11,059 '• ...... 45 " 11,293 " ...... 38 " making a difference of 36 degrees between the earth's surface and the highest elevation attained, or about one degree for every 311 feet of alti- tude. However, much more confidence is to be placed in the statements of Humboldt and Sir John Leslie, who believe the difference to be more marked nearer the surface of the earth. The human body is supposed to be affected by the rarefaction of the air at great heights, as well as by a diminution of the temperature. On this point, however, there exists a diversity of opinion, some maintaining that all the unpleasant effects experienced in these ascents are to be attri- buted to the fatigue consequent on so difficult a journey; whilst others affirm that these effects are due alone to the character of the atmos- SOURCES OF MOISTURE. 147 phere. Under ordinary circumstances the equality of pressure from the air is so equally balanced without and within, that although a pressure is main- tained equal to about 32,000 pounds, it is not felt. If any considerable portion of this pressure be removed, the bloodvessels, especially of the mucous surfaces, are more easily ruptured, and hence hemorrhages from the lungs and other parts of the body are more apt to occur. Strangers visiting Potosi, in South America, which is the most elevated town of any size in the world, being upwards of 13,000 feet above the level of the ocean, do not recover from the unpleasant effects produced by a rarefaction of the air at this height under a year, and pulmonary complaints are much more frequent among them than the inhabitants of the low country. Taken as a whole, all the gentle slopes on this continent descend east- wardly towards the Atlantic, and the abrilpt ones rise on its western aspect. In this respect a manifest difference is observed between this continent and Europe, which gradually declines westwardly towards the Atlantic. This general configuration necessarily gives rise to a moister and more temperate climate in Europe than in America, in the same parallels of latitude. This effect would be much more obvious were it not for an admir- able compensation made by the presence of the gulf stream and the trade wind that accompanies it, From this source, not only the Atlantic coast, but the Mississippi valley, which is exposed at its southern extremity to the Gulf of Mexico, derives a larger proportion of its moisture, and is equalized with that of Europe. The trade wind, fresh from the gulf stream, spreads itself along the whole Atlantic region and upon the slopes of the Alleghanies loaded with vapor obtained from the ocean, and not only supplies this part of the continent with a copious supply of water, but even distributes its favors, in a less degree however, to the Mississippi region, through its great inlet on the Gulf of Mexico. Were this great interior valley exposed to the southwest winds from the Pacific, instead of being shut out from them by 148 EFFECT OF MOISTURE the Rocky Mountains, its climate would doubtless be softer and more uable, and its influence over health and disease largely modified. There is, perhaps, no concomitant of the atmosphere more immediately concerned in the maintenance of the functions of the body, more influential in the preservation of health, and more active in the production of disease, than moisture. Man constantly exists not only in an atmosphere of air, but likewise in one of aqueous vapor, which insinuates itself between the particles of common air, and pervades to a greater or less extent the entire etherial ocean, seriously modifying it, and influencing its action on the animate creation. The human body is composed, in a great proportion, of fluid particles, which are incessantly in a state of motion—sometimes slow, and at other times rapid—that find a ready egress by means of the exhalent vessels, both from the external and internal open surfaces. In a dry state of the atmos- phere, especially when combined with an elevated temperature, the exha- lents are exceedingly active, and give off a greater amount of fluids than are required to be parted with for the due performance of the functions of the body. For this reason the desire for liquid aliment is manifestly increased in summer. Every one must have observed the difference in the amount of liquid taken in a dry or a damp day, at the same season of the year; indeed, this appetite, when not unnaturally created, and when the body is in a state of perfect health, is almost entirely dependent on the hyrometic condition of the atmosphere for the variation in its demands. In Arabia and the interior of Africa, where the air contains compara- tively little moisture, the inhabitants exhibit a dry and rigid muscular fibre, and possess an exceedingly small supply of fluids. In the British Islands, and the coast of New England, in our own country, where the quantity of moisture contained in the atmosphere is unusually great, the inhabitants exhibit a greater proportion of fluids in their organization than any other UPON THE HUMAN BODY. 149 people on the surface of the globe. In Mexico, the table lands are cele- brated for the dryness of their atmosphere. The rapacity with which it seizes on fluid particles is said to be so great, that the flesh of animals seldom becomes putrid, even during the heat of summer. The fluid por- tions combining with the atmosphere, the solid are preserved by means of this process of natural drying. The Indians upon the southwestern frontier resort to this method of securing their food by jerking the flesh of the buffalo. The influence of moisture, as experienced by its presence or absence in winds, is very well known. Those winds which pass over a large extent of water are moist, light and warm, and exert a beneficial influence over the system, whilst those which find their way over a considerable tract of land are drier and heavier. In warm countries, the winds from land, freighted with the additional heat derived from the burning soil, and deprived of the greater proportion of their moisture, are dry, hot, suffocating, and are frequently productive of the most dreadful effects to those travellers, who, on the deserts of Africa, or the plains of India, are exposed to their action. This aqueous vapor, so necessary for the due performance of the animal functions, has its force determined, and its quantity established in the atmosphere, by locality, temperature, pressure, and motion of the air. In its atrial form, vapor, like all the other constituents of the mixed atmosphere in which we live, is colorless and transparent; but in the act of condensing, it imparts to the atmosphere a certain degree of opacity, proportioned to the conglomeration of the watery particles. The visible vapor, arising from the condensation of the transparent portions of the watery atmosphere, becomes manifest to our senses, in the form of clouds, mist and fog; and when the collection is too large to be sustained by the buoyancy of the air, it descends upon the earth, in rain, hail, or snow. 150 EFFECT OF MOISTURE. The vapor in the atmosphere is derived from the evaporation of water at the earth's surface. This process takes place with greater rapidity at a high than at a low temperature, in a dry than in a moist atmosphere, in an agitated rather than in a quiet air, and hence a warm climate and dry winds are highly favorable to its production. These general observations will enable the reader to understand why certain localities in the same latitude are different from others. With these characteristics of territory before him, he will readily comprehend why the same degree of latitude presents a great variety of forms of disease, some of which are referable to one condition of climate and others to another, and will be prepared to explain many apparently contradictory phenomena which present themselves in the investigation of the causes of mortality in so extensive and diversified a country as that embraced within the limits of the United States. INFLUENCE OF SEASONS. 151 CHAPTER XIII. INFLUENCE OF SEASONS. The following table exhibits the number of deaths which occurred in each of the four seasons of the year, in each State of the Union :— States. Spring. Summer. Autumn. Winter. Alabama, 2,084 2,229 2,852 1,686 Arkansas, 756 718 933 548 California, 54 92 417 322 Columbia, District of, 236 253 189 146 Connecticut, 1,399 1,162 2,127 1,026 Delaware, 273 380 345 209 Florida, 226 252 247 174 Georgia, 2,559 2,535 2,692 2,051 Illinois, 2,492 3,333 3,649 1,742 Indiana, 2,765 3,540 4,160 2,039 Iowa, 523 526 605 356 Kentucky, 3,436 ^ 4,942 4,060 - 2,424 Louisiana, 2,784 ^3,505 "- 3,053 2,514 Maine, 1,882 1,774 2,569 1,334 Maryland, 1,385 2,730 2,561 1,777 Massachusetts, . 3,945 3,964 7,645 3,583 Michigan, 1,117 1,047 1,325 832 Mississippi, 2,089 2,371 2,645 1,460 152 DEATHS IN EACH SEASON. States Spring. Summer. Autumn. Winter. Missouri, 2,160 5,422 2,842 1,507 New Hampshire, 1,013 990 1,459 751 New Jersey, 1,463 1,750 2,175 J,037 New York, 10,101 12,444 14,843 7,602 North Carolina, 2,707 2,678 2,425 2,697 Ohio, 6,122 9,520 9,010 4,159 Pennsylvania, 7,649 7,517 8,129 4,042 Rhode Island, 473 520 817 520 South Carolina, 1,997 2,058 2,259 1,465 Tennessee, 2,924 3,818 3,039 2,244 Texas, . 585 706 804 691 Vermont, . 890 672 941 590 Virginia, 5,144 5,489 4,576 3,608 Wisconsin, 768 630 963 509 Minnesota, . 6 10 7 .. New Mexico, . 288 235 214 292 Oregon, 13 5 9 14 Utah, 56 97 30 52 From these returns it will be seen that the summer and autumn months proved more fatal than those of winter and spring. In most of the Northern States, as Maine, New Hampshire, Massachusetts, Connecticut and New York, the most fatal season was autumn ; while in many of the Southern States, as Virginia, Kentucky, North Carolina and Louisiana, the period of greatest mortality was summer. This does not appear to be invariably the case, as in Alabama, Georgia, Mississippi and South Carolina, the number of deaths in summer and autumn nearly correspond, but slightly prepon- derate on the side of autumn. The influence of Asiatic cholera, which prevailed as an epidemic during the summer of 1849, may have had some effect in changing the relation of the deaths to the four seasons in which they are classed, as it certainly had in the case of Missouri, where 5422 deaths are recorded in IN DIFFERENT STATES. 153 the summer quarter, and but 2842 in the autumn; but it is presumed generally to have had but slight effect, as the persons who were victims were usually of the humblest class in towns, and had but few friends to report their deaths to the authorities, by whom these returns were made; besides, the whole number of deaths reported as having died of cholera, in the United States, is 31,506, while it is known that 5,071 died from this disease, in the city of New York alone, and as many more in St. Louis, The great mortality which pervaded the whole valley of the Mississippi, from this disease, is, of course, not to be found in these returns.* With scarcely an exception, the season of winter is to be found least prolific of disease. This diminished mortality does not appear to be confined to any particular section of country, but embraces with equal force the States located in the colder latitudes of the north, and the milder ones of the south, and contrasts in the most striking manner with the results of the registration returns of England. From an examination of these, it will be seen that the heaviest demand upon life, in England, is in the winter season, when, according to the census returns, it is least severely taxed here, and that the periods of freest exemp- tions from disease there are those upon which it falls with greatest severity here. Now, while this table exhibits in the most positive manner the in- fluence of the seasons upon disease, it at the same time shows clearly how very materially the law of mortality in England and the United States is at variance, and demonstrates the necessity of great caution in the use of the former when applied to an elucidation of the value of life in the United States. This great winter mortality in England " exhibits," remarks the Re- * Report on Asiatic Cholera in the United States, in 1849, by James Wynne, M. D. Appendix C to the Report of the General Board of Health, London. 19 154 DWELLINGS IN DIFFERENT SECTIONS gistrar-General. ain a striking light the fatal effects of cold." The degree of cold in the northern part of the United States is not only equal to that of England during the winter months, but far more intense, and if the mor- tality was due to cold alone, it should be far outstripped by that of this country, while in fact, with a lower depression of the thermometer than in England, this particular season is more healthy here than there. But the Registrar-General alludes to another cause which may operate with greater force in England than in this country, and certainly does so in the rural districts. This is "the crowding and privations to which a consider- able part of the population is necessarily more exposed in cold than in warm weather." A manifest difference in the habits of the inhabitants of the two coun- tries is their relative division into town and country populations. Eight hundred and fifteen towns in Great Britain, in 1851, contained an aggregate population of 10,556,228 persons, nearly equal to one-half of the whole population, from which it would appear that the whole was nearly equally divided between those who resided in towns and those who dwelt in the country, giving a slight preponderance to the latter. The aggregate town population of the United States in 1850, who dwelt in towns of not under 4,000 inhabitants, was about 3,000,000. Mr. De Bow estimates " that the village, town and city population includes about one-fourth of the whole," leaving as residents of rural districts three- fourths of the population, instead of one-half, as in England and Wales. The statistics of neither country show any excessive crowding of the population into a small number of tenements, and will doubtless surprise those "who have derived their information upon this point from a knowledge of some wretched and confined portion of a populous city in either country, where, notwithstanding the census returns, overcrowding does exist to a very alarming degree. OF THE UNION. 15.1 The number of dwellings in Great Britain and Ireland, according to the census of 1851, was 4,717,172. The number in the United States, in 1850, was 3,362,337. The relative distribution of the population among those of the United States has been given in the census returns, from which it would appear that upon an average there was a house for every six persons, and ninety- three houses for each hundred families, which are thus distributed :— „ ,.._... Dwellings of white and Geographical Divisions. fre£ colored New England, . . . 448,789 Middle States, . . . 1,046,131 Southern States, . . . 423,681 Southwestern States, . 359,511 Northwestern States, . 1,041,332 California & Territories, 42,893 'amilies of white and free colored. Ratio of families to 100 inhabitants. 518,532 19.01 1,175,612 18.01 426,691 17.88 366,802 17.65 1,066,777 17.54 43,781 23.68 Total, . . . 3,362,337 3,598,195 18.00 " Upon the average for the Union, there are 16.82 houses for every 100 white and free colored persons, or a little less than one house to every six persons, the ratio between the States varying from 15.17 dwellings to every 109 persons in Rhode Island to 25.6 in California. The proportion of fami- lies to dwellings in the Union is as 107.01 to 100. In Utah and Oregon there is one dwelling to every family; in Louisiana 100 to every 110; in Connecticut 100 to 114; in Massachusetts and Rhode Island 100 to 126, &c, &c."—Compend. Census. In conjunction with this is placed a tabulated statement, embracing similar information concerning the several principal European States:— 156 DWELLINGS IN EUROPE. „ Numberi Countries. „,„„ 3F Persons to Dwelling. Number of each 1 Persons to Family. Number of Families to each Dwelling. * 1801. 1851. 1801. 1851. 1801. 1851. Scotland, . . . 5.46 7.80 4.42 4.81 1.236 1.620 England & Wales, 5.64 5.47 4.69 4.83 1.204 1.132 Great Britain, . . 5.61 5.71 4.64 4.83 1.209 1.182 France,........ 4.85 ... • 3.97 .... 1.222 Austria,........ 6.89 4.44 .... 1.551 Prussia,....... 8.13 .... 5.13 .... 1.585 " The average number of persons to each dwelling in Ireland, in 1851, was 6.35 ; and in Belgium in 1846, 5.42. The number of dwellings in Ireland in 1851 is stated at 1,047,735, making the total for the British empire, including the islands, 4,717,172. Adding the dwellings of the slave population, at least, on the average, as good as those of the operative classes of Europe, and estimating one dwel- ling for six slaves, the total dwellings in the United States will be 4,197,914. By comparison, one dwelling to every 5.82 persons in Great Britain, and one to every 5.52 persons in the United States."—U. S. Census. It would seem from these statements, which must be considered as authentic, that ample provision has been made in each country included in these tables to provide a requisite supply of house room for its inhabitants; and it might reasonably be anticipated, that with a sufficient number of houses to accommodate six of the entire population in each, that excessive overcrowding could not take place. The reports, however, of the English commission to enquire into the condition of large towns, as well as those of the Committee of the Legis- lature of New York, to enquire into the condition of tenant-houses in the city of New York, the Sanitary Committee of Massachusetts, and the report of the First Committee on Public Hygiene of the American Medical Asso- ciation, show that the tendency of the poorer classes of the inhabitants of INFLUENCE OF THE SEASONS. 157 populous cities on both continents is to congregate in large numbers in the most confined and unhealthy portions of the places in which they reside. The evidences are too manifest to admit of a denial of this fact, and it becomes a matter of importance therefore, in estimating the relative salu- brity of a country, to ascertain Avhat portion of this class of inhabitants are residents of town, and what portion reside in the country. The estimate of Mr. De Bow has assigned to three-fourths of the population of the United States a country residence. The justness of this estimate is con- firmed by the statistics of the occupations of the free male inhabitants of this country over fifteen years of age, from which it would appear that of 5,371,876, whose occupations were defined, 2,400,583 were engaged in agricultural pursuits. The registration returns of the respective States, although varying somewhat in detail, appear to corroborate the correctness of the census returns, in regard to the seasons upon which mortality makes the largest demands. Mr. Shattuck prepared a table showing the percentage of deaths in each of the four seasons which occurred in Massachusetts in the two years terminating with 1845, from which it would appear that the greatest mortality occurred in August and September, and the least in May and June:— Months. 1844. 1845. Winter—January, Februarj', March, . . . 23.82 24.70 Spring—April, May, June, . . . . 21.21 20.41 Summer-—July, August, September, . . . 28.80 29.86 Autumn—October, November, December, . . 26.17 25.03 In this table the winter has been made to terminate with the 31st of March, instead of the 1st of March, as it is presumed to have done, in the computation of deaths given in the census returns. The English report adopts the same arrangement of months, as that selected by Mr. Shattuck. 158 INFLUENCE OF THE SEASONS As a difference appears to exist as to the division of the seasons, it may be more satisfactory to define the months in which the mortality absolutely occurred, and with this view a table is presented, giving the number of deaths which occurred in the State of Massachusetts, during the three years terminating with January 1st, 1856, and the months in which they took place :— Months. Males. Females. Unknown. Totals. January, . 2,296 2,344 10 4,650 February, 2,212 2,214 36 4,462 March, 2,555 2,621 43 5,219 April, . 2,450 2,481 21 4,952 May, 2,227 2,239 38 4,504 June, 2,103 m 2,052 17 m 4,172 July, 2,780 2,679 32 5,491 August, M3,716 M3,733 53 M 7,502 September, 3,548 3,524 59 7,131 October, 2,618 2,733 44 5,395 November, . m 2,092 2,116 24 4,232 December, 2,303 2,378 37 4,718 Not stated, 37 40 8 422 85 Aggregate, . 30,937 31,154 62,513 State of Kentucky for the year Months. Deaths. August, . . M 1,053 September, . . 906 October, . . 802 November, ; . 631 December, . 723 Unknown, . . 441 A similar table is given for the 1853:— Months. Deaths January, . m544 February, 626 March, . 696 April, 685 May, . 615 June, 705 Julv, 984 ON MORTALITY. 159 And likewise one tabulated in a somewhat different manner, but embracing the same information, for Rhode Island:— No. Percentage. No. Percentage. January, 32? 6.83 August, . M717 14.93 February, 336 7.00 September, 542 11.28 March, 384 7.99 October, 403 8.39 April, 335 6.97 November, 327 6.81 May, 349 7.27 December, 314 6.54 June, m310 6.45 Unknown, [6] .... July, 458 9.54 Totals, . 4809 100.00 " The mortality of Providence for fifteen years, as shown in Dr. Collins' tables, corresponded very closely with the above. The proportions of deaths in the several months were as follows:— Per cent. Per cent January, 6.81 July, . 9.55 February, 6.82 August, . M14.96 March, 7.67 September, . . 10.66 April, 6.76 October, 8.46 May, . 6.99 November, , 7.20 June, m6.45 December, 7.67 In connection with the mortality of the different seasons, as here presented, that which occurs upon the Pacific coast becomes important, as presenting a new arrangement of climactic influences, and a somewhat novel condition of society. The circumstances connected with the settlement of California are so peculiar as to render the facts derived from its vital statistics a matter of considerable interest, and it fortunately occurs that these facts, although embracing the results of but a single year, enables this comparison to be instituted. 160 INFLUENCE OF THE SEASONS The annexed table shows the monthly mortality of San Francisco from 1st June, 1855, to 1st June, 1856 :— Males. Females. Still-born. Totals. June, 52 19 3 74 July, . August, . September, October, 82 80 S4 80 32 25 29 26 7 5 5 7 121 110 118 113 November, . 75 36 5 116 December, 74 15 5 94 January, February, March, 82 68 63 24 20 15 9 3 10 115 91 88 April, May, . 61 60 30 20 8 7 99 87 Totals, 861 291 74 1,226 Dr. Sanger, from whose very excellent report to the Mutual Life Insur- ance Company, on the mortality of California, this table has been taken, adds: —"From this table, it will be observed that the greatest mortality occurs in autumn, and the least in the spring months—the former season having an excess of 73 deaths over the latter. The maximum of mortality is found in the month of July, when there were 121 deaths, and the minimum is 74 deaths in June. If we examine the table comparatively with reference to the causes of fatality for these two months, we shall find that the excess of deaths in July is partly due to accidental causes, and partly to an intensity of endemic, epidemic or malarious influences prevailing during this month. " With respect to the seasons, Sacramento is similarly placed with San Francisco, in its mortality. We find, however, that the maximum of mor- ON MORTALITY IN CALIFORNIA. 161 tality took place in the month of November, when there were 30 deaths against the minimum of 15 deaths in February. "From January to August, the mortality averages 17, and for the remaining five months over 25 monthly. From what has been stated, it is apparent that the greatest mortality, at Sacramento, occurs during the mala- rious season. This result is not surprising, because its location is such as to make it a favorite habitant for miasmatic disease. We regret that we have not before us the causes of the mortality for each month in the year, from an inspection of which we could arrive at more positive conclusions. " There are important reasons why we should regard the exhibit of mortality in San Francisco as an excess, when compared in proportionate terms with the general fatality of the State. We shall have occasion to refer to the mortality of Sacramento, in confirmation of our opinion. Sacra- mento City is the principal resting-place on the great thoroughfare to the northern mines, and in reference to its position geographically, ought to afford just comparative views of the rate of mortality from malarious causes in this immense valley. " In the first place, San Francisco is the gateway by which the large emigration constantly arriving here, as the commercial emporium of the Pacific, becomes gradually dispersed over the whole interior. The principal influx is from the Atlantic States, and of late years the routes via the Panama or Nicaragua Isthmus have been preferred to the more tedious journey across the plains. The almost malignant type of miasmatic fever, endemic, in the land crossings from ocean to ocean, is well known. To cut short premises, already familiar enough to the public, from the severity of past experience, we are having a population thrown upon us semi-monthly, to a greater or less extent, an invalid population, although with the improved facilities for transit not likely to suffer so much in the future. " Then, again, we have had the usual history of scurvy and typhus 20 162 DR. SANGER ON THE attached to our emigrant ships in the long sea voyages around Cape Horn, from Australia, the Pacific Islands and the East Indies, under circumstances where a large number of human beings are crowded together in bulk, with limited accommodation for their wants, breathing a close and impure atmosphere, and provided, perhaps, with a scanty supply of nourishment, or one unsuited to the requirements of life at sea. The fatality from these causes has sometimes been frightful among the Chinese emigrants. For example, in the months of August and September, 1854, out of 4700 Chinese who arrived here, there was a mortality of 300 in port. " In two of the vessels that arrived here during these months, there is a reported fatality of one out of five of the passengers during the voyage. From an inspection of the books of entry, at the Custom-Housc, there is reason to doubt whether the captains of ships have in all instances during this period made faithful returns of the extent of the mortality occurring on shipboard. " Lastly, our city, in a sanitory sense, may be considered the hospital of the State. The invalid, from all portions of the interior, naturally enough finds his way to San Francisco, perhaps to seek a change in climate, or responsible medical advice, or to extend the facilities for successful treat- ment, and to secure for himself the full enjoyment of those comforts and personal attentions which his enfeebled condition demands, and which are most amply afforded in the metropolis of a new country. " The mortality in our public institutions, the County Hospital and the U. S. Marine Hospital, illustrates the force of our observations. The for- mer averages in the neighborhood of 170 patients constantly under treat- ment, the latter about 200, exclusively seamen. The combined mortality from these hospitals has been 16 per cent, of the entire mortality of the city. It should be remarked, that more than one-third of the patients received into the County Hospital are properly residents in other counties, MORTALITY OF CALIFORNIA. 163 who may come here voluntarily, or, as there is reason to believe, in many instances by the direct connivance of the local authorities to free themselves from the burden of their support.'"' The registration returns of many of the States, among their other numerous defects, fail to indicate the months in which the deaths included in their reports took place. There is a sufficient uniformity among those which have not failed in this ■ particular to show that the maximum of mortality in the United States is reached about the close of summer or the beginning of autumn, and its minimum about the termination of winter or beginning of spring. This is precisely the reverse from what occurs in England and Sweden ; the maximum in the latter country being attained in April, and the mini- mum in October, nor is the month upon which the maximum and minimum of mortality falls the same in every part of the United States. It has already been seen that a difference in this regard was indicated by the census returns; and were the registration reports of the various States sufficiently numerous, and accurate in detail, it would be possible to show an important difference in this respect between the great geographical divisions of the country. As a general rule, however, the law of mortality which prevails in the United States is tolerably constant and uniform in attaining its highest altitude in that season of the year when summer merges into autumn, and when the heat is most intense. Nor does the law appear to be affected by a town or country residence, the prevalence or absence of an epidemic, ahealthy or unhealthy season, but pursues its course with great uniformity year after year, and invariably demands of this particular season the largest number of its victims. - Report on the Mortality of California, by A. F. Sanger, M. D. J 64 EFFECT OF LOCALITY In order to illustrate the effect of locality upon the rate of mortality, the annexed table, showing the mortality of various cities in different parts of the United States, is introduced :— -Boston, 39 years, 1811 to 1849, Lowell, 13 " 1836 to 1848, -New York, 45 " 1S05 to 1849, -Philadelphia, 34 " 1807 to 1840, Baltimore, 14 " 1836 to 1849, ( Whites, Charleston, 27 " 1822 to 184SX Blacks, ( Both, Savannah, 8 " 1840 to 1847, Whites, New Orleans, 4| " 1846 to 1850, Per cent. 2.45 2.11 2.96 2.55 2.49 £.48' 2.57 4.16 8.10 This table, which was prepared with great care by Dr. Simonds, of New Orleans, exhibits the startling difference of 6 per cent, in the annual mortality between the healthiest and most unhealthy localities, and further shows that in each particular place a rate of mortality different from that of all the others prevails. Had the opportunity presented itself of ascer- taining the difference between town and country in each of these localities, it would doubtless have exhibited a condition of things highly in favor of a country life. But the most remarkable difference is, that which is exhibited between the cities of the north and south, as represented on the one side by New York and Philadelphia, and on the other by Savannah and New Orleans. In neither of these instances does there exist a means of comparing them with the rural population by which they are surrounded, other than such as is afforded by the census returns. Were there in existence State Regis- ters, as accurate and carefully compiled as those of Massachusetts, by which this comparison could be made, they would doubtless furnish information, both curious and instructive. UPON MORTALITY. 165 Dr. Simonds, in his remarks on the high rate of mortality of New Orleans, says, that it has been in a great degree attributed to the reckless- ness of its floating population—to which opinion he is not disposed to assent. " The only idea," he adds, "to be attached to the term floating popu- lation is that of persons who, though in the city, have not by length of residence acquired citizenship, or identified themselves with the city. This population must therefore consist of three classes—those who visit the city chiefly for pleasure and amusement; those who have visited us for the trans- action of business, to dispose of their crops, purchase their supplies, &c, &c. ; and those who have come here for the purpose of earning a livelihood, or of making a fortune, whose intention is to settle here and make it their place of residence, if they can do so consistently with their future welfare. The first two classes are here but for a few days, or at most a few weeks ; they have left behind their ties of family or business that prevent a pro- longed sojournment in the city; they are ready to flee at a moment's warning on an alarm of general sickness or a little personal indisposition ; they reside at hotels and boarding-houses, in which, so far as my observa- tion and inquiries go, there are but few deaths; and these classes, therefore, cannot contribute essentially to the mortality of the city. " But is the floating population of New Orleans so much larger than that of other cities, as to account for a mortality double that of any other city ? Has New Orleans a greater number of -visitors in the pursuit cither of pleasure or of business than New York ? Certainly not. During a few months, say for half the year, New Orleans contains a large number of strangers, and also a large number of persons who claim citizenship and do business here, but who fly during the hot and sickly season to more con- genial and salubrious climes. But New York is constantly thronged with visitors—its business season may be said to continue during the whole year— 166 DR. SIMONDS ON THE and there is no season during which there is not collected together a large number of seekers after pleasure. Places of amusement, which are sup- ported by strangers, are with us closed during a considerable portion of the year,—but not so in New York. Our hotels are deserted during the sum- mer—theirs are always filled. But with us even a large portion of the private residences are closed for two, three, or four months of the year. " The third class of the floating population consists chiefly of immi- grants and adventurers, of perhaps but small or no means, who have cut off the ties that bound them elsewhere, and who, though but a short time resi- dent here, are, to all intents and purposes, our own population. This class is enumerated in our census, pay taxes, contribute by their labor to the prosperity of the city, and will (if they escape the hand of death) become as truly citizens as seven-tenths of our present population, of whom indeed they constitute a large proportion. That this class contributes largely to swell our bills of mortality, is indisputable; but that the deaths from this class should be included in our calculations on the health of the city, is equally certain. " If New Orleans really has proportionally a larger floating population than other cities, the reason is very obvious. Of the number attracted hither by the advantages of the city, a greater proportion die speedily, and consequently a smaller proportion live sufficiently long to become identified with the city. What length of time is requisite to change the character of those who come to reside in the city, from a floating to a permanent popu- lation ? When this is settled, the record of deaths can be examined with reference to this question. Life Insurance offices recognise no fixed period of time, but require that the applicant shall have experienced the yellow fever, which on an average will be epidemic every three years. Our State laws require two years residence to entitle a citizen of other States to be considered a citizen of this State. The United States requires the foreign MORTALITY OF NEW ORLEANS. 167 immigrant to have resided five years in the United States. The annual reports of the Charity Hospital have generally stated the period of resi- dence as under or over three years. Let us say, then, that three years is a fair average to constitute the stranger a citizen in this respect. Of one hundred persons settling in New York in three years, nine will have died and ninety-one will become permanently resident; while of one hundred settling in New Orleans, twenty-four will have died in the three years, leaving but seventy-six permanent residents, the law of mortality of the general population being applied to the class of unacclimated. This state- ment is not strictly accurate—in fact, the difference would be very much greater, as those who maintain the position that our mortality is caused by foreigners, and that for natives and the acclimated our city is very healthy, must admit a much greater difference in the mortality of the newly arrived population. Again, suppose that on the 1st July, 1847, one thousand per- sons settled in each city, there would remain to be enumerated in the census on the 1st July, 1850, less than seven hundred and sixty persons in New Orleans, and more than nine hundred and ten persons in every other large city. Our neglect of sanitary measures, our indifference to the deaths of strangers, and our criminal disregard of the lives and welfare of those who settle among us, has done more to retard the advance of New Orleans than all the assertions of its salubrity can possibly remove. " It may be said, however, that the floating population are foreign im- migrants, who are merely passing through our city. Let us, then, examine the statistics of immigration, to see what light they throw upon this point. According to a statement published in connection with the reports of the New Orleans Charity Hospital, the total arrivals at New Orleans from foreign ports, coastwise, and by steamboats, during seven years, from 1842 to 1848, was 222,122—-while the arrivals at New York from foreign ports alone during the same period, was 738,462. (Hunt's Magazine, XXL, 657.) But 168 DR. BARTON ON THE how do the arrivals at the two cities from foreign ports alone compare ? During the year 1847 the total arrivals in the United States was 250,000, of whom 166,110 landed in New York—leaving but 90,000 for the rest of the United States. (Ibid.) Thus about two-thirds (66.44 per cent.) of all foreign immigrants landed in New York. Again, from 1845 to 1848 inclu- sive, four years, 101,293 persons arrived from foreign ports in New Orleans —number considerably less than the population of New Orleans and La- fayette by the late census—while 556,209 arrived in New York, being more than the population of that city at the last enumeration. The attempt to excuse the gretit mortality of New Orleans by referring it to the vast number of immigrants landed in our city, is not sustained by the facts." * Arc these ill-fated cities, in which mortality rages to such a fearful extent, dark spots in the midst of an otherwise sunny landscape, or do they bear in their high rate of mortality but a just comparison with the sur- rounding country ? Dr. Barton, of New Orleans, whose exertions, in all matters pertaining to public health and philanthropic objects, have been unwearied, has prepared a series of tables, from the information furnished to him by the marshal, which divides the mortality of the State, as col- lected by the United States authorities among the respective districts in which it occurred, and gives for the State of Louisiana a detailed statement, which should have been extended to the whole Union :— STATEMENT OF POPULATION AND DEATHS IN WESTERN LOUISIANA, 1850. Inhabitants. Deaths from Cholera. Deatus per Cent. Free. Slaves. Total. Free. Slaves. Without Cholera. With Cholera. 'jU,ol'2 121,158 211,470 103 501 5.09 5.22 EASTERN DISTRICT OF LOUISIANA, INCLUDING NEW ORLEANS. Inhabitants. Deaths from Cholera. Deaths per Cent. Free. Slaves. Total. Free. Slaves. Without Cholera. With Cholera. 181,306 122,7U0 304,069 965 1040 3.23 4.34 * Simonds on the Sanitary Condition of New Orleans, p. 42. MORTALITY OF LOUISANA. 169 These tables exhibit a mortality without a parallel in the United States, and show that there are causes in operation throughout the State tending to render it eminently unhealthy. Dr. Barton alleges that— " The period adopted for taking the mortality of the State, with its census, has been an unfortunate one for Louisiana, for during the whole period embraced under the order to the marshals and their deputies for this enumeration, viz., the year ending in June, 1850, has been precisely one of those periodical cycles alluded to in the former part of this report as about the septem-decennial period for the return of epidemic cholera. Such has been the fact, and large mortality has resulted in the whole zymotic class (to which cholera belongs) ; for although I have been enabled to separate the cholera from the other mortality in most of the parishes, yet the mortality has been much larger in the congenerous diseases of this class, than usual; and many parishes of the western district of the State, where we know that the mortality is not in ordinary years more than one to one-and-a-half per cent., has been made, by this return, to show four, five, six, eight per cent., and upwards ! This is to be deeply regretted, and the only remedy to be found is in the enactment of a registration law by the State Legislature, through which the actual sanitary condition can be made known annually." * With the fact that the mortality of New Orleans has rarely fallen below four per cent, and has for the last four and a-half years averaged 8.10 per cent., according to Dr. Simonds' estimate, and according to Dr. \ Barton, for the entire period of its existence, 4.87 per cent., it cannot be considered otherwise than an extremely unhealthy city. Nor can a rural * Barton's Vital Statistics of Louisiana, p. 21. 21 170 DR. NOTT ON population, whose mortality reaches 5.22 per cent, as in the case of the western parishes of Louisiana, be called a healthy one. The remarkably low rate of mortality which was found to obtain in some of the eastern parishes of the State, and which appear more striking in contrast with the great mortality of the other portions of the State, would lead to the belief that an amelioration of its condition might be effected; but when, and in what mode, is left for those who are familiarized to each locality to deter- mine. To what extent the baneful influences which are seen to have foothold in Louisiana extend to the neighboring States, cannot, in the absence of more exact information, be accurately judged. It unfortunately happens, that in the contiguous State of Mississippi, which it is feared is more unhealthy than the returns have made it, the number of deaths were more carelessly noted than in any other State. That these influences do extend for some distance along the Gulf of Mexico, including the lowlands, which lie contiguous to its borders in the Texas, Mississippi, Alabama and Florida, and gradually lose themselves in the more elevated regions of these States, appears to be quite evident. It is quite certain that the section of country embraced within the limits just defined, is possessed of features peculiar to itself, and cannot be considered as a standard by which to characterize any other section. Dr. Nott, of Mobile, in alluding to these characteristics says, that in the Southern States are high and healthy sand hills, placed in immediate contiguity with the rich alluvial lands of the rivers. The former are healthy, while on the low lands the most deadly malarial fevers prevail in summer and autumn. " Let us suppose," he remarks, " that a thousand inhabitants of Great Britain or Germany, should be landed at Mobile about the month of May, and one-third placed on the hills, one-third in town, and the remainder in the fenny lands around the latter. At the end of six SOUTH-WESTERN MORTALITY. 171 months the result would be, that the first third would complain much of heat, would perspire enormously, become enervated, but no one would be seriously sick, and probably none would die from the effects of the climate. The second third, or those in the city, if it happened to be a year of epidemic yellow fever, would, to say the least, be decimated, or even one-half might die, while the resident acclimated population were enjoying perfect health. The remaining portion, or those in the fenny districts, would escape yellow fever, but most of them would be attacked with intermittent and remittent fevers, bowel affections, and all forms of malarial or marsh diseases, fewer would die, but a larger proportion would come out with broken constitutions.*" Independent of the northern and southern climates, which have fre- quently been alluded to, and which find their types in Massachusetts and New York on the one side, and Kentucky and the Carolinas on the other, is this southwestern climate, stamped by characteristics bestowed upon it by its proximity to the Gulf of Mexico, and the peculiar character of the shore which borders it, and which are observed in their more complete development upon the borders of the Gulf, within the territory of Mexico. It has been seen that each of these divisions possesses marked and characteristic features, distinguishing the one from the other, and rendering them amenable to different laws of mortality. The laws by which the two former are apparently regulated, correspond pretty nearly to those of simi- larly situated countries in Europe, but in no European country have features of mortality been discovered which would assimilate in character to the southwestern part of the United States. * Nott and Gliddon's Indigenous Races, p. 364. 172 CLASSIFICATION OV CHAPTER XIV. DISEASES. In forming an estimate of the comparative healthfulness of a county as a whole, or of individual portions of it isolated from the others, it is neces- sary to ascertain the chief diseases which furnish the outlets for human life, and their relative prevalence in the one or the other sections. Without positive information concerning the ages at death, the infor- mation afforded by a simple record of the diseases which terminated life would be valueless, but with this information they become of the highest value; hence observations made in small places where the diseases can be accurately registered, are usually considered of more value in furnishing data for calculation, than in larger ones where the record is carelessly or inefficiently collated. It has heretofore been found exceedingly difficult to arrange such a registration for diseases in large places where no possible information concerning them could be obtained, except such as the register afforded, as would clearly identify them, and admit of deductions being drawn from them ; thus, Boston, New York, Charleston, Baltimore and New Orleans have each had their peculiar classification, frequently so diverse in arrange- ment as not to admit of comparison, without great caution. DIFFERENT DISEASES, 173 This difficulty has been remedied within a few years by the very general adoption of Farr's classification of diseases, which all the States, and most of the cities, at present employ. This classification divides diseases into two general classes of zymotic and sporadic diseases—the former term being used to designate epidemic, endemic and contagious diseases, and the latter those whose cause is found in the individual attacked by the disease. An example of a zymotic disease is given in Asiatic cholera, and of sporadic in dropsy. Zymotic diseases usually prevail in groups, attacking at the same time a large number of individuals, and are prevalent at one time, and absent at another. Sporadic diseases, on the contrary, occur singly and scattered, and under like circum- stances are generally prevalent. An additional division is made into twelve classes, which refer to the part of the body attacked by disease, one of these being placed under the head of zymotic, which is a class by itself, and eleven under the head of sporadic, thus: CLASSES OF DISEASE. 1. Zymotic diseases. SPORADIC DISEASES. 2. Of uncertain or general seat. 3. Of the nervous system. 4. Of the organs of respiration. 5. Of the organs of circulation. G. Of the digestive organs. 7. Of the urinary organs. 8. Of the organs of generation. 9. Of the organs of locomotion. 10. Of the integumentary system. 11. Of old age. 12. Of external causes. Since the adoption of this arrangement, which is very methodical, and at the same time quite simple, the returns of diseases have been much 174 GENERAL MORTALITY more reliable and easily classified. In collecting the number of deaths which took place in the United States, in the year 1849-50, this classifica- tion was given to the United States marshals and their assistants; and although they were not acquainted with the names of diseases and their mode of arrangement, yet, with the aid of this nomenclature, they were generally enabled to make a tolerably accurate return of the diseases returned or described to them. This information has been collated, and classified in such a manner as to embrace within a few tables the names of the diseases, the season in which deaths took place, the age, sex, nativity, occupation and color of the deceased, from which it will be seen that the deaths from Zymotic diseases, were 131,813:— Of which died of Cholera,.....31,506 " " " Diarrhoea,..... 10,706 " " " Dysentery, ..... 20,556 " " " Fever, general, .... 18,108 " Fever, scarlet, .... 9,584 " " Fever, typhoid. .... 13,099 The deaths from Sporadic diseases and unknown, were, 192 210 Of which died of Dropsy, ...... 11,217 " " " Cephalitis, .... 6,424 " " " Convulsions,.....6,072 " " " Consumption, .... 33,516 " " " Pneumonia,.....12,130 It will be seen by an examination of the chief causes of death, that a larger proportion of deaths are embraced in the slow and noiseless army of consumption, than in the more terrific and apparently fatal one of Asiatic OF THE UNION. 175 cholera. It is quite certain, that the deaths from both of these diseases have been under-estimated, and probably in nearly a like proportion. The deaths from consumption, in Massachusetts, and the northern parts of Europe, usually exceed 2,000, out of every 10,000 deaths, and their relative proportion to the number of deaths in every country and under every variety of climate is very large. For the purpose of instituting a com- parison between different parts of the Union, in order to ascertain the rela- tive prevalence of this and other prominent diseases in each, the following table has been introduced, showing the number of deaths from the several causes named, which took place in each state named :— Ohio. New York. Maryland. Deaths. Per ct. Deaths. ■ Per ct. Deaths. Per ct. Apoplexy, 123 0.42 356 0.77 60 0.62 Cholera, 5,808 20.05 5,822 10.57 xGG 1.72 Consumption, 2,558 8.83 6,691 14.67 1,101 11.44 Dysentery, 2,563 8.83 3,691 8.11 607 6.30 Fever (general) 1,479 5.10 799 1.53 139 1.44 " Bilious, 201 0.68 330 0.72 264 2.74 " Congestive, 112 0.38 73 0.16 44 0.45 " Typhus, 750 2.59 1,037 2.27 360 3.74 " Scarlet, 1,301 4.49 1,028 2.26 561 5.83 " Yellow, 5 0.02 16 0.03 6 0.06 Disease of Heart, 137 0.47 545 1.19 129 1.34 Old Age, 506 1.74 1,393 3.05 278 2.88 Paralysis, 197 0.67 431 0.94 105 1.08 Pneumonia, 895 3.08 1,661 3.20 149 1.54 Scrofula, 101 0.34 177 0.38 35 0.36 Dropsy, 624 2.15 1,496 3.28 312 3.24 This statement would appear to indicate a greater prevalence of con- sumption and dysentery in northern, and of fevers and dropsical affections in southern latitudes. Were this bsolutely true, it is easy to see Avhat 176 INFLUENCE OF THE SEASONS. important results would flow from an exact knowledge of the circumstances connected with the mortality of the different latitudes. The returns are not sufficiently accurate to warrant the assumption of such an important con- clusion from them alone, but the fact that neighboring States in one latitude and contiguous States in another, should exhibit results which naturally lead to such an inference, is a sufficient reason for making a very careful examination of such facts as would sustain or overturn the conclusion. The present mortuary returns of the general government and the States, do not supply sufficient numbers of these facts to warrant the estab- lishment of a deduction from them. Did consumption prevail so much more extensively at the north than at the south, as these returns would appear to show, it might naturally be supposed that its cases would be increased, and their progress accelerated by the rigid season of winter, but an examination of the returns show that the effect of the seasons upon con- sumption is comparatively slight, and that if winter produces any effect at all, it is rather an ameliorating than an injurious one. The distribution of the deaths from consumption among the seasons, is as follows:— Spring. Summer. Autumn. Winter. 9679 8,742 7,982 6,800 Below will be found a table, embracing the deaths from consumption in Massachusetts for five years, terminating with 1855 :— Months. January, February, March, April, May, June, July, Totals. Percentage. 1,744 7.90 1,691 7.66 1,966 8.90 1,948 8.82 1,942 8.78 1,698 7.60 1,790 8.10 Months. Totals. August, 1,884 September, 1,947 October, 1,850 November, 1,739 December, 1,869 Unknown, 23 Totals, 22,091 Percentage. S.53 8.81 8.38 7.87 8.46 .10 100.00 UPON MORTALITY. 177 The deaths in Kentucky from consumption, in 1852, were 956, or 9.20 per cent, of the deaths from all known causes. In 1853, the deaths from this disease were 846, or 11.45 per cent, of all the deaths. The months in which the deaths took place are as follows:— Months. Totals. Months. Totals. January, . 57 July, . 75 February, 67 August, 69 March, 72 September, . 67 April, 104 October, . 62 May, . 78 November, 62 June; 79 December, 64 From these various tables, it appears that the two maximum periods of death from consumption are in the spring and autumn, and the two mini- mum periods in winter and summer. In this respect the observations made in Kentucky corresponded very nearly with those made in Massachusetts. They likewise agree as to the age upon which consumption falls most heavily, which is between twenty and thirty years of age. One-fourth of all the deaths which occur from this disease are singled from those who are at this interesting period of life. The next most fatal period is that between thirty and forty, after which the proportion of deaths, as compared with other diseases, or with itself at these periods, rapidly declines. The proportion of female to male deaths is greater than in most other diseases; in Massachusetts they bear the relation of 59.06 females to 40.80 males, and in Kentucky a proportion nearly corresponding to this. But, although the characteristics of the disease are identical in both places, and exhibit a remarkable similarity in the season of the year, the period of life, and the sex upon which it falls, yet the relation Avhich it bears to other diseases, as developed by these returns, is widely different, and appears to corroborate the census mortality returns. 22 178 EFFECT OF LOCALITY Dr. Bowditch, of Boston, under the auspices of the Massachusetts Medical Society, is making a series of careful examinations throughout the State as to its origin and possible means of prevention, from which it is hoped many valuable facts may be derived, even should he fail to obtain any information by which its progress can be materially arrested. Were it possible to extend a series of similar observations, minute and accurate enough to determine its relative fatality to the number living or the aggregate dead over the whole Union, their importance would be greatly above the expenditure required for their prosecution, or the labor necessary for their accomplishment. The facts already elicited lead to the belief that results might be obtained, which would not only be gra- tifying but in the highest degree beneficial to humanity. Next to consumption, dysentery is the most fatal disease of the northern States, and a very serious one at the south. Unlike consumption, its heaviest demand is made upon the earlier years of life—full one-half of all the deaths from this disease taking place in the first five years of existence. It also differs from consumption in the fact that it is amenable to the in- fluence of the seasons. It prevails to the greatest extent in the months of August and September, and almost entirely ceases in the depth of winter and early spring. In Kentucky, dysentery is so fatal a disease, that it is styled by the Registrar "the great scourge of the State." In 1852, there were 1,923 cases, which constituted 18.47 per cent, of the entire mortality of the State. During this year epidemic cholera prevailed to a considerable extent, and caused 722 deaths. In the following year, 1853, its intensity was con- siderably diminished; but it yet furnished a large item for the annual list of deaths—the number was 901. In some portions of the State it was par- ticularly fatal; as an example, out of 113 deaths returned from Simpson county, 84 were ascribed to dysentery. UPON MORTALITY. 179 These two diseases select most of their victims from comparatively early life ; and although no age is exempt from them, yet the period inter- vening between twenty and thirty years of age is that upon which the former falls most severely, and that from birth to five years, the one most susceptible to the latter. Nor are they confined exclusively or mostly to city life, but are found to prevail in the balmy atmosphere of rural districts, as well as the confined and vitiated air of town. The returns of Kentucky, as made manifest in the registration reports just cited, and by the mortality tables of the census of 1850, exhibit a larger proportion of deaths from dysentery than the other States whose latitude is equally low. This corresponds very well with the prevalent opin- ion heretofore entertained by the medical men of Kentucky, unsustained by statistical evidence, and gleaned exclusively from observation. How far the peculiar geological formation, upon which the soil of the greater part of the State reposes, which consists of a disentegrated grey and blue limestone, contributes to bestow this unfortunate precedence on Kentucky, or whether it in truth exists to the extent hitherto supposed or revealed by the returns of deaths, are questions that can only be solved by a more careful notation of the deaths occurring within the State, and the rendition of similar returns from other southern States. Fever, in all its varieties, except scarlet fever, which is essentially a disease of childhood, and dropsy, fall with greatest intensity upon middle and advanced age. An examination of the census table, giving the ages at which death took place from particular diseases, as well as the returns made by the separate States, fully sustain this opinion, and at the same time show that a greater relative proportion of these diseases occur in southern than in northern climates. The annexed statement shows the percentage of deaths which occurred 180 EFFECT OF LOCALITY in Massachusetts for a period of twelve years and in Kentucky for one year, from each of the causes above named :— Consumption. Dysentery. Fever. Dropsy. Massachusetts, . . 22.44 7.54 7.08 2.34 Kentucky, . . . 9.20 18.47 15.18 2.21 This statement covers a period sufficiently long, in the State of Massa- chusetts, to correct the errors of a single year, and without doubt gives a faithful representation of the average per cent, of mortality from each of the diseases included in the list. The period covered by Kentucky, how- ever, is too short to be equally reliable; besides, in the year indicated, 1852, dysentery prevailed in an epidemic form throughout the State, and was un- usually fatal. The comparison is the best at hand, and gives some concep- tion of the relative prevalence of consumption, fever and dropsy, in each of the respective States. The purpose, however, is not so much to show the relative prevalence of the one or the other disease, in these two States alone, as to" indicate by their ratios of mortality, taken as types of a large extent of country, the particular classes of disease to which each are most exposed, and which prove the most destructive to human life. It is to be regretted that no series of statistics of mortality, equally re- liable with those of Massachusetts, are to be found in any southern State, with which a comparison might be made with more satisfactory results than the one just instituted. It is of the first importance to ascertain the rela- tive prevalence of particular diseases in particular latitudes, because as each falls with greatest violence upon some particular period of life, it is possible to arrive at tolerably correct conclusions in regard to the most fatal age in different climates, by a knowledge of the diseases most common to them. Thus it would be fair to infer, that if the diseases which have been UPON MORTALITY. 181 mentioned as having most prevalence at the north or the south, as the case may be, really do prevail in either latitude to the extent which has been indicated, then the ratio of the population in either section, at particular ages, will indicate their presence or absence. With the view to develope this proposition, a table giving the per cent, of the several ages of the white population of each of the States to the total population of these States, as deduced from the census of 1850, is introduced:— States and Territories. ■3 o o o © id CO o © © O © © © io o © © d o d O > o a a a P 2.86 3.37 0.29 2.63 2.07 2.74 2.75 2.91 3.14 3.27 3.18 3 10 13.88 15.03 1.77 10.66 8.84 11.68 13.78 14.10 13.57 13.70 14.67 13.47 11.86 10.60 11.57 9.13 12.35 14.45 13.61 8.48 11.20 10.58 12.62 12.80 12.19 9.58 12.77 13.69 14.13 9.89 12.56 13.42 12.44 12.30 13.27 15.30 15.87 16.27 2.28 12.96 10.56 13.94 15.80 16.06 15.35 15.96 16.13 15.36 12.97 12.77 13.06 10.34 14.99 16.20 15.37 10.78 13.04 12.21 14.50 14.72 13.80 10.5G 14.78 15.71 15.34 12.15 14.55 13.85 11.91 14.18 14.07 12.04 13.88 14.25 2.13 11.57 10.44 12.54 12.48 13.95 13.34 13.58 13.19 13.27 10.94 12.31 11.94 9.86 12.54 13.93 13.39 10.79 11.84 11.07 13.25 12.88 12.04 10.25 13.46 15.04 12.86 11.52 13.12 11.14 9.29 11.42 10.77 12.07 11.67 11.13 5.94 10.67 10.47 10.92 10.06 11.24 10.96 11.33 10.47 11.15 9.05 11.50 10.34 10.65 10.75 10.82 10.90 11.26 10.76 10.78 11.20 11.16 10.68 10.43 11.02 11.75 10.33 10.93 10.91 9.43 7.55 11.41 9.18 11.70 16.90 17.53 50.60 19.70 19.36 17.83 18.02 16.95 17.74 17.11 16.86 17.62 21.£5 17.14 18.74 21.23 17.38 17.18 18.28 18.00 18.33 20.25 17.30 17.76 18.43 20.74 17.23 17.00 18.67 16.95 17.33 19.13 28.44 20.47 24.28 19.02 10.77 10.77 24.50 13.91 13.59 12.77 12.51 10.28 12.11 10.98 12.54 11.03 16.64 11.95 13.44 14.46 12.95 11.25 12.12 12.53 12.68 13.58 11.05 11.64 12.27 14.27 11.22 10.21 12.64 12.45 11.33 14.67 16.08 11.77 14.43 12.00 6.96 6.51 8.72 8.65 9.94 8.51 7.39 6.93 7.34 6.88 7.17 7.09 8.36 9.15 8.65 9.67 8.66 6.82 7.05 10.17 8.71 8.96 7.64 7.69 8.28 9.48 7.71 6.79 7.34 9.92 7.92 8.13 7.00 7.13 6.55 8.09 4.15 3.22 2.41 5.41 6.96 4.94 4.40 4.03 4.00 4.30 3.72 4.22 3.64 6.03 5.13 6.05 4.57 3.86 3.73 7.46 5.55 5.39 4.96 4.55 5.07 6.06 4.98 4.12 3.62 6.72 5.02 4.33 3/01 4.67 3.26 3.75 1.96 1.36 .50 2.64 4.51 2.65 1.95 2.25 1.70 1.97 1.51 2.30 1.46 3.56 2.76 3.71 2.17 1.72 1.59 4.83 3.21 2.95 2.82 2.69 2.84 3.76 2.72 2222 1.36 4.26 2.84 1.82 1.03 2.76 1.13 1.71 .80 .43 .09 .90 2.33 1.14 .66 .92 .54 .69 .43 1.00 .47 1.80 1.15 1.81 .71 .62 .50 2.67 1.41 1.29 1.31 1.02 1.20 1.78 1.23 1.03 .39 2.26 1.28 .50 .33 .93 .16 .47 .23 .09 .03 .23 .78 .26 .16 .30 .11 .17 .09 .31 .11 .59 .30 .58 .14 .15 .12 .96 -44 .38 .40 .26 .33 .56 .41 .32 .09 .76 .39 .10 .08 .52 .02 .04 .04 .01 .01 .03 .08 .03 .03 .05 .01 .03 .01 .05 .02 .06 .04 .06 .02 .02 .01 .13 .04 .04 .06 .03 .03 .06 .08 .05 .01 .08 .06 .01 .03 .14 .01 .01 .01 .01 !oi .01 .01 .01 .01 .01 .01 '.'67 0?, 02 73 Columbia, District of... .04 07 ,05 01 09, 09 03 03 .02 —Louisiana............ 2.70 2.40 2.88 2.33 2.74 2.93 3.31 1.92 2.76 2.47 2.87 2.87 2.79 2.46 2.35 3.03 3.09 2.10 2.65 3.41 2.78 2.00 2.37 3.81 2.75 .12 14 .12 .03 .05 .02 .02 .03 .05 North Carolina........ Ohio................. .02 .03 .05 Rhode Island......... South Carolina........ .01 .03 .03 .12 .01 03 .06 f Minnesota..... Terri- J New Mexico .. [Utah........ .23 .50 Total.............. 12.00 13.83 12.28 10.89 18.55 12.36 8.13 4.90 2.67 1.15 .34 .04 .05 182 EFFECT OF LOCALITY UPON MORTALITY. From this table it would appear that, as a general rule, the per cent. in the earlier years of life, to the whole population, is greater in the south- ern than in the northern States; that this difference disappears in middle life, from 20 to 50, when, unless affected by migration, the proportions become about the same in both latitudes, and that from this period the per cent is steadily in favor of a northern climate until the last, when it returns again to the south. New Hampshire, which exhibits a smaller percentage of population in the earlier years, shows a largely increased one in the declining period of life. This is, doubtless, in part due to the emigration which has for years been at work in draining the State of its more youthful population, while it has left a large proportion of the aged at home; but the universality of the law requires some more general and effective means than emigration to account for its action, and this is doubtless to be found in the relative preva- lence in different latitudes or states of one or the other of the diseases through which the flood of humanity flows to its destined goal. AGE AT DEATH. 183 CHAPTER XV. AGE AT DEATH. One of the most valuable elements connected with mortality returns, is a correct enumeration of the ages at which death takes place, for, as it is possible by a knowledge of the diseases which usually prevail in a parti- cular locality to determine with considerable certainty the ages upon which these diseases fall, so it is likewise possible, with the age at death, conjoined to those of the living, to estimate the comparative healthfulness of different places, and the probable diseases which prevail, and consequent value of human life within them. It has already been seen, that the relative proportion of persons of a given age, to the whole population, differed very materially in different climates, and it has been inferred that the ages at death would correspond- ingly differ. This would probably be true if the population was stationary ; but as it is affected by migration, the proportions cannot always be depended on, as many elements besides mortality conjoin to disturb these relations. The first prominent feature that arrests the attention in an examination of this subject, is the great mortality that prevails among the young. 181 INFANTILE MORTALITY. In all countries, and under all circumstances, in the same country, death makes its heaviest demand upon the infantile portion of the popula- tion ; but although the demand is always greater upon this age than upon any other, yet surrounding circumstances have much to do in rendering it comparatively moderate or excessive. Between the pure air of the country and the more confined atmos- phere of town, or between the healthy portions of town, inhabited by the more opulent, and the confined and filthy courts in which the poor congre- gate, the differences are wide and startling. In regard to this particular period of life, it must be admitted that the mortality returns of the census are not what they might be desired, and probably very largely fall short of the mortality. A reason for their want of accuracy in this report is easily found in the facility with which the deaths of young children escape recollection, while those among older persons are remembered. Hence, when a record of them is required, it might easily happen that those who were competent to furnish information were negligent without meaning to be so. The larger part of the returns would seem to bear out the inference already drawn from the comparative rates of mortality among the young, manifested by the Massachusetts returns, and those of Charleston and New Orleans. From some, however, a different conclusion might be drawn; and as it has happened in more than one instance that the returns of two neighboring States, influenced apparently by the same causes, and subject to the same laws, yielded an entirely different result, it has been deemed most prudent to leave their guidance entirely, while investigating the facts connected with the mortality of infants, and the influence of locality upon it, and trust to those more scanty, but more reliable, records which the States in a few instances, and the populous cities in many, have placed within reach. IN TOWN AND COUNTY. 185 It is true, that these latter returns are confined exclusively to that phase of life which developes itself in aggregate numbers, and as the pro- portions between city and country mortality are quite at variance with each other, the same reasoning cannot be applied to both. The State returns are not numerous, and the mortuary records of the census in their applica- tion to infantile life are abandoned with greater regret, because they would, if reliable, have furnished most important data by which to elucidate the laws which regulate the infantile mortality of those rural districts in close proximity with the towns which have kept for a series of years bills of mortality. In some portions of the country this infantile mortality is rather increasing than diminishing, and presents figures which are certainly large. Mr. Shattuck found that the infantile mortality of Massachusetts had increased in four years, from 1757 to 1762, or over 6 per cent, and that the deaths of children under one year, amounted to 17.62 per cent, of the whole.* Dr. Curtis shows that 49.81 per cent, of all those who died in the cities of Massachusetts were under ten years while, in rural districts 41.11 per cent, of the deaths were under ten. " This," he properly remarks, " is a high rate to be sustained by persons who have not attained the termina- tion of the tenth year of existence, and, so far as we have statistics, speaks more unfavorably for the cities than the rest of the State, "f In Charleston, the mortality under ten years, is 36.95 per cent., and in New Orleans it declines to 33.38 per cent. This would confirm the infer- ence that a rigorous climate was unfavorable to the tender age of infancy and early youth, and that a warm one was that best suited to their condi- tion. Dr. De Sassure and Dawson, however, in presenting a table of the * Shattuck's Letter to Secretary of State of Massachusetts, p. 83. f Eighth Registration Report, p. 116. 23 186 FARR ON THE deaths which have occurred in Charleston, from 1822 to 1848, complain that the proportion of deaths under one year has increased from 15.59 to 17.32 per cent, or about the same as that of Boston. In the succeeding years, and especially the last few, the diminution, as compared with Massachusetts, was such as to render the whole mortality occurring, under ten years, 4.16 below that of the whole State of Massachusetts, and 12.86 per cent, below that of Boston. From the Charleston mortality, which is inserted, it will be seen that the infantile mortality has been subject to great fluctuations, averaging from 1822 to 1836, 15.59 per cent, falling for the next period, from 1830 to 1840, to 13.09, and again not only rising to its former standard, but surpassing it, and assuming an attitude of 17.32 per cent. The proportion of this mortality, between the races, is as follows : First Period. Second Period. Third Period. White, . . . . 9.11 7.70 10.82 Black, .... 21.07 17.24 '21.64 The average age at death has been considered so good a test for the comparative healthfulness of a country, that the States of Massachusetts, Kentucky and Rhode Island have taken good care, in tabulating the returns made under their respective registration acts, to ascertain and record the average age at death with considerable precision. The process of ascer- taining the average age at death is simple, and consists in adding up the sum of the ages of those who die, and dividing the aggregate among the number of deaths. This means of determining the relative health of a given population has been in use for a long period, and was in fact employed before any enu- merations were made of the living. It is liable to very material errors, when applied to a population as fluctuating as that of the United States, which have been ably pointed out by Mr. Farr :— AVERAGE AGE AT DEATH. 187 " Take a street (C) in a town where, from the erection of new fac- tories, or from any new field of labor being thrown open, a considerable number of young men and women have been attracted within the last 10 or 15 years; there is a demand for the labor of children; marriages take place ; nearly all the young couples have children, two, three, or four in a family. Take another street (D), inhabited by artisans, whose business and numbers have remained nearly stationary, and tradespeople who have suc- ceeded to old shops established by their fathers;—suppose the salubrity of the two streets, and the rate of mortality at the corresponding ages, the same,—it is evident that as the street C contains no old people, and the mortality in the first two or three years is always relatively high, the deaths registered will be at early ages—the mean age at death low ; while in the street D, the deaths will many of them be at old ages, and the mean age at death relatively high. If all the inhabitants of the two streets died in one year, the mortality would be the same. Yet the mean age at death would differ in the same ratio as the mean age of the living. The same results would be produced by the death of one-thirtieth of the inhabitants in each street The cases which have been put will enable us to understand such a case as is said to have occurred in Leicester, where the mean age at death was 131 years in the undrained streets, and 231 in the drained streets. That the real mortality was higher in the one class of streets than in the other, is probable; but this is not proved by the method, for the undrained streets may be new streets, inhabited by young people—a part of the 8,600 in 46,000 not born in Leicestershire; while the drained streets may be old streets inhabited by the old inhabitants of the towns.* On account of the system of compensation which it involves, the method of comparing the total deaths to the population of the streets gives results nearer the truth; * I find, upon turning to the Census Returns, that the population of some of the new and old streets in Leicester differ in the manner described. 188 FALLACIES OF THIS METHOD but ho one acquainted with inquiries of the kind would place much con- fidence in any other method, as applied to particular streets or small dis- tricts, than that upon which the Life Table is founded—the comparison of the numbers living with the numbers born and dying at the several periods of life. In the Registrar-General's Report, the mortality is only given for statistical districts of an average population of 50,000. " The mean age at death in the districts of the metropolis furnishes a series of very striking illustrations of the errors of the method: according to which Greenwich is the healthiest district in the metropolis; and would be placed first in a table of salubrity, as the mean age at death is 36 years in Greenwich, and only 31 in Hackney, 31 in St. George, Hanover-square. This result is produced by the accumulation of old men in Greenwich Hos- pital,* who, of course, die at advanced ages, and make the mean age at death high. Supposing the mortality among the old veterans to be the same as the mortality of the general population, it is evident that the living at 60-70-80, &c, would be increased as much as the dying, and that the method of comparing the deaths with the living would give true results. Rotherhithe, according to the same method, is healthier than Islington, Marylebone, and Pancras: in Whitechapel the mean age at death is 26 years; it is placed therefore higher than St. James's district, comprising the lower end of Regent-street, and higher than the wealthy City of London, in in which the mean age at death is only 25 years; an effect to be ascribed partly to the City of London workhouse for old people at Peckham, which is also one of the causes why the mean age at death is 25 years in the city, and 34 years in Camberwell. The ' mean age at death' is 21 years in St. Saviour, and 30 in St. Olave. That these results are absurd must be evident to all who are acquainted with the subject." f * The deaths of 291 pensioners were registered in 1841; the total deaths in the Greenwich District were 2198. t 6th Registrar-General's Report, p. 575. ILLUSTRATED. 189 There is probably no country to which these remarks are more appli- cable than to the United States. It is asserted by Mr. Farr that the popula- tion in England is so much affected by migration as seriously to interfere with the results of the average age at death, or the mean age at death, which is but another form for expressing the same idea. But the fluctu- ations of population in England are trivial, when compared to those that take place in the United States. Not only is the amount of immigration largely in advance of that of any other country, whose statistics of popula- tion are known, but the changes of the native inhabitants from place to place are much greater than those of any other people. The restless and indomitable spirit which is characteristic of the Ame- rican nation, and induces them to court hazard or risk, either of life or property, apparently for the sake of overcoming it, has entirely absorbed all great attachment for place or love of home. The associations which gather around this sacred spot, and endear it to the hearts of the people of most nations, is one of slight tenure in the breast of an American. It is true that among the aged, who have spent a long life upon their quiet acres, in the deep bosom of the country, this feeling is still extant, and occasion- ally one of their more adventurous offspring, who has gone forth in the busy world, and is involved in its cares and perplexities, turns a lingering look towards the old homestead, where his quietest and happiest hours have been passed; but this feeling is but momentary, and is chased away the next instant by some one of the many schemes that take possession of his restless mind. Occasionally one, in whose breast the recollection of home is more vivid than is usually the case, returns to his native acres and strives to find happi- ness in maturer years in the contemplation of the scenes of his youth; but it usually happens that the glad spirit which enlivened that period, and beautified every running brook or shady glen, with a coloring of its own, has 190 AVERAGE AGE AT DEATH fled, and in place of the blithesome boy, the care-worn man gazes upon the scenes which once inspired the most delightful emotions with a listless eye and languid look, and wonders how his youthful fancy could have been taken captive by the scenes upon which he now coldly looks, with but little pleasure and much pain. A visit like this too frequently dispels the gay illusion which the man of the world amid his many cares had created for himself, and he returns to the world a wiser but also a sadder man ; and if he changes his place of residence, it is to some one further removed than ever from that of his youth, where the associations which he forms are those of the moment. The great uncertainty of this rule, when applied to such a population as that of the United States, is still further illustrated by a comparison of the average age at death, in the States of Massachusetts and Kentucky. In the former, for a period of five years, ending January 1st, 1854, 92,174 deaths are recorded, whose average age was 26.93 years. In the latter State the recorded deaths, in 1852, amounted to 12,058, with an average age of 20.55 years for the white population, and 17.59 for the colored. During the year 1853, 9,105 occurred, the average ages of which were 20.76 years for the whites, and 18.34 for the colored deaths. Thus— Massachusetts, for five years, average age at death, . . 26.93 years. Kentucky, for 1852, white, u u a . 20.55 " " " black, u u a . 17.59 " " for 1853, white, u n a . 20.76 " " " black, a n a . 18.34 " These facts establish pretty clearly the proposition, that the more youthful a country or population is, the less will be its average age at death, provided the proportion of females assimilates pretty nearly to that of the males, as it is the presence and death of the infantile part of the population that reduces the average age at death. In California, where the IN NORTHERN AND SOUTHERN LATITUDES. 191 female portion of the population is greatly in the minority, a high average age at death might be expected; whereas in Indiana, Iowa or Kentucky, it would probably be low, for it is to be taken for granted that in each of the new States the proportion of children to the number of females of a mar- riageable age is greater than in the older ones. It will be seen that those populations in the old world and in the new, that remain in the most perfect state of repose, losing perhaps their younger members by emigration, but receiving none of the same age in return, exhibit the highest average age at death. This is evidenced by Geneva, in Switzerland, and Concord, in New Hampshire, both of whose populations are remarkably stationary. Plympton, in Massachusetts, is another evidence of the effect of an aged and stationary population upon the average age at death. " The whole number of deaths in Plymptom, during thirty years, from January, 1812, to January, 1842, was 218 males, 226 females; total, 443. The average age of all the deceased persons, was 40 years, 10 months, and 25 15-24 days. The average age of the males was 39 years, 9 months, and 9 20-24 days. The average age of the females, was 41 years, 11 months, and 28 8-24 days. There were probably as many people in Plympton, at the commencement of the war of the revolution, as there are now, i.e., 861."* These illustrations show that the same causes which produce a low average age, either of the living or the dead, operate alike in both hemis- pheres, and are the peculiar incidents of American life. That a large per- centage of infantile mortality will not only depress the average age at death, but also that of the living, is readily admitted; but this is not the only cause competent to produce this result, nor is it always a manifestation of the unhealthiness of a place, and certainly none of its want of prosperity, as is made manifest by a comparison of some quiet town in New England, and an active town in the New States. * Report of Town Clerk. 192 AVERAGE AGE AT DEATH The annexed table exhibits the average at death in Boston, New York, Philadelphia and Charleston, four cities in different degrees of latitude, situated upon the Atlantic seaboard, and of an age corresponding tolerably well with each other :— All Ages. Under 20. Over 20. Place and Period. Number. Average Age. Number. Average Age. Number. Average Age. Charleston, 1822 to 1830, ) Whites, > Blacks, ) Both, 3,447 4,076 7,523 32.63 28.66 30.59 963 1,950 2,913 4.62 3.93 4.16 2,484 2,126 4,610 43.55 51.33 47.28 1831 to 1840, ) Whites, > Biacks, ) Both, 3,366 4,297 7,663 32.65 30,74 31.05 866 1,957 2,823 5.14 4.70 4.88 2,500 2,340 4,840 43.26 48.24 45.11 1841 to 1848, Whites, v Blacks, ) Both, 1,866 2,847 4,733 33.41 28.35 30.39 614 1,416 2,030 3.68 3.90 3.83 1,272 1,431 2,703 47.74 52.56 50.29 Boston, 1821 to 1830, Both, 10,731 25."88 4,913 3.38 5,817 44.88 1831 to 1840, u 16,314 22.72 8,565 3.33 7,749 44.15 1841 to 1845, a 10,422 21.43 5,875 3.31 4,547 44.86 New York, 1821 to 1830, a 42,817 24.36 20,018 3.15 22,709 43.14 1831 to 1840, << 74,819 19.46 40,728 2.95 34,091 39.18 1841 to 1843, a 29,939 19.69 14,127 2.86 10,812 41.68 Philadelphia, 1821 to 1830, a 36,614 25.53 17,794 3.22 19,820 45.57 1831 to 1840, u 49,678 22.64 26,812 2.91 22,866 45.78 1841 to 1844, n 21,356 22.01 12,088 3.02 9,268 46.79 An examination of this table leaves no room to doubt that New Yor and Philadelphia were depressed to this low standard, by the great mortality which prevailed in each among the infantile portion of the population. It has already been seen that the infantile period of life was more kindly dealt with in the warm climate of the southern States, and it might reasonably be anticipated that in proportion to the number of inhabitants living of that age, the deaths would be fewer at the south than at the north. GENERAL OBSERVATIONS. 193 CHAPTER XVI. GENERAL OBSERVATIONS. An attempt has been made in the preceding pages to take a compre- hensive survey of the vital condition of the population of the whole Union, and, so far as the facts permitted, to pourtray and classify the peculiarities of each section. The materials used in the prosecution of this undertaking, were not all that might be desired, but such as actually existed, and could be commanded. In many instances they have been sufficient not only to lead to suggestions, but also to substantiate them; in others, they have only served the purpose of exciting the mind to the adoption of an infer- ence, without supplying the materials necessary to prosecute it to a final conclusion. Some of the most apparently important deductions, drawn from scanty and insufficient data, are in this position, and await the accumulation of a sufficient number of facts to prove their correctness, or show their improba- bility. In no part of the country has the registration of births, deaths and marriages been conducted with sufficient care, and arranged with sufficient precision, to ensure such results as might be desired, with the single exception of the State of Massachusetts, whose labors in this department of enquiry are above all praise. 24 194 EFFECT OF LOCALITY Climate and latitude are seen to exercise an influence in the production of particular diseases, and in the relative number of deaths at particular ages, too evident not to be admitted, and too important to be overlooked. " The influence of climate," says Dr. Johnson, in his work on Italian climate, "not only on the complexion, but on the features and the whole organization of man, as well as of animals and vegetables, is now unques- tioned. The inhabitants of Italy, notwithstanding the unlimited admixture of Gothic, Grecian, African and Asiatic blood, are almost as uniformily natu- ralized in respect to color, features, and even moral character, as the inha- bitants of Spain, Greece, Egypt, Hindostan, or China. It is impossible to attribute this natural stamp, or impress entirely, or even principally to race or hereditary descent, in any country, and least of all in Italy, which, from the circumstance of its universal domination at one time, and complete subjugation at another, became an immense human menagerie, where specimens, nay, colonies of every people on the face of the earth, were commixed and blended together ad infinitum. Climate, then, assisted by some other physical causes, and many of a moral nature, has effected as homogeneous a people, mental and corporeal, in Italy, as in most other countries."* Dr. Armstrong, Deputy-Inspector of Hospitals and Fleets, in the Eng- lish service, says: "So powerful are the effects of external circumstances, that some of the most striking changes have been produced in the human constitution in the course of a few generations, and become permanent. In the West India Islands the white race, descended from the earlier European settlers, as well as those brought from England, in early life, are tall and well proportioned, with great freedom in the joints. In general, however, the chest is less capacious, and the muscles less strongly marked. Pecu- Johnson on Change of Air, p. 225. UPON MORTALITY. 195 liarities are also observed in the greater prominence of the bones of the cheeks and depth of the orbits; the complexion is paler, and the skin cooler. In New South Wales, the descendants of the first settlers exhibit the same peculiarities, although in a less degree. " The influence of warm climates is apparent after a few years' residence within the tropics. Europeans lose their sanguineous complexions and ac- quire the power of resisting heat better than the new comer. This power of accommodation to circumstances arises from a corresponding change in the functions of life, and which is usually attributed to the individual having undergone the process of seasoning, a process of which the most vague opinions seem to be entertained. Even within the limited extent of our own country (England) we observe the influence of local situation on comparing the natives of mountainous districts with those of the low country."* It is stated by Sir James McGregor, Director General of the Army Medical Board, that so great is the influence of climate and surrounding circumstances upon the physical character of the human race, that a corps levied from the agricultural districts of Wales, or the northern counties of England, will last much longer and endure more hardship than one pro- cured from the materials which abound in the manufacturing towns, as Birmingham and Manchester. The effect upon the physique by residence in manufacturing towns is particularly striking. Thus, out of 613 men enlisted in Birmingham and its neighborhood, but 238 were approved as fit for service. This permanent deterioration is still further illustrated by the disqualification for those posts requiring a certain standard of size and strength, produced by long residence in the more crowded parts of London. It is said, that of the men from Spitalfields, and other crowded districts in * Armstrong on Climate, p. 8. 196 EFFECT OF LOCALITY London, who apply for situations in the police force, two out of three are rejected, as physically unfit. In further illustration of this point, " it is observed, that in some of the worst conditioned of the town districts, that the positive number of natives of the aboriginal stock continually diminishes, and that the vacancy, as well as the increase, is made up by emigration from healthier districts."* In regard to the influence of climate in our own country, Dr. Prichard remarks:—"The tall, lank, gaunt, and otherwise remarkable figures of the Virginians, and men of Carolina, are strikingly different from the short, plump, round-faced farmers of the midland counties in England. The race is originally the same, and the deviation in it must be attributed to the in- fluence of the circumstances, whatever they may be, which are connected with local situation."f ■ All of these authorities, which might be greatly multiplied, are empha- tic in their testimony as to the influence of climate over the human organi- zation in a state of health, predisposing it to disease under certain defined circumstances, and preserving it from them under others. The facts col- lected in the preceding pages demonstrate the extent of this influence in the wide range of latitude and climate embraced within the limits of the United States, " which is," says Maltebrun, " so inconstant and variable, that it passes rapidly from the frosts of Norway to the scorching heats of Africa, and from the humidity of Holland to the drought of Castile." The effect of climate is greatly modified by long residence, by which means the system undergoes a change fiting it to withstand the deleterious influences that surround it. This process is termed acclimation, and is espe- cially marked in its effect upon the constitution of those who change their * Report of Poor Law Commissioner, 1842. f Researches into the Physical History of Man, by James Cowles Prichard, vol. 2, p. 56S. UPON MORTALITY. 197 residence from a cold to a warm latitude. " Habit," remarks Dr. La Roche, " seems to possess the power of modifying the system to so great an extent, and so permanent a degree, as to justify those who hold it in the light of a second nature. In virtue of the influence it exercises, and the peculiar organic changes resulting from long exposure to the sensible and insensible qualities of the atmosphere, or to the extraneous materials by which the atmosphere may be contaminated, man enjoys the faculty to which I have alluded, of living under climatic influences of the most diver- sified characters. He resists the inclemencies of the elements, the insalu- brity of the seasons, the extremes of temperature, as well as the action of malarial and other exhalations. With time, the native of the north acquires the privilege of supporting with impunity the scorching rays of a tropical sun, though the result is not obtained without inconvenience, suffering, and even danger, and without, in the greater number of instances, subjecting the individual to the ordeal of disease. Not so easy is it to become habitu- ated to the baneful action of those modifiers—such as malarial exhalations— which exercise their agency on the principles of vitality.* Those who are born in the neighborhood of marshes, are less affected by the miasm arising from them, than new comers, who are almost certain to be attacked by malarial diseases. The American bottom, which is situ- ated in Illinois, contiguous to the Mississippi river, and extends backs to the bluffs, some few miles inland, presents one of the most extensive marshy districts in the United States. The inhabitants of this fertile but miasmatic district, although possessed of a yellow and sallow hue, acquire the power of resisting the miasmatic influence that constantly environs them to a cer- tain extent, while an exposure for a single night to those unaccustomed to the miasm is almost certain to be followed by an attack of fever. It is so * La Roche on Yellow Fever, vol. 2, p. 20. 198 ACCLIMATION TO customary for strangers visiting the more southern parts of the valley of the Mississippi to be attacked by fever, that Dr. Fenner says, " the term accli- mation is perfectly well known to all the inhabitants of the lower valley, and indicates that persons coining from a northern climate and settling there, arc very liable to have attacks of fever during the first two or three years of their residence, but afterwards become quite exempt." * Drs. Nott, Dickson, and many other southern medical men Avho are in the habit of observing the effect of long-continued residence in malarial districts, are of the opinion that the system is rather predisposed to an attack of autumnal fever, by having previously suffered rather than pro- tected by its occurrence. In the malarial districts of Maryland, the writer has had occasion to observe frequent attacks in the same individual, and has known one instance in which a gentleman has suffered from sixteen attacks of remittent fever in seventeen consecutive seasons. These observations, although applicable with greater force to southern than northern latitudes, are nevertheless general in their application, and ex- tend to all varieties of climate and many modifications of disease. The same laws which modify the temperature, arrange the constituents of the soil, and bestow upon the inanimate objects of creation their peculiar and marked characteristics, also exercise their control over the human system, bestowing upon it peculiarity of color, shape, and powers of en- durance, and so modify it as to fit it for the particular situation in which it is placed. The most fatal disease, however, to those who are unacclimated, is yel- low fever, which prevails within the tropics and in the southern cities of the United States. Dr. Barton, in his excellent report on the yellow fever, as it occurred in New Orleans, has a table showing " the life cost of acclimation; * Fenncr's Southern Medical Reports, p. 32, YELLOW FEVER. 199 or liabilities to yellow fever from nativity, as exhibited by the epidemic of 1853 :"— Estimated Estimated Ratio per 1000 Nativities—State and Country. population mortality of the in 1853. from Fever. Population. New Orleans, ......„ 0Q, (140 „ go State of Louisiana, .... ' (25 Arkansas, Mississippi, Alabama, Georgia,) oi^r 42 13 2° South Carolina, ....)' North Carolina, Virginia, Maryland, Ten-1 . Qq , -. -o on qo nessee, Kentucky, .... J ' New York, Vermont, Massachusetts, Maine, ) Khode Island, Connecticut, New Jersey, [■ 10,751 353 32.83 Pennsylvania, Delaware, . . . ) Ohio, Indiana, Illinois, Missouri, . . 2,030 92 44.23 British America, ..... 381 20 50.24 Totals,..... West Indies, South America, Mexico, . Great Britain, ..... Ireland,...... Denmark, Sweden, Russia, Prussia, Germany, .... Holland, Belgium, .... Austria, Switzerland, France,...... Spain, Italy, ..... Totals.....62,448 7,011 111.91 It is supposed by many that a continued residence in a city where yellow fever is of frequent occurrence, as in Charleston, Savannah, Mobile, or New Orleans, furnishes an entire immunity against its attack.* It is extremely doubtful, however, whether any permanent immunity can be obtained which is not based upon an absolute attack of the disease. Dr. Stone, of Charity Hospital, New Orleans, whose experience in yellow fever is 66,946 825 12.32 1,790 11 6.14 4,598 240 52.19 26,611 3,569 204.97 588 96 163.26 17,718 2,339 132.01 152 50 328.94 797 176 220.08 9,967 480 48.13 2,217 61 22.06 200 DR. BARTON ON large, is clearly of the opinion that the disease must be once taken in order to afford future protection. In a large practice, he has known no one to escape, although he has frequently observed attacks in young children, and even infants, so slight as scarcely to attract the notice of their nurses or parents. Dr. Barton asserts, " that perfect acclimation is only to be derived from once having had the disease.'''' " One of the most extraordinary features of this epidemic," remarks Dr. Fenner, in speaking of the scourge of yellow fever, in 1853, "is presented in the fact, that the natives of the city, both white and colored, have suffered severely, and many of them have died." The same was observed at Charleston, Savannah and Mobile, as well as those towns on the Mississippi river which were visited by the disease. Nor is the immunity extended to those rural districts where it does not prevail. Dr. Dowler, in speaking of the disease as it prevails at Charleston, says: " Those who live in the higher parts of the State, at a distance of two or three hundred miles, and who come to Charleston during the four months in which the yellow fever commonly prevails, are as liable to be attacked by it as strangers; and, therefore, all intercourse between the country and city is suspended for one-third of the year, excepting that of a few white persons, who, from necessity, go to the latter, always taking care, however, not to sleep there." The table already introduced, showing the relative mortality in New Orleans, in each 1,000, of the inhabitants of different countries, and dif- ferent sections of this country, exhibits in a very remarkable manner the influence exerted by long residence in a"warm climate. Thus among the strangers from the northern portions of the United States, a larger number were attacked than among those from the lower latitudes of Kentucky, Vir- ginia, Tennessee, and North Carolina; and of these latter, a much larger number than from the still lower latitudes of South Carolina, Alabama, Georgia, and Mississippi. The proportions being : MORTALITY IN YELLOW FEVER. 201 From Northern latitudes, . . . 32.83 per 1,000 " Middle " . ... 30.69 " Southern " ... 13.22 In regard to European residents, the same preference for subjects from northern latitudes obtained. While those from Austria, Russia, and Great Britain suffered severely, those from France were less subject to attack, and those from Spain and Italy still less. From this it would appear that a long- continued residence in warm latitudes, even when freed from the causes that produce yellow fever, effects such a modification in the constitution, as to serve in some degree to ward off an attack, and that an eminent predispo- sition is found in that condition of body, induced by a long residence in a high latitude. That the chances of escape from an attack of yellow fever, when exposed to its influence, by a native of South Carolina or Virginia, are greater than those of a native of Ohio, New York, or the New England States, under like circumstances, appears to be tolerably well established. Did the opportunity exist for obtaining similar information in regard to the diseases which prevail in northern latitudes, in the more inclement season of the year, it would probably be found that the natives of warm latitudes suffered much more in the process of acclimation than is generally supposed, and that modifications of habit, equally important with those already noticed, are necessary, in order to enable the southern resident to with- stand the depressing effects of cold. That these alternations of temperature exert a powerful influence over the human organization, and that a continued residence either amid the snows of the frigid zone, or the burning heat of the equatorial region, pro- duces such modifications as to render a sudden transition from the one to the other a matter of extreme hazard, cannot be questioned. Not only the facts set forth in the preceding pages, but the concurrent testimony of 25 202 INFLUENCE OF nearly all accurate observers, goes to show, that independent of all local circumstances, the heat of low latitudes is sufficient to induce a train of affections peculiar to and dependent on a warm climate, while cold, on the contrary, is attended with those peculiar to northern regions. " Fever, dysentery, liver disease in some shape, with every variety of bowel affections, may be regarded as the diseases of hot climates. Cold, on the other hand, when inordinate or sudden, arrests the subcutaneous circu- lation, retards secretion and colorification, and drives the blood from the skin, which becomes rough to the interior, where it circulates sluggishly and in large quantities. The natural effect of this derangement of these im- portant functions is to induce inflammatory or sub-inflammatory affections, especially of those parts which are most engorged. Hence, inflammation of the mucous membrane of the air-passages—cough and bronchitis—are espe- cially induced by sudden or extreme cold."* An examination of the causes of death in different latitudes, as developed in this report, will demonstrate how generally affections of one or the other of these classes are amenable to the influence of elevated and depressed temperature, and how important a feature they constitute in the medical history of the country. In England the winter months are invariably the most fatal, while in the United States they are usually among the most healthy. In regard to the effect upon aged persons, the winter of England and that of the United States presents a fair parallel. A remarkable instance of the effect of long-continued cold upon the human system is found in the case of Dr. Kane and his companions in their recent search in the Polar regions for the ill-fated expedition of Sir John Franklin. Upon the return of Dr. Kane and his party from their residence of three years in a high northern latitude, they found that the effect of summer heat in a northern climate was so depressing as to produce extreme * Dunglison's Human Health, p. 27. COLD AND WARM CLIMATES. 203 nervous prostration, and unfit them for mental or corporeal exertion. In the case of Dr. Kane, this nervous prostration was so great, as absolutely to destroy all power of physical endurance, and finally resulted in his death. The effect of age is important In those affections which are depend- ent upon an increased excitability of the system, as in all the diseases in- duced by warm climates, the middle period of life is that in which they prove most fatal; while those diseases which are induced by a diminution of this excitability, as in the case of those due exclusively to a cold climate, old age, or an impaired vitality, are least favorable to recovery. The effect of this diversity of climate and surrounding circumstances upon the relative prevalence of the one or the other of the diseases to which each are subject, and the comparative duration of life, has been fully recog- nised by those whose duty it is to apply the laws of mortality, either known or supposed, to the operations of life assurance. Experience has de- monstrated to those companies having risks in different countries or in different climates in the same country, that the percentage of mortality, under apparently like circumstances, is greater in some situations than in others, and that what might be a profitable rate in one would be a losing rate in the other. The annexed table, showing the combined results of the operations of the order of Odd Fellows in the United States, for ten years, commencing with 1843, and ending with 1852, is highly pertinent to this subject, and illustrates, in the most marked manner, the influence of locality upon health and disease. This table derives additional value from the circumstance that the Odd Fellows were for the most part like those who seek assurance in the middle period of life :— 204 STATISTICS OF MORTALITY ite Grand Lodges. Beneficial Members. Number Sick. Ratio Sick. Number Deaths. One death to each Maryland, . 59,131 13,021 4.5 641 92 Massachusetts, . 78,711 9,892 7.9 659 119 S. New York, . 161,742 28,818 5.6 1,733 93 N. New York, . 93,142 14,662 6.3 653 142 Pennsylvania, . 204,689 37,150 5.5 1,829 111 District Columbia ,, 10,398 2,458 5.2 77 135 Delaware, . 7,800 1,016 7.3 61 127' Ohio, . 59,673 9,973 5.9 639 93 Louisiana, . 9,924 1,110 8.6 211 47 New Jersey, Kentucky, Virginia, . 42,671 . 17,561 . 31,048 6,989 2,197 4,824 6.1 7.9 6.4 322 243 336 132 72 92 Indiana, . 17,981 2,582 6.9 203 88 Mississippi, . . 8,266 816 10.1 89 92 Missouri, . 10,988 1,446 7.6 187 58 Illinois, . 14,339 1,613 8.3 162 88 Texas, . 1,340 139 8.2 34 39 Alabama, . 7,469 725 10.3 119 63 Connecticut, . . 37,713 5,843 6.4 273 138 South Carolina, . 13,812 1,518 9.0 128 107 Tennessee, . 11,918 860 13.3 93 128 Georgia, . 11,768 1,403 8.3 134 87 North Carolina, . 6,710 645 9.8 59 113 Maine, . 33,138 3,543 9.3 271 122 Rhode Island, . 9,621 1,537 6.2 78 123 New Hampshire, . 14,454 1,812 7.9 120 120 Michigan, . 14,341 2,077 6.9 111 129 Wisconsin, . . 9,099 625 11.8 58 156 Vermont, . 4,785 490 8.2 27 177 Iowa, . 4,380 425 7.9 6.3 36 9,586 121 1,008,612 160,209 105 This table would have derived an additional value if it had contained the ages at death, and the occupations of the deceased. This latter enquiry, AMONG ODD FELLOWS. 205 whose importance is of the highest value in measuring the relative duration of life, has latterly received much attention at home and abroad. It unfor- tunately happens, however, that the European observations are mainly confined to England and Scotland, and those in this country to the States of Massachusetts and Rhode Island. Mr. Neison, the Actuary of the Medical Invalid and General Life Office, at London, obtained, after much labor, the results of a sufficient number of Friendly Societies, whose province is to provide for the sick, to enable him to institute a comparison into the relative health of the various occupations included in the returns, and the comparative healthfulness of each in town and country districts. This enables a comparison to be made between the returns of the occupations, as found in the Massachusetts reports, and those of similar occupations in England. It is much to be regretted that no extensive means of comparison with the records of Massachusetts, is to be found at home, the only State which has noted the occupations of the deceased being the neighboring one of Rhode Island, and the whole number of occupations so noted being confined to less than two hundred deaths. The results of Mr. Neison's investigations disclosed the fact, that not- withstanding the circumstances which at the first view might be supposed to exercise a very large influence in abridging life, the members of Friendly Societies were longer lived than the average residents of the same districts of similar ages, although a large number of these latter were among the' affluent classes of society, who from their greater comforts and limited exposure, were supposed to present a higher average age at death than their more humble neighbors. The data collected from the Friendly Societies was carefully arranged in three classes, dependent upon the residence of the members, viz., town, city and country, in order to test the effect of locality upon the life of 206 STATISTICS OF MORTALITY persons pursuingXhe same occupation under the different circumstances of town and country life. These were grouped together, and a table of the expectation of life, formed from the results, and contrasted with the expec- tation of life among the males in England and Wales for the same periods. This table, which is given below, shows that at each age the expectation of life is invariably in favor of the members of the Friendly Societies, and speaks in very encouraging language to those whose province it is to toil at laborious and frequently dangerous occupations :— Expectation IN Difference in Favor of the Three Districts. Age. Three Districts. England and Wales. In Years. Per Cent. 20 43.77 40.69 3.08 7.57 30 36.60 34.09 2.50 7.34 40 29.33 27.47 1.85 6.75 50 22.19 20.84 1.34 6.45 60 15.69 14.58 1.10 7.60 70 10.20 9.21 0.98 10.72 These results, so far showing that the circumstances in which the laborious classes are placed limit their duration of life, absolutely exhibits a prolongation of it beyond what the most favorable life tables, selected from the best classes of society, have ventured to go, and excited much surprise among those who were by no means ignorant on this subject. But although the average was more favorable to life than that of the whole population, yet a large difference was found to obtain in the relative healthfulness of different occupations, as will be made manifest by the following table:— AMONG MEMBERS OF FRIENDLY SOCIETIES. 207 Clerks. J, No. 2. Plumbers, Painters, and Glaziers. J, No. 3. Bakers. J, No. 4. Miners. J, No. 6. 31.83 36.90 40.02 40.67 27.57 30.50 32.35 33.15 21.85 24.30 24.47 24.92 16.04 17.09 19.09 17.53 12.42 12.16 14.06 11.85 Ages. Rural, Town, and City Districts. G. 20 43.77 30 36.60 40 29.33 50 22.19 60 15.69 From this it appears that the expectation of life at twenty years for all trades included in the Friendly Societies, is 43.77 years; for miners alone, 40.67 years; for bakers, 40 years; for painters, plumbers and glaziers, 36.90 years ; and for clerks, the low average of 31.83 years. "The very remarkable difference," adds Mr. Neison, "between the above employments and the general results, cannot fail to occasion some surprise; and at the same time conclusively prove, that any district con- taining a majority of the above, or other equally unhealthy employments, must show a very reduced average value of life for the district, independent of the local situation itself on health."* The Massachusetts returns not only embrace those usually included in Friendly Societies abroad or at home, but also those on the one hand in the latter classes whose means are abundant and exposure little ; and on the other, who derive their sustenance from the hand of charity. The following table exhibits the most common occupations of those who have died in Massachusetts during eleven years and eight months, ending on the last day of December, 1854, together with the average age that has been attained by the deceased, in each of the selected occupa- tions :— Journal London Statistical Society, vol. 8, p. 313. 208 RATIO OF MORTALITY IN No. 9698 Agriculturists, 29 Artists, 11 Bank Officers, 688 Blacksmiths, 124 Butchers, 198 Cabinetmakers, . 1498 Carpenters, 234 Clergymen, . 437 Clerks, . 286 Coopers, 263 Gentlemen, 21 Glass Blowers, 111 Hatters, 7 Judges and Justices, 92 Jewelers, 6410 Laborers, 171 Lawyers, 363 Machinists, 313 Manufacturers, \f il ooror\* v 47.16 40.10 61.72 51.41 49.63 47.04 49.33 56.61 33.73 58.84 63.83 39.86 54.90 67.19 42.56 44.57 56.60 37.63 44.30 No. Age. 359 Masons, . 41.61 408 Mechanics, . 42.88 816 Merchants, 52.06 69 Millers, 61.58 50 Musicians, 40.46 260 Operatives, . 34.19 368 Painters, 42.10 356 Paupers, 65.19 322 Physicians, 55.25 129 Printers, 36.55 80 Ropemakers, . 55.95 2299 Seamen, 45.99 238 Shipwrights, . 56.48 2436 Shoemakers, 43.66 194 Stonecutters, . 43.66 287 Tailors, 42.51 175 Tanners and Curriers, 47.37 648 Traders, 46.53 95 Weavers, 46.83 " Of these 33,580 individuals the combined ages amounted to 1,724,031 years, or 51.34 years to each man. " A portion of the females who died during the same time, admit of the following classification:— Domestics, Dressmakers, Housekeepers, Milliners, Nurses, Operatives, 43.96 Seamstresses, 32.36 Shoebinders, . 51.15 Straw-braiders 35.53 Tailoresses, 54.61 Teachers, . 27.69 41.83 45.59 35.09 40.63 28.70 " The aggregate ages of the 2,376 females thus given, amounted to 109,724, and the general average of the whole gives 50.39 years to each individual. DIFFERENT OCCUPATIONS. 209 The Registrar of the city of Boston has furnished the following table of ages of 706 men, of the principal professions and trades, who died in 1855, and whose ages were reported :— No. Profession or Occupation. Ages Ranging from Aggregate Ages. Average Ages. 305 Laborers, 16 to 88 12,292 40.30 69 Mariners, 16 " 79 2,663 38.59 45 Clerks, 16 " 74 1,484 32.98 35 Tailors, 20 " 90 1,368 39.08 32 Merchants, . 26 " 91 1,882 58.81 32 Traders, . 24 " 79 1,590 49.68 33 Carpenters, . 18 " 87 1,510 45.76 22 Painters, . 19 " 76 888 40.36 20 Shoemakers, 21 " 55 687 34.35 15 Teamsters, 22 " 73 516 34.40 12 Gentlemen, 28 " 83 718 59.83 11 Printers, . 20 " 68 434 39.45 10 Masons, 25 " 71 402 40.20 9 Machinists, 23 " 46 304 33.77 8 Bakers, 26 " 60 309 38.62 8 Farmers, 35 " 71 457 57.12 7 Blacksmiths, 20 " 58 245 35.00 6 Ship Carpenters, 30 " 70 307 51.16 5 Physicians, 25 " 72 249 49.80 5 Clergymen, 36 " 73 269 53.80 4 Coopers, 26 " 55 162 40.50 4 Curriers, . 19 " 40 114 28.50 4 Engineers, • 27 " 54 183 45.75 5 Lawyers, Totals, . 27 " 91 301 60.20 706 29,334 41.55 There is no absolute means of separating those who resided in town from those who lived in the country, but it is presumed that the agricul- turists were exclusively residents of the country ; while it is probable that 210 EFFECT OF OCCUPATION the larger part of those classed under the heads of mechanics and laborers dwelt in towns of greater or less size. The effect of locality, upon this pre- sumption, is made strikingly manifest in the superior value of life possessed by the agriculturist over that of the two classes of laborers who reside in town, being eighteen years longer in duration than that of the mechanic, and nearly twenty years beyond that of the laborer. These observations correspond somewhat with those of Mr. Neison's, which value the probabilities of the life of the baker below the average of mechanics, the life of the painter still lower, and that of the clerk lowest of all the occupations. They cannot be pursued further, because Mr. Neison has not given the probabilities of life incident to the other trades that came under his inspection, but they are sufficient to show that under like circum- stances the relative probabilities of life, as compared the one with the other, do not differ materially in England and Massachusetts. This classification shows a very marked difference in the average age at death of the different mechanic arts, besides those just alluded to. Tan- ners and curriers, butchers and carpenters, stand high upon the list; while machinists, and stonecutters, and printers, take a low stand. This table is very valuable so far as it goes, but it fails to enumerate many occupations more unhealthy than those already named, as the white lead manufacturer, the friction-matchmaker, and the daguerreotypist. There are obvious reasons, growing out of the circumstances incident to each pursuit, why one should be more favorable to longevity than another; and were the diseases in each case carefully noted, it would lead to very satisfactory and practical results. In 1819, the English Government selected Mr. Finlaison, an eminent mathematician and vital statistician, to determine the law of mortality, and establish the value of the government annuities, and tontine schemes. Assisted by a large number of competent clerks, and aided by access to the IN EUROPE AND AMERICA. 211 records of the names of those who for the space of a century had been upon the registers, as the recipients of annuities, or the nominees in tontines, and also provided with unlimited means to defray any expenditure required in the prosecution of his inquiries, he labored assiduously at his task, and at the expiration of ten years made a final report to the Lords of the Treasury, which comprised in a large number of tables the rates of mortality, and the value of a great number of different classes of annuities averaged for single and more lives. These tables, thus laboriously wrought out with consummate skill and great care, are regarded as the true exponent of the expectation of life in the class covered by his inquiries, and have always commanded the fullest confidence. From a comparison of the data furnished by them, as well as that col- lected by the various assurance companies, it appeared that the value of life among the government annuitants, and the insurers of lives in the different assurance companies, which represented the affluent and superior classes, was less, as has already been observed, than among the humbler classes, found among the members of Friendly Societies. Dr. Guy, of King's College Hospital, from the facts afforded him by the works on peerage and baronetage, made a classification of the deaths which had occurred among the members of noble families, above twenty years of age, for a long period of years. The number of deaths thus collated amount to 2291, of which 1989 were derived from the peerage, and the remainder from the baronetage. From these facts Mr. Neison formed a life table, showing the expectation of life in the males of the peerage and baronetage. The expectation of life, as thus deduced, together with the results obtained by Mr. Finlaison, on English annuitants, the experience of several 212 EXPECTATION OF LIFE assurance companies, Milne's and Farr's tables, and that of the French annuitants, are placed side by side in the accompanying table :—■ Age. Peerage and Bart. England (Mr. Farr.) English Ann. (Finlaison.) Sweden & Finland, (Milne.) Carlisle, (Milne.) Equitable, (Morgan.) Amicable, (Galloway) French Ann. (Depar.) 20 38 40 3S 39 41 42 40 25 35 36 36 35 38 38 38 37 30 31 33 33 32 34 34 34 34 35 27 30 30 28 31 31 30 31 40 24 27 27 25 28 27 26 27 45 21 23 24 21 24 24 22 24 50 18 20 20 18 21 20 19 20 55 15 17 17 15 18 17 16 17 60 13 14 14 12 14 14 13 14 65 10 11 12 10 12 11 10 11 70 8 8 9 7 9 9 8 9 75 6 6 7 5 7 7 6 G 80 5 5 5 4 5 5 5 5 85 4 4 3 3 4 3 4 3 90 3 3 2 3 3 3 3 2 95 2 2 . 2 3 . 100 1 t . M t . „ These columns certainly do not exhibit as high an expectation of life, either among the members of the families of the peerage and baronetage, or the English annuitants, as the average of English life shown in the column based upon Mr. Farr's results, and all of these fall below that of Mr. Neison's, based upon the facts developed by the returns of the Friendly Societies. A comparison of the laboring and more independent classes in the United States, as developed by the Massachusetts returns, do not exhibit the same favorable results for the former, as are made manifest by the English tables. On the contrary, the average age at death of those engaged in mechanical pursuits is lower than the average age of the better classes. AMONG DIFFERENT CLASSES. 213 The average age of laborers is 44.80 years, and that of mechanics as a class 46 years, while with merchants, the average age is 46.30 years, with professional men 49.03 years, and with public men 50.32 years. Among individual pursuits, those of the clergymen, advocates and medical men, rank higher than either of the trades, with the exception of the cooper and the shipwright, and the retired gentleman attains to an age superior to them all, averaging 68.29 years. There is a very wide difference between the relative chances of life enjoyed by the different classes in Massachusetts and England, which must arise either from the higher expectation of life among the better class here, as compared with the same class in England, or a lower expectation among the laboring class here, as compared with the same class there. In applying the principles of the laws of mortality to life assurance, it must be taken into consideration, that while a knowledge of their rates at the extreme periods of life is necessary, yet at the same time those cir- cumstances which affect its duration after the first period has passed, and extreme age has not been attained, are of more immediate and practical importance, because it is precisely in this period of life that most appli- cants for assurance present themselves, and over which most of the policies, whose duration is limited by a fixed number of years extend. It may thus happen that the proportionate mortality of one latitude may not exceed that of another, or may even fall below ; and yet the probabilities of life at the ages usually covered by life assurance may be much less. Thus, if the prevailing disease be dysentery or scarlatina, its heaviest demand will be made upon the early periods of life; if consumption and scrofula, it will fall with greatest force upon the period between 20 and 30 years ; and if dropsy, apoplexy, or paralysis, it will fall with greatest force upon advanced life. In order, therefore, to determine with any degree of accuracy the 214 CONCLUSION. effect of locality upon the duration of life, a knowledge of the diseases that terminate it is as necessary as an exact account of the number who have died, and the ages at which death took place. The tables accom- panying this report will, it is hoped, enable these comparisons to be insti- tuted with a reasonable approximation to correct results. INDEX. Acclimation, .... " Dr. La Roche on " Life, cost of " Dr. Nott on Age of parents, effect on sexes at births. Ages of living in each State, . " at marriage in Massachusetts, . " " " ." Kentucky, . " " " " Belgium, " " " " North and South, Aged class of population, . American summer, heat of . " " source of disease, . Army mortality in British service, . " " " United States, " statistics not applicable to civil life Atlantic plain, features of Average age of English population, . " " " American " " " " at death, Balfour, Dr., on table of mortality in Eastern British service, Births, census returns of " disparity in ... " wliy greater in some places than others, .... TAGE 171 190 197 199 198 76 181 92 93 93 9G 33 130 130 131 133 134 137 32 32 183 131 45 45 45 Biiths, more abundant in new than old countries, .... 45 " affected by the seasons, . 49 " Milne on .... 48 " in Massachusetts, . . . 58 " in Rhode Island, ... 59 " in New Jersey, . . . 63 " in Connecticut, . . .03 " in Kentucky, ... 64 Born dead, proportion of . . .77 " " " in Kentucky, 78 " " " in Massachusetts, 77 " " " in European coun- tries, ..... 79 Boston, births in ... . 55 " " of nrftives and foreigners, 56 " " in different wards, . . 56 " " mortality in . . 164 Bowditch, Dr., on consumption in Massa. chusetts, ..... 178 California, mortality . . . . 160 Carpenter on sexes at birth, . . 76 Carnival, effect of on season of marriage in France, . . . . .91 Chadwick on population in United States, 31 " " average age of living, . 32 Chickering on Emigration, ... 43 11 INDEX. PAGE Census returns of births, . . . 103 " " " marriages, . . 103 " " deaths, . . 107 Climate of the great lake region, . . 144 " " mountain " . 144 " " seashore and inland, . .194 " Dr. Johnson on . . . 494 Clark, Dr., on still-born, ... 81 Conception in Kentucky, ... 83 " effect of seasons on . . 83 " Milne on ... 84 " in Sweden and France, . 85 Connecticut, births in 03 Consumption, season most fatal, . . 176 " in Massachusetts, . . 178 " in Kentucky, . . .177 " Dr. Bowditch on . . 178 " per cent, of, in Massachu- setts and Kentucky, . 180 Curtis, Dr., on sexes at birth, . . 67 Deaths, census returns of . . .107 " in different States, . . 107 " number of in United States, . 107 " proportion of sexes, . . 108 " in Massachusetts, . . .108 " in New Hampshire, . . 108 " per cent, at different ages, . 109 " excess of males in early life, 110 " proportion to living, . .110 " male and female in Massachu- setts, ... . Ill " " " Dist. of Columbia, 111 " " " Wurtemberg, . Ill " ' affected by migration, . . 113 " in each season, . . .151 " different States, . . . 151 Dependent classes, . . . .33 Diseases, classification of . . . 172 " of warm climates, . . . 202 " of cold " . . 202 per cent, of, in different States, 175 " " " " localities, 179 Drake, Dr., on Mississippi Valley, . 19 PAGE Dwellings, number of in Europe, . . 156 « ' " " in United States, 155 Effect of locality on mortality, . . 164 " " geological formation on health, 141 Emigration, per cent, in United States, . 39 » " " " different States, 39 " '■ " " European countries, 41 " Irish to America, . . 52 Emigrants, condition of . . 41 " now and heretofore, . . 43 " in town and country, . . 40 Emigrant office, English, report of 53 European States, births in . .65 Fecundity, laws of . . .48 Females, deaths among . . . 108 " " in Massachusetts, . 110 " " in Dist. of Columbia, 110 " "in Wurtemberg, . Ill " " in excess in country, . 115 Female mortality in Massachusetts, . 125 " " in Maryland, . .125 " " in England, . . 125 Fever, a disease of middle life, . . 179 " per cent, of, in Massachusetts and Kentucky, . . . 180 Finlaison on English Annuitants, . 180 Gotha Bank do not insure pregnant women, . . . . . 122 Geology of the Atlantic plain and slope, 137 " of Valley of Mississippi, . .140 Gulf stream, effect of 141 Guy, Dr., on lives of English peerage, . 211 Hofacker on sexes at birth, . . 76 Hopfs' statistics of male and female mortality, . . . . .122 Heat of American summer a source of disease, . . . . . 135 Ireland, marriages in . . . .50 " proportion of births, . . 50 INDEX. Ill Ireland, Thorn's statistics Irish condition of in Ireland and America, Infantile mortality, .... " " excess of " " census returns, " " want of correctness in, 53 52 57 184 184 184 Kentucky, births in ... 64 " still-born in . . .81 " conception in . . . 83 " months most prolific in . 83 " and Montpellier correspondence, 80 Kennedy's table of male and female mor- tality, ......125 Kane, Dr., effect of cold climate on, . 203 Life-table, English . . . . 13 " insurance experience in male and female mortality, . . . 122 Local influences, effect of . . . 129 Laws of mortality not alike in England and America, . . . . .153 Louisiana, Dr. Barton on . . . 168 Locality, effect of on mortality, . .178 Mississippi Valley, .... Mountain ranges, .... Mortality census, .... Mortality returns, .... " of Europe, .... " per cent, of . , ■ Milne on Conception, .... Massachusetts, reports of births, Male and female, proportions of in the United States, . Massachusetts and Sweden, correspond- ence between ..... Marriages, in different months . " Massachusetts, " Kentucky, " Shattuck on " in different States, . " census returns of . " proportion of, in different States 103 Moisture, sources of ... 147 75 80 88 83 89 90 103 103 Moisture in Europe and American cli- mates, . Mortality in different States, " of the sexes in Massachusetts, . " " " at different ages, " correspondence between Sweden and Massachusetts, " among British troops, " maximum and minimum periods of..... " in Massachusetts, " in Kentucky, " in Rhode Island, " in California, " in Northern and Southern cities, " in Southern States, Dr. Nott on Moureue on marriages in France, . 147 107 121 121 128 131 158 158 158 159 100 104 170 91 63 New Jersey, births in . New Orleans, Dr. Simonds on the mor- tality of ... 165 " Dr. Barton " " . 1G8 Nott, Dr., on mortality of Southern States 170 Neison on effect of occupation, . . 205 " on select lives .... 205 Occupation, effect on life . . . 205 " in other countries, . . 208 in England, ... 206 " Deaths in each . . .208 Odd Fellows, table of mortality among 203 Population of United States, " ages of . " distribution of " ratios of each age " origin of " productive capacity of Probabilities of life, Productive classes, . Prussian Government's providence, Proportion of sexes at birth, " of males to females in the U. S. Parallelisms in U. States and Europe, . 21 21 21 21 22 31 26 33 35 67 75 133 IV INDEX. Per cent, of mortality in the chief cities of the United States, 1G4 Quetelet on male and female deaths, . 117 " the moi tality of the sexes at different ages, . . .121 Registration among the ancients 10 ' in Geneva, Switzerland, 11 ' in England, • 12 ' in United States, 12 ' in Massachusetts, 12 ' in New Jersey, . 13 ' in Connecticut, 13 ' in Rhode Island, 13 ' in Kentucky, . 13 ' in Virginia, 13 ' in South Carolina, . 13 Rhode Island, births in ... 59 Rate of mortality in different countries, 132 " " in U. S. Army, 133 States, areas of .... 19 " per cent, of area, 19 " ratio of . 19 Sexes, proportion of at birth, 07 " " in Massachusetts, 68 " " in Providence, 71 " " in Europe, 70 " " in Kentucky, 72 " " in Virginia, 72 " " in Charleston, S. C. . 73 Sadler on sexes at birth, . 70 Still-born, properties of . . 77 Seasons, effect on conception in Kentucky, 83 Sutton, Dr., on conception in Kentucky, 83 Sweden, table of conception in . 85 Shattuck on New England marriages, 90 Sardinia, returns of males and females, 118 " returns of male and female deaths in town and country, . 120 PAGE Sutton's table of mortality of sexes in Kentucky,.....125 Seasons in the United States, . . 135 " influence of . . .151 " deaths in each . . . 11 Summer mortality in the United States, 152 Sanger, Dr., on mortality of California, . 160 Simonds on the mortality of New Orleans, 160 Southwestern mortality . . .170 Southern mortality greatest in middle life, 180 " " in infancy and old age, 180 Summer mortality in United States, . 202 Tucker on probabilities of life, . . 26 " on mortality in the United States, 26 Thorn's Irish statistics, . . . 53 Tripe on still-born, .... 80 Table of mortality among British troops, 131 " " " in U. S. Army, . 133 Temperature, range of in the U. States, 192 " sea and inland, . . 192 Trade wind, its influence, . . 147 Town and Country mortality in England and America, . . . .154 Table of per cent, of living of each age in the various States, . . . 181 United States territorial limits, . . 18 great divisions, . . 19 " growth of ... 23 " natural divisions of . 137 " proportion of town and country population . 155 Virginia, births in .... 64 " still-born in . . . 81 Value of European lives, table of . . 206 Wargentin on still-born, . . .81 Winds in United States, . . . 135 Winter, mortality in Europe . . 13 5 " in England, . . 202 NEW YOKK: WM. 0. BRYANT & CO., PRINTER?, 41 NASSAU STREET, CORNER OF LIBERTY. m vy if, ,i\ • ■■ii'F'ii ■<"'• .X JrVM yM-'fr'ii'ik'f-W Mm;'fc,->ffl ■*,&. 1/7.-xi Hi J>- m fill. j m >'/Av: f 'ni'*ld:Ht ';f" il 85 $ x '/■yx^ 'X+/'x/$ • --■■!if -s •.:.i« I «SaI*X i-W* *?SMJ &*. f/'tf fK' !<-#» # i/i'/i >/#$ Itttf' ')'#? fflS &*■ ftffl /;/, '; x -V~Sf£Ji m ml l&rHii I m i#$j