influences we bring around us by our own voluntary choice. One person takes
proper food, at proper times and in proper quantities ; another indulges his appe*
tite, and takes unwholesome food, at irregular intervals, and in injurious quanti-
ties. One person clothes himself so as to maintain an uniform temperature of
the body at all times ; another guards not agtfinst the changes in the tempemture
of the seasons, but allows himself to be alternately heated and chilli. One
man selects a place of residence where the air he breathes is pure ap«l invigorat-
ing ; another, where the noxious impurities of the air carry disesFi) and death to
his vitals. One person keeps his skin in a healthy state by /i^uent bathing ;
another permits it to be coated over with impurities. One chooses an occupation
which gives suflicient exercise, physical and mental, to keep all the energies of
his body vigorous ; another, one that requires too msch labor for his physical
nature, or has in itself unhealthy influences, or, in hi« occupation over-exerts him-
self so as to impair his physical and mental capacity. One man exposes himself
to the contagion of small pox, knowing, at tbe same time, that it is dangerous,
takes the disease and dies ; another vaccinates himself, and thus protects and
saves his life. One man ventures upon the ocean without sufficient knowledge
to manage his craft, and thus exposes himself to accidental death ; another is
cautious, and ventures no farther than safety permits. The act of the one
in each case is favorable, and prolongs life ; the act of another is unfavorable,
and abridges it And will not every one say, that all these acts and influences
Digitized by VjOOQIC
92 BIRTHS, MARRUGES AND DEATHS.
for good or for evil, are more or lees within the control of man ?— That life
may be saved and prolonged, and that the time of our death may, in some aense,
be postponed ? Numerous illnstrationB of this truth present themselves within
the circle of our own knowledge. The late Rev. Dr. Ripley, of Concord, when
settled, in 1778, had a feeble constitution ; and one man voted against him be-
cause he thought it useless to settle a man whose probabilities of living were so
smalL He, however, by great care and attention to his health, acquired a pretty
good constitution, and survived his 90th year. He probably added 50 years to a
life, which another man, under similar circumstances, would not have enjoyed.
We know, we have seen in these Reports, that these influences are not alike
in all places, nor in all seasons, nor in all employments, nor in all circumstances ;
and that sickness and death take place in proportion as these influences are favora-
ble or unfavorable. Some places and circumstances are more fatal to children,
some to adults, and some to the aged, than others. In one locality one class of
diseases, and in a difierent one another class prevail. Endemic influences difler
very much in difierent places and seasons. But what these influences are, or
wherein they differ, we are not informed. We only know it by partial investiga-
tion and vague report We have not sufficient data for definite plans of action.
The tendency of our people is to become a manufacturing people ; and manu-
factures have been so far investigated, that the cost of every article — material,
transportatioD, labor, wages, board, &c. — is clearly known. But what amount of
life is sacrificed thereby we know not We do not know, though we ought to
know, whether there exists, or whether there is any tendency to, such a condition
in any of our cities and towns, as would justify the remark of Mr. Chad wick,
before quoted, making them " characteristic of those crowded, filthy, badly ad-
ministered districts in England, where the average duration of life is short, the
proportion of the young very great, and the adult generation transient"
The impression seems to have become general, that human life is improving ;
that it is longer and healthier now than formerly. This, however, needs confirma-
tion, before it shall be asserted as truth. From investigations which have been made,
I am inclined to think otherwise, especially in some places, and when the present
time u compared with a period fifly years ago. We do not know, though we
ought to know, how fiur our habits — ^the universal thirst for wealth in America,
the reckless speculations of some, the hap-hazard mode of living and disregard
to health of oihers, the luxury and extravagance of certain classes, and other
practices of modem society — tend to check the progress of the population, in-
crease disease, and weaken the race.
The average duration of life, and the average age at death, vary according to
difierent infiuences. We have not, as yet, a sufficient number of facts to illus-
trate these differences in America. Life insurance is now as common in
Europe as insurance on property % and it is becoming more common in this coun-
try. But data do not exist, sufficiently accurate, to form a proper table of rates
which shall be paid here for such risks. The rates charged by the Massachu-
setts Life Office were calculated from the deaths alone, and are therefore sup-
posed to be incorrect, as are others which have since been calculated here.
These matters concern the insured — the people as much as the insurers — and are
important to be generally known. But there is a higher value than this to be
gained. For while it is important to the insured and the insurer, (comprising a
Digitized by VjOOQIC
LETTER TO THE SECRETARY. 93
small pfirt only of the people,) to know how long a known life will probably con-
tinae, it is also important to all others, comprising the great mass of the popula-
tion, to know how long they may probably live, mider the difierent circumstances
in which they may be placed.
the
W
sac
on
bir
I
Ion
trie
nnf
not
chi
poc
as long in Liverpool as m Surry ! At 30 it is shortened 7.8 years, or about one
fifth ! Yet before the facts developed by the Registration System were known,
it was asserted by one of the most accurate writers in England, that ** the great
increase in the town of Liverpool is attributed to the salubrity of the air, and the
progressive improvement in its trade, conmierce, steam-navigation and rail-roads " !
This is a forcible illustration of the importance of Registration. Facts of equal
importance may be developed in our own State, in relation to the condition of
our towns and cities. If the table of Mr. Wigglesworth adopted by the Massachu-
setts Life Insurance Company is a correct representation of the mean duration of
life in this State, (though we believe it is not,) it is as unhealthy as Liverpool,
and the most unhealthy districts of England.
The average age at death, as has been already said, is not to be taken as an
exact index of comparison for the health of a place, unless we have the number,
age, and condition of the living. It is, however, an interesting fact to be known,
and we present, in the subjoined table, several calculations made from such data as
are in our possession.
Digitized by VjOOQIC
94
BIRTHS, MARRIAGES AND DEATHS.
(*)
Period ofObwr- Nmber of
NmberoT.
ratioo.
jears.
Death&.
atdeaib.
1779 to 1842,
63
OoDCord, • • >
1,600
38.08
1812 to 1845,
33
Plytnptoo, {seepage 32,) .
4^ ,
41.00
1805 to 1836,
32
Amherst, N. H.
815
32.00
iei7 to 1843,
27
Dorchester, Mass.
1,767;
32.20
1842, . .
1
Maancbosetts Returns,
6,986 '
34.77
1843, . .|
1
u u
7,798 1
33.82
1844, . .!
1
a u
7,689 1
33.74
1845, . .
1
M U
8<388
30.26
1611 to 1820,
10
Cily of Boston, .
8,020
27.25
1821 to 1830,
10
u u u ^
. 10,731 :
25.88
1831 to 1840,
10
u u u
. 16^14 i
22.72
1841, . .
1
England, .
. 335,106
29.46
1841, . .
1
Ireland, .
> • 1
28.00
1841, . .
1
London, .
• 1
27.00
1841, . .
1
Liverpool,
. 1
20.00
1814 to 1833,
20
Geneva, Switzeriand, males.
54219 !
38.44
1814 to 1833,
20
" « females,! 5,688
42.68
1814 to 1833,
20
" « both,
10,907 j
40.67
This statement affords another striking iUnstration of the infloence of locality
on longevity. Estimating by the above average age at death, the valae of life to
be 100 per cent, enjoyed by the people of Plympton, then the people of Bostcm
wonld, according to the age 1631 — 1840, enjoy bat 55.41 per cent; or, in
another view, the people of Boston, on the average, live a less number of yeais
by 44.59 per cent than do the people of Plympton !
To obtain all the needfol information on this subject, we most have the aid of
government The Legislature must direct as to the method of coDecting and
registering the facts in the towns, and the agency by which they shall be return-
ed, digested, arranged, published and spread before the people. We have bad a
trigonometrical survey that has drawn out the topography and boundaries of our
towns, the height of our elevations, and the course of our rivers ; we have had a
geological survey that has figured to us the structure and formation of our soil,
and pointed out the probable mineral worth of every place; we have had
an agricultural survey, designed to reveal the physical resources of our lands, and
to teach our farmers where and by what means crops of grain and grass may be
produced in greatest abundance and at the cheapest rate, where and how sheep
can be best and cheapest raised, hogs fattened and cattle maintained ; we have
had a zoological survey which presents the names, localities and habits of beasts,
birds, fishes, insects and reptiles, which exist in this Commonwealth ; and we
rejoice that such surveys have been made. It was for the good of the people that
they were undertaken, and they reflect high honor on those who instituted them.
But while we have all these surveys and maps, pointing out the boundaries of
our counties and towns, the localities of our mineral wealth, the best lands for
farming and the production of domestic animals, and the existence of noxious
and innoxious wild animals, we may ask where is the sanatory map which points
out the healthy and unhealthy localities in the State, which will reveal to our
people where and how human life can best be sustained and longest continued.
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LETTER TO THE SECRETARY. 95
and where and how haman energy and prodoctive power can be best brought
to bear upon the culture and development of the sources of wealth in the
State ? Have we not said by such legislation that our cattle and our hogs are of
more value than the lives of ourselves and our children f Have we not extended
to the brute, whose worth is measured by dollars and cents, a species of legisla-
tion which has been withheld from nyin, who is of immeasurable value ? When
compared to investigations into the physical condition of man, ell other investiga-
tions dwindle into insignificance.
The following sensible remarks on this subject are quoted from a review of
Dunglison on Human Health, in the American Journal of the Medical Sciences,
published in Philadelphia, for April last, a most able quarterly periodical work : —
" What our governments, either national or state, have done for the health of
the people is unknown to us. If they have enacted any laws, or taken any meas-
ures to prevent the beginning and the growth, in this country, of the lamentable
state of things that has been shown to exist in regard to the poor of Europe, they
have escaped our notice. They have done almost every thing else ; but this they
have left undone. They have legislated for property, but not for life. They have
cared for the lands, the cattle, the money of their constituents, but not for their
health and longevity. They have held out encouragements for the people to
raise the largest crops, the strongest horses, the fattest hogs, and the most active
silk-worms ; in short, for the greatest productive power of land or beast, but noth-
ing is done for the great producer, the owner, director and enjoy er of all. Con-
gress has surveyed the public lands, and ascertained how much and what sort of
crops can be raised upon them ; and urged their fruitfulness as a motive for peo-
ple to buy and settle upon them ; but whether these settlers are to live or to die
upon those lands, is not thought worth the inquiry. They have taken pains to
inquire at how much cost of capital and machinery, and of labor, horse-power
and steam-power, of men-power, mines can be wrought, cloth can be made, and
ships can be saUed ; but how much cost of life, how much deterioration of health
and strength are necessary for these operations, these have not received any ex-
amination. Whether our manufacturing population is sinking to the weakness
and depravity of the operatives of Manchester, or are yet as healthy and live as
long as men and women in other employments ; these are matters which our gov-
ernments ought to inquire into, but which they have not regarded.
'* Massachusetts is the only State that has provided for the Registration of Births
and Deaths, and the causes of mortality. And even this law is not completely
enforced. The only attempt which the national government has made to gather
any facts in regard to the sanitary condition of the people, was an inquiry into the
number of the deaf and dumb, the blind and the insane, at the enumeration of 1840.
And these facts were so carelessly gathered and faithlessly published, as to be
worse than useless.
" The same diversity of physical and sanitary condition, which is shown to exist
among the rich and the poor of Britain, is also found here in this favored land.
We have examined a few towns, and our facts corroborate those of Mr. Chad-
wick. The difference of domestic condition and of longevity between the com-
fortable and the straitened classes is not so wide here as it is there, but it is none
the less certain. In Dorchester, Mass., the poor averaged 27 years, and the
prosperous fanners 45 years of life. In Concord and Brooklyn, a similar difier-
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96 BIRTHS, MARRIAGES AND DEATHS
ence wmt tbown. Thii ptitiil dealing of death with hia aobjecta ia ct iinu e d the
moat zmoDg the children. Among the poor of Dorcheater, 33 per cenL of all
the deaths were under two years of age ; among the richer, oohr 12 per cesL
died at that age. On the other hand, 27 per cent of the proaperooa, and oiilj 9
per cent of the nnproaperooa, reached or paaaed their thiecto i c and ten jearSL
Theae facta show that there is, at leaat, a field c€ inqoirj almost nwtnnrhpd in
America, bat which we commend to the paternal care of oar goreinoent to in-
yesdgate and ascertain the extent of the erik, and the discrepancies which are
fband in the three towna abore-named.*
It is roelancbolj to think that oat of 90,761 peisons, whose agea are known and
embraced in the Reports for the past 4 years, 13,154 died nnder 20 years of age*
and before they had attained their full maturity of life ; more meknchoiy that this
great mortality among the yoang is increasing from year to year ; and more md>
ancholy still, that it is owing to c ir c um s ta nces which are mostly within the con-
trol of the people, and are partly preventable, if known and understood.
It may seem strange that any attempt should be made to estimate in money
what money did not procure, and cannot restore if taken away ; jet the inclina-
tion of some people is to estimate every measure by the profit or loss in doDars
and cents which it will produce, rather than by any general good it affisrds to
humaoity. These considerations justify the remarks I propose now to make.
Looking at this subject, then, merely in a pecuniary point of riew, and upon
man merely as a producer, who is to add to the wealth of the State, we must
consider this subject of Registration and its conseqaent developments, as having
a most important bearing upon its prosperity. In this view, man may be regarded
as worth so much to the State as his power of production exceeds the cost of his
maintenance. We may look upon all expenditures for his support and education,
during infancy and childhood, as so much capital invested, which may be made
profitable, when he shall receive his full development and productive power. The
death of all children may be considered a loss equal to the whole cost of their
previous maintenance. Some persons open family accounts with every child,
and can at any time show the expenses incurred. It may be below the truth to
estimate the average annual expenses which each child in the State incurs, at
$50.
The population of Massachusetts may now be estimated at 800,000. From the
returns of deaths received, I have estimated the whole number of deaths in the
State last year to have been 14,000, which is nearly 1 in 57, or 1.75 per cent of
the population. Of these 14,000, there died at least 6,000 children and youth
under 15 years of age. Estimating the average ages of the whole of these in the
same proportion as those actually known, it will give for each about 4 years, or
24,000 years of life for all. This, at $50 a year, amounts to $1,200,000 as the
cost of their maintenance. And all this sum was lost to the State last year by
premature deaths, before any return could be made for it Can any one doubt
that half, at least, might have been saved by proper knowledge and care ?
The proportionate number of deaths among the young has been increasing for
several years past in this country, as our investigations prove ; and we see no
reason to believe it will be less, until more knowledge is diffused in regard to
the laws of life and the liability to death, under different circumstances. This
immense loss of the productive power of the State, may be considered aa an
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LETTER TO THE SECRETARY. 97
annaal tax, which the people must pay eveiy year, until they find out and use the
means of prevention.
It has been said that the strength and dignity of a nation consist not in its
lands, its houses, its wealth,-^but in its people. And I haye already stated, that
that people is most prosperous which contains the greatest proportionate number
of the productive age. In the above calculation, we have not taken into account
the loss sustained by the death of those belonging to this age. This would
greatly swell the amount of loss. We have stated that by care and attention the
late Dr. Ripley probably added 50 years to his life. We are now considering,
time as money, labor as money, l}fe as money, and not the real, moral value of that
good man's services. Estimating then this time to be worth $1.00 per day, or
$300 per annum, the 50 years of life were worth $15,000, and that sum was
saved by the prolongation of his life. The deaths in this State last year, as we
have estimated, were 14,000. Of these, 5,000 probably died between 15 and 60
years of age. Let us suppose that by proper knowledge of the laws of health
and a proper care in obeying these laws, 5 years might, on the average, have
been added to each of their lives, — and this seems not an extravagant supposition,
— then we should have saved, instead of losing, as we have done, 25,000 years of
life, which, estimated to be worth in this adult age, only $150 a year, would
have produced $3,750,000 ! And this loss must be annual !
There is still another view of this great subject William Farr, Esq., one of
the ablest writers on Vital Statistics of the age, stated in McCulloch's Statistical
Account of the British Empire, that " when 1 person in 100 dies annually, 2
are constantly sick ; although this exact relation is, perhaps, not preserved in in
fancy and old ago, or where the rate of mortality deviates from the standard, it
may be safely assumed as a near approximation to the truth." This principle
may be more simply expressed thus : The proportion of persons constantly sick
in a population, is double the annual proportion per cent, which the deaths bear
to the living in that population. According to the estimate already given, the
proportion of deaths to the population in Massachusetts was 1 in 57, or 1.75 per
cent. Double this per centage, and we have 3.5 as the proportion per cent ; and
this proportion of 800,000 is 28,000, the actual number constantly sick in this
State.
Sickness occasions a two-fold loss ; one for the time and labor of the sick, and
the other for the nursing, medical attendance, medicine, and other expenses^
which they require. The first may be esUmated at $50, and the second at $150,
or $200 per annum for both, which multiplied by the 28,000, give a total annual
loss by sickness of $5,600,000 ! It is supposed that half of this sickness is pre-
ventable, and that half of this enormous sum might be saved if the laws of
health were properly understood and obeyed.
We might save then —
By diminishing the mortality of infancy and childhood, $600,000
By prolonging the Urea of adults, 3,760,000
By preserring the general health and diminishing sickness, . . . . 2,800,000
Making, according to this view, an annual total saving of . • t7,160,000
This amounts in ten years to $71,500,000, or about one quarter qf all the prop-
erty qf the CommonweaUh, according to the valuation of 1840 !
13
Digitized by VjOOQIC
98 BIRTHS, MARRIAGES AND DEATHS.
Tiiis is a pecimiaiy view of the vabject Bat, bowe? er atiikiiig it may appear,
it deseires not to be meDtioned, when contrasted with another, which preKnts
itself. The amount of widowhood and orphanage which death occasions, and the
poverty and suffering which often accompany them, may be estimated by the
community or individual who contributes to their relief. Man may be convinced
that vast losses are annually incurred by neglect of health, and that any sums
expended to prevent them would be a coital invested, on which an emMmoos in-
terest would be paid, by diminishing the sickness and mortality and increasing
the productive labor of the people. But who can estimate, in dollars and cents,
the care, anxiety and suffering, mental and physical, which the premature sick-
ness or death of a husband or wife, a father or mother, a son or daughter, a broth-
er or sister, a friend or connexion, may occasion ? Who can tell how much even
one such death, by blighting earthly hopes, impairs the vital energies of the living,
and accelerates the approach of another ? The mental anguish and physical
suffering which sickness and death produce, may possibly be feebly figured to
one's own imagination, but their full force must lie concealed in the mind of each
individual sufferer.
But we would not rest our reasons in favor of Registration on any pecuniary
view of the subject Man is not a mere producer — a mere machine. His life or
death, his happiness or misery are much too high objects upon which to place a
pecuniary value. He is more nicely made, more wonderfully organized, requires
to be guarded with more care from any infiuedce that may surround him, to pro-
duce disorganization and unfit him for use, is capable of higher and more noble
purposes, and has a higher and more noble destiny ; and in proportion as in each
of these he exceeds a mere machine, in such proportion ought we to regard
his intellectual and moral nature, and the means used to preserve and develope
his physical powers to enable him best to accomplish the great purposes of his
intellectual and moral existence.
This is a matter of great magnitude. It deserves that full illustration which
could only be derived from facts preserved and gathered from every part of the State.
•• As there is a poverty that is self-inflicted, and may be self-removed," says a late
writer, ** so there is a certain amount of disease and annual mortality in every
place that is self-inflicted ; and the community that does not strive by every avail-
able means to reduce its disease and mortality bills to the lowest sum of human
suffering, and the lowest rate of annual mortality, is as guilty of suicide as the
individual who takes with his own hands the life God has given, and hurries un-
bidden into the presence of his Judge."
It may be asked, what can the government do to arrest the hand of death ? We
do not suppose that an act of the Legislature can compel a child to live, or an
adult to keep his energies in a healthy state of action. But it is as certain that
human life may be prolonged by knowledge and care, as it is that an ox will fatten,