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 rapidly in a Negro settlement, not
because they are Negroes, but because their manner of living brings
them into the most intimate contact with one another, so that whatever
disease attacks one, rapidly spreads to all of the others who are not
immune.
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 to the _contracted_ death-rate of the whites due to their
superior social and financial condition. Their environments are, as a
rule, as healthful as education can suggest and as money can obtain,
and when disease overtakes them, they combat it not only with the
skill of science, but with the power of will. The incentives of life,
so lacking for the colored people, are theirs in all of their
plenitude. The earth is theirs and the fullness thereof, and there is
no power therein that they may not covet. This feeling, this
knowledge, becomes _vis-a-mente_ that proves a potential factor in
their struggle with disease. Despite this powerful influence however,
and because of it, the _morbidity_ of the white man in this country is
great. I venture the assertion that his morbidity far exceeds that of
the Negro--not because he is more prone to disease, but because he is
enabled to live longer with disease on account of the influences to
which allusion has already been made. The plain fact is, the Negro
dies sooner and the white man lives longer with disease, which
presents the unique question: Is it not more advantageous to the
public good to die of a disease and be buried safely and deeply
beneath the soil than to live with it and thus increase the
opportunities of disseminating it?
(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 excessive mortality of to-day? May he
not believe that "death is the philosophy of life?" May he not feel
that his race is being strengthened by the dying of the weak, just as
a tree is strengthened by losing its unsound branches? If so, then the
future Negro in this country will be the fittest of "the survival of
the fittest," and will represent the grandest type of physical manhood
that the world has ever known.
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?
BY DR. R. F. BOYD.
[Illustration: R. F. Boyd, A. M. M. D.]
R. F. BOYD, M. D., D. D. S.
Dr. R. F. Boyd has clearly demonstrated by energy, pluck,
ability and upright dealing with his fellowman, the
possibility of rising from poverty's hard estate to honor's
golden prize. Dr. R. F. Boyd was born and partly reared on a
farm in Giles County, Tennessee, where he learned to hoe, to
plow, to reap and to mow. When quite a boy he worked for the
famous surgeon, Dr. Paul F. Eve, in Nashville, and attended
as best he could night school in the old Fisk buildings on
Knowles street. He taught his first school at College Grove,
Tennessee. The Doctor would teach a school and at its close
re-enter Fisk University or Central Tennessee College. In
1882 he graduated from Meharry Medical College, with the
degree of M. D. He went to Mississippi and taught a high
school at New Albany and practiced his profession till the
fall of 1882, when he re-entered the Central Tennessee
College to complete his college course, receiving at the
same time an adjunct Professorship in Chemistry at Meharry
and made teacher of Physiology and Hygiene in Central
Tennessee by which he was able to pay his college expenses.
In 1883 he was made Professor of Physiology in Meharry,
which position, together with a position in the Literary
Department, he held till he graduated from the College
Department of Central Tennessee College, in 1886. In 1887 he
graduated from the Dental Department of Meharry, receiving
the degree of D. D. S., teaching in the school at the same
time. In June, 1887, he opened his office in Nashville,
where so many had tried and failed. In 1888 Dr. Boyd was
made Professor of Anatomy and Physiology in Meharry; in 1890
he attended the Post-graduate School of Medicine at Chicago,
from which he received a diploma. In 1890 he was made
Professor of Hygiene, Physiology and Clinical Medicine,
which position he held until 1893, when he was made
Professor of the Diseases of Women and Clinical Medicine,
which chair he still holds. In 1892 he took a special course
in the Post-graduate Medical School and Hospital of Chicago,
on the diseases of women and children, among whom the
greater portion of his practice is. One of the greatest
needs of the colored people in the South is well regulated
hospitals, where trained nurses can handle and care for the
sick under skilled physicians. Until Mercy Hospital was
instituted, there was no place of this kind in the South. It
was Dr. R. F. Boyd who established and instituted this the
largest and most complete hospital owned and controlled by
colored people. There surgeons of our race do all kinds of
operations and trained and graduate nurses of the race care
for the sick under their management.
It is in this institution where the graduates of Meharry in
the Medical and Nurse-Training Departments get their
practical work. It is the great center to which colored
physicians of the South may send cases to be operated upon
by skilled physicians and handled by trained nurses. The
death rate of this institution has been less than three per
cent from all causes.
Besides this work, Dr. Boyd has taken a great interest in
secret societies. As an Immaculate, he has gained a National
reputation and has filled nearly all of the offices in the
Supreme Lodge. As a Pythian he has served the Grand Lodge as
Grand Medical Register, and has been honored by the Supreme
Lodge as Supreme Medical Register, and is Surgeon General of
the Military or Uniform Rank of that Order. The Ancient
United Sons and Daughters of Africa is a creation of his own
brain and he is at present Supreme Secretary of that Order.
As a business man he ranks among the foremost of the race.
He owns some of the best realty of the city, among which is
the Boyd Building, 417-419-421-423 Cedar Street. This
building has four business fronts, a hotel and restaurant,
offices of various kinds and four large society halls, in
which about forty societies meet. The Mercy Hospital was
purchased by him solely, at a cash value of $6,000. Besides
this he is the owner of other valuable property of Nashville
and suburbs.
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, often below the ground, with an
insufficiency of both light and air; the clusters of homes built in
the bottom and low places, closely pent up, back to back so as to
prevent ventilation with only one entrance to each, and a privy
between; the over-crowded conditions of these uninhabitable quarters
and the quality of the food taken by those who live in these
disgraceful dwellings must be looked after.
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 over the South may send or bring their surgical cases here and
get every advantage that can be provided by the best first-class
hospitals and infirmaries all over the country. We have the best
graduate-trained nurses in constant attendance and the resident
physicians are men of the race who have made marvelous progress for
two decades in all branches of their work.
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.