(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?