Figure C 82.
A striking peculiarity of cities, especially large cities, is, as pointed out before, the high mortality amongst men; for this general observation Figure C 83, male and female mortality in town and country, offers an example. Whereas the female mortality in Berlin, in the higher age groups, is even lower than in Mecklenburg with its preponderantly country population—which is evidence that in town life there are no inherent circumstances adversely affecting all persons in a high degree—the male mortality in all the age groups is higher, and in some much higher. The special adverse influence on men of town life is also apparent in the upper part of the figure (comparison of male and female mortality). In Mecklenburg the mortality among men is at most 25% higher than among women, and during the period of most intense child production, as well as in the highest age group, it is even smaller, whereas in Berlin the differences are much more accentuated. It may be remarked that the higher male death-rate in Mecklenburg between the ages of 40 to 75 years can only to a small degree be explained by physiological reasons. This is shown for example by the fact that in the provinces of Schleswig-Holstein, Pomerania, Hanover, Hessen-Nassau, and the Rhein Provinces in the country, the expectation of life for men aged 25 years is about equal to that of women.
The higher male mortality in cities is only partially explained by the specific harmfulness peculiar to men's town occupations, though the mortality of peasants and agricultural labourers ranks amongst the lowest. A very important part in this connection may be played by syphilis. How terribly syphilis injures the body, though it is seldom directly fatal, is shown by the experiences of life insurance companies, of which examples are given in Tables C 84 and C 85. With the Gotha Life Insurance Bank, for instance, the mortality of the syphilitic at the ages of 36 to 50 years was found to be nearly double as high (186%) as that of the non-syphilitic.
Table C 85 shows to what a high degree the heart and vessels especially are harmed by syphilis. At this point it is to be noted that it may now be considered as proved that the statement that general paralysis causes death in 2.9% cases among the non-syphilitic is erroneous, because general paralysis only occurs among persons who have been affected with syphilis. There is no doubt that the poison of syphilis is also most injurious to the germs and the progeny; the fœtus is sometimes infected in the mother's womb, and sometimes suffers by the general debility of the maternal body. A large proportion also of those children who attain a higher age are either enfeebled or damaged in many ways, and this inferiority is often passed down to the grandchildren. The most recent Serum investigations (the Wasserman reaction) are the first to throw full light on this. In Germany syphilis occurs much more frequently in town than in the country; this no doubt dependent on prostitution and on a much greater degree of promiscuity of sexual intercourse in cities. In the country couples keep together with greater constancy, even in the case of cohabitation without marriage.
The frequency of syphilis and other venereal diseases in town and country is illustrated in Table C 86, which gives the result of the enquiries of the Prussian Government on the 30th April, 1900, and Table C 87 after Schwiening, on the frequency of sexual diseases among military recruits. Also Table C 88 which gives the frequency of delirium tremens, epilepsy, and general paralysis in the Prussian lunatic asylums, points in the same direction by the great differences shown in the frequency of general paralysis in the different institutions. This table, at the same time, indicates what is also supported by other observations, that the frequency and intensity of harmful influences through alcohol are much greater in towns than in the country; this may be partly because in cities there is a greater and more regular abuse of alcoholic beverages than in the country, partly because town-life induces a greater susceptibility to alcoholic poisoning than country life (less intense metabolism with sedentary occupations).