A Comparative View of the Mortality of the Human Species, at All Ages. Black William
Dublin, and in almost all towns of considerable magnitude and population, the total annual births are inferior to the burials. It is calculated, that in London, within the last 150 years, near a million more of the human species have been wasted, beyond what were reared by its own original growth and procreation. But in small villages and country districts, the annual births exceed the burials; and it is from this redundance that a supply is furnished for the extraordinary consumption of armies, navies, war, colonization, emigration; exclusive of sickness, and other morbid casualties: the country and village surplus prevents depopulation.
Providence has also wisely ordained, that throughout those European kingdoms, of which we have any registers, a few more Males should be born than Females; and indeed such a surplus is rendered necessary from the waste by wars, emigration, intemperance, mechanical arts, and trades, the inclemency and vicissitudes of the weather and seasons, the vices and misfortunes to which political punishments are annexed; with various other noxious casualties, to all which the male sex are most exposed. In Dr. Arbuthnot’s Table, printed in the London Philosophical Transactions, of the proportion between the births of the sexes; in forty-six years were baptized of males, 329,742; of females, 308,644: excess of males only, 21,098. By the London bills, from 1657 to 1776, I find that there have been christened of males, 1,041,149; of females, 983,061, or as 18 to 17: and therefore, that in this long interval of 120 years, and comprehending two million of births, there is only a trifling excess of males, amounting to 58,088: a number which would scarce recruit the consumption of a few active campaigns. The excess of male beyond female births, is not so considerable as books of calculation have represented. In volume the 7th of the Philosophical Transactions abridged, there is an account of the annual births during several years at Vienna, Breslaw, Dresden, Leipsic, and Ratisbon: and in those cities, male and female births were as nineteen to eighteen. Amongst the abortives and stillborn, we also find the plurality of males. Lastly, if the registers can be depended upon, it appears that there are more births in Winter than in Summer, both in town and country. But although the fruit of the human womb may not have arrived at maturity before winter, it is no proof against the general law of the spring and summer influence on animals and vegetables, in contributing to fecundity and generation.
CHAPTER I.
The Comparative Mortality of the Human Species, and of the Sexes at every Age, in City, Town, and Country; and in different Kingdoms of Europe: illustrated with a Chart, and with Tables. The Comparative Mortality of the Human Species, by different Diseases and Casualties: exhibiting a Chart, and Tables of all the Mortal Diseases and Casualties in London during Seventy-five Years: illustrated by and contrasted with the united Observations of Medical Authors, with various Hospital Registers; and with a Variety of Materials, Observations, and Comments of the Author.
That learned Physician, Dr. Arbuthnot, in his Preface to Huygen’s “de Ratiociniis in ludo aleæ”, says, There are very few things which we know, which are not capable of being reduced to a mathematical reasoning; and when they cannot, it is a sign the knowledge of them is very small and confused; and, when a mathematical reason can be had, it is as great a folly to make use of any other, as to grope for a thing in the dark when you have a candle standing by you. Medical writers, almost universally, have neglected, or barely skimmed the surface of the following important subjects. The public registers of births, burials, and diseases, are overlooked by all the modern systematick authors: they leave us equally ignorant of the aggregate, or comparative number, or force of those fiends which haunt and ravage the globe. To speak metaphorically, in medical books, the extensive desolation of the most rapacious tyrants and conquerors are confounded with the uninteresting history, and petty depredations of a robber. The detached observations of physicians, or other literary individuals, confined perhaps to a small town or parish, a meagre detail of village remarks, furnish, in innumerable instances, foundations too slight for the erection and stability of general proportions. In order to form useful tables of the ratio of mortality at various ages, to determine upon the absolute and relative havock by different diseases, upon the general effects of climate, season, local situation, diet, drink, luxuries, new customs, and manners, &c. we should extend our views far beyond the narrow bounds of a parish, or even of a province; we should include an interval of many years, collective numbers, and large groups of mankind.
It appears to me, that a great number of the fundamental principles, or of the primary orders of medical architecture, have not yet been established, neither in Pathology, to which this Dissertation is chiefly related; and much less in Therapeuticks. The lumber and mountain of ponderous systems, heaped together from Galen to Stahl, can only be compared to Egyptian pyramids. Except what has been done by a few authors, hereafter to be mentioned, the sciences of Medical Arithmetick and Universal Prognosticks, are new in medicine. In emergencies, the constant appeal has been, with oracular reverence, to aphorisms and opinions of individuals. In a word, no medical author has yet attempted to take the gages of life and death, and of morbid devastation, and, in one general survey, to encircle the horizon of human existence and distempers. I have made some, at least laborious efforts, to rescue a momentous part of active medicine from that conjectural stigma with which the whole profession has been branded in the lump. And, however it may be slighted as an heretical innovation, I would strenuously recommend Medical Arithmetick, as a guide and compass through the labyrinth of Therapeuticks.
We are now to view the human race unexpectedly arrested, and struggling in the tragical and last stages of their terrestrial pilgrimage. The vision of human life is soon at an end: we are ushered into the world with lamentable exclamation; and are too often torn out of it in pain and agony. Bills of Mortality, however defective and inaccurate, yet sufficiently demonstrate this awful truth, that very few of the human species die of old age, or natural decay: by far the greater proportion are prematurely cut off by diseases. Of all the animal tribe, who usually bring forth one at a birth, none die in such numbers, in infancy, as the human race. In London, Vienna, Berlin, and every other overgrown metropolis of Europe, on an average, one half of the children born, die under three years of age. But in country towns and villages, the proportion of infant mortality greatly abates. In some country towns of England, of considerable magnitude and population, as Manchester, half the children die under five; at Norwich, half under six; at Northampton, half under ten years of age. London, therefore, will have lost, out of equal capitals, a number in the intermediate space, between three and ten, more than Northampton.
Attend next to the small proportion of Infant Mortality in open country districts. By Dr. Short’s registers of several small country villages in England, the major part born live to 25, 27, 33, and 40. In many healthy country parishes, half the inhabitants born live to mature age; to 40, 46, and a few even to 50 and 60; and rear large families of children. In some extensive country districts of Switzerland, similar observations have been made by Susmilch and Muret. Here, therefore, is an astonishing disparity between the duration of city and country life: but particularly, let it be engraved upon the memory, in the early stages of puerile exigence. Infants in cities resemble tender delicate plants excluded from fresh air; or fish confined in stagnant putrid water: they perish before acquiring a solidity and seasoning to endure the adulterated quality of the surrounding element; and their thread of life is then suspended by a tender cobweb.
Mortality, universally, during the first year after birth, is the most enormous in the funeral catalogue. A London infant at birth, has but an equal chance of living to three years old; whereas in the country, as before observed, half born survive to maturity. Upon reaching the third year, in cities, infants are somewhat seasoned, and the hurricane of puerile carnage is greatly abated. There is not afterwards such a prodigious disproportion between city and country mortality; and, in a few years after, from seven to ten, they approach nearer to an equality. From the London registers of burials, it appears that more die in the metropolis under two years of age, than from two to upwards of forty; and more under five years of age, than from five to between fifty and sixty: yet under five, there are but an inconsiderable number alive, compared to the latter class above that age: the deaths are greatly disproportioned to the living numbers or capitals. A few more die in the short interval between five and