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?
BY DR. JOHN R. FRANCIS.
[Illustration: Dr. John R. Francis]
DR. JOHN R. FRANCIS.
Dr. John R. Francis, physician and surgeon, was born in
Georgetown, D. C., in 1856. He attended the private and
public schools of Washington, D. C., until his sixteenth
year. His academic education was received at Wesleyan
Academy, Wilbraham, Mass. He began the study of medicine
under the tutorage of Dr. C. C. Cox, at that time dean of
the Board of Health, and one of the foremost men in the
profession of medicine in the District of Columbia.
His professional course was taken at the University of
Michigan, from which he graduated with high honor in the
class of 1878. Settling in the home of his boyhood, where he
was well and favorably known, and where his parents before
him were honored and respected, it is no wonder that he
succeeded and stands as the leading Colored physician of
Washington, D. C.
Dr. Francis was appointed in 1894 by the Secretary of the
Interior to the position of first assistant surgeon of the
Freedman's Hospital, with a salary of $1,800. He instituted
several needed reforms in the treatment of patients. He
installed the present training school for nurses, and,
indeed, was so active in his reformation of affairs in the
institution that those who know the facts admit that Dr.
Francis, more than any other man, is responsible for the
opening of the new era of the Freedman's Hospital, which led
to its present flourishing condition. He is now, and has
been for several years past, the obstetrician to the
hospital.
He is the sole owner and manager of a private sanitarium on
Pennsylvania Avenue, Washington, D. C. This institution has
proven to be a panacea to the best element of Colored
citizens.
It is a noteworthy fact that Dr. and Mrs. Francis have both
served as members of the Board of Education of the District
of Columbia.
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_, and _ignorance_. For obvious reasons I will submit them
in the following arrangement:
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 hereditary proclivity to some forms of the acute
communicable diseases, such as diphtheria and scarlet fever and also
to immunity from the same.
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
money and keep it, thereby obtaining the means with which to supply
themselves with the necessaries of life, and possibly, with some of
its comforts, will materially wipe out a large percentage of that
class of diseases and death that proceed from such causes as worry,
excess of work, physical and mental strain, late hours, broken rest,
etc.
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?
BY JAMES RANDALL WILDER, M. D., PHAR. D.
[Illustration: Dr. J. R. Wilder]
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 organism
is in a transition state. It is equally true that the use of any organ
before it has attained its complete growth or development is damaging
to that organ and interferes with its normal function, and "we cannot
but believe that children developed in immature sexual organs must be
deficient in true vital force and energy. It is often noticeable that
a child apparently strong and vigorous, may have but little power to
resist disease, or may even be strongly predisposed to some
infirmity." The colored women in the section under discussion who
become mothers, are usually multiporæ long before the twenty-fifth
year.
(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.