Newspaper Page Text
GOD DOES NOT FIX THE DEATH RATE
By Dr. Woods Hutchinson A. M.
Second in the Series |D,‘ the World's Foremost Medi
cal Writer in Which He Exposes Absurd Theories
and Fallacies Relating 1o Longevity—Next Sunday
*\\'ll.\ We Get No _\lvssugvs from the Other World™
By Dr. Woods Hutchinson.
President-Elect American Academy of Medicine
HE old eynic philosophers averred that
nothing wae sure but death and taxes.
But with .the death rate cut down 50
per cent within fifty years and Single. Taxers
declaring war to the death on ali taxes save
one—and even that possibly‘ to be abolished
when we can control our natural resources—it
looks as if the saying was in need of revision.
Even though there be “a Divinity that shapes
our ends, rough hew them as we will” 1t s
evident that our skill with the hatchet is im
proving rapidly.
In the sense that we must all die some day,
which is a ‘consolation rather than otherwise,
for the happlest life, like the greatest battle,
gets to be a bore sooner or later and begins to
run around in circles, death is still sure. But
as to the time, the. method and every other
detall of our final taking leave of the world, we
are almost absolutely free agents, and the sky
is the only limit. To paraphrase Scripture:
“The dirty and unventilated man shall not live
out half his days"” And even what the span
of those days. the so-calied natural duration of
life, may be is still quite unsure, and. for all
that we can see, unlimited. Nearly sixty years
axo. in the very dawn of sanitary science, Chad
wick, the great English health ploneer, declared
that he was prepared to plan and build a city
which should have any desired death rate, from
five per thousand per annum up'
He was simply laughed at by both the plous
and the practical men of those days, but within
little more than half a century a lineal descend
and of his in science, one William C. Gorgas,
fulfilled his prophecy almost to the letter by
building just such a city, a whole country, in
fact, and that not in the bracing, healthful
porth, but in the worst and most notorious
pest hole in the seething tropics. For two dif
ferent semi-annual periods the death rate of
the white employes In Panama, including
nearly a third of women aud children, touched
six per thousand per annum. And General
Gorgas could work at least two-thirds of the
same miracle all over these United. States if
e were appointed secretary to a great National
Department of Health and Public Safety and
given a free hand a® to pure water, good food,
airy, sun-lit houses, war on-infections, and last,
but by no means least, good wages. It is very
significant that the lowest northern white wage
rate paid in Panama, the first and only “spot
less town” in history, was five dollars -a ‘day,
aud the lowest colored or tropical white- rate
ihree dollars a day, more than double what they
nad been accustomed to at home,
An Apparent Paradox
That Tells a Big Truth.
Here, as everywhere, the apparent paradox
helds: Dotible the wages and you halve the
death rate and treble the net efficiency. In
deed, when Gorgas was asked what should be
the first sgtep to lower the death rate in a
Northern factory town, he replied, “A-minimum
wage of $3!” “But,” says some one at once,
“we all must die some time of something. Sup
posing that we can save a thousand :lives from
poisoned milk in infancy, from the ‘little pesti-
Jences’ in childhood, or tuberculosis and typhoid
in youth, aren't we simply. shifting the deaths
from one part of the life scale to another, post
poning “the day of -account, but altering the
final balance and settlement not:a whit?”’" Does
not.our boasted- increased average length of
life consist mainly-of a huge saving of-lives in
Infancy, childhood and early youth, by c}odd‘lin%
and hot-housing,and ‘promoting the survival o
those who woild- otherwise have died at those
periods until they can beno longer.kept. golng,
and break down and die in spite of us at forty,
forty-five or. fifty? This is apparently ¢ sup
ported by the. curious fact. that, while our.
death rate for all earlier ages of'life has gone
down tremendously, that from forty-eight” to
+ixty’ has not only not diminished, but éven-in
creased slightly, about -per cent in males.and
2% per cent :in’ females. ~This:straw .is eagerly
‘lutched at. by our;life insurance companies’to
-xplain ‘the-fact that . they are still“insuring
lives in“the ‘twentieth century with. a death
‘atelof’ fifteen ‘per thousand at rates fixedin
fie:nineteenth whencthe'death rate .was'over
hirty. . i .
Atothe first sight,, this;pessimistic’ contention
seems. ‘plausibler and . has :been ,used. as- the
basis/foribitter attacks uponiour modern meth
ods ofpsanitation and)social ‘betterment. But,
as'a matter, of fact, ‘it/has ‘astonishingly little
support, orstanding; in court when ‘the actual
factsdare’ studied. . ‘First ofall,“it“rests upon
‘thej purely gratuitous assumption:that there is.
a/fixed, and’definite limit to ‘the healthiest and
soundesthuman life; ’beyond which; it “is Uim=
possible to extend our/ span upon this planet.”
This, Olike? most 11n§ygersdl)1x accepted assump-,
tions, is®basedoupon; little;more ‘than|legend and
tradition,”and( the/ experience that in theold;
unhappy days, beforethe dawn of the scientific,
era, barely two-thirds Jofa° ‘century lago, 7the
days of ignorance and -filth, ‘of cowardice and
cruelty, of poverty and piety, which ‘we;fatu
ously refer to as “the good old days,” most
human beings who worried through the fam
ines and the pestilences, and the private stab
bings and the public slaughterings, the offal
they were glad to get for food and the sewage
for water, were at the end of three-score or
three-score and ten years pretty well worn out
and ready to drop into the chimney corner and
prate about “Vanitas vanitatum!”
Their bodies had endured more insults, at
{acks and hairbreadth escapes in a month
than ~urs do now in a year. And it is the
thin- that have happened to us that make us
ol# aot the mere length of time we have bheen
upon ‘the ‘planet But_even ,If we accept the
mournful, wailing dirge: “The days of our years
are threescore years and-ten, And If by reason
of ' strength they * be fourscore years. yet is
their strength labor and trouble, for it is soon
cut off and we fly away,” as our War song, we
have plenty of leeway before we bump against
the ‘inevitable. If everybody lived to be sev
enty that would roughly mean a death rate of
about twelve per thousand & year in a station
ary community. . Bui as most modern com
munities are not stationary, in fact are increas
dng at the rate of two to five per cent per an
num, this means an actual possible death rate
of about six or seven per thousand. And the
best we have ever wop yet for a whole country
or large city is from 13 to 15, So we still have
s long and cheerful way to Tipperary before
we reach even this imaginary NHmit
But It is most singular how the more closely
we study the question of the so-called “natural
term”’ of life the -more impossible it “bpcomes
to find any positive proof of such a thing. Some
very interesting and careful studies of“the
natural lifetimes of animals bave recently beea
made -by eminent biologists and statisticians,
potably Prof. Chalmers Mitchell, director or
the famous London Zoological Society’s’ Gar
dens. The investigations covered a large num
ber of species, wild, in captivity and domestic,
with the singular and unexpected result’ that it
appeared Impossible to fix any definite” limit
at which-life under anything approaching ideal
circumstances - must- come to an ‘end. - Cer
tainly nine-tenths of “either wila or domestic
animals were found to die under half their
maximum age from causes which might be
termed accidental, i. e, which.had nothing to
do ‘with the essential exhaustion of their vital
powers. In'not a few species, such as_some
fresh ‘water fishes which could be accurately
observed -in ‘pouds for. considerable periods,
not merely -life, but’ also. growth appeared to
continue .indefinitely. until terminated by cap
ture, drought or disease. The famous “mon
ster,” .wary old trout, in the deep hole under
the tree roots, or the wise old pike, the despair
and the delight of .the angler, is apparently
only an illustration of what many “little fishes
in the brook” might attain to if possessed of
adequate Intelligence, wariness and courage.
It. was even difficult to fix within fifty. per
cent. of what might be called an average
natural term of life for most animals, including
such: familiar fellow boarders as dogs, cats and
horses. -It.was . found that the lifetime of a
dog or a horse was, up to twenty years for the
latter and ten or twelve for the former, pretiy
much -what we chose to make it by our skill or
our ignorance, our care or our neglect, and
well attested cases are on record of nearly
double these equine and canine ages being: at
attained. This almost perfectly corresponds
with-the results of our study of and experience
with the genus humanum, for the more carefully
we look into the actual facts of the case under
the microscope, in the test tube and on the post
mortem table, thie more overwhelmingly are we
driven to the conclusion that the so-called signs
of old age are the clear marks of either mal
nutrition, overwork or of infectious disease
which we were supposed to have recovered
from. It-would seem only reasonable that there
should be such a thing-as the decay. of our body
and its various organs, simply through the
cumulative .effects of ‘successive decades of
wear. and tear. But so far as clear and djstin
guishing marks of senile decay in our internal
organs is concerned, almost every. one,of them
shows the unmistakable handwriting. and ' foot
prints of some form of infectious disease.
Old Age Hardly
Ever a Cause of Death.
That famous decay and hardening of the
arteries, for instance whose pompous.Greco-
Latin name, Arterlo-Sclerosis, has been digni
fied into a new disease of .civilization, is now
clearly traceable in the great majority of cases
to one_or another of the infections, or ‘fevers,
after the normal resistance .of the .body has
been lowered by prolonged : muscular over
'ti‘gln. bad:food and bad air. Kven more.con
trary to popular impression, death by old age is
and always has been. one of the rarest of exits
from this world’s stige. Two decades or more
ago Flexner discovered that the great majority
of ‘deaths occurring’ in ‘'hospitals, even in_those
who had been crippled in their joints, or heart,
or ‘Kidneys, -or liver, or'nervous system,,and
‘were 'ln| a state .of serious chronic, . disease,
were 'due- not actually to that chronic ‘disease
itself, but’ to a_sudden ‘and . vicious attack' of
‘what would ‘under’ other. circumstances have
been a trivial-infection, like a cold;in the’head,
an/inflienza, a tonsillitis,jor a mild bronchitis
or.pneumonta.- So uniformly was this the (case®
that; he( coined the’;phrase: “Terminal()infec
tions” to,describe’.these last: germs - “straws
which broke'the) camel’s,;back® -of ;vital, re-.
sistance. ‘E,Sqi“-'vg)ld‘élyu‘hdil _the 'idea extended
sirice ;that | most of our( boards ~of Jhealth! or/
census’ ‘bureaus, refuse, to ‘acce ptofold lage" as.
an adequateand intelligible causeof death;in’
o dbathcertifcae, -+ o 0 - ° % & o
- Although., we may operhaps.-be inclined” to
‘Egjsenf:}th\ifiqug“purue Ihalrasblohtlng, withfa°vague
s‘§93:_tggf‘;f’fée,lllqugQt’hq\t‘v"any“man@who'»llves to be
seventy-five ‘or over is entitled to die of any
thing: he pledses and no questions asked, vet
it is an interesting and consoling thought, with
applications of considerable practical value,
that so far there is scarcely a single attested
case on record of any human being actually
dving, simply, in the classic phrase, “because
he couldn’t live any longer,” upon purely in
ternal grounds. Most deaths from “old age”
are due to pneumonia, of a mercifully painless
and swift type, seldom running more than
four days and often only two. We may even
feel some little sympathy with the man giving
his family history in making application for
life insurance, who. when asked what his
maternal grandfather, aged elghty-five, died of
replied after some minutes of cogitation,
“Well, I really couldn’t say positively. but 1
know It wasn't anything serious!” It.ls cer
talply significant and hopeful, that, so far as
the actua!l facts go. the full. natural, unstarved
up!nfoctod. unsweated possible Hmit of human
life has probably never vet been reached. It
leaves all sorts of possibilities open to us in
the future. On the other hand, studles upon
the lower animais have swept into the limbo
of legend and tradition, where they belong
& great deal of “skimble-skamble’ stuff about
the superior longevity of animals as con
trasted with man. All the animal centenarians
for ‘instance ‘have gone into the Waste-paner
basket, like thelr alleged human confrores. No
basis whatever was found to exist for the huge
jongevities clalmed for the raven, or the turtie,
or the elephant, or any of the other animal
Methuselahs, except the very rich and abun
dant one of our utter and complete ignorance
of the actual date of their birth. For Instance
In the elephant, practically all tame elephants
are born wild and captured after maturity.
Longevity of Certain
Animals a Popular Myth.
Of the few born in captivity none have ever
reached the age of fifty. Most of them show
all the signs of old age at thirty-five or forty
The royal elephant that had earried five gen
erations of rajahs or kings was found to be a
myth, or else the knife or the polson bowl
had been very busy among the rajahs. Our
atter lack of knowledge about the rate of
growth of the tortoise and of the turtle, and
the ease with which the guileful practical
joker can carve on the shell of the torpid and
helpless heast any name and date he chooses,
from “Adam, Year L. up, leaving it to be dis
covered next season with open-eyed wonder by
the parlor naturalist. As an amusing lllustra
tion, a huge tortolse weighing nearly 300
pounds was “rought to the New York zoo from
the Galapunos Islands; it was alleged to be
over 200 years old, and to grow about an inch
in diameter. a year. For several' months it
hibernated but woke up in the Spring, began
to grow, and in three months gained over 30
per cent. in size and weight. It was probably
between five and seven years old. This forms
the basis of the huge longevities attributed to
these beasts,
In the case of the raven, it is simply a case
of “All coons look alike to me,” for the single
pair .of ravens_that had bullt their nest con
tinuously for 125 years in one turret-of the old
castle may have comprised anywhere from ten
to fifty different generations, for anything that
any human observer could tell 'to the con
trary. The same utter lack of accurate knowl
edge explains the extraordinary longevity
ascribed ‘to. the -eagle, the lion, the wild swan
and the boa constrictor. There is absolutely
no trustworthy record of any elephant. over
fifty, or any raven over twenty, nor of any tor
toise over thirty years old; and the oldest fish,
fiesh or fowl ever positively known in'captivity
was a parrot which attained the age of thirty
three in the bird house at the London Zoo.
With apologies to Poe:
“We are driven to agreeing
That no living human being
Ever yet was blessed with seeing,
Bird or beast that reached three-score.”
gso that all the talk about animals taking a
certain time to reach. maturity, as evidenced
by the condition of their teeth-or the unlon
of the heads of their bones.with: their shafts,
or_their first mating period, and then'living so
many multiples of ‘that "time, with. the en
chanting conclusion; that human: beings, upon
thist principle;, ought to reach at least 160 to
200" years, must.go by the board completely.
We come ‘as near to lving. our full natural
span_of life as any known animal. In-fact, the
conditions "~ under . which we live are as
“natural” and’ healthful as those that.surround
any animal; and ‘we have not the slightest
reason to-regard ourselves as inferlor-in‘either
health, vigor or'longevity.to any of our animal
cousing or bird relatives.
Let us see for a moment what the big, mas
sive figures in the death lists are at the dif
ferent’ periods-of life, and how far they come
within our own control..ln infancy, the message
of the scroll is.so .vividly: clear:that he who
runs may read it. We used to have,.in the pre
bacterial “days, a death rate during the first
vear of life of anywhere ‘from 250 to 350 per
thousand born. In'the'words of/Hood's jingle:
‘“What different lots:our birthdays:bring,
For instance, one little mannikin thing
Survives to ‘bear many'a wrinkle, -
“While, déath ‘forbids another:to wake;
And ajson that itvtook(nine . moonsito make.
~ -Expires/without‘a twinkle:, *, * * .
“s * vol Our idestinies ‘happy.or.fatal. . :
Onelittle cbdifis”{:g.gt"fvvrny G 0 g
On {ta very first trip in. Babbacombe Bay;
While’another:rides safe“at Port'Natal.”
Within ten years.of the time we had aban
doned “The-Lord - gave, - the - Lord - hath-taken:
away’ attitude, we found that a third of this
slaughter of the innocents was due to bad air
and respiratory diseases; another third to dirty
milk, and we impiously proceeded to thwart
the “dispensations of Providence,” with the
result that in less than forty years our infant
death rate has been cut down just about this
clearly preventable two-thirds; and a com
munity which loses more than ten infants in
the hundred during their first year considers
itself more or less disgraced. And really
civilized communities like New Zealand and
gome of the Swiss Communes, where they
starid for those ridiculous things called “chil
dren's rights” to food, fresh air, play and love,
save all but seven, and even five in the hun
dred, of their babies. We are finding that
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. - g - e 54
4 ~
DR. WOODS HUTCHINSON.
even though the “son that expires without &
twinkle” has its cause in tne "sins of the
fathers” and a very important one, whose re
moval will be attended by farreaching im
provements in many other departments of
human life and happiness.
But, challenges some heavy taxpayer and
real estate owner, the real Clirce that turns
men into swine s not woman, the enchantress,
but the possession of and by too mmany acres
of dirt. “Suppose you tide these weakly and
ailing babes over into their second year, won't
you simply spread the mortality over the next
five years as they slip their anchors one after
another, after costing the community just that
much more for every year they survived?”
Figures Show Infant
Mortality Cut in Half.
Let the figures answer. We only got the
mortality cut in two about five or ten years
ago, but long enough for it to make its damag
ing effects visible upon the vitality of the chil
dren of the next five years, and the damning
results are beginning to show themselves al
ready. Instead of rising tremendously on ac
count of the unfit and undesiraple infant lives
loaded onto it, the mortality of the next period
of life, up to the fifth year, has gone steadily
down and down, until its reduction is almost
as -great as that for the period of infancy.
Passing on up through the Seven Ages of Man,
the next period, that of childhood proper, from
the fifth to the fifteenth year, shows an almost
equally marked saving of life, partly on ac
count of the good work coming in to our aid,
which has been done against those modern
Herods, the diseases of childhood--scarlet fever,
diphtheria, whooping cough, measles, etc., and
partly because “the ‘children , with whom we
have-to work' are: bigger, 'stronger -and with
better resisting power against disease, on ac
count of the good care ‘that has been taken
of them -in- infancy.
The tide of victory over the flood of short
coffins sweepg steadily on-into the next period,
that of young adult life, from fifteen to twenty
five, for. here our fight against: tuberculosis,
pneumonia and typhoid comes to our aid, and
clear through the next period, that of manhood
and womanhood; twenty-five -to forty-five. “ The
SCaptains‘of the Men) of Death’ ‘are .beaten
backward at’every point, although the victory
{8 not. quite- so complete here.ag it;was(in in
fancy. "It"is only when' we'reach the climax,
and the “beginning decline cof'life ' that! our
lives (begin'to’ wayver .and:the enemy splucks
up lcourage, to ;try: to:hold his ‘own.” ißut ‘even
this counts: for/ nothing -until about,the fiftieth
year, after:which, as°our insarance expeorts so
loudly trumpet' on | every occasion; the death
rate remains ‘the same as it did forty years
ago. Indeed, in the“period between ffty-flve
and sixty-five it falls about § per cent. below
the former average. This temporary check is
usually attributed to the so-called stresses and
straing of civilization: over-feeding, dissipa
tion, hurry and excitement; and the diseases
which principally cause this death rate of mid
dle age, Bright's disease, cancer, heart disease,
paralysis and other degenerations of the nerv
ous system, fibroses of the liver and hardening
of the arteries (arterio sclerosis) have been
dubbed the “diseases of civilization.”
The moment, however, that these diseases of
middle life began to be investigated, it was
found that they had no connection whatever
with eating, drinking, high living or the pres
sure of city life. On the contrary, nearly two
thirds of them were clearly traceable to dam
ages left upon the heart; arteries, kidneys,
liver and nervous syptem by the little infec
tions of childhood, the greater Infections of
middle life, typhoid, tuberculosis, syphilis and
rheumatism, and even such trivial annoyances
as colds in the head, sore throats and Summer
sicknesses. In other words, the reason why
the death rate after fifty is not yet declining
{8 that our work In saving babies and In
lJowering infant and child mortality was aot
tairly under .way unt!l about twenty-five years
ago, in other words, after our present crop of
fifty-vear-olders had reached young adult life.
We men and women of middie age are the
hangovers from the pre-hygienic period; and
the young people who are coming up to take
our places will probably not show a third of
the so-called diseases of middle life that we
do, because they were protected during thelir
infaricy, childhood and young adult life from
the principal causes of these chronic degenera
tions.
The IntelMgent care and protection now
ziven to the teeth alone will add ten or fifteen
years to our life, to say nothing of the dis
covery that abscesses in the gum and about
the roots of the teeth are one of the chief
curses of chronic rheumatism, particularly of
the most painful and crippling varieties, and
that dirty mouths cause a large share of our
anemias, our dyspepsias and our neuralgias.
Twenty years more and toothaches will be a
curiosity, and plates and dentures and artificlal
teeth almost unknown. The youngsters now
coming up will keep their teeth till they are
eighty, and thelr digestion and elastic galt in
proportion.
What. would not we semi-centenarians have
been spared in the shape of choked nostrils,
irregular teeth, perforated ear drums,. broken
mouths and pigeon breasts i only the magic
word’ “adenolds” had been -known and acted
upon in our childhood:days? The cripples of
our generation are nearly all ‘dead and our
new ones are coming up to take their place;
children’s ~hospitals : cure them all mnow; the
blind asylums:.are.emptying 'fast,’and’tenanted
chiefly by old or middle-aged vietims. 'Thanks
to ‘spectacles and °artificial ‘teeth, old-age.ls
relieved ‘of half its dreariness and boredom.
Woman Shows No
Increase in Death Rate.
I-may mention in . passing that woman has
igain shown her customary superior vitality
ind’ vigor, and that her death rate at these
wges-so deadly to men shows practically no in
srease, and a distinetly superior decline at all
sther periods of life. That this comparatively
ieavy mortality during the periods from the
fiftieth to the sixty-fifth year is due to a speci
fic cause of this sort is supported by the
cheering fact that after the sixty{ifth year
the death rate again begins to decline, as com
pared with that of the same age forty years
ago, while the percentage who pass seventy
five is larger than it ever was before.
8o that we are in a position now to laugh
at those loud and gloomy predictions about
what would happen on account of our short
sighted methods of saving infant life, “promot
ing the survival of the unfit,” and lowering
the general average vitality of the race. The
children of to-day of all ages from the fifth
year on are from one to three inches taller,
six to twenty pounds heavier, and have from
three-fourths to two inches better chest de
velopment than the children of corresponding
ages thirty years ago. And, what iz practically
the same thing, our American children of to
day have the same superfority over the ohil
dren to-day of the particular European mf‘i
try in which their fathers, n:andulhm or
great-grandfathers were born. How much ‘é
further this reduction of the death rate can be
carried along through the declining years of
Hfe is a question, but it is one which need not
concern us muoh. If we can live.a full, active,
useful life up to sixty-five, seventy or seventy
five years of age, what happens to us after
that need distress us little. To litve hard and
usefully, and die us suddenly as possible, are
the ideals of biological philosophy. There is
neither merit, nor credit, nor comfort, in out-
Itving our usefulness and our happinesa .
Ninety Years About ‘
the Limit of Human Life.
While we are utterly unable to say that there
{s any fixed Hmit to the duration of human
life, the probabilities are that even under m‘!
most ideal conditions which can be furnished
by sclence the vast majority of us will flj
by the wayside before our eighty-fifth or nine- 13
tieth year, and most of us will not only be will
ing, but glad to do so. There are just as many §
old people in the world as there ever were In
proportion to the population. = The “idea Mg
old age was more frequently attained in earlter
ages 18 merely one of the many deluaions
connected with “the good old days:” All the
people we have known who belonged to those
earlier days were naturally very old—there
fore that was the charaoteristic of the whole
generation. They held the same delusions
about their grandparents; our grandchildren
will hold 1t about us. % ?j
S 0 far as we know, there are just nfl
centenarians as ever, for the good and 2
clent reason that there is not'a single legally
authenticated case of any human being having
passed his hundred. and first year in all his- 3
tory, either ancient .or modern, as has been
proved by careful’-and exhaustive investi
gatlons by competent sclentists and statistic.
jans, Sir George :Cornwall, Berry and others.
No one need have the slightest ambition to w*
come a centenarian, for of the thousands ‘fi:‘q
those who are alleged to have reached thef
hundred and first year, only three names v
ever have been heard of save for the faot of
their mere turtle-like persistence of life. It =
is probable that the next third of a oem
will see as large a proportion of the hum
race reaching the age of, say, sixty or letymf
as now survives the fitst ten years of life; &
as that will mean that we have done our work,
lived our lives, started the next genertm&;‘;
its way to success, and had an honored L
comfortable decade or two in which to conn!g i
the rising generation and see the results i
our work and muse over what it was all abouf; =
we shall be as ready for our last sleep as %
are now for our pillow after a hard d %
work, e
. 5 s 5 S
Other articles in this series |
2 iR
—one each Sunday—will be as |
follows: e
No. 3—Why we get nc messages from ©
the other world. ;:_
No. 4—Why civilized man Is losing his }
halr. e
No. 6—Why we grow fat. : :,,I'
No. s—Why we get thin. ¢ 1;