  WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? Mrs. Warren Logan
In these days of specialists among physicians and of specialists among students of social science it seems rather presumptuous for a teacher to attempt any formal discussion of causes and remedies for the high death rate among Negroes in the cities of the South. A few suggestions, however, may serve to draw more attention to this vital subject. The sections of the cities inhabited by Negroes are generally the most unsanitary. The house in which the average Negro family lives is poorly built and too small. Frequently old houses are set aside as too far gone for any except Negro tenants. In many instances these dilapidated houses contain germs of disease which it is practically impossible for the young and the feeble to withstand. The food, fuel, clothing and general comforts of a family thus housed are insufficient. Food plays too large a part in the havoc made by death among Negroes. In many instances, there is great intemperance in both eating and drinking. With another large class there is actual scarcity of food and that, too, often of poor quality. Add to this, irregularity of meals and poor cooking and one can not wonder at the low state of health nor even at the excessive mortality. One of the most serious phases of ignorance is criminal carelessness in regard to nutrition. Cooking is that part of household work which almost every woman undertakes and very few understand, and herein lies the foundation of disease. The long death-roll among Negroes contains an excessive number of infants. Careful investigation shows that this slaughter of innocents is due in large measure to improper feeding. Some mothers must be away from their babies earning bread and shelter. Others leave their little ones for less worthy and less honorable purposes. Others neglect their offspring because they have a fancied or cultivated dislike of children. Far be it from us here to attempt a technical discussion of tuberculosis, but in plain simple language, let us cite a few facts in regard to lung diseases among Negroes. The oft repeated statement that the Negro slave did not have consumption, cannot be verified, for lack of authentic records on the subject. The Negro free, however, is dying of consumption and kindred diseases in appallingly large numbers. Many theories in regard to consumption have been exploded, but it is acknowledged by all, to be an infectious disease. As such, ignorant people do not understand how to escape it; indeed, until anti-spitting laws are more universal and more rigidly enforced, every one may be exposed to these deadly germs. They respect neither race lines nor intellectual grades. The Negro, however, seems to be peculiarly susceptible to this class of ailments. 1. Because of comparatively small lung capacity. 2. Because of general low nutrition. 3. Because of lack of bath rooms and their proper use. 4. Immorality. 5. General indifference to the incipient stages of the disease. Colds and coughs are passed by as matters of course with little or nothing done to prevent or cure them. The physical life and death of man has a much more intimate connection with his moral life than is at first thought apparent. Too many children are robbed by Sin of a child's first right, viz.: the right to be well born. If parents have lived lives of shame and thereby weakened their bodies, the effects of this will be a sad legacy of weakness in the persons of their children. Men and women given to social impurity will hardly escape the notice of those about them. Their characters are imitated and shame and weakness, physical as well as moral, multiplied. "Sin conceived and brought forth Death." Among people of low intellectual development and low moral standards, family love is below normal. With this defective class, there is much indifference to the life and death of their dependent relatives. The young and the aged are shamefully neglected. It is sufficient Better environment, greater comfort in the homes, come only as a return for money. Money will come as a return for labor. Money will come to those who earnestly desire it, because they will work for it. They will do whatsoever their hands find to do, accepting the pay such labor brings, but fitting and aspiring for something better. There is usually plenty of work for all honest, industrious Negroes in Southern cities. Even money may not cause the old shanty to give place to a good house nor raise the standard of general comfort very materially, except as the demands of the family are enlarged as a result of education. No one factor will have such weight in the decrease of suffering and the reduction of the high death rate as enlightenment of mind. The system of education in vogue in Southern cities will work slowly because up to the beginning of the twentieth century, school attendance has not been made compulsory. There are no truant schools, no reform schools. Idleness tends to vice. Idleness and vice are in no way conducive to health and longevity. Many Negroes do not want education for themselves nor for their children. These people swell the death lists in Southern cities' health offices to such distressingly large numbers. They are often cared for and buried by funds from the city treasury. Would it not pay to try compulsory education? To try teaching them to help themselves, to save themselves? To say that the home life of the masses must be improved is but another way of saying they must be educated. Among the most potent forces in the uplift of a people are the school, the press, the courts and the church. Under a system of compulsory education, the Negro would much sooner learn to observe the laws of health and thus to extend his life. When newspapers in Southern cities are fairer in their attitude toward the black citizen, he will become a better citizen. It will increase his respect for others and greatly increase his self respect. He will then make more effort to live and to live well, because his life will seem more worth living. Every state included under the "Land of the free and the home of It pays the municipality better to educate and reform its citizens than to convict and execute them. A cultivated, spiritual ministry will emphasize the best teaching of the schools. An active church will sustain a fair press; will uphold law and order; will supplement the work of the good doctor and in various ways try to reduce the number of funerals among the Negro population in Southern cities. SECOND PAPER. WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? Hon. H. A. Rucker.
One who has never been taught to appreciate what health is and to understand hygienic laws can not become a safe guardian of his or her physical being. For when this being is attacked, as is constantly the case, by its millions of enemies, if all of its portholes have not been properly guarded it easily falls prey to disease and death. As a race the Negro has had neither the time nor the opportunity to inform himself on the principles of health saving or in those of health getting—if there be such. Both prior to and since his emancipation his time, except nominally, has been the property of others from whom he has barely eked out an existence, and, from a humanitarian standpoint, has had but little interest in caring for his health. During the years of his enslavement, his mortality, in proportion to his numbers and his environments, was no less than it has been since he became a free man—and the bald statement that his death-rate during the past thirty-eight years has greatly increased, may not be founded on facts. Fair play in discussing this phase of the subject demands careful and patient inquiry into the past history of a people Wherever the Negro has been cared for either by himself or by others he has enjoyed the same immunity from disease and death that those of other races have. And whenever neglected or abused, whether the failure or fault rests with himself or others, impaired health, decay of mind and body and death have ensued. Compared with the masses but few Negroes at any time within the history of the life of the race in this country, have been properly guarded against exposure—the few who in ante bellum days were selected as house servants and to fill other kindred places, were measurably protected. And now the same classes and that of the more fortunate or business classes have limited protection from more than ordinary exposure. The masses have always done the drudgery. And that too without knowledge or reference to health keeping. A common practice of employed Negroes is to go or be sent on short quick errands, leaving warm and, in this respect, comfortable places of employment without hat or wrap to breast chilling winds or atmospheric conditions many degrees removed from their places of services. In this practice is the exposure from sudden changes of temperature without preparation. The drayman, the cartman, the man in the ditch and others whose employment is in the open air are exposed not alone by the character of the work in which they are engaged but also by reason of the fact that six days of the week, those in which they labor, of necessity, their clothing is poor and shabby and their persons are ill kept. While the seventh day finds them as a rule well clad and well shod. Then their homes—no, their houses, partly because of circumstances beyond their control and partly on account of their improvident natures, are little more than shelters or huts. These houses are built in what is known or accepted as Negro tenant districts, and those acquainted with the localities need no evidence to convince them that they are not sought as either health or pleasure resorts. They are the city alley ways and the low malarial districts where the noxious gases and foul vapors rise from emptying sewers. They have been thrust into prisons where they were provided with the poorest of covering and meanest food for their bodies; where scurvy and other loathsome diseases have made their impress upon them and where incentive to cleanliness is as distant as the North and South poles. Freed from prison life they have gone forth mingling with a class of people infecting them with their scales and spreading disease and death. Then again the race is without proper places to care for its unfortunate, aged and infirm; without orphanages, reformatories and homes for its friendless. Institutions which are potent factors in the efforts of a people to prevent neglect and cure criminal tendencies. All of these conditions are breeders of ills and conductors of death which must be and happily are being abated. The remedy suggested is a knowledge coupled with an appreciation of health. Both to embrace the science of health preserving and of health getting; better homes and better habits, even to being "temperate in all things." Acquired, accepted and practiced the mortality of the race will be materially lessened. THIRD PAPER. WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? Dr. John R. Francis
In the study of the causes and remedy for the great mortality among the colored people of Southern cities I shall not waste time and words in an attempt to prove, by much statistical evidence, that which is already too well known to us as an admitted fact, viz.: a mortality of colored people in cities of the South, very largely in excess of that of the white people of the same communities. I am fully justified, in the face of our present enlightenment, in entering, at once, into the discussion as to its causes. If it be true that the animal organism is intended by nature to pass through a cycle, and that natural death is not a disease, but a completion of the process of life, it follows that the organism, with exceptions, as to any particular class of people born in health, is constructed to pass through this cycle and is not of itself,—that is to say, by its own organism,—capable of giving origin to any of the phenomena to which we apply the term disease. We must, therefore, seek for origins of the phenomena in causes lying outside the body, and affecting it in such manner as to either render the natural actions and processes irregular, or to excite actions and processes that are altogether new. Writing out in correct lists all the groups of phenomena that make up the term disease, we will find that they invariably come from without. From my point of view all the groups of diseases are in truth accidents; exposure to some influence or influences that pervert function or create new motion. I must first refer to the cause to which at various times has been ascribed the responsibility for this excessive mortality, viz.: that innate vital weakness exists in the colored population of this country as a result of amalgamation. On this theory the black race when mixed with the Caucasian is the only one which produces with the latter a progeny of weakened innate vitality. I have never seen this statement supported by any trustworthy knowledge or information. On the other hand it has always been accompanied by the most absurd arguments which invariably tend to expose the mind of the writer as being prejudiced to the intermingling and the intermarriage between the two races. It is among the possibilities that physiological peculiarities account for dispositions to disease belonging to typical classes of the human family. No one has as yet been able to determine what those peculiarities are. Whether they are primitively impressed on a race, or are acquired is a question that can be answered only when the exact relationships of diseases to race are discovered. My own view is, that acquired and transmitted qualities and specific existing social peculiarities are sufficient agencies for the production of all the known variations of vitality belonging to peculiar races. I am now thoroughly convinced that the causes of this great mortality of the colored people of the cities of the South are poverty, prejudice, 1. POVERTY: a. Contagious Diseases (close contact).—Diphtheria, scarlet fever, small-pox, tuberculosis, syphilis, etc. b. Unsanitary Nuisances (11,705 abated in the District of Columbia for year ending June 30, 1900).—Filthy alleys, cellars, bad drainage, garbage, filthy gutters, hog pens, filthy houses, filthy lots, stagnant water, filthy privies, leaky roofs, sewers, filthy yards, filthy streets, wells, etc. c. Unsanitary Homes.—Only those houses that are refused or abandoned by the white people are offered to the colored people for dwellings. d. Impure Food.—The large quantity annually condemned in the District of Columbia is an indication of that to which the poor is subjected. e. Impure Air.—Bad design and construction (small rooms) and unhealthy location. f. Impure Water.—Unhealthy sources, cheap, shallow and unhealthy wells, etc. g. Infantile Mortality.—Unusually large from poverty alone. 2. PREJUDICE: a. Idleness and Crime.—Late hours, broken rest, depraved association, tobacco, alcohol, syphilis, other diseases, etc. b. A Destitute Laboring Class.—Prejudiced employers, poor pay, excess of work, deficient rest, worry combined with physical exhaustion, unsanitary rooms, etc. c. Defective Homes.—Small rooms, poor ventilation, either no water supply, or a very bad one, neglect of sanitary measures by both landlord and agent, all the nuisances enumerated above, etc. 3. IGNORANCE: a. Diseases from bad hygiene (public, home, and personal). b. Induced diseases from physical strain. c. Diseases from combination of physical and mental strain. d. Disease from the influence of the passions. e. Disease from sloth and idleness. f. Disease from late hours and broken rest. g. Disease from food. h. Disease from water. i. Disease from alcohol. j. Disease from tobacco. k. Disease from errors of dress. l. Children of parents diseased or weakened from various causes. The space allowed for this article will not permit the discussion of all the causes mentioned above. There are, however, a few that are worthy of our special consideration. For the purpose of condensation, I will attempt the elucidation of the importance of such causes as demand our most serious attention by incorporating them in the following discussion of the most important part of this article: "How is this great mortality to be lessened?" In my opinion the remedy for this alarming condition exists in education and money. In other words our remedy is the same as that of other races. The only difference is that the barriers we must surmount are so very peculiar and so very much greater than that of other peoples we must do our best to, at once, recognize the fact and begin the work. I believe the goal is ours and if we will only struggle manfully and hopefully onward we will soon reach it. With EDUCATION AND MONEY as the remedy, the colored people must be taught that the first step towards the reduction of disease is to begin at the beginning, to provide for the health of the unborn. The error, commonly entertained, that marriageable men and women have nothing to consider except money, station, or social relationships demands correction. The offspring of marriage, the most precious of all fortunes, deserves surely as much forethought as is bestowed upon the offspring of the lower animals. It is well that we teach, in the school room and from the pulpit, about the condition that exists in the parental line, maternal and paternal. The necessity for such instruction is somewhat indicated, in the effect upon the prenatal state, of such conditions as scrofula or struma, of various forms of tuberculosis and syphilis, of epilepsy, of rheumatism, and of insanity. These are only a few. We have to contend even with We must furnish, by all available means and through every possible channel of information, persistent and systematic instruction in public, home and personal hygiene. We should utilize especially the power of the pulpit and influence the public school authorities to institute, in the colored schools throughout the South, special instruction on these subjects. The importance of such instruction is evident in the agitation which is now occurring among the educators in the schools of the Eastern states. If it is needed there then the need of it in the colored schools of the South must be urgent indeed. We must give such education as will tend to a better general knowledge, especially of the two diseases which, I believe, more than any, should be the most dreaded as being the most prolific of injury to mankind and especially to the colored people on account of their ignorance of the communicability of disease combined with their poverty. I refer to the contagious maladies tuberculosis and the one called "specific" or syphilis, the moral as well as the physical blot on all civilized life. The former is well known nowadays to be one, if not the worst contagion to which the human family is subjected. In its various forms it is responsible, probably, for more deaths among the colored people than any one disease with a definite phenomenon. As less is known about the latter disease, syphilis, I must mention it a little more forcibly, however unpleasant and brief the utterance. The poison of the malady once engrafted into the living body, and producing its effect there, leaves, according to my professional experience, and observation, organic evils which are never completely removed. Various forms of disease of the skin; some forms of consumption; some phases of struma or scrofula; many forms of cachectic feebleness and impaired physical build—what are denominated delicate states of constitution—these and other types of disease are so directly or indirectly connected with the "specific" taint, it becomes impossible to be too careful in tracing it out, or in measuring the degree to which it extends in the field of morbid phenomenon, in our efforts to improve the vitality of the colored people and to enlighten them upon this class of diseases. The widespread encouragement of thrift, industry and efforts among the colored people to gain a livelihood or, to put it more boldly, to get Washington, D. C., is considered a very clean city. It is, therefore, significant that the 11,705 nuisances, referred to in the foregoing, are an indication as to the great risk, from this source throughout the South. It is obvious at once that the colored people, who form the bulk of the poor class, are the principal victims to that which escapes official inspection. Notwithstanding the fact that the colored population of the District of Columbia is less than one-third of that of the whites, in the year 1899-1900, there died in the homes located in the back alleys of the city 411 colored persons and eleven white persons, indicating to what extent these unsanitary homes are occupied by the colored people. Space will not permit the further elucidation of the foregoing causes and remedies, which I have done nothing more than to touch upon. However, I cannot close without giving further emphasis to my views by offering in evidence the conditions, as to vitality, of the Jews. The facts are that this race, from some cause or causes, presents an endurance against disease that does not belong to any other portion of the civilized communities amongst which its members dwell. We do not have far to go to find many causes for this high vitality. The causes are simply summed up in the term "soberness of life." The Jew drinks less than the Christian; he takes, as a rule, better food; he marries earlier; he rears the children he has brought into the world with greater personal care; he tends the aged more thoughtfully; he takes better care of the poor; he takes better care of himself; he does not boast of to-morrow, but he provides for it; and he holds tenaciously to all he gets. It may be true that he carries these virtues too far, but I do most earnestly plead that if the colored people will only emulate the Jew, they, like the Jew, will win, like him they will become strong, and like him in scorning boisterous mirth and passion, will become comparatively happy and healthy. FOURTH PAPER. WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? JAMES RANDALL WILDER, M. D., PHAR. D. James Randall Wilder was born at Columbia, S. C., and is the son of Charles M. Wilder, who was postmaster at Columbia for many years. His mother was Marla Coleman, also a native of the Palmetto State. Dr. Wilder is a man of spotless character, and enjoys a striking appearance, a magnetic personality, and a brilliant and versatile mind. His early training was received in the public schools of his native city. He spent a season in the classical department of Howard University, and from there he went to Howard Medical College, from which he graduated in the year 1888. Availing himself of the unrivalled opportunities afforded by the Freedman's Hospital, he rapidly acquired both theoretical and practical knowledge, so that when he stepped into the world he possessed a preparation seldom equaled by the young practitioner. He has also the degree of Phar. D. from Howard. He located in Washington, the capital of the nation, where today he enjoys a large and lucrative practice. His modest, sympathetic nature makes him an ideal man for the sick room. His ability has won professional recognition not only for himself but for others. He was for many years physician to the National Home for Destitute Colored Women and Children, and is today the examining surgeon for a number of benevolent and charitable organizations. He has been prominently connected with many of the business ventures of the colored people in the District of Columbia for the past ten years, and is ranked as a broad-minded, solid, public-spirited citizen—a grand object lesson for what is best and most progressive in the community. He has invested his earnings judiciously, so that today he has a competency seldom attained by a man of his years. The success gained, the making the most of himself, renders him the best advocate of truth, and a potent factor in the growth and development of the race. This plain, honest, earnest young man is a type of the generation since citizenship came—a splendid example of worth since the selfhood of the race has been partially recognized, and the members have been permitted to add their quota to the sum of human advancement and achievement. The hour calls for fact, not fancy—for flesh-and-blood examples of what has been done by the young manhood of the country. The interest here and now is due to the fact that he has had somewhat to say on a subject of vital moment, and has said it vigorously and eloquently. Here he is the champion of truth, performing a service in a dignified, scholarly manner, and so winning the praise and gratitude of all lovers of truth. His article must call a halt to those inconsiderate ones who persistently repeat what through haste and insufficient data has been given to the world as fact—as logical inference from scientific investigation. Dr. Wilder has collected a large library of professional and literary works, and has never ceased to be a hard student. His home shows the taste of the scholar and wide-awake practitioner. He married Miss Sallie C. Pearson of Columbia, S. C., and to them have been born two children—Charles McDuffie and Susan Maceo. Dr. Wilder belongs to that class of quiet, earnest souls who pursue the "even tenor of their way" and are doing most to establish truth, to refute error, content to let the "deeds, though mute, speak loud the doer." The American Negro finds himself, at the beginning of the twentieth century, seriously embarrassed by the many false and damaging accusations that have been made against him, not least of which is the charge of physical inferiority. The charge has been wholesale that the Negro differs from the white man physically, and that he is ethnically and strongly predisposed to certain fatal and contagious diseases. This stigma of disease has been placed upon him and repeatedly emphasized, but despite the fact that the effort has been made for years, by men learned in anthropology to find and prove the inherent inferiority of the Negro, based upon anatomical, physiological and biostatic peculiarity, to-day the bare statistical fact of his high mortality alone supports the calumnious fabrication. It is true that according to official statistics the Negro's death rate in this country is relatively high, but the causes of disparity are extrinsic and remedial and he was not stamped thus ab initio, but by the fiat of the Creative-will. The Negro, identified as he is with the great human family, is subject to the same deteriorating influences that affect his fellow-man. Hence impure air and water, polluted soil from defective sewerage, adulterated food-stuffs, and the unhealthful conditions imposed during the school-going period of life—which are questions of public hygiene and general concern—contribute, in no small degree, to his mortality. But aside from these influences, common to all people, he is subject to others peculiar to himself, on account of the environments that govern him. The proverbial unreliability of statistics justifies the assumption that the Negro's death-rate is not as great as it is said to be. The occupations of the Negro tend to keep him in the back-ground and to encourage a neglect on the part of the census enumerator to record accurately all of the Negroes in a certain locality. But the Negro dies faster than the white man, and it is not my purpose to deny it, but to recite a few of the real causes of the disparity in the cities of the South, and to show how that mortality is to be lessened. (1) American slavery, with its unparalleled cruelty and bestiality has injured the Negro, intellectually, physically and morally. It has been claimed that the admixture of the Negro with the Caucasian has given us a resulting mulatto, weaker physically than either of the parent stock, but this statement is based upon hypothesis, and is not borne out by the facts in the case. It is true, however, that a resulting lowering of vitality has followed the admixture of "kindred blood," which was almost unavoidable during the days of slavery as the result of certain well-known procreative practices that obtained on the part of the master, and on account of the itineracy of the Negro incident to his chattelism. In "those dark days" it was hard enough for the Negro to recognize his near kin on his maternal side, and it was infinitely impossible for him to trace the "family tree" from the paternal side. The evil effects of this consequent admixture of "similar" blood cannot be denied, and must bear a modicum of responsibility for the excessive mortality of the Negro of to-day. (2) The fact that the great majority of the Negro women in the cities of the South are compelled to work steadily even while they are enceinte, doubtless often interferes with the normal development of the internal organs of their offspring, causing a lack of vitality which is not apparent to the casual observer, but which must make them an easy victim to disease. (3) The same social and economic conditions that keep the expectant mother busy with her daily labors, also abbreviate her "lying-in-period," which not only weakens her physically, but deprives her newly-born offspring of its natural food—thus consigning it to an infant's grave, or so debilitating it that it succumbs to the first disease with which it becomes affected. It is bad enough to be bottle-fed, physiologists tell us, but it is infinitely worse to be hand-fed. The majority of the Negroes in the Southland are hand-fed from birth with food decidedly improper both as to quality and quantity, thus making defective the very substructure of their being. Is it any wonder that such a people die faster than another people, who nurse their young or have it done, or who give them pure cow's milk modified scientifically, or other artificial infant food prepared skilfully amid the best sanitary environments? (4) The early motherhood of the Negro has its evil effects. The proper age for a woman to become a mother is at twenty-five years and usually before that time development is not complete, and the whole (5) The element of overwork must come in for its increment of responsibility in the excessive mortality of the Negro. While deficiency in exercise favors a lack of nutrition conducive to wasting in size, on the other hand too much work favors hypertrophy of vital organs and tissue degeneration. The average healthy man should work about eight hours per day and "should do work to the equivalent of 150 foot-tons daily." The American Negro's working hours, as a rule, are regulated, if at all, by the exigencies of the work to be performed, as it appears to an exacting employer. (6) The kind of work performed by the Negroes in the Southern cities includes all menial occupations, which conduce to accident and exposure. The death-rate among the laboring class of any community, irrespective and independent of its nationality, is necessarily greater than that of the well-to-do leisure class. (7) The manner of living of the majority of the colored people in the cities of the South—which is sometimes the progeny of ignorance, but oftener the result of necessity—is responsible, in a large measure, for their high mortality. They are crowded together on back streets, in lanes and ill-smelling bottoms, near ponds of stagnant water, on the banks of rivers—wherever their scanty means consign them. The ignorant among them, like the ignorant among any other people, ignore the teachings of hygiene, because they are ignorant, and not because they are black. They do not know the value of fresh air and sunlight and cleanliness, and hence are ignorant of the fatality attached to the unholy trinity—darkness, dampness and dirt, which is responsible for the tuberculosis that is charged to their "inherent tendencies." The pittance that is paid to the Negro in the name of wages forces him to crowd together in narrow and ill-ventilated sleeping apartments, which is decidedly unhealthful and favors the spread of contagious diseases. Thus smallpox spreads The lack of suitable clothing and proper food, as a result of poverty, weakens the Negro physically. The neglect of the bath through lack of time, is responsible for much of the heart, kidney and skin diseases so prevalent among the laboring classes of the colored people. It takes time to keep clean, and the laborer has no leisure. Ignorance of the seriousness of certain diseases like syphilis, scrofula and rheumatism, has played an important role in the drama of his mortality. (8) Another fruitful cause of his excessive mortality arises out of his struggle for existence. The exigencies of life are such with him that he does not heed the admonitions of nature made manifest in the early symptoms of disease, so that unwittingly he becomes habituated to discomfort and pain. When the common Negro laborer lays aside his implements of labor on account of sickness, the disease with which he is affected is well founded and passed beyond the abortive and often the curative stage, and very frequently when medical advice is obtained, it is of the dispensary or "physician to the poor" type, which too often savors of unconcern, inexperience and incompetency. (9) The prevalent habit among the colored people of taking patented cure-all nostrums, which contain narcotics that insidiously benumb the sensibilities and mask the symptoms of disease, would naturally contribute to the mortality of any people. (10) Not the least fruitful of all of the causes of the Negro's excessive mortality, is a lack of resistance to disease, engendered by the social conditions that obtain in the Southland. There he is so oppressed and persecuted that he finds himself not only an easy prey to disease, but an early victim to death. He has little to live for, and his religion promises him much after death, which, in a sense, he welcomes as a relief from his trials and troubles. This statement will not appear exaggerated when one considers the powerful influence that the mind has over the body. A cheerful, hopeful, contented mind, predisposes to a healthy body, and conversely, a discontented and despairful mind, interferes with the vital functions and invites disease and death. (11) Lastly, in a consideration of the relatively high mortality of the Negro in the cities of the South, considerable weight must be given (12) The remedies for the excessive mortality of the Negro in the cities of the South are self-evident. He is a man and identical with other men structurally, so that whatever is health-giving and life-lengthening for other civilized peoples, is health-giving and life-lengthening for him. To be specific, his greatest need is an increase of knowledge along the line of hygiene, and a studious application of that knowledge. He must not only be taught to run the race of life intelligently, but he must not be hindered in the process of his running. He must know the life to lead, and then lead it. In this he must have the liberal co-operation of his employer, and his brother-in-white generally. He must be paid in accordance with the labor that he performs and must be allowed an equitable participation in the every-day affairs of life. Actuated by the hopes and aspirations that actuate other men, and given a man's chance in the struggle of life, his industry and genius will soon improve his condition and bring him material prosperity, upon which depends, in a measure, the development of moral, intellectual and physical growth. Leisure and opportunity, comfort and freedom from sordid cares and anxieties regarding the immediate necessities of life, must be secured, if a race is to find time for study and thought, and to develop its best moral and physical life. May not the Negro justly find some consolation in his FIFTH PAPER. WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? R. F. Boyd, A. M. M. D.
This is a question of vital importance to us as a race and to the nation as well. Much thought has been given to it by the best thinkers of both races and many articles have been written by friend and foes. All kinds of solutions have been proposed and yet the great death-rate goes on. In the larger cities of the South our people die from two to three times as fast as the whites. The number of premature deaths is on the increase; the infant death-rate is appalling; and consumption, a hitherto unknown disease among our people, is credited with one-fourth the victims of all ages. All the powers of science and art are being taxed to the utmost to afford a complete solution to this problem. Every large city in the South is being awakened to the sense of the importance of this subject. And well they may; for the ignorance, the vice, the poverty, the habitation and the food that cause this alarming death-rate effect the whole community. A proper knowledge and observance of the laws of health will give happiness to all. Man is as subject to the organic laws as the inanimate bodies about him are to mechanical and chemical laws, and we as little escape the consequences of the neglect or violation of these natural laws, which affect the organic life, through the air we breathe, the food we eat, the water we drink, the clothes we wear, and the circumstances surrounding our habitation, as the stone projected from the hand, or the shot from the mouth of the cannon can escape the bounds of gravitation. What we need is the gospel of the physical health to be preached from every pulpit, and in every school room and in every home. All strong motives of religion and the eternal world are taught from the pulpit and the Sunday school to enforce certain duties that are no more important to the well-being of man than the laws of health, which are so widely disregarded. These laws are God's laws as truly as any inscribed by Him on the Table of Stones. The boards of health of our cities prescribe rules and regulations to insure the peace and happiness of the individual and the longevity of life which must apply to all in order that they might live out the expected term of life. What is the natural term of life? Physiologists have fixed it at a hundred years. Florens at five times the time required to perfectly develop the skeleton. David says: "The days of man's life are three score years and ten; and if by reason of strength they be four score years, yet indeed is his strength labor and sorrow." Under modern hygienic rules and regulations the days of man have been increased in civilized countries. Carefully prepared statistics show that while the maximum age has not increased in many centuries, the number of persons who survive infancy and reap a ripe old age is greatly increased. According to the Secretary of the Chamber of Commerce of New York City, civilization largely interferes with the laws of evolution, by survivorship and by encouraging the waste which arises from it. We know that a human being soundly constituted continues in good health until he reaps a ripe old age, provided certain conditions are observed and no injurious accident befall him. We might learn a lesson from the early Jews, or the ancient Greeks or Romans, if we had at our command statistics of their mortality. Doubtless they had a small death-rate! For they were strong and vigorous and observed the laws of hygiene. When these laws are properly observed, they decrease mortality and bring about greater health, comfort and happiness to the individual and to the country at large. Those who would preserve health in themselves and in the community in which they live, who would reap the greatest benefits of earth, and live out the appointed time, must strictly conform to these essentials: 1. A constant supply of pure air. 2. Cleanliness of person and surroundings. 3. Sufficient nourishing food properly prepared and properly taken. 4. Sufficient exercise of the various organs of the body. 5. The proper amount of rest and sleep. 6. Right temperature. 7. Proper clothing. 8. Sufficient, cheerful, innocent enjoyment. 9. Exemption from harassing cares. Conform strictly to these rules and all avoidable disease will be annihilated. On the other hand, where hygienic and sanitary science is not enforced, filth, decay and putrifying matter is sure to accumulate. In this we have suitable material for the propagation of disease germs, which cause all communicable and contagious diseases. These minute organisms exist in the atmosphere everywhere, and multiply by their own peculiar method of procreation; such as filth, heat and moisture. A population under the influence of vice, poverty, filth, debauchery, foul air, poorly prepared food and crowded dwellings, or in low, damp localities, with no rule regulating their eating or sleeping, clothing or exercise, is sure to have a great degree of mortality. With our thorough knowledge of how to prevent epidemics, most of the diseases that enter the body through the respiratory, digestive, cutaneous, circulatory, nervous, and genito-urinary systems should be less frequent. Taking the facts which I have here given into account one may see that not only do health and longevity depend upon laws which we can understand and successfully operate, but man has it in his power to modify to a great extent the circumstances in which he lives, with a view to the promotion of his well-being and preservation. We know that the draining of a marsh pond banishes malaria; a change from the city to the country reinvigorates, and that those who live in the high, well drained portions of our cities have the smallest degree of mortality and that the greater comforts possessed by the affluent secure for them longer life than the poor who are not so favored. To diminish the mortality in the Southern cities will depend upon both the individual and social efforts as well as upon the public measures of the legally constituted authorities. The dirty neglected portions of our city where refuse and rubbish, animal and vegetable matters are deposited and allowed to rest and send up their poisonous odors from house to house, must be looked after. The dwellings of our people must be improved. The old, dilapidated stables, in the narrow, filthy alleys; the low, damp basements and dark cellars, Habits of living must be corrected and a crusade against ignorance and vice begun by society. I don't think I would miss it very far when I say that one-third of the colored people in our cities live in just such dwellings as I have described here; while most of the white population live in well-built houses in the healthy portions of the cities. Is there any surprise that there should be so great a disproportion in the mortality of the races? Compare the statistics of all the large cities and you will find that under similar conditions, this same proportion in mortality exists in the Northern and foreign cities, where the food and dwelling of the poor have the same difference. But this same difference exists nowhere in the world as it does in the South. It is almost impossible for a colored man to rent a respectable house anywhere in the cities; but the dark, low, damp, confined, ill-ventilated cellars and alley houses are rented for as much as comfortable quarters ought to bring. I don't wonder that the mortality of the Negro is so great; but I do wonder that it is not greater. Any other race of people would have been exterminated in twenty years. The remedy for the high death-rate is the enactment, and enforcement of laws against allowing the people to sleep in basements, cellars, old stables, alley houses, in low malarial sections of the cities, and making the penalty against the landlords so great, that they will not rent such places for dwellings. Regulate the kind of tenement houses and the number of persons who shall sleep in one room, the kind of food and rules for its preparation; break up these late church meetings in poorly ventilated houses, and the problem will be solved. The infant mortality will be reduced one-half when our people learn that the care of a good conscientious physician is necessary, from generation to development, and through the entire stage of adolescence; not so much to cure, as to prevent disease. Our whole system of medicine is now turning upon prevention rather than cure. When the public is educated up to the point of paying physicians to prevent as well as cure diseases, then, there will be less sickness and fewer epidemics. Then sanitary science, under the strict observance of hygiene, will reach perfection; the rude, gross habits of living will be corrected; a system of perfect drainage and ventilation will be inaugurated; pure air and fresh water supply will be furnished to every public and private house; only pure, unadulterated foods will be on the markets; every hotel, private and boarding-house will furnish properly prepared diets, and universal cleanliness will be the law. Last, but by no means least, I call your attention to another most potent remedy for the diminishing of the great mortality of the race in the South. Besides the city hospitals, the whites have many other hospitals and infirmaries, supported by church and benevolent organizations where those that pay are at the hospitals because they can receive the constant attention of a physician and nurse. We need and should have such hospitals. The benevolently disposed people, the churches and societies of the cities could establish and well support them. In them, there would be pay wards and charitable wards. Each church and society supporting the hospitals could send their indigent sick to the charity wards and those who can pay, to the private apartments. These hospitals would afford a much needed opportunity for young women of the race to prepare for trained nurses and afford better facilities for the physicians to practice surgery and study remedies. We have established in the city of Nashville, the Mercy Hospital under the care and management of the Board of Trustees, composed of some of the best citizens and heads of our great universities. Among the directors are, Hon. J. C. Napier, President; W. T. Hightower, Treasurer; Dr. G. W. Hubbard, Dean of Meherry Medical College; Dr. P. B. Guernsey, President of Roger Williams University; Prof. H. H. Wright, Fisk University, and Dr. R. H. Boyd, President of the National Baptist Publishing Board. The hospital is located at 811 S. Sherry street, Nashville, Tenn., in one of the most quiet, beautiful and healthful localities of the city. The site is high and well drained; the building large and commodious and up-to-date in all its apartments. There are two large wards; one for male and one for female, and private rooms, to which good pay patients are assigned where they will come in contact with no one but their physician and the nurse. In this hospital great care is given to surgical work of all kinds and especially to abdominal surgery and gynecology. Colored physicians all Since the establishment of the hospital we have had a record of which few similar institutions can boast. During the first year we have had more than 140 surgical cases, including abdominal section and other major operations and yet the death-rate was less than 3 per cent from all causes. Our operating room is well appointed, with an abundance of sunlight by day and gas light at night. Many of the physicians of the South have sent us cases for which we are very grateful. We have had cases from Alabama, Arkansas, Mississippi, Texas, Kentucky, Missouri, Florida, and Georgia. Until the other cities of the South are able to afford the facilities and accommodations and the skill and experience of the Mercy Hospital we feel that it is the duty and should be the great pleasure of every colored physician to send his surgical cases to this hospital. I consider this one of the great factors to solve this vexed problem. The causes of the great mortality among the Negroes of the large cities of the South are due to ignorance; vice; debauchery; poor food, illy prepared; unsanitary environments; their habitation in the over-crowded tenement houses; in old stables; damp cellars; and low, damp sections and in narrow, filthy alleys, where the foul air, improper nourishment, poor ventilation and the want of personal cleanliness, furnish the proper condition for the development of disease and death. Correct these conditions and educate the people up to a thorough knowledge of and a strict compliance of the laws of health and the problem is solved. The death-rate among our people will not only be lessened, but I believe the Negro will outlive any other people on earth. SIXTH PAPER. WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED? H. R. Butler, A. M., M. D.
The causes of excessive mortality among the colored people in Southern cities are said to be many and have been discussed from just as many points of view by students of the social status of this people. But after several years of professional service among these colored people, which service gave me an opportunity to more closely study them, their faults, habits, needs, methods of living and their knowledge of hygiene and its laws, I have calmly reached the conclusion that the want of money is the main cause of the excessive mortality of this people. It is true that there are several minor causes, but all have their origin in the one mentioned. Among the most prominent of these minor causes may be mentioned Ignorance and Poverty. Let us briefly consider the first of these. The colored people have made wonderful progress in the acquirement of knowledge since emancipation, and this improvement has played no small part in reducing their excessive death-rate. Yet from this height we look down and see the great masses of these people still held in the death-like grip of ignorance. To these, education has taken no knowledge of clean homes, pure air, ventilation, soap and water and other things conducive to good health. These are they who to-day are falling so rapidly before the great reaper, death. It is a truth known to the profession, health departments and students of this subject that most of the deaths of the great human family occur between birth and the ages of five years. The children of the colored race are not an exception to the above statement. If the children of the intelligent, good, better and best die fast, it stands to reason that those of the ignorant, bad and poor would die even faster, and this is just what I have found to be the case. Ofttimes, among the lowly masses, ignorance is the first to take charge of the babies at birth; it sticks a slice of fat meat in their innocent Even when manhood and womanhood are reached, ignorance, ghost-like, stands forbidding the ventilation and cleaning of homes; it says: "It's too cold to bathe;" it sends men and women to bed in wet and damp clothes and does many other acts that multiply the graves in the old church-yard on the hill. We come now to consider poverty. Oh, what an enemy it is, and has been, to the human family! It makes its home mostly among the ignorant, and especially among the masses. In the cities of the South the great masses are colored people. Hence it is among these that poverty sits enthroned—a sceptered king ruling amid disease and death. It retards the masses of the race in their march to the city of improvement; it prevents them from having larger and cleaner and better homes; with its bony fingers it points them to the cheap renting huts in alleys, dens, dives and basements of cities, and commands them to enter and die; it follows them into the market places and fills their baskets with cheap adulterated and semi-decayed food-stuffs; aided by prejudice and man's inhumanity to man, it drives the colored people from the healthy country districts into the crowded, sickly settlements of the Southern cities, where they soon sicken and die. Poverty, supplemented by ignorance, and the want of the true Christian spirit, stands in the doorways of the public hospitals, infirmaries and libraries where aids to health are to be found and forbids these people to enter either on account of their color or the "want of space." Poverty keeps these people from building such institutions for themselves. Again, the colored people of Southern cities constitute the great labor force, hence most of the diseases that result from exposure are more prevalent among them than they are among the white race. Those diseases that result from improper foods, poor sanitation, want of pure air, need of better homes and want of public parks and baths, together with those untimely deaths due to the want of proper medical attention, good nursing and surgical operations at the right time are more extensive among the colored masses because they are Along with the observations already mentioned on this subject, and which observations have led me to reach the conclusion that "the want of money" is at the base of this excessive mortality, is this encouraging fact—that the colored people are not dying now as fast as they were even a decade ago. The reason of this is not far to seek. The truth of the matter is, these people are growing in wealth and intelligence and in proportion as they have acquired these essential qualities their mortality has decreased. I have observed in my practice that those who live in good, clean, well ventilated homes have no more sickness and deaths than white citizens of equal intelligence and wealth. I now call to mind, here in Atlanta twenty homes of colored citizens which are fitted and furnished with all modern conveniences, including heating and baths. The owners are well-educated and spend much time and money in keeping their homes and yards clean and in good sanitary condition. What I wish to say is this, in twelve years' time only two deaths have occurred in that circle of twenty homes, and one of these was a baby whose death was due to an accident, and the other was an aged person whose death was the result of Bright's disease. Does not this speak volumes to prove the truth of my position? What I have observed here in Atlanta relative to the real causes and prevention of this excessive mortality is true in other Southern cities. It is no doubt plain to the reader that I have not mentioned here a single cause upon which this excessive mortality rests, but that which money can remove. That being true, what is the conclusion of the whole matter? It is simply this: 1st. Pay the masses sufficient wages to remove their ignorance and poverty, to build better homes and to furnish and equip them with baths and other things necessary and conducive to good health, to purchase proper food-stuffs, fuel and comfortable clothing. 2d. The cities should enlarge their present hospital facilities, or build others especially for these people, cities and towns that have no such facilities should provide them at once, parks, public baths and libraries should be opened by the cities for the poor. It is simply a matter of money, before that mighty king, ignorance and poverty, together with all their allies, take flight. |
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