Chapter 28

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.

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.

(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 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.

R. F. BOYD, M. D., D. D. S.