/8'76-l' BOUGHT WITH THE INCOM:^ FROM THE SAGE ENDOWMENT FUND THE GIFT OF Henrg W. Sage 1891 ..A- /r^3t 1 . 4/^//l n Cornell University Library HG8785 .M99 1876 + Preliminary report of the mortailty expe iry repo llllfll 3 1924 030 240 133 olin Overs S HHff '--7r j: ^/ /;i>^^^<- 5 c. :?. ^^<^; -1, ^ X, ^ ^/ /^^.^^ /c" ^-^-^ y yy /= r OMj Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924030240133 MORTUARY EXPERIENCE The Mutual Life Insurance Company of New-York. From 1843 to 1874. /\.i2.^3fcb; Entered, according to Act of Congress, in the year 1876, by The Mutual Life Insuhance Company of New-Vork, In the Office of the Librarian of Congress, at Washington. TRUSTEES AND OFFICERS Mutual Life Insurance Company of New-York. DECEMBER 31, 1875. FKEDERICK S. WINSTON, President KICHABD A. McCTJBDY, JOHN M. STUART, Vice-President Second Vice-President. BROADWAY, CORNER OF LIBERTY STREET. Frederick S. Winston, John V. L. Pruyn, Robert H. McCurdy, William Betts, Samuel M. Cornell, Samuel E. Sproulls, Lucius Robinson, William H. Popham, Samuel D. Babcock, Wm, Smith Brown, Henry A. Smythe, William E. Dodge, BOARD OF TRUSTEES. George S. Coe, William M. Vermilye,' John E. Develin, Martin Bates, William A. Haines, Seymour L. Husted, Oliver H. Palmer, Henry E. Davies, Richard A. McCurdy, Francis Skiddy, James C. Holden, Herman C. Von Post, George C. Richardson, Alexander H. Rice, William F. Babcock, F. Ratchford Starr, Frederick H. Cossitt, Lewis May, Oliver Harriman, Thomas Dickson, Henry W. Smith, John H. Sherwood, Egisto p. Faberi, George H. Andrews. WILLIAM H. C. BARTLETT, LL.D., Actuary. LEWIS C. LAWTON, ERASTUS C. BENEDICT, Assistant Actuaries. FREDERIC SCHROEDER, Assistant Secretary. ISAAC F. LLOYD, Secretary. MEDICAL DEPARTMENT. GUSTAVUS S. WINSTON, M.D., WALTER R. GILLETTE, M.D., ELIAS J. MARSH, M.D. DEPARTMENT OF LAW. WILLIAM G. DAVIES, Assistant OLIVER H. PALMER, Solicitor. WILLIAM BETTS, LL.D., \ LUCIUS ROBINSON, [ Of Counsel. HENRY E. DAVIES, ) WILLIAM J. EASTON, Aitditor. JOHN A. FONDA, Cashier. THE MUTUAL LIFE INSURANCE COMPANY OF NEW-YORK, 140 TO 146 Broadway. New- York, December 31, 1875. To THE POLICY-HOLDERS AND THE PuBLIC : A preliminary report containing the mortality experience of this Company, prepared by the Medical Department, was issued a few months since. The report from the Actuarial Department, then in course of preparation, has since been completed, and both are now presented in this volume. While the distinguished learning and ability of our Actuary had secured entire confidence in the methods and developments of this report, he preferred and suggested that he submit the same in all its details to the critical examination of a person whose eminent mathematical attainments, intimate acquaintance with vital statistics and practical knowledge of Life Insurance, would detect whatever of error in principle or inaccuracy of deduction it might contain. Professor C. F. McCay, LL.D., was, accordingly, selected, and his letter giving the results of his critical examination is appended to this introduction. It is believed that these statements from the Actuarial and the Medical Depart- ments of the Company set forth, with truth and accuracy, the facts of its mortuary history. If they shall satisfy those interested in its affairs of the soundness of the princi- ples on which its business has been conducted, and of the integrity and fidelity of its management, and if they shall be found to contain information serviceable to its contemporaries, the past labors and anxieties of the Executive Officers in the service of this pioneer institution will not be unrewarded. F. S. WINSTON, P resident. Note. — The following figures give the monetary condition of the Company, and the relations of the amounts of insurance, assets and returns for over-payments, to one another, at the different epochs named in the first column : Amount of Dividends, or February ist. Insurance in Force. Assets. Surplus Returned 1848 9,997,813 551.575 352,186 1853 17,599,773 2,060,649 576,356 1858 30,481,302 4,685,909 1,303,616 1863 40,047,197 9,225,120 3,000,000 1868 194,341,614 25,319,320 7,719,707 January ist. 1873 264,591,882 58,550,059 15,624,163 1874 289,505,836 65,609,838 2,991,197 1S75 301,928,726 72,446,970 3,539,664 Returned for over-payments, 35,106,889 Amount paid for death claims, matured endowments, and annuities, 26,594,909 Total sum returned to policyholders, $61,701,798 The number of deaths reported by the medical officers differs from that finally given by the Actuary. The former only includes those deaths the claims on account of which had been paid; the latter embraces all deaths reported, including claims paid and those not due and unadjusted. Baltimore, December 4th, 1875. F. S. Winston, Esq., President of M. L. I. Co., New-York Dear Sir : At the request of Professor Bartlett, I have carefully and thoroughly examined his official report on the vital statistics of the Mutual Life Insurance Company of New- York, from the commencement of its business in February, 1843, to the close of 1873 — comprising a period of thirty years and eleven months — and find it in perfect accord with my own views in regard to the method of treating this important matter, and fully concur in the deductions drawn therefrom, as set forth in the Professor's letter addressed to you on this subject. The value and importance of this contribution to the vital statistics of the United States seem to me very great; and the ability- with which the facts have been treated, so as to reveal and develop the truths they contain, will add very much to the well-deserved reputation already achieved by your distinguished Actuary. And permit me, in closing my labor, to avail myself of the occasion to congratu- late you on the abundant evidence this investigation has disclosed of the prudence, economy, and wisdom with which your Company has been managed in the past, and which have made it a source of just pride to the people of this country, and a sub- ject of admiration and respect to the insurance world abroad. The preliminary report of the Medical Department, on these same vital statis- tics, has also been submitted to my consideration, and I find that the results so far developed are interesting and important, and that the investigations in which I found your medical staff engaged, with so much ability and industry, promise to add largely to our knowledge of the laws by which hereditary and other diseases affect the duration of human life. Very respectfully, yours, etc., C. F. McCAY. MEDICAL STATISTICS. PRELIMINARY REPORT MORTALITY EXPERIENCE The Mutual Life INSURANCE COMPANY OF NEW YORK. From 1843 T** 1^74- By G. S. WINSTON, M. D., and E. J. MARSH, M. D., of the Medical Department. SECOND EDITION. PRINTED BY ORDER OF THE BOARD OF TRUSTEES. 1876. C/90 /I /:^636 To the Policyholders of The Mzitual Life Insurance Company of New York, and the Public : The present report of the experience of this Company, is the continuance of a design begun eighteen years ago. We then printed a volume compiled from our own experience and arranged by James Wynne, M. D., with some other matter bearing upon this subject. In 1859 ^^ published the experience of the Company for the first fifteen years of its history, from the records of the actuarial department. The present publication is from the Medical department of the Company, and covers its entire mortality experience from 1843 to 1874. Great professional tact and skill have been displayed by the Medical gentlemen whose names are signed to this report, in the arrangement and scientific classification of this mass of valuable material ; and the results of their labors are most satisfactory to, and duly appreciated by, the Board of Trustees. These gentlemen have not only achieved results which are highly creditable to them- selves, but which cannot fail to be serviceable to the Company in its future business. Their labors cover a period of an entire human generation, and embrace over 100,000 insured lives, with family his- tories, habits, occupations and other interesting points of vital statis- tics ; all of which must have a special interest for persons engaged in life assurance. The value of such full analyses and classifications of the results of experience must be apparent to all life insurance companies. Life assurance, though largely developed, is yet but an experi- mental business in this country, in consequence, not only of the magnitude of the area over which policies are issued, the variety of climate, of occupations and habits of the people, but especially of the comparatively short period since 1843, when it began its active career. Our actuary. Professor Bartlett, is engaged, with his staff, in preparing a reliable report of the experience of the Company from the records of his department, which will be published as soon as completed. The two reports, that now printed by the Medical department, and the one from the Actuarial department, when published, will embody facts of the most important character for the attention and guidance of the Company in its future operations. The following information, furnished by the Actuary, is very valuable, as showing the extent of the field in which the facts reported upon by the medical department transpired. Experience from Beginning — ist February 1843, to the 31st December 1873,— 30 years and II MONTHS. Number of lives insured 101,967 Number who have died 5. 385 Number living in the Company at end of 1873 68,688 Number of years of life lived in the Company in the interval 578,1 12^ Average age at entrance of those now living 35u5 F. S. WINSTON, President. PRELIMINARY REPORT. F. S. Winston, Esq., President of The Mutual Life Insurance Company of Ne-ju York. Sir : — Having been Instructed by you to collate the mortality statistics and records of deaths that have occurred among those in- sured in The Mutual Life Insurance Company since its foundation, and to arrange them in tabular form for convenience of reference, and to deduce such lessons as this experience of the past might teach for future guidance, we now submit some general tables and observations upon them. The total number of assured lives to the end of 1873 is 101,967. There have died during the same period 5385, or five thousand two hundred and twenty-four males, and one hundred and sixty-one females. The cases of females are given in the first table, while the subsequent ones include the males only. The females will be considered on a future occasion. We have omitted them in the general tables because they are few in number; and yet might, to some extent, if included, change the proportional mor- tality from different diseases, as they occur among males. Table I. gives a list of causes of death, and numbers dying from each cause. The total numbers are subdivided into series of one thousand cases each in chronological sequence. This division was employed at first under the idea that errors could thus be more easily avoided or discovered, and also that this chronological arrange- ment might show what, if any, difference existed between the expe- rience of the first and last thousand losses of the company. By this subdivision some facts in the history of the company are promi- nently shown. For example : the numerous deaths from yellow fever, in the earlier years, when more insurances were taken in the Southern States ; the epidemics of cholera ; the losses from this disease, dysentery, and by casualty at the time of the first California emigration ; the deaths from war casualties, diarrhoeas and dysen- teries, contracted in the army, as shown in the second series ; and in the more recent series, the late epidemics of smallpox and cerebro- spinal fever. The most important lesson, however, to be learned is the fallacy of basing conclusions on too small numbers, as is evi- denced in the extreme variations in the occurrence of the common diseases ; as, cholera morbus occasioning ten deaths in one series, and two in the next ; erysipelas giving ten deaths in one series, and nineteen in the next ; and similarly of many others. In arranging the list of diseases, the classification is nearly the same as that known as Dr. Farr's, and used in the mortality statistics of the Board of Health of New York City, Brooklyn, and many other cities. The classification of the London College of Physicians was followed in the reports of the last United States Census, but is not yet generally adopted. It is very similar to Dr. Farr's, and could be easily substituted if desirable. Table I. TABLE OF. DEATHS ocmrring in the Mutual Life Insurance Company, from 1843 ^'^ 1873, inclusive, showing Causes of Deaths and Number Dying of each Cause, arranged in Chronological Series of 1,000 Cases. DISEASES. Total. Smallpox Measles Scarlet fever Diphtheria and malignant sore throat Typhus fever Typhoid fever Erysipelas Pyaemia Cerebro-spinal fever Yellov^r fever Remittent fever Intermittent fever Congestive fever Typho-malarial fever Fever Carbuncle Influenza Dysentery Diarrhoea Cholera Cholera morbus Goitre Malignant pustule Glanders Purpura hemorrhagica Alcoholism Total Zymotic Diseases. Ansemia Cancer Dropsy Gout Rheumatism Gangrene Tubercular meningitis. Lumbar abscess Total. 1843-73 5,224 38 I 10 12 30 304 78 II 22 27 72 4 37 3 28 12 I 81 53 67 22 I I I 3 31 950 7 91 82 7 20 4 I 4 I. I II. ' III. 1843-62 1 1862-68 1 1868-70 1,000 4 I 4 2 12 35 15 18 21 2 7 12 I 34 18 43 4 242 2 7 19 2 4 1,000 I 1,000 2 3 9 59 20 19 19 16 4 20 21 I 2 I 2 I 3 72 13 2 IV. i V i870-'7i 1871-73 1,000 1,000 3 3 2 8 17 2 II 7 3 4 4 4 4 I 5 5 10 I 4 3 60 10 4 '5 17 16 12 18 I 3 8 I I I 2 58 19 5 15 7 4 4 167 i 135 ' 156 I 27 II 2 3 I VI. 1873 224 Females. 161 I ,: 20 I i t 1 4 5 , I 50 , 25 Table I. — {Continued.) DISEASES. Scrofula Tabes Mesenterica. Morbus CoxEe Consumption Total Constitutional Diseases. Apoplexy Congestion of brain Softening of brain Paralysis Disease of brain Convulsions and epilepsy Insanity Anxiety Fright Encephalitis Cerebro-spinal sclerosis Cerebral embolism Anemia of brain Effusion on brain Neuralgia Progressive muscular atrophy . Tetanus Inflammation of spinal cord .... Disease of spinal cord Congestion of spinal cord Total Diseases of Nervous System Disease of heart Peri-and endo-carditis Hypertrophy of heart Valvular disease of heart Fatty degeneration of heart. . . Dropsy of heart Rheumatism of heart Atrophy of heart Paralysis of heart ... .' Abscess of heart Angina pectoris Aneurism of aorta Rupture of aorta Embolus of pulmonary artery. Phlebitis Total Diseases of Circulatory System Epistaxis Disease of larynx Bronchitis Pleurisy Total. 1843-73 5 17 2 920 11,60 307 no 67 132 82 32 28 2 I 64 I I I 4 3 2 4 7 I 849 201 22 17 12 13 2 I I 17 17 I 325 I 14 47 41 I. i843-'62 2 3 I 183 224 58 23 n 23 16 5 2 152 26 5 5 51 I 2 II II. i862-'e I 6 150 207 50 19 10 22 '9 12 2 146 38 4 5 5 2 3 64 III. i868-'70 I 2 I 197 235 58 16 12 26 13 6 165 41 8 2 10 3 68 3 10 5 IV. i870-'7i 4 184 231 57 26 17 33 21 6 3 39 I 3 2 3 2 58 2 10 6 V. i87i-'73 I 2 171 69 21 16 22 II 3 8 13 I I I 170 44 4 2 4 2 3 68 VI. 1873 35 42 Females. 26 '5 5 I 6 2 35 13 16 6 I I 5 I I 19 Table I. — {Coniinued?) DISEASES. Congestion of lungs Inflammation of lungs. . . Abscess of lungs Hemorrhage of lungs . . . Disease of lungs Emphysema and asthma. Pulmonary apoplexy Gangrene of lungs (Edema of lungs Total Diseases of Respiratory System Inflammation of stomach Ulceration of stomach Disease of stomach Hemorrhage of stomach Congestion of stomach Tumor of stomach Inflammation of bowels Ulceration of bowels Hemorrhage of bowels Congestion of bowels Disease of bowels Obstruction of bowels Perforation of bowels Peritonitis Gastro enteritis Disease of stomach and bowels Hemorrhage " Strangulated hernia Colic, Tympanites and Constipation. Dyspepsia Gangrene of tongue Stricture of oesophagus Fistula in ano Diseases of spleen LeucocythEemia Ascites Abdominal tumor Undefined diseases, abdomin'l organs Jaundice Inflammation of liver Cirrhosis of liver Abscess of liver Disease of liver Congestion of liver Hypertrophy of liver i Acute yellow atrophy of liver. . . . Fatty degeneration of liver Bihary calculus Obstruction of hepatic duct Total. 1843-73 61 31 16 19 I 2 94 i6 16 4 7 6 2 57 15 2 I 5 7 3 I I 2 4 2 10 2 7 10 31 25 14 45 10 4 I 2 3 I 12 I 48 I 20 I 8 4 3 I I. 1843-62 14 36 5 19 10 3 I 25 6 5 I 3 I 4 3 II. i862-'68 20 72 3 9 S I I 2 I 129 5 4 4 I 24 3 4 in. i868-'7o IV. i870-'7i V. II 3 10 61 87 "5 I 3 8 10 I 4 I I I 2 ! 105 6 3 3 I I 17 I 4 3 I II 2 I 2 I 20 5 12 6 5 II 3 I 153 I 16 4 VI. i87i-'73 ' 1873 3 ' 6 17 'j 15 .. 1! I ii I . . :i I 28 ' 26 Table I . — {Continued.) DISEASES. Total. i8«-'73 I I. 1843-62 II. i862-'68 III. i868-'70 IV. V. 1871-73 VI. 1873 Females. Rupture of gall bladder I Total Diseases of Digestive System 488 89 I I 5 6 2 I 2 I n I I 10 6 2 I I I I I 100 103 84 21 16 Bright's disease 82 8 2 I S3 40 I 8 6 I I 2 2 7 3 I 28 3 '6 6 I 2 I 2 19 17 12 2 4 I I 2 16 3 I 13 9 8 2 I Inflammation of kidneys Abscess of kidneys Tumor of kidney Disease of kidneys Diabetes Addison's disease Inflammation of bladder Disease of bladder Hemorrhage of bladder Rupture of bladder , Urinary calculi Gravel Disease of prostrate gland Stricture of urethra Gangrene of scrotum Total Diseases of Urinary System 218 19 36 49 58 44 12 2 Debility, Exhaustion and Prostration Abscess 61 21 5 7 2 13 8 5 2 16 4 I 2 II 5 I 3 12 2 I 3 '6 II 3 I 2 4 3 2 I I Tumors Inflammation of joints Old age 2 2 Total 109 15 23 20 24 21 6 5 Accidents and Injuries 357 59 60 II 90 4 74 14 70 II 51 17 12 2 2 Total violent deaths 416 61 71 94 88 81 68 14 2 Cause unknown or ill-defined Childbirth and Puerperal Diseases. . 26 10 3 7 15 2 1 17 In stating these causes of death, due allowance must be made for their probable and almost necessary inaccuracies. Carelessness in making out the certificates of death, ignorance on the part of many practicing physicians, and unavoidable doubts, owing to the inexactness of medical science, and changes in medical nomenclature and pathology, all tend to render any such mortality tables incorrect in many details. Still, as the same elements exist, and in probably the same proportions in all cases, they do not interfere with the comparison of reports gathered from various sources. The first general class — zymotic diseases — has been the cause of nine hundred and fifty deaths, and of these, the first series of i,ooo cases, viz.: from 1843 to 1862, gives by far the highest pro- portion, on account of the losses from yellow fever, cholera, and dysentery, which have prevailed subsequently to a very limited extent. Typhoid fever caused very few deaths in the first series, but afterwards rapidly increased ; while malarial fevers have considerably diminished. There have been thirty-eight deaths from smallpox, half of which occurred during the recent epidemic of 1872 and 1873. The percent- age of this disease in the total mortality is small, but still we believe it could be almost entirely done away with by strict insistance on successful revaccination of applicants. Twenty-two deaths by cerebro-spinal fever are recorded, almost all during 1872 and 1873. This number will probably be increased by a further examination of cases, some deaths from this disease having been ascribed to meningitis. In the first and second series, 1843 to 1868, there is quite a large number of deaths from diarrhoea and dysentery, which occurred chiefly among the California settlers, and the soldiers in the late war. Thirty-one deaths are recorded as caused by alcoholism, meaning thereby its immediate effects, intemperance, or delirium tremens. It would be extremely desirable to ascertain how far it was a remote cause of premature death, if this were possible, but it certainly cannot be done by an examination of the certificates of death. As the use of alcoholic drinks is believed by many to be a most important factor in abridging the duration of life, it is a matter for serious considera- tion whether we can obtain any valuable statistics from the company's records and experience, by comparing the length of life, and cause of death, arranged according to the habits of the individual at the time of application, or through life when known. The second class — constitutional diseases — caused one thousand one hundred and sixty deaths in all, with no special prevalence for any one series, though with some fluctuations. Consumption caused nine hundred and twenty deaths, cancer ninety-one, dropsy eighty-two, rheumatism twenty, and gout only seven deaths. Consumption has been the cause of far more deaths than any other disease, giving a percentage of 17.61 of the total mortality, while deaths recorded under other headings, but properly belonging to this, would swell the number to 20 per cent. This is a very large percentage, but still much smaller than that occurring in the popu- lation at large. In the report of the Board of Health of New York City, for 1871, the mortality from consumption is given as it,}4 per cent of the total. But this is not a fair comparison for insur- ance purposes, for the reason that the large mortality of young chil- dren, from their peculiar diseases, makes the percentage of the diseases of adults comparatively small. A calculation of the deaths of adult males, taken from the above-mentioned report, gives consumption a percentage of 30.17 on the total mortality for this period of life. Our percentage of 17.61 seems to compare favorably with this. The deaths from cancer have been ninety-one, and those from dropsy eighty-two. Dropsy is properly only a symptom, though often given as the disease causing death ; and whenever the real cause could be ascertained, the case has been referred to its proper head. The deaths from diseases of the nervous system were eight hun- dred and forty-nine, embraced principally under apoplexy, paralysis, and softening, congestion and disease of the brain. We believe these terms are used synonymously by many physicians, and should, therefore, be calculated together in our general tables. However, we have as yet considered them apart in most cases. This class of diseases appears to have increased somewhat, though not materially, in number during the last few years, probably because more elderly persons are insured now than formerly. In twenty-eight cases, insanity is recorded as the cause of death, while in addition several other insane persons committed suicide, and their cases are recorded under this title. The prevalence of this disease appears, from the series, to be irregularly fluctuating. Three hundred and three deaths are attributed to some form of heart disease, and seventeen to thoracic aneurism. The number of these has increased in frequency of late years, and probably for the same reason mentioned in diseases of the brain. In two- thirds of the cases, " disease of the heart " alone is stated, while in one-third the special form of disease is mentioned. Six hundred and forty-eight deaths are recorded from diseases of the respiratory organs ; of these, three hundred and eighty-eight cases were from pneumonia, and forty-seven from bronchitis. It is most probable that those diseases are often confounded in diagnosis and death certificates. The number of deaths from pneumonia has constantly increased with almost every series, from thirty-six in the first, to one hundred and fifteen in the last. We are entirely unable to account satisfactorily for this increase. The deaths from abscess of lungs, hemorrhage of lungs, and disease of the lungs should, probably, all be included under consumption ; but, for the present, we have placed them with diseases of the respiratory organs. Diseases of the digestive organs have caused four hundred and eighty-eight deaths. They are recorded under very many names, and different affections, the diagnosis of which must have been doubtful, so that, for any practical purpose, they must be collected in large groups. We find here an example of the change of nomenclature and pathology, viz. : " inflammation of the bowels," which is frequently recorded in the earlier series, while in the latter peritonitis takes 13 its place to a certain extent, both names evidently referring to the same affection. There were five deaths from hernia, in only one of which it is recorded that there existed a hernia at the time of insurance. Diseases of the urinary organs have caused two hundred and eighteen deaths. Eighty-two were from " Bright's disease," and fifty- three from " disease of kidneys." It is noteworthy that, in the first series, extending from 1843 to 1861, there is not a single case reported of death from " Bright's disease," and only five from " disease of the kidneys." This is not because the disease did not exist and cause death, but only that up to a very late period it was not generally recognized by physicians, and deaths now attributed to Bright's disease were formerly recorded as " dropsy," " convulsions," " conges- tion of brain," etc. The number of deaths from accidents and injuries was three hun- dred and fifty-seven, of which the second series, 1862 to 1868, gives the largest proportion — ninety ; among these are included twenty-nine killed in battle. These accidental deaths should be still further sub- divided to show the kind of accident producing death, but we have not yet been able to make such a list, many of them being merely recorded as "accident" or "casualty." In the last two years the deaths from this cause have greatly fallen off in number. The total number of deaths from suicide has been fifty-nine. The last series gives the largest proportion, but this is probably an accidental oc- currence, as there is no regular or gradual increase with each series. There have been thirteen deaths from " old age," and all have occurred within a very few years. In examining a record of deaths occurring in an insurance com- pany, it will, of course, be remembered that this can give no idea of the actual mortality experience of the- company compared to the total number insured. This proportion must be elsewhere ascertained. 14 We have to deal only with the dead, and those surviving are not taken into the calculation. We hope to learn from these records, however, at what age each disease is most to be ex- pected in each section of the country ; what diseases are to be anti- cipated and guarded against ; what, if any, may be the difference between natives and foreign-born in respect to longevity ; how long the influence of the medical examination of applicants effects the mortality among assured lives. Furthermore, we can learn the effect of occupation, hereditary ten- dencies, and physical condition and configuration. The first portion of these enquiries we have attempted to elucidate, and have prepared tables showing the experience of the company in these respects. The results are not very marked in all cases, and, sometimes, of doubtful value on account of the small number of cases examined. In compiling these tables it has not been thought necessary to consider each disease by itself on account of the large number of diseases recorded, and often, the small number of cases of each one of them ; but the more important ones have been tabulated and the others consolidated into the nosological classes to which they belong. We have thus formed columns of thirty-seven diseases, or groups of dis- eases, and afterwards again consolidated these into fourteen groups, and considered these in four ways: ist, age at death; 2d, nativity; 3d, residence at death ; 4th, year of insurance at which death occurs. Beginning with the ist, we have formed three tables, marked II. III. IV. and one colored diagram, V. Table II. gives the causes of death, and the number of persons dying at each year of life ; Table III. grouped in decennial periods of life ; Table IV. causes of death con- solidated and ages grouped in decennial periods ; and the colored diagram illustrates the last table. 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Tj-M M -^ tN lO CO Cn INOO 01 "n ""co"m -^Thio tJ-\0 \0 01 COiOtNOl M CT>00 MM M LOiO On ■MM CO ':j-vo m in -"J- cn ■<^oo oi \0 d IN 'snoisinAnoo pcu jCsdanda « ■ ■ CO ■ ■ ::::'- (N 'MM 01 M M - CO ■ 01 COOl M ■ - 01 M M • ■ M ■ ■ •□iwja JO asuasia: poB SuiTiayos 'BiBicBJUj; H OO • • 01 . . • M ■ N ■ 01 'i- lo ^t- CO covo ^J^oo ov VO M \0 yD t1- 0\0 m vO lO ON^CO •niBia }0 uoi^gaSuoo o ■ • H ■ H -: COM « CO ^M~M « ■^COLOW CO -"O W COtN. ■rt- CO COOO LO In ■^ ■* -01 ■^ O CO d cr,oo M LoyD CO MM MM MM H M d lO •Xiajdoilv tx ■ ■ ft : : MOIMOIOICONOO INOO M OO Tt M M -Bra IBnoi^Ti;i}snoo JaqiQ £• : : s T :^ M d « H M MMHCldCltOMM ■ yD oib « to~t^ 01 tN CO Ti-' d cocO'^'^-^'+oi coco • M 01 « •"m"n"m 01 « M COM « « N M M M ■ o M M oo' LOO loyD M \o cococod McodM w d CO M d ■auLlduinsuoo ■^ OiM C M W « CI lO M OMO W M ua.niBO Ov ' " • ■ H • ■ Tl- ■ M Tj-COM ■ M CO ■^Tl-lO ■itsdojo: « ■ • OO ■ ■ . . . H - ICO ■ -MM ■ M M M -co d ■■^dtNCOLOrhCOM CO Cn d ■sasHasiQ: oi)oui,t2 Jamo §> : : ■ CO ■ c ■^\0 . M y3 Tj-in Tj-iolo tNoo o\Tj- lO IN^D CO M Cn. tJ->0 Tt- lO Cn (y.^ ■[nsipiiODiv CO • ■ M ■ « • ■ ■ ■ ■CIM -MCOMCIMM " "cO N~crN"^"~0l"01~^'coTH"' ■ M M d • d d d - M """ ; '. ■VJaiotio .S- :" ■ M • M ■ COM • ■ lOdcn -MMdThd ■ ■ N 01 d d CO « ■ M cod • ■Ba3qii'Bi(j •j^jaquasXa; CO MM OO • ■ H ^ • ■ . M M ■ « -^ M M M M tN M tN M 01 M • ■ ■ 0) CO M M M ■ M -^ LO CO~CrN "lO CO U-) ■ Mcoc^MM■r^o^co■^ U1 IT) CO 01 -^"^lO 01 « tN M M d dMNdco-^^^Mcod COM MCOCOdM Tj-OlCO 'd-00 ^ lO'^ ~tN LO M ■ N d LO •sniadisija ■R : : d • N ■sjaAaj ivLi«[8M •O H H H • • * M (M ■^d Nob~« M LO • H •Bi9Aa^ Bntid^i pns pioqdiCx CO CO *o 01 ^ o co'o y3 o o^^o OOOtNMOvCOOtNO MMM M MM cno\co •1VJ.0.L o^ « t^ O t^ tJloo a\ o 0) N iJT^iOCN\0 M M Q00O^T^OQ0OlO tNOO H M 01 LO^D "JD tOVD "O C^ Cnoo CO m LO Cn On m On -^ \o N \0 yD LO^O LO vo M M M H g ^ ^ - ' d C 00 o^q < h O H M M CO -T « J^mu^^J^ to vOy^'OMDMD'O'd^. ^^& O w W cn-^tovo Cnoo On IN 00 00 0^ 6 j C 1 1 I? 'IJ-eajj JO sas^ssjo; JO sasBSSKJ aaqiQ •liuotsinA -U03 puB Asc[a[id3[ 3l\i JO S3SB9SIQ;'pU'e '3uiU33J0g 'sisXjBa'Bj "uiBJig JO uoi;s33uo3 •Xxaidody "sasEasiQ lBUOTiniI3SU03 J3l{30 •uondmnsuoQ ■JSOUBQ ■AsdoJQ -siQ DpoinX^ -laHlO •uisipnoDiv ■BJ31040 "ESOHJJBIQ ■Ajajuasj^Q •SEpdTSjCig •J3A3j[ O hH ON ON \0 ■^ ON CO ro 00 CO ^ u-t On r:J- 00 \o 00 -^ ro "-> CO o' ^" g 00 I^ ON ^ ^ 00 M 00 'O \o ^ o ON ro ■^ 00 CO CO O ON 00 vo ffl ro " 00 M ^ 1- . I^ ON '^ 00 On m NO CO 10 q t^ ON "^ On 00 LO 00 CO r-i NO ON ^ ON CO 00 CO lj~, NO •1VJ.OX H O W H ►J H O H ON ir^ M CO r^ HH CO J~ ►-H a) On CO O O V CO Ph CL^ On NO NO o " ^o NO o " NO ON ro On vo ON NO" - o 00 On O 00 NO CO CO NO r^ ro 00 lo 00 - „ CO ^ - CO CO On O O « M CO 00 CO On vo NO ^ O u O 10 dj NO hn u hn iH hn n hr rH n1 rt c rt a; ON d u ON c C3 t^ (H 00 CL, c w pq < 1— 1 t^ ^ O t^ Ov ^ m - M -psuyap-n! M >-* -' i>» - o M JO UAVou^^un asiiE;^ - KH "^ Cn •* I^ "vo « On CO 0) _• N ■^ . "-■ "-■ " •-^ t^ ^ 00 -^ 00 vn M M ►H Tj- -ih Ov ^ u\ ■saunf 00 ■^ 00 ON K. Tj- iri VO .-< u-i HH -UJ pUB s^uspiDDy \o o\ CO t^ ^ n ro —t t^ -+ n CO VO CO \o S 8 l-H fT) CO VO •uonsnEqx'^ puB 00 IT\ '-' 00 " CO uoneJ3S0J(i 'XijiiqaQ OS ~^o ^ 0\ ON " O "co~ CO ■sSun^; JO asBasiQ puE 00 ^8 'sSBUJJOiuajj 'sssDsqy CO to "-" o ut Ln CO 00 f^ "^ 'r^ ON~ vo_ . ■uis^sXg XjBuufi CO VO M CO M t^ " !->. I^ JO S3SB3s;q; JsqiQ t--. ~o6'~N~ en kT f^ __. irn 00 VO CO i-i •sAaupi^j JO s3SEasiQ[ ^ tv. N N '^l- CO ui Tt- ON m Lo LO N "- HH CS CO u-i LO t^ ^ !>. Ov 00 Ov ■-^ ^ irv r. N IV. ■saisqBTd t^ cs ■^ ■"■ "-I NO On LTl ^ "^ CO ^ ^ M ON VO o t^ 0\ N M ■uiais^S 3Ans33i(j VO (S 00 CO ^ O - o ^ M JO S3SE3SIQ Jaqio - - - " tS tv. 1-, "- O I^ o\ HH ^ 2. •+ t^ ^ HH o^ •J3AT7 JO sssbssiq; ^ CO M CO VO O ^ VO I^^ M " '^ ro ro i^ r^ OS rj- VO n t^ CO On m "-" n M ON •S11IU03II3(J o CO *"■ ■"■ <-> CO ON tv ^ " " '-' ^ VO if\ t>. VO N t^ u-i 00 u^ 1^ -+ _( On •SpAVOa JO S3SE3SIQ - o CO ^ N CO CO Tt M CO r^ t^ r^^ M « 1^ Ov O VO ^ CO - ro CO vn " O •qOEUJOig JOS3SB3SI(J t-^ rh ^ '"' ■-> CI " o CO LO ^ - '- M M M M -S/tg Aj05Baids3-g "o~ rv. ~^ M "rC "^^ OO CO On h -' CO HH n^ . . u-» OO ^ LTl CO f-^ JO sasBSSja; JsqiO w La «-r, Ln LO u^ \o NO t-n tr, r, ■oip 'a3B pio CO L/^ "- O CO ■^ W VD Li-i Ov '93BqjJ0uiaji 'sssDsqy - "IrT ci "cO~ M c* \o •* CO O" lo CO vo'"' - o CO CO •Xsu oo VO N ^ CI -f M ^ ^ CO CO vr» -nsij pUB sijtqouDJa: "rC - - - M '^'^Z.'^ CO ^ ^ M vn CI ■. -+ VO t^ CO ON "Z ■ -^ CO ^ rh u-i ON Ov O VO « VO r^ CO OO i^ N n M CO CO N ro O CO O 't CO n ^ N -tj- •avxox M Tt • •^ ir\ u-t t-r\ 0^ n ^ CI 2 a 2 ^ (A ffi r. fin ci be H fTt >> en >^ >, ni >, ni >. rt >^ rt >> ri % - m < hJ ON c 0\ a C ON -S S" "S Ov s- c o w <: N C CO Tj- S ^ 5J °o £ a £ < Q H o H u o o o o O u O cj O U o u O o M u i-i l-H +j >-( ■M J-. *-' >-l ^& OJ 0-, ^ £ O CO OJ ^^ 2,c^ O OJ VO Cl- O OJ 0. o a; OO Ph 19 > •(sSy piQ Suipnp -m) pagissViou^ 'SspiD -ing puB sju^piDDy Xj-BUIJ^ jo S3SB3SIQ; 5- -jssSiq; jo sasE3si(j -sXg jOoiBJidsa-g JO S3SEasiQ[ Js^l^O •Biuouinauj -B[noJi3 JO sasBssiQ JO s3SBasi(2 J3t{l0 •Axsidody -uoi4miisuo3 JaqiO •j3DU'e3 •uopduinsuoQ •S3SB3 -siq; oijouiXz Jaq;o •SI3A3^ piot|dXx ^ sniidj^x CO CK 4 00 CO d o On On u^ \o ^ rO u-t •-• On N ^ NO ON CO -^ iJ-» 00 "^ VO O ^ On •-Ti LA LTl vd M I>^ 0\ I>- t^ 00 00 NO NO "^ ir\ i-H O 4 O O ^^iS' ^^ O On on t^ CO On ^ 00 NO ri On N ON % M O CO O t^ 00 O 0\ 0\ ^ O "^ u^ m Ln 00 o ^ ";)■ VO CO m \o CO CO CO H^ 00 VO ^ O " t-^OOoOiS OnN Tj-t-^t-^-!i-000 uivo osoOoo"^r c IL> O L-. V o 00 C Unclassified [iacMlug OlcLA^e.J Accidents and Smcid.es. Urinaij System. Digestive System. Respiratory System. ]!^einn.onia. Diseases of Heait. Apoplexy Oflier Diseases of N"eiYoii3 System. ConstimptioTi. Cancer. Otker ConstitatLonalDlseaseE Typhoid Fever Other Z3motic Diseases. ^ ^ 2M J^L 5^ i.Si 2.52 % ^ % ^ N i N' ^ -* % '^ ?> ^ N S3 ^ ^ ^ ^ s s ^ ki "^ ?H ^ ^ S^ '^N ■1 Jn ^^^^^^B ■^ ^^^H ^ H '■■3 9= 22 1 s . J — — 23 1 , U-i K» r 1 - 24 : !_ ^~~ "^ — — 25 -j"' n i^S^ ;;: »• 26 y 27 - -' ' 1 - J i -i^S. , ;> — — 28 L_-. 1 _L: 1 ! ^ ^ 29Xj.._U_ i_u_. —- '? 30 1 . i ; i-= — — 31 :■"■,;- ^- ^ 32 ^ 1 > i -= V 33 ^ -^^ V U *^ ■^ 35 — - -^ Is 36 « "" \ 37 ? ? < / 38 ^-. \ 39 ■~- ^_. ^ ■~" ■ — ~ - 3 40 p— > - ^ 41 ' ... . -'' \ 42 : -■^ ri <■ '^ 43 ^ -^ ~- — -,, "^ ~- *^ 44 ->- ^ 7 45 [ ■^ ' r / 46 , 1 "~--- iTj ?► > 47 -- --^ ^ - / 48 -< —"' / 49 >. ■ ■^ v "^ 50 - =c ^^-- ■^ S 51 -^ tr ^ -' 52 ^ ^ "~~ ■^ s 53 >- r" — ■" "' / / 54 y^ 55 j<. ;=- 56 V N ^ '',•' ^"^ 57 N / < 58 y \ 59 -< -— — \ r> 60 ■^ .> 61 1 ^ -^ s= 62 > , l.<| 63 ^ < >- 64 ^ •< < 65 ) -^ > ^ 66 4 "-- r / / 67 , > / / 68 r / / , 69 J / 10 < / 71 > 72 f 73 i > 74 > 1 25"^ / 76 N 77 /i 78 19 / 1 8081,82 / 91 , ' ! The left haiui figures represent tlie Ages, The fig'ures on top the number of deaths for Apoplexy- & Typlioid Fever. Anif or the general Mortality Mo the actual number. The Black line indicates Tj'phoid Fever. " Bine 11 11 Ajpoplexy: "Red " " The General Mortality. > M M < 3I{3 }0 S3SC3SIQ; JsqiQ •IJBSii stujo sasEasjo; •tua^sAg snoAjajsj at{? JO S3SE3SIQ Jaq^o ■suois -[DAuo^ puB Asdaijda JO asBasiq; 'pue 3uTU3JJ0g " 'sisAlBJBJ •uiBjg JO uopsaSuo^ •jCxsidody •sosBasiQ 'uopdmnsuoQ ■jaouB;^) •Xsdoj(j •sssea -siq: ojiomX^ jaqio •uis;|oqoD]Y ■Ejspqo •BaoqjJBiQ; •XjaiuasjtQ ■SB[3dtsAj3 *SJaA3^ JBIJBIBI^ •SJ3Aaj U-l HH fO ■ N i-H m rovo 00 -^ m CO M ro l-H 1^ l-H ^s. O H a\ M u-i >-( LTi r-N. i-H • -o N vo en 00 -^d- -^ cooo y:> 0\ i-H m •-< mm xr\ ,-, m i-H CO -^ M ■ ■^ N i^ CO >■ LO l-H lJ-\ . -r^ Q\ H O M ^ (N O '-' •qviox - iJ^N OrOO COM W t^ C^ 00 -a "O S S-S 3 CU ^ _^ i5 c ta^^ V a! C c 2 5 u rt b & s Ln u-1 0) M a >. ■S g g ^J^ :3 'o o T3 C . ni ! tn 'C J (/I 5-^F c S^< n 25 .8 C > m < -[[I JO uMou^fun 3sn-E3 ^ ^ ; rj- HH ^ ^ *"* r^ •sapiDing ON fv-'CO'-vO ■ • ...CO ■^ • • • ■ ' ' '. •ssunfu]; pUB s^usppoy ■UOUBJJSOJJ »-^ Onoo 00 HH ^ . CO Lr» M l-t CO CO. -co ■ •'-HM-. . M..LO CO M ■D^ 'aSy PIO 'aS^HiJouiajj *ss30sqy 00 u-i.-rOMM-^t-' • .... CO .... -HA JO sasEasiQ; jaqiQ CO en VO-^-HH- -. N ■ • • ... ■sKsupi^ JO saseasiQ; ■ssisq^iQ 2" M . m u-ioo ONM'-i''-H • ..-co ^ CO ■ • • .... ... •tnaisXg 3A13S33 -IQ JO S3SB3SI(l"j3ll30 OS.-(Lr,NhHT:fi-( ■ .. ■^ . .... ■J3At'^ JO SSSBaSIQ ■siiTuoiuaj 9: 0\M OM-" 00 ^ - ^ • . ■ « . . ■ CO CO ^o CO ■s[3Moa JO sasBasiQ 1 CO r^cOMrhcs-.i-. • ••-i-i^OOO-'-c--- • -..CO •sSunijo uopsaSuoQ ■Biuoiunaujj 00 00 CO •) rO 1-000 h-l -rj- en • t-' • >-t ...(-I. ,_, .|_.cO HH )-H LJ-^ • ■ .... . . ■avxox !>. On t^ COOO i-HHHONr^O\00 hhu-iu-iMcsi \o ^conn i-'U-iMOSCOOfOM 00 0^ N M urt CO NATIVITY. hi c ct E 1- (L C 0. C Switzerland Italy Holland Denmark Norway and ( Sweden . . ( ' ' Russia Poland Bohemia Hungary Turkey East Indies, ) Mauritius and > Oceanica... 1 West Indies SouthAmerica. . . At Sea Unknown 26 > w m < ■uisiSitg XJ03B(no M n \r\ OO CO ^ o N c^ 00 CO M CO " t ^ OO CO -JI3 JO sasBasiQ JaqiO ^' i CO >-l 1 so CO ' ^ o OO M NO On NO ri N ON ^v CO 't ^ 00 U-, "-> LJ-\ 9. OO (S 00 M t>* w ^ lO " so M r) t^ r^ •laBajI JO sss^asjo; c^ N M . i-O LTl uo NO LTl IN. 1^ lO 4 CI OS OO l-Ti t-v. CO ON ON CO 00 M M OO CO „ lo rr, ^=1- r^ •luajsAg snoA ^ N 00 ■"^ u~i !>. i-O n 00 ^ CO ir% -J3JS[ JO S3SB3SIQ WlllQ M M fl CO CO ^ ^' ^ 00 1^ n N _ ro On LO o " 5 HH CO M ^ CO j^ ON CO •suois fO ^O M LO o CO N M -[nAuo3 pui? Xsdajidg r-.. CO •uiBig HH 00 >-i On ^ OS 00 NO CO ro NO U-N ON \o '-' ON o ^ oo CO CO M r^ CO '-' r^ "f 1-1 so •-• o t^ On JO 3SB3SIQ pUP n M 01 - 3uiua;jog * 'sisAjbjbj u^ lO 4 CO LTl NO t\ 4 01 _ CO 01 ON I^ -h r^ OO l_l 00 CO w CO u") t^ LO 'UTuia JO uoi;S33uo3 -; 00 CO ON q q C-1 00 ^ C^ ir\ n N »-. M CO '"' ^ lo 01 t> CO T-O On !2 OO J>. -+ t-H rr\ CO 00 00 so uo :r^ SI I^ s. OO ^ •^ lO ON "-• OO On •-I n " o ON o\ •i^xsidody en M M l-O LO CO M 4 CO r^ On 01 ^s 00 00 CO t^ o C^ ■^ "1 o M i-O CO -« 00 ^ On \0 ■S3SE3SIQ; vo M ^ M -t CO M -H cs ^ so h-i ro [Buonnipsuo^ JaqiQ - - - N 01 - t^ 00 n M ^ O NO r^ KH CO '^ r^ l-O CO iri -1- ON (.^ w CO w vO o t>. 1-0 Tt N lO ^ ^ O '-' On ■uouduinsuoQ o\ i>^ t^ • N t\ CO LO d NO CO t^ 01 N r^ CJ HH -+ ON _ ^s. On ui O m o hH CO ^ -H ON CO c^ t^ ON r^ lO i-O CO 01 O MD u-i OD CO « uaouBO ■"■ '"' CO M n '"' *"■ -t SO CO « t^ I— CO On \o M NO 'i- 01 LO ^ « " o ^ OO LO u-i CO LO vn NO SO lO M CO oo •Xsdoj(j '"' ■"" ri (S CI M " SO CO O '^ 00 rv. NO On OO NO ^ r^ CO CO " •+ 00 t^ M CO ■sasBa ON MD M Cl M CO 01 H-. -^ C^ CO NO NO -siq; Diioui^z JaqiO to " CO lO CO NO CO ^ so 01 CO H. ON ON ON CO CO NO CO CJ bH 00 C4 •-I On oo M M CO u-i -^ NO M CO 00 HH M '-' l>^ •uisipqoojY ^' ^ ^ 00 SO CO v^ 00 1-ri '^ CO NO CO M HH CO " O I" ON N i_ •BJaioiio vO M i-O -t CO N CO o ^ •o o 00 - Ov CO — VO r-N. N -^ M oO hH CO M „ 1 NO ON rv NH lo ■^ 00 CO 00 ^ 1^ M ■E3oqjJB[Q; so' CO OO HH 1-n M 00 CO lO ____ ■^ \0 N LO lO cs "3 '^ ON \D ■Xjajuas^^O; 00 U-N \o ij-i \C' I>. "- o NO i^ H- ^ (N Ol c^l so ro r^ CI ~" o 00 0\ ,_ MD lO lO o c^ oo M u-i CO hH :: o ~t- •sE[3disj03 r>^ ^ vO >-0 M OO M N NO ri 00 hH 00 r^ N MD n i-n ei ON ^ OO ^ CO ►-. lo o - o" Cl On -1- CO NO M CI On Os C^ ^ ■J3A3^ l^jJ^lEJ^ >-< M n '- ■"■ ci ~* ^ CO '^ ON O LO ^ On O ■^ MD 01 l-O t>- N O CO ^ r^ •J3A3J cn CO OO CO C-1 f-^ ■« 00 ■s ~ ■Lr\ H-, snqdAx ptce pioijdAx (TJ NO r» r^ SO 4 " 01 r\ CO CO NO ^ i>. CO HH ON 00 ~^^ t\ LO ^~CO~ CO 00 T-n t^ CO rs, 01 M On o u-» CO i-i~i 01 CO On I-^ ^ t^ « Os O 'IVXOI, M On lO c< 01 c^ ON ■ CO lA CO 6\ -i- ':!- ■"■ ^^.^■^ ^ S - u-i 01 ,,_^ C c/} C >-, G "S T3 en C Ti C- O C G 1 CO C ^ c H ^i CJ t3 OJ C u T3 O g CU 0^ J2 u ^ i-^ CJ "O u w m ^ r^ n ^ ^ OO -Ti- NO "5 oo n n l>s H^ CO •pauysp-ui \o -. -t o OO NO r^ ^ n ^ JO UiVL0U3tun s3sn'B3 ^ " " " - CO CO OS ro !>. vr o ro N CO t^ N s: ■LTk i-i ^ n CJ CO -+ •sspioms - - ■ ■ - - On o c^ t^ n CO ITN 0\ ro ^ OS r^ 00 M o t-^ t^ m CO vo NO CO On hH '^ CO N \n ON " •ssunCuj pu'E s;u3ppDV en ^ ^ NO LA CO oo 00 w Cl HH r^ 00 M N rO 'O ^ NO ■^ h- oo '^ 'Z^ 'uopsn-Et^xg; puB KO - ^ M ■* M I^^ ^ " " •- " '-' 00 Cl 00 M Lo On ^ W -+ ro (^1 (N I-O M !-• ir> CO M •D13 '32v PIO -* ON CO oo Oj CO ^ CO 'aSBqjJOinajj 'sssDsqy - C-l M [->. ^ m vo ^ « ■^- nD vo 0\ t^ '- ■uia^sAs Aj-eu p*-) ^ N V3 CI '^- t^ N "PA JO sasBasiQ jaqiQ - oo CJ ^ oo N NO c:\ o oo ^ lo r^ O n -ir CO^ Th f^ M CO cl •sAaupi-^^ JO S3SB3S1Q M CI ^ CO Cl LO Cl '-' r^ M — ^O^ K^ 6 r^ lo IN. M CO I-. o o S 4 r^ m i^ CO CO u a o ■saaaqBid K- vo M CO ^ On '^'-' -* t-rt <" 1 u-i o M VO Cl — cr\ 00 ■+ " •OlSJsXg 3AI3S33 \o ^ ^ cl CO -i- c^ *-■ ^ i>- -](j JO sasBSSiQ; aaqiQ ^ M N Cl i>. M "On oo "^ On OO ~^' ns "r^ - CO MD~" Cl 1 t^ M o\ 00 "^ -^ CO O t~- o o CO CO •j3Ai'][ JO sasBssiQ; N CI CI rO CO M vo r^ -I- O" 0" rO MD -+ 1-1 1— 1 o S^ u^ O ro CJN « O NJJ ■!j- (J\ N O ■si]iuo5U5d; _ CI ^ C^ ^ vo „ '•*"^ " CO CO .* "-n « ■* 'aSBqajomafi 'ssaosqy - " - ri - " M VO tN CO CO oo N M 00 o \0 ^ Lr> to ^o N n »-n NO "^ •Xsu CO MD NO Cl '^ vo -^ M lO -n3[(j puB spTqDUOJg " " " CI n - Cl O ON f^ !^ . lO VO t^ M I>^ ■^ t^ "R j_ UN 00 ^ r^s. i^ CO «« 00 LO CO t^ M M c "^ CO ^ M ON t^ -^ ON o o ■iviox N •^ ^ "^ C^N ^ 4 M ^ „ N Tl- a\ T^ CO • * vo CO !>. CO tN " O CO a ho a bo bo a rt ^ bo p ■eI c a (U CO > < f- c 55 g 1 '^ > c cc (L OJ OJ u p-t "bjj C OJ Pi cc c 3^ o c 5S u OJ t- 12 C H cr o 1:^ fe 28 X H •(aSy PtO 3"!pnp •sapp -ing pu-e sjuappoy •uiaisXg AjBUUfl JO SSSBaSlQ 'U3)SAg 3Apsa3l(I JO S3SB3SI(J JO sasEasjo; ^a^O ■■Eiuomnaujj ■uiaisAg Xjoi -E[noJi3 JO sasB3si(j ■uiais^S snoAjajij JO sss'EasiQ JsqiO •Xxa[dodY •SSSEaSTQ ■jaouBQ •uonduinsuo^ •sasBa -siQ 3i}ouijC2; -tamo ■SJ3A3J 00 t^ 00 00 CO ON ON CO ON ON CO 00 4 00 4 NO OO ^ I— I fn ^ ON OO M o o o -d- tN. CO VO CO ^ a\ f^ o CO OO r^ ^ M OS 00 VO to OS CO OS CO OO - 4 o CO VO O O VO OS u^ 1-1 OS o CO ^ -' O -* 4 •ivxox < H O H P4 CO ,-, OS o t^ Os bo 3 S ;-! o ■a c ni t3 C "So c W CL, ■T3 C ni C ID ■a B a! bo .a cd ^ c a y o C Ph Ui o tj) CU 29 Of the entire mortality, those born in the United States give 75 per cent; Germany, g}4 ; Ireland, 4^; England, ^'A ; Scotland, iH per cent. Total, United States, 75 ; Foreign-born, 25 per cent. The circumstance of nativity seems, in the large majority of cases, to have very little influence on the cause of death, and it is remarkable how slight a variation from the seventy-five per cent, there is for most of the diseases. The following exceptions seem most noteworthy: In typhoid and malarial fevers, diarrhcea, cholera, and pneumonia, the percentage of the United States rises to or above eighty, and in cancer, alcoholism, dropsy and peritonitis it falls below seventy per cent. The deaths from alcoholism are chiefly among foreigners, and in the following order of nationality : England, Ireland, Scotland and Germany. Consumption varies considerably ; it gives the largest proportional mortality among the natives of Ireland, and the smallest among the English. Apoplexy gives the largest percentage among the Scotch, and the smallest among the Irish, and the same holds good for diseases of the nervous system in general. The foreign-born give a much higher mortality from cancer than natives; 35.17 per cent, instead of the usual average of 25. Among foreigners, the Germans give the highest proportion and the Scotch the lowest. Heart diseases prevail almost uniformly among all nationalities. For diseases of the digestive organs, Ireland gives the largest percentage of diseases of the stomach, and the smallest for diseases of the bowels. Scotland gives the largest proportion of diseases of the kidneys. Accidental deaths occur equally among all nationalities. The na- tive born, the Germans, and the English give nearly the same propor- tion of suicides. The Irish and Scotch do not afford a single instance. 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'SJSAa^ snud -Xx puB pioqdAjL '■d- CO N COCO in l>. .- CO ^o^0^^^c^^^^ CO C Onoo m On •- Mt^l-HM .MHMhHHirOM ■ - .hH . . ■aviox M COOO vnvO CO HH M -sf ^ I-- M COCO OvOO 00 Ov 1>^ K. •$ ^ ^ iA% ^£^m^ " S DEATHS DURING YEAR OF INSURANCE. h > 1'^ - LC -1= ^vo .00 X NO I-H X X c X x: XX XX sOO c X NO (fi X X c ^ - - - - : J3 J3 ,i3 ^ X 4-.^ +j 4-t +- 4_) Tj m C^ ->«3 t^oo 0\ 11 £ n N N ts ro f,^p 38 ■psugQp-m 40 JO UAVou^iun 3snB3 c ) ■^ CO »^ COVO COCOrOt-HrOl-H. NH^.H^HH. f-l CI 'sapioing h n CO i-OVO MU-icocOMi-Hi-i . .mM .Mh- . . ^ . .|_,,_| ■ssunf -ui puB siugpiDoy CO M COOO M i-H -^vo ^ ^00 w^OCON'^i-^'-.hHwcOM - ••-« ^u-^rO^cONC^M h-.^ •uopsn-B^ -xg puB ' 'uoi3 -Baqsoj(j 'Xjjiiqad ■313 'aSy PIO 'sSbiij -aoui3n 'sssosqv w txO 00 i-t CO ThOO COCO- -cow -hHWM -M ■ <^ ^ -WW . . . -w . 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LO NO CO u^ ""* CO " -' M n (I. O f5 r DEATHS DURING YEAR INSURANCE < a C a, S: 1 0- t- a. > G cu t- rt > CS C (U a cu a. > i-n O ID (U ho oJ C o > o O in 5 OJ o V '■o < (U bo C 40 c > w •psuijap-iii JO DAvousiun 3snB3 ^ r. ^ i-r\ M - ■+ r-^ CO (7\ lO CO M 0\ CO r^ M 00 " Ov '^ M CO m 1^ o VO 0\ 1-^ ^J~i HH ^ CO M CO t^ t-^ H-., M l_ f-. ^ c M to OS i-t 'J- o\ n o 5 •S31J ix;j CO VO VO "^ o •-< o\ IN. o i-n -nfui puB siuapiDoy MD z Ov VO VO rl- •uoiisnBqxg; puB vS ^^ - o\ t^ o ir\ s; CI O VO IN 1^ M l-< t-i ■oy 'aSv PtO ^ M ^ C\ « ~ ■* "*• In „ •* O t_, 'sSBqjJOuiaji 'sssosqy " "^^ CO -IJfl JO S3SE3SIQ JaqiQ CO fO ^ On N -* 00 OO „ ^ Ov CO vo CO \j~k VO M •sXaupt;^ JO sssEasiQ; ■^ ^ t^ CO CO ^ VO 1^ 5 M r- » ti CO ^ IN (S r-^ CO "-t „ OS CO Ov ^ ■* -:!- 1^ CO \J^ '"' VO Ov "^ ON -iQjosasBQSjci'jaqio CO « Lo CO or r^ ut -t CO Ov M 00 VC n On CO '-' Ov N 00 1— •-< >-* t^ i-t t^ C3 VO M uo VO •+ IN. VO ^ OO «M 00 O \jr\ M CO t^ CO M t^ '-' VO CO vn CO IN. o\ o\ 1^ >j-> o m 00 CI VO t^ t-^ _! t-i ^ 1- \o T^ ON 0\ VO o M vn "^l- LO ^ t^ CS >* N »-r» w o O O (S Tt- CO CO w c^ IN •-' CO CO M Iv. vjD N Ov « r^ -^ fO n M CO c^ VO ,-1 l-H o « •-I >-• •raajsXg Ajo^ujid O IN CO VO u^ VO o M CO CO Ov t^ ■sSunq JO 3S^3St(j puB 'aS-EqjaouiaH 'sssosqy oc VO o M ° IN CO ^ CO CO o C4 o •H w M •-« '-' ^ oc 00 t>^ -' Ov ^ ^ ■r*- Ov l^ N OO en m CO CI OO -n3|(j puB sijiqouojg ■s2un7 JO uops3Suo3 ^c In oc O '^ 8 IN CO 1* 1^ o 00 ■+ u^ _ H » » » OQ CO t^ o CO M M VO „ M o •BiuomuaUjj OO ^ ^. OO ^ O N ov 00 IN CO l\ r-^ t^ l~v ^ rt M CO ^O n (^ CO CO CI CO c CO M OC n I>K •^vlOx ■ u-» u-i vn CO ►1 '"' CO ""* M in CI ■ O u DEATHS DURING YEAR INSURANCE TO i- C o cc bJ) C o 1-1 > ni -t-j (J ID > O > o < V ^^ TO o o C > tr ■ Oh (N O ■a o LO CD Ph 41 (■33v Pio; Suipnpui) payissB[iu0 'sapiD -ing puB sjuapiDoy ■subSjq XjBUUf]^ JO S3Se3St(J SAl^SsSlQ JO SaSB3SI(J "uiaisjCg ^lojEJid -sa"a; JO sasBasiQ Jiaqio ■Eiuouinauj -BjnOJl^ JO S3SB3ST(J -'lua^SiCg snoA -J3N J° sasBssjd Jaqjo no f^ O 0\ CO ^ I-. fO ^ O ON ^ On > X w 1-1 m < ■Xxaidody ■S3SE3SIQ; lBuoj;n5i3suo3 JaqiQ 5 •J3DUB3 ■uoijdojnsuo^ c<-) VO 8 5 ON _• N ,0 O NO NO. NO O •^vxox NO oo to O O NO bo ^ «2> 34 35 ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk. Risk. I 2142 II 2I2I 4 2135-5 6 2122 .5 IS 2069 9 2 4029 19 3707-5 25 3766.5 26 3767-S 14 3754-5 22 3 3i°3 16 3473 29 3190 14 3242-S 20 3277-5 21 4 2688.5 16 2740-5 IS 3102.5 20 2839-5 19 2871 5 12 5 2126 20 2368.5 17 2418.5 12 2732-5 15 2509-5 21 6 i6S7-S 12 1784-5 IS 2024.5 16 2056.5 24 2320.5 21 7 1216.5 12 1325 12 1385-5 10 1623 12 1663 18 8 692 7 896 3 983-5 16 1002 .5 II 1209 II 9 395 6 487-5 I 640 7 681 5 714 5 lO 220.5 I 308.5 3 367 3 494 6 548 4 II 108.5 184 I 261.5 2 307-S 2 407 -5 4 12 39-5 99-5 159 I 224 5 253-S I 13 25-5 33 89 3 139 I 200 3 14 14 23 2 31 81.5 I 129-5 2 IS 12 14 16 30 67-S 16 6 II 9 14 26 17 7 5-5 9 7 1 1 18 2 6 4 9 6 19 2 5 3 9 20 I 2 4 2 21 2 4 22 I 2 23 I Table I. — Continued. NUMBER OF ENTRANTS. 4IIO 3754 3555 3302 348 3 AGES AT EXPOSURE. Years of Insur- 36 37 38 39 40 ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk. Risk. I 2003 11 1830 8 1746 7 1622 II 1705 5 2 3692.5 21 3534-5 23 3220.5 19 3096 23 2890.5 16 3 3287 5 21 3221.5 10 3064 19 2815.5 19 2705.5 22 4 2892 5 26 2917-5 23 2900 25 2731.5 25 2496 29 5 2565 5 28 2542-5 30 2590.5 21 2577.5 28 2423 14 6 2150 5 20 2161.5 16 2150 21 2249.5 21 2196 21 7 1854 5 20 I7I4.5 12 1741 23 1743 15 1795.5 15 8 1231 5 7 1382 16 1272 9 1314.5 13 1287 14 9 89s 5 3 887.5 10 1025.5 4 942 6 961.5 7 lO 544 4 7°7.5 8 686.5 6 812.5 10 747.5 5 II 460 2 459 3 581 3 568.5 2 671.5 8 12 349-5 3 394.5 392 7 511 5 478 6 13 227 4 318 3 353 3 345 6 457 2 14 179-5 2 202 3 290 I 322 319.5 3 15 113-5 152 I 176.5 3 246 4 290.5 3 16 59 I 96.5 I 125.5 156 2 212 3 17 20.5 50. s 78.5 I III 130.5 I 18 10 18 41.5 65 2 92.5 6 19 5 8 12.5 31 49 I 20 9 ° 5 7 12 22 21 2 7 3 4 9 22 4 I 5 3 4 23 2 3 I 4 3 24 2 3 I 4 25 I I I Table I . — Continued. NUMBER OF ENTRANTS. 2885 1 2704 242 9 1 223 2 210 5 AGES AT EXPOSURE. Years of Insur- 41 42 43 44 45 ance. Exposed Exposed Exposed Exposed Exposed to Died, to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk. Risk. I 1414 3 1330 5 II98.5 8 1095 8 1027 8 2 3030 20 25°7-S 15 2365-5 20 2131 13 1950 10 3 2559 17 2666.5 IS 2223 12 2082 .5 17 1870 17 4 2400.5 13 2271 17 2406 21 199s 18 1874-5 17 5 2215 II 2137 13 2005 18 2129.5 19 1784-5 13 6 2075 12 1925-5 22 1856 10 1730 17 1843-S 17 7 1786.5 23 1678 10 1561-5 14 1515-5 18 1382 13 8 1315-5 9 1321 9 1268.5 II II53 9 I133 5 9 919-5 3 900.5 8 935 5 847 8 836 9 10 746.5 5 735-5 3 705 -5 7 744 6 657-5 4 11 626.5 6 615-5 4 597 4 596.5 12 638 6 12 573-5 6 532 8 533 3 516 8 520. 5 4 13 420 2 501-5 3 477 2 482 5 440 2 14 419 I 390 -5 460.5 4 436-5 8 436 3 IS 277 3 370.5 3 349-5 5 405-5 4 383 -5 5 i6 239 246 3 326.5 3 306.5 4 362.5 6 17 179 3 202 5 222 3 283 I 262 .5 4 i8 109.5 149 I 170-5 197-S 2 252 I 19 72.5 I 90.5 II9-5 2 139-5 166.5 2 20 35 60 76. 5 I 102.5 119 21 16 28.5 S3 I 62 I 85 22 9 IS 25 42 55 I 23 3 7 14 I 23 38 2 24 2 I 7 12 I 21-5 25 2 2 3 9 26 I 2 3 27 ■ ■ I 28 - -5 I Table \.— Continued. NUMBER OF ENTRANTS. 1864 156 2 1513 1 1321 .1296 Years AGES AT EXPOSURE. of Insur- 46 47 48 49 5° ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk. Risk. I 913-5 5 764-5 9 745 6 647-5 6 635 5 2 1827.5 10 1608.5 14 1366 7 1327 15 1 144 9 3 1746 22 1612.5 13 1394 II 1227 16 I177-5 8 4 1676 23 1569 13 1462 20 1243 9 1092.5 6 5 1692 20 1492 19 1397-5 18 1289.5 6 1090.5 13 6 IS49 18 1459-5 15 1274-5 17 1202 II II06 .5 9 7 1472.5 9 1213-5 18 "75-5 13 1003.5 7 958-5 15 8 1023 10 1041.5 13 855-5 14 863. 5 4 738.5 10 9 788.5 10 707 8 714 6 574-5 7 585. 5 10 lO 632 7 593.5 II 552-5 6 559 9 422 3 II 534.5 4 531-5 3 493 4 452 6 453 8 12 543-5 4 467-5 9 460.5 5 423 8 385 8 13 469 9 478 7 409-5 4 417 9 381-5 9 14 402 7 414 2 426 5 376 5 367-5 4 IS 392-5 5 359 I 371-5 354-5 I 324 2 i6 325.5 3 350-5 2 314-5 7 341 3 312 4 17 319 3 289-5 3 312.5 2 277 2 295-5 i8 229.5 I 276 4 249-5 5 274-5 7 248 2 19 209 2 193-5 2 234 4 201.5 2 228 3 20 136 164 3 163 I 205-5 170 3 21 98.5 120 134 I 138-S 2 179-5 I 22 75 87 I 103 119 121 .5 2 23 51 69 I 77 3 92 109-5 I 24 33 46 I 62 I 65-5 3 80.5 I 25 14 26 43 I 53-5 I 53-5 26 4 7 13 31 I 44 27 2 2 5 10 19 28 I I 3 8 29 I I I 3 30 • - I ■5 e Table I. — Continued. NUMBER OF ENTRANTS. 973 923 763 680 529 AGES AT EXPOSURE. Years of Insur- ance. 51 52 53 54 55 Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Rislc. ■ Risk. Risk. 2 Risk. I 473 5 455 5 375 2 335 258 3 2 II20 II 828 8 821 12 643-5 5 580 8 3 1009 10 1007 14 722 7 721 8 558 II 4 1067 13 918 10 909 10 640 12 629 5 5 975 9 949 13 817-5 8 804 8 557 12 6 944 -S 10 836 4 816. 5 II 7i°-5 13 685 10 7 903 II 747 10 670 5 655 6 545 15 8 668-5 8 634 14 530 8 478 4 469.5 4 9 480.5 2 464-5 8 423-S 5 354 7 320 5 lO 441 8 378 6 349-5 7 314-5 6 251 4 II 3SO-S 3 339 3 311-5 5 282 8 258 9 12 375 6 292 5 294 4 259 6 236. s 5 13 346.5 5 328 3 259-5 3 261.5 5 225 6 14 341-5 2 312 7 296 2 235 2 237 5 15 326 II 300 4 277-5 3 263-5 6 207.5 3 16 294 2 283-5 3 261.5 4 242-5 4 226 2 17 273 3 254 5 4 252-5 2 237-5 4 219.5 5 18 256 4 237 5 2 223 4 213-5 3 204.5 3 19 213-5 2 215 5 I 212.5 192.5 5 182.5 2 20 201 168 5 2 182 8 186 5 165.5 3 21 148 2 170 5 2 142-5 I 158 2 161 5 22 165 I 124 5 2 158 I 130.5 2 146 2 23 no. 5 I 152 2 no 3 140. 5 5 114 2 24 95-5 4 lOI 5 139-5 I 94.5 2 125.5 2 25 71-5 79 I 83-5 4 112. 5 2 76 I 26 38 I 55 58. 5 2 (^i 80 2 27 32 29 43 2 49 I 44.5 28 13 18 22.5 I 29 2 37 I 29 4 9 13 14 19 I 30 2 I 8 4 7 31 ' • I .. 6 3 Table I. — Continued. NUMBER OF ENTRANTS. 464 391 35/ 23s 202 AGES AT EXPOSURE. Years of Insur- 56 57 58 59 60 ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk ■ Risk. I 225-5 I 189.5 2 175 2 114 I 99-5 4 2 457 4 391-5 4 332 4 302 3 199-5 3 3 516 8 393 3 352.5 7 293-5 5 272 2 4 487 9 452 9 348.5 6 310 6 252-5 6 5 554 5 420 3 393-5 13 3°i-5 5 274 10 6 457 6 463 6 363 4 338 10 257-5 5 7 515-5 8 345-5 4 361-5 6 291.5 6 254 2 8 371 6 359 7 247 -5 6 265 6 189.5 3 9 317 8 239-S 4 225 6 142.5 2 177 2 lO 220.5 3 216 2 170 3 157-5 2 113 3 II 193 4 169.5 2 147 2 144 4 130 4 12 216 4 162 I 135 I 130 2 123-5 4 13 206.5 3 189 4 140.5 4 121 2 112 I 14 203 I 183-S 168 2 125-5 2 103 15 203-5 174-5 6 162.5 2 146.5 2 no 4 16 177 I 180 2 146.5 6 144-5 5 132-5 3 17 197 8 157-S I 161. 5 3 126.5 3 123 6 18 186 I 162 .5 3 134-5 I 136.5 2 II4-5 2 19 173-5 4 160.5 3 134 3 118 5 III 3 20 161 2 146 5 135-5 3 III. 5 2 100.5 4 21 142.5 2 143 I 122 I 113 I 100.5 2 22 146 I 130 5 123 3 108.5 I 102.5 5 23 i3°-S 131 5 "3-5 114 4 96.5 2 24 loi .5 4 114-5 4 118.5 I 103-5 2 IOI.5 5 25 112 I 85 96 100 3 92 4 26 58.5 88 I 65 I 71 I 78 I 27 59 I 43 I 65-5 2 46 54-5 3 28 36 39-5 I 27 t 42-5 28.5 29 25 I 21 25 20 30 30 10 12 14-5 12 10 31 3 4 I 3 3 4 Table I. — Continued. NUMBER OF ENTRANTS, 147 1 123 1 80 1 61 1 4T AGES AT EXPOSURE. Years of 61 62 63 64 65 Insur- ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. t Risk. Risli. Risk. Risk. Risk. I 73 2 61 I 39-5 2 30 I 20 I 2 159 6 129 98 I 65 2 51 2 3 172-5 3 134 2 120 2 85-5 2 60 6 4 239-5 6 149 5 117 3 108 4 79 4 5 214-5 4 209.5 4 122 .5 2 100 3 93 4 6 227.5 3 185 6 176-5 4 103 5 80.5 3 7 207 5 167-5 3 ^ZS 2 126.5 3 73-5 4 8 194 9 140.5 3 II4-5 3 96 6 89 I 9 129 122.5 2 85-5 3 79 3 60 3 lO 120 3 83 2 76-5 2 62.5 2 53 3 II 90 5 97 3 63 2 62 3 44-5 I 12 109-5 4 74 3 80 5 55 53-5 I 13 14 109 I 99 4 67-5 2 65-S 52 I lOI 3 99 I 84-5 I 60 I 60.5 15 91-5 I 84-5 89 I 72-5 2 51-5 16 94-5 I 86 2 72 2 79-5 4 59-5 3 17 115 2 82.5 74.5 2 57 5 67 6 18 107-5 4 102 3 72.5 3 66 5 49 3 19 20 95 3 94 2 85-S 2 54 5 56 3 91 2 79 4 80 I 69 46 I 21 85 3 77 69-5 I 68 I 64-5 I 22 86 3 72 2 71-5 3 65 4 61 3 2^ 88.5 2 73 2 64 2 63-5 I 55 2 24 87 2 82 62.5 55 I 58 2 25 26 88 3 77 3 72 2 54 2 46.5 I 73 6 69 I 57 3 58-5 I 44 I 27 60 I 51-5 3 57 I 44 2 45 2 28 38 I 36 I 37-5 2 42 I 32 29 3° 31 24 2 28 I 23 I 25 29 I 20 7 14 II-5 18 3 15 3 6 2 Table I. — Continued. NUMBER OF ENTRANTS. 14 20 II 1 ■= 1 ' Years AGES AT EXPOSURE. of Insur- 66 67 68 69 70 ance. E.xposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risli. Risk. Risk. Risk. 6.5 9-5 5-5 5 3 2 36 5 12 18. 5 II 9-5 3 47 5 2 35-5 I 12 I 18 10.5 4 48 5 I 41 32 I II I 17-5 5 68 5 4 45 3 39 3 30 I 10 2 6 73 5 4 51-5 3 35 I 31 28 7 63 5 2 53-5 I 41-5 28. 5 I 25 2 8 47 3 41 4 33-5 I 24-5 19 9 65 2 28 I 24 I 21 ° 13 10 36 2 43 I 16 18.5 14 I II 36 3 26.5 I 31 3 14 I 16 12 37 28.5 2 23-5 22 12 I 13 48 I 33 23-5 3 21 2 20 14 47 I 44-5 29 2 19 I 19 2 15 S3 42 I 39 I 24 16 I i6 44 2 49-5 2 39-5 I 35 23 2 17 50 2 36. 5 2 40-5 3 32 I 31 I i8 SI 4 43-5 2 29-5 31-5 2 27 I 19 40-5 3 43-5 I 37 3 23 3 25 2 20 43-5 2 30-5 4 35 2 28. 5 16 I 21 45 ■ 2 38 I 22.5 I 3° I 24 3 22 59 2 40-5 I 35 2 21 I 27 I 23 49 2 52 I 36 3 30 2 20 24 46.5 2 44 5 46.5 3 28.5 2 27 I 25 53 5 34 2 31 I 39 4 24-5 26 35 34 2 25 I 20 I 30 3 27 31-5 I 27-5 I 23 I 22 13 28 27 22 22 16 I 18 I 29 22 2 22.5 I 16 I 16 10 30 17 I II-5 14 2 7 8 I 31 6 9 I 5 8 2 Table I. — Continued. NUMBER OF ENTRANTS. 5 I 2 I I Years AGES AT EXPOSURE. of Insur- 71 72 73 74 75 ance. Exposed Exposed Exposed Exposed Exposed to Died. to Died. to Died. to Died. to Died. Risk. Risk. Risk. Risk. Risk. I 2-5 •5 I •5 •5 2 6 S I I 2 I 3 9 6 I 5 1-5 4 9-5 9 5 2 s I 5 16 8-5 9 3 4 I 6 8 2 14 I 8 I 8-5 3 I 7 20.5 5 12 I 4 7 I 8 15-5 I 13 3 5 I 3 I 9 14 12 2 8 I 4 10 9 8 4 I 4 I II II I 7 8 I 2 12 IO-5 3 9 1 7 2 4-5 13 10 6 7-5 4 4 I 14 18 I 10 I 4 7 4 15 16 I 14 8 3-5 I 6 I i6 12 12 12 6 2 17 20.5 3 II I 9-5 I II 5 i8 28 3 14 3 9 6 10 19 24 I 22 9 7 6 I 20 22 2 20 2 21 9 I 7 21 14 18 2 14.5 I 16.5 2 7-5 2 22 15-5 I 14 I 14.5 I II I 13 I 23 25-5 2 14 2 13 I II 2 10 I 24 18 20 I 12 I 9 3 8 25 24 I 15 6 17 I 10 I 5 26 19 18.5 6 13 I 8 27 20 12 I 16 I 4 10 I 28 lO 18 8 I 10 I 3 29 13 I 6 12.5 3 5 30 3 6.5 2 4 2 31 5 4 I 2 Table I. — Continued. NUMBER OF ENTRANTS. AGES AT EXPOSURE. Years oi Insur- 76 77 78 79 80 Exposed to Risk. Died. E.\posed 10 Risk. Died. Exposed to Risk. Died. Exposed to Risk. Died. Exposed to Risk. Died. I 2 I •• 3 I I 4 I I I 5 I I I 6 3 I I 7 I 3 I 8 2 3 I I 9 I I lO 3 II 2 12 2 2 I 13 2 I 14 I 2 I IS 4 I I 2 i6 5 3 I I 2 I 17 I S I 2 I i8 5 2 I 3-5 I 2 I 19 9 I 3 I 2 2 ° 20 4 7 2 3 I 2 21 6 4 I 5 3 I 22 3 5 I 2 5 I 3 23 II ^ 3 4 I i-S 4 I 24 9 I 8 I 3 3 I 25 6 7 3 5 3 I 3 26 S I 3-5 2 3 3-5 2 27 6 I 2 I 3 I I 5 I 28 6 5 2 I 2 29 2 5 3 2 I 30 4 I I 3 2 ° 31 I 2 I i-S -> Tabi,E \.— Continued. N U M H IL R C) F ENTRANTS. i 1 » 1 " 1 ! - 1 « Years AGES AT EXPOSURE. of Insur- ance. 81 82 83 84 85 86 Exposed to Risk. 1 Died. Exposed to Rislv, Died. Exposed to Risk. Died. Exposed to Risk. Died. Exposed to Risk. 1 Died. Exposed to Risk. loied. IS I i6 I 1 17 I I 18 I ° I 19 I I I 20 2 •5 I I 1 21 2 2 ; I I 1 . . 22 I 2 2 I 23 2 I I 2 I i .. 24 3 I I 2 25 I I 3 I 1 I 2 26 I I I 27 2 I I I 28 I I 29 ! I 30 I 1 1 31 ! I 1 NUMBER OF ENTRANTS. Years of Insur- ance. " 1 1 XPOi AGES AT E iURE. 87 88 89 90 91 92 Exposed ! to Risk. Died. Exposed to Risk. Died. Exposed to Risk. Died. i Exposed p,. , to Risk. ,^"=''- Exposed to Risk. Died. Exposed to Risk. Died. 21 I 1 •• 22 I . . 23 I 24 . . 1 I , ° 1 25 1 . . . , i . . 26 ! . . , . . I j I 27 I . . ° : . . 28 1 . . I . . . . 29 i . . 1 I ' 30 I ! 1 .. 1 1 . . I t 1 . . Table II. Comparison between the rates of retiring in different years of Insurance. Age Ratio of Withdrawals to Exposures DURING THE at Entrance. ISt 2d 3d 4tli Sth 6th Five Years. Five Years. Five Years. Five Years. Five Years. Five Years. 20 to 24 .103 .038 .018 .015 .009 .006 25 to 29 .078 .032 .017 .014 .Oil .005 30 to 34 .062 .030 .018 .014 .012 .008 35 to 39 .058 .028 .021 .014 .013 .006 40 to 44 •053 .028 .021 .014 .014 .006 45 to 49 .050 .025 .021 .010 .Oil .012 5° to 54 .047 .023 .018 .016 .014 • osr 55 to 59 .047 .014 .016 .009 .025 60 to 64 •033 •°33 .032 Table III. Rate of retiring in successive years of Insurance. All ages combined. Years of Mutual Life. Twenty English Offices. Insur- 1 ance. Exposures. Retirants. Ratio. Exposures. Retirants. Ratio. I 49647-5 2672 •054 64247 1750 .027 2 86929.5 8697 . 100 117679-5 8495 .072 3 74939 5066 .068 104313 5297 -051 4 66224.5 3189 .048 93668 3958 .042 5 58277 2212 .038 84416.5 2831 -034 6 49609 1618 -033 76689.5 2207 .029 7 39409 1042 ■026 70086.5 1751 .025 8 28636 1094 .038 63722.5 t 2397 .038 9 19968.5 395 .020 57685 1086 .019 lO 15289 5 341 .022 52343-5 829 .016 n 12542 5 223 .018 47207.5 713 -015 12 10710 5 209 .020 42265 660 .016 13 9485 5 181 .019 37994-5 545 .014 14 8574 5 161 .019 34055-5 399 .012 15 7519 5 155 .021 30549 370 .012 16 6580 5 89 .014 27147-5 299 .Oil 17 5736 89 .016 24343-5 25s .010 18 4944-5 69 .014 21604.5 195 .009 19 4137 54 .013 19329-5 167 .009 20 3473 34 .010 16996.5 133 .008 21 2967 36 .012 15150 118 .008 22 2635-5 33 .013 13537-5 lOI .007 23 2345 32 .014 12006 92 .008 24 2072 28 .014 10634.5 69 .006 25 1738.5 II .006 9294 56 .006 26 1291 6 .005 7995 58 .007 27 961-5 9 .009 6945 -5 41 .006 28 666 6 .009 6032 24 .004 29 456 2 .004 5214-5 27 .005 3° 240.5 5 .021 4483 18 .004 31 106. 5 I .009 3872.5 13 .003 Table IV. Mortality Experience of the Mutual Life, from 1843 ^^ 1873, inclusive. Years of Life Actual Ratio of Actual Deaths to 1 t 1 Age. Aee. *»o^ . Exposed. Deaths. Probable Probable Exposed. Deaths. American. Deaths. NewActuaries' to 10 648 2 ... to 10 II 59-5 ... II 12 56 ° ... 12 13 53-5 13 14 58.5 14 IS 79-5 15 16 116 16 17 167 17 18 273 I .003663 474 675 18 19 523 5 .009560 I 231 I 583 19 20 lOII .5 9 .008898 I 140 I 370 20 21 1876. s 15 .007994 I 018 I 177 21 22 3091 -5 14 .004529 573 654 22 23 4605 30 .006515 819 938 23 24 6337-5 41 .006469 808 930 24 25 8319 58 .006972 865 , 996 25 26 10353-5 S3 .005119 630 : 722 26 27 12182 .5 80 .006567 801 896 27 28 13970 85 .006084 736 802 28 29 \ 15556 93 .005978 716 763 29 30 I 17144 112 ■006533 775 810 30 31 1 18486.5 120 .006491 763 790 31 32 ' 19591 127 .006483 753 775 32 33 20599 136 .006602 757 772 , 2,Z 34 ; 21382.5 150 .007015 794 801 1 34 35 22054.5 154 .006983 781 776 ; 35 36 1 22558 173 .007669 844 822 j 36 37 22615.5 167 •007384 800 763 ! 37 38 22466 .5 172 .007656 814 766 38 39 22284.5 192 .008616 899 839 39 40 21951 iSi .008246 842 785 40 41 21444.5 138 .006435 643 602 41 42 20684.5 144 .006962 679 638 42 43 19958-5 155 .007766 738 689 43 44 19032.5 179 .009405 869 802 44 45 18151 149 ■ .008209 735 666 45 46 17159 172 .010024 867 770 46 47 15943 172 .010788 899 786 47 48 14809.5 161 .010871 869 754 48 49 13773 140 .010165 776 673 49 50 12734 136 .010680 775 677 SO Table IV. — Contimwd. Years of Life Actual Ratio of Actual Deaths to Age. Age. Exposed. Deaths. Probable Probable E.xposed. Deaths. Deaths. American. New Actuaries' 51 I1738 134 .011416 •785 691 SI 52 10687 138 .012913 839 746 52 S3 9782. 5 125 .012778 782 i 698 53 54 8829.5 135 .015290 879 786 54 55 7827.5 136 -017375 936 841 55 56 6861 96 -013992 704 637 56 57 5965 90 .015088 707 646 57 58 5206-5 93 .017862 ] 779 718 58 59 4553 87 .019108 773 716 59 60 3946.5 93 •023565 883 820 60 61 3392 5 90 .026529 919 \ 855 61 62 2865 5 (^l .021986 703 653 62 ! 63 2384 5 60 .025163 i 741 690 63 64 1988 5 69 .034700 941 881 64 1 65 1653 5 63 .038101 950 900 65 66 1333 5 55 .041245 944 908 66 67 1073 44 .041007 861 843 67 68 860.5 41 .047647 916 916 68 69 686 25 •036443 i 642 651 69 70 558 26 .046595 752 764 70 71 449 23 .051225 757 766 71 72 348 25 .071839 974 975 72 73 270.5 18 •066543 830 816 73 74 182.5 16 .087671 I 007 974 74 75 143-5 12 .083624 886 853 75 76 103 II .106796 I 044 I 009 76 77 75-5 12 .158940 1 I 431 I 404 77 78 52.5 3 •05714:. 473 472 78 79 39-5 3 •075949 577 1 587 79 80 30-5 5 -163934 I 135 1 I 182 80 81 18 2 .mill 701 745 81 82 14-5 2 ■137931 791 858 82 83 9 I .mill 580 638 83 84 6 .... 84 85 5 I . 200000 849 987 85 86 3 ... . . . 86 87 3 1 . . . 87 88 2 88 89 2 ... 1 89 90 2 I .500000 I 100 I 800 90 91 I .... 91 92 I I I .000000 1-587 i 3 333 759 92 Totals, 578112.5 5515 .009540 -799 Table V. Synopsis of Table IV., in groups of five ages. Age. o to 14 15 to 19 20 to 24 25 to 29 3° to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 92 Totals,. . . . Years of Life ! Actual exposed. Deaths. 875-5 1158.S 16922 60381 97203 II1979 103071 79835-5 53771 30413 14577-5 5606.5 1808 414 78 15 4 578112.5 6 109 369 645 858 797 794 668 502 375 228 108 41 Probable Deaths. American. 6-57 4. It Ratio of Actual TO Probable. New Actuaries'. American, ■304 5515 8.95 6.28 .670 134-49 116.78 .810 496.38 448.87 -743 838.83 817-53 .769 1036. 18 1081 . 19 .828 1057.69 1133-72 -754 958. 10 1087.66 .829 824.01 930.73 .811 641.03 702.82 -783 447-25 480 . 40 .838 259-45 265.99 .879 128.20 128.16 .842 44.01 44.98 -932 12.78 11.94 .782 4-37 3-37 . 229 2.07 1. 16 .966 6900.36 7265.76 -799 New Actuaries'. • 478 -955 -933 • 794 -703 -730 .718 ■ 714 .781 -857 -843 .912 .838 -297 1.724 ■ 759 Table VI. Mutual Life Experience. Adjusted by Interpolation. Age. 4 2> 90650 610 .006729 .008554 78 34 90040 627 .006964 .008755 80 35 89413 644 .007203 .008996 80 36 88769 658 .007412 .009326 79 37 88111 669 •007593 .009677 78 38 87442 679 .007765 .010000 78 39 86763 663 .007642 .010271 76 40 86100 652 •007573 .010501 75 41 85448 648 .007584 .010687 71 42 84800 657 .007748 .010915 71 43 84143 666 •007915 .011277 70 44 83477 707 .008469 .011727 72 45 82770 751 .009073 .012321 ! 73 46 82019 790 .009632 .013014 74 47 81229 810 .009972 .013719 73 48 80419 836 .010396 .014424 72 49 79583 859 .010794 •015115 i 71 5° 78724 888 .011280 .015778 71 Table VI. — Continued. Age. 4 '4 Rate. New Actuaries' i ., '^^'"O ?/ j^^j-g , Mutual Life to New Actuaries'. SI 77836 917 .011781 .016512 71 52 76919 971 .012624 .017322 73 53 75948 1025 .013496 •018315 74 54 74923 1058 .014121 .019448 73 55 73865 1099 .014878 .020655 72 56 72766 1158 .015914 .021960 : 72 57 71608 1199 .016744 •023358 j 72 58 70409 1258 .017867 .024892 72 59 69151 1364 .019725 .026695 74 60 67787 1453 •02143s .028729 75 61 62 66334 64787 1547 1710 •023321 •026394 .031043 •033657 75 78 (^2, 63077 1858 .029456 .036468 81 64 61219 1985 .032424 •039374 82 65 59234 2101 •035469 •042331 ! 84 66 57133 2223 .038909 •045434 85 67 5491° 2219 .040412 .048665 83 68 52691 2254 .042778 •052044 82 69 70 50437 48148 2289 2376 ■045383 .049348 •055988 .060956 81 81 71 45772 2519 •055033 .066862 82 72 43253 2779 .064250 .073682 87 73 40474 2921 .072170 .081540 88 74 37553 3101 .082577 .090042 92 75 34452 3243 .094131 .097988 96 76 31209 3127 .100195 . 105812 •95 Table VII. Mortality Table deduced from tlie zvholc experience of the Company. i Expectation. Age lO Log 4 4 d. d^ '4 Age. Mutual Life. American. 1 New Actuaries'. 1 5 .0000000 I 00000 603 .006029 52-03 48.72 50.29 10 II 4.9973739 99397 600 .006035 51-35 48.08 49-54 II 12 4-9947449 98797 597 .006043 50.65 47-45 48.73 12 13 4.9921 126 98200 594 .006051 49.96 46.80 47.89 13 14 4.9894766 97606 592 .006061 49-26 46. 16 47-03 14 IS 4.9868364 97014 589 .006072 48.56 45-50 46.16 15 16 4.9841914 96425 586 .006083 47-85 44.85 45-29 16 17 4.9815415 95839 584 .006097 47-14 44.19 44.44 17 18 4.9788856 95255 583 .006111 46-43 43-53 43-61 18 19 4.9762233 94672 580 .006128 45-71 42.87 42.82 19 20 4-9735536 94092 578 .006147 44-99 42 .20 42.06 20 21 4-9708757 93514 577 .006160 44-26 41 53 41.33 21 22 4.9681887 92937 575 .006191 43-53 40.85 40.60 22 ^3 4-9654915 92362 575 .006218 j 42.80 40.17 39-88 23 24 4.9627828 91787 573 .006247 42-07 39-49 39-15 24 25 4.9600613 91214 573 .006280 41-33 38-81 38.41 25 26 4-9573255 90641 572 .006316 40-59 38.12 37-66 26 27 4-9545736 90069 573 .006358 39-84 37-43 36.91 27 28 4-9518037 89496 573 .006404 39-09 36-73 36.16 28 29 4-9490137 88923 574 .006455 38-34 36-03 35-42 29 30 4.9462012 88349 1 575 .006513 37-59 35-33 34.68 30 31 4-9433635 87774 578 .006577 36.83 34-63 33-95 31 3- 4.9404976 87196 580 .006650 36.07 33-92 33-21 32 i^ 4-9376001 .86616 583 .006730 35-31 33-21 32-48 Z2, 34 4.9346673 86033 586 .006821 34.55 32.50 31-75 34 35 4-9316949 85447 592 .006922 33-78 31.78 31.02 35 36 4-9286783 84855 597 -007035 33.01 31-07 30.29 z(> 37 4.9256121 84258 603 .007162 1 32.24 30-35 29-56 37 38 4.9224904 83655 1 611 -007304 31.47 29.62 28.84 38 Table V 1 1. — c 'oiitimicd. ' KXPECTATION. Age, Log /, h >h '1. 7, Age. 83044 Mutual Life. American. New Actuaries'. 28.12 39 39 4 9193067 620 .007462 30.70 28.90 40 4 9160536 82424 630 .007641 29-93 28.18 27.40 40 41 4 9127226 81794 641 .007839 29-15 27-45 26.68 41 42 4 9093047 81153 654 .008062 28. 38 26.72 25.96 42 43 4 9057893 80499 669 .00831 1 27 .61 26.00 25-23 43 44 4 9021649 79830 686 .008589 26.83 25-27 24-51 44 45 4 8984185 79144 704 .008901 26.06 24-54 23-79 45" 46 4 8945355 78440 726 .009250 25.29 23.81 23.08 46 47 4 8904997 77714 749 .009640 24.52 23.08 ^-^-38 47 48 4 8862927 76965 776 .010077 23-76 22.36 2 1.68 48 1 49 4 8818942 76189 805 .010565 22.99 21.63 20.99 49 5° 4 8772814 75384 837 .011112 22.23 20.91 20.31 50 51 4 8724287 74547 874 .011723 21.48 20. 20 19.63 SI 52 4 8673074 73673 914 .012406 20.73 19.49 18.9s 52 S3 4 8618857 72759 958 .013171 19.98 18.79 18.28 53 54 4 8561275 71801 1008 .014026 19.24 18.09 17.62 54 55 4 8499928 7°793 1060 .014982 18.51 17.40 16.96 55 56 4 8434367 69733 1120 .016052 17.78 16.72 16.32 56 57 4 8364090 68613 1,83 .017247 17 .06 16.05 15.68 57 58 4 8288533 67430 1253 .018583 16.35 15-39 15-05 58 59 4 8207068 66177 1329 .020077 15.65 14.74 14.44 59 60 4 8118989 6484.S 1410 .021745 14.96 14.10 ^:.-'^?. 60 61 4 8023508 63438 7498 .023610 14. 28 13-47 13-24 61 62 4 7919742 61940 1591 .025692 13.62 1 2 . 86 1 2 . 66 62 63 4 7806703 60349 1691 .028018 12 .96 12.26 12.10 63 64 4 768328s 58658 1796 .030615 12.32 1 I .67 11-55 64 65 4 7548250 56862 1905 •033512 11 .70 n . 10 1 1 .01 65 66 4 7400213 54957 2020 ■036745 1 7 .08 10-54 10.49 66 67 4 7237624 52937 2136 •040352 10.49 10.00 9 • 9''^ 67 68 4 7058745 50801 2254 .044372 9.91 9-47 9.48 68 69 4 6861636 48547 2371 . 048S5 1 9-35 8-97 8.98 69 70 4 6644122 46176 2487 •053840 8.80 8.48 8.50 70 Table VII. — Continued. \ \ d ' Expectation. \ Age. \ Log 4 I, < 7 Age. ! 1 71 ^x Mutual Life. American. New Actuaries'. 8.03 1 4.6403768 1 43689 2594 1 ■059393 8.27 8.00 71 72 4-6137852 41095 2695 .065569 7.76 7-55 7-58 72 73 4.5843325 38400 2781 .072434 7.27 7. II 7-15 73 74 4-5516774 35619 2852 .080057 6.80 6.68 6-75 74 1 75 4.5154381 32767 2900 j .088516 6-35 6. 27 6.38 75 76 4.4751870 29867 2924 097892 5-92 5-88 6.02 76 77 4.4304457 26943 2917 I0827I 5-51 5.49 5-67 77 78 4.3806788 24026 2877 II9746 5-11 5-11 5-34 78 79 4.3252869 2 1 149 2801 132415 4-74 4-74 5-03 79 80 4-2635989 18348 2685 146378 4-39 4-39 4.72 80 81 4.1948644 15663 2534 161741 4.06 4-05 4-43 81 82 4.II82425 I3129 2345 178608 3-74 3-71 4-17 82 83 4.0327930 10784 2125 197085 3-45 3-39 3-93 83 84 3-9374627 8659 1881 217272 3-17 3-08 3-71 84 8s 3.8310736 6778 1622 239266 2 .91 2.77 3-51 85 86 3.7123065 5156 1357 263I5I 2.67 2.47 3-31 86 87 3-5796853 3799 1098 288995 2-45 2.18 3.10 87 88 3-4315578 2701 856 316849 2.24 1. 91 2.88 88 89 3.2660748 1845 640 346733 2.05 1.66 2.63 89 90 3.08II658 1205 456 378631 1.87 1.42 2.36 90 91 2.8745151 749 309 412492 1.71 1. 19 2.08 91 92 2.6435287 440 197 448207 1.56 .98 I 80 92 93 2. 3853049 243 n8 485612 1-43 .80 1.50 93 94 2.0965957 125 66 524480 ' 1.30 -64 J 20 94 95 1.7737642 59 33 564510 1. 19 -50 .93 95 96 I. 4127423 26 16 ! . 605332 ! 1.08 68 96 97 1.0089737 10 6 1 . 646501 .98 .50 97 98 0.5573619 4 1 3 1 • 687508 .87 98 99 0.0522004 I I i 727790 .70 ■ • , 99 Table VIII. Experience of Nezv Actuaries' , males, and of Mutual Life for each year of Insurance. N Ew Actuaries'. Years of Ratio -H T 1 T ■ r- T^ J -r • ^ of Mutual Insur- Mutual Life Rate. Life Act to New uaries'. iince. Exposures. Deaths. Rate. I 64247 295 .00459 .00498 1 08 2 117679-5 897 .00762 .00649 85 3 IO4313 1032 .00989 .00761 77 4 93668 1077 .01150 ■00855 74 S 84416.5 nil .01316 .00928 71 6 76689.5 1003 .01308 .01008 77 7 70086.5 999 .01425 •01035 73 8 63722.5 949 .01489 .01107 74 9 57685 885 •01534 .01002 65 10 52343-5 853 .01630 .01151 71 II 47207.5 850 .01801 .01220 68 12 42265 756 .01789 .01419 79 13 37994-5 757 .01992 .01360 68 14 34055-5 726 .02132 .01050 49 IS 30549 697 .02282 .01223 54 16 27147-5 662 .02439 •01444 59 17 24343-5 621 •02551 .01691 66 18 21604.5 518 .02398 .01861 78 19 19329-5 550 .02845 .01861 65 20 16996.5 483 .02842 .01900 67 21 15150 449 .02964 .01618 55 22 13537-5 449 -03317 .02125 ' 64 23 12006 412 -03432 .02644 77 24 10634.5 359 -03376 .02992 89 25 9294 345 .03712 .03278 88 26 7995 312 .03902 .02634 68 27 6945-5 323 .04650 .03016 65 28 6032 244 .04045 .02252 56 29 5214-5 236 .04526 .02632 58 30 4483 231 ■05153 ■02495 48 31 3872.5 183 .04726 .01878 40 Table IX. Experience of New Actuaries' , males, from ages 37 to 43 — Average age at entrance, 40. Ratio of Mutual Age. Exposures. Deaths. Rate. Adjusted Rate. Life to New Actuaries'. 40 12217 .5 46 -0038 .0052 I 00 41 22660 168 .0074 .0072 86 42 20361.5 195 .0096 .0089 81 43 18451 196 .0106 .0104 77 44 16856 217 .0128 .0117 75 45 15478 178 .0115 .0126 76 46 14273-5 196 -0137 •0134 76 47 13085 179 -0137 .0138 78 48 II946.5 169 .0141 .0147 78 49 i°934-5 I7S .0160 •0153 82 5° 9940 164 .0165 .0163 85 51 8971 148 -O165 •0173 83 52 8111.5 144 .0178 .0191 78 53 7331-5 137 .0187 .0207 76 54 6632 175 .0264 .0221 73 55 5858 150 -0256 .0234 68 56 5265 118 .0224 .0252 70 57 4724 no -0233 .0259 80 58 4267.5 131 -0307 .0270 72 59 3748.5 I02 .0272 .0283 77 60 3367 104 .0309 .0298 83 61 3°35 95 -0313 .0316 81 62 2719-5 86 .0316 .0340 80 63 2417 89 .0368 -0370 80 64 2123.5 88 .0414 .0402 79 65 1811.5 76 .0420 .0436 78 66 1585 85 -0536 .0472 75 67 1363 68 .0499 -0510 73 68 1187 60 ■0505 -055° 69 69 1032.5 73 .0707 -0593 66 70 886.5 46 -0519 .0637 63 Table X. Experience of New Actuaries , males, from ages o to 36. Average age at entrance, 29. Ratio of Mutual Age. Exposures. Deaths. Rate. Adjusted Rate. Life to New Actuaries'. 29 39273 146 .0037 -0037 I 00 30 71282.5 412 .0058 -0057 93 31 62626.5 474 .0076 .0073 90 32 55778.5 467 .0084 .0085 89 zz 49834-5 493 .0099 -0095 87 34 44971-5 433 .0096 .0101 85 35 40933 415 .OIOI .0103 83 36 37137-5 367 .0099 .0102 t 83 37 33562.5 338 .0101 .0105 81 38 30360 -S 314 .0103 .0106 82 39 27323 329 .0120 .0111 80 40 24392 259 .0106 .0117 78 41 21906.5 272 .0124 .0122 75 42 19637 272 .0139 .0129 74 43 17609.5 214 .0122 -0137 72 44 15711-5 229 .0146 .0143 71 45 14121.5 227 .0161 .0148 68 46 12515 193 -0154 .0156 1 68 47 11206 176 -0157 .0163 67 48 9885.5 166 .0168 .0169 1 68 49 8856 148 .0167 .0179 70 50 7957 157 .0197 .0186 i 78 51 7100 154 .0217 .0193 86 52 6345-5 119 .0188 .0201 91 53 5575-5 113 .0203 .0211 92 54 4853-5 97 .0200 .0223 88 55 4268 121 .0284 .0237 82 56 3762.5 87 .0231 -0253 73 57 3273-5 85 .0260 .0272 61 58 2847.5 89 .0312 .0292 49 59 2498 78 .0312 -0314 -36 Table XL Experience of New Actuaries', males, from ages 44 to 54. Average age at entrance, 49. Ratio Df Mutual Age. Exposures. Deaths. Rate. Adjusted Rate. i Life to New Actuaries'. 49 9585-5 63 .0067 .0080 I GO 50 17806.5 170 .0095 .0105 82 51 16076 218 .0136 .0129 73 52 14664.5 233 •0159 ■0150 69 S3 13405 221 .0165 .0169 69 54 12318 235 .0191 .0187 70 55 II317 237 .0209 .0202 ''I 56 10301.5 216 .0210 .0216 76 57 9364 212 .0226 •0233 79 58 8559-5 207 .0242 .0250 77 59 7749-5 216 .0279 .0275 70 60 6970 200 .0287 .0300 62 61 6298 215 ■0341 -0325 58 62 5620.5 200 •0356 ■0352 59 63 5022 187 .0372 .0380 64 64 4478.5 184 .0411 .0400 73 65 4018.5 178 •0443 .0426 82 66 3562 147 •0413 .0456 85 67 3162.5 159 •0503 .0482 89 68 2790.5 150 -0537 •0515 91 69 2449 131 ■053s .0567 92 70 2164.5 130 .0601 .0616 96 71 1895-5 130 .0686 .0668 99 72 1638 119 .0727 •0743 V 73 1401 106 -0757 .0812 87 74 1189.5 115 .0967 .0876 77 75 989 97 .0981 •0934 65 76 830-5 73 •0879 .0986 51 77 697 72 -1033 •1033 36 78 568 64 .1127 .1074 19 79 463 50 . 1080 . IIO9 Table XII. Experience of Nezv Actuaries', males, from ages 55 to 75. Average age at entrajice, 59. 'Ratio of Mutual Age. Exposures. Deaths. 1 ?ate. Adjusted Rate. \ Life to New 1 Actuaries'. 1 59 3151-5 39 0124 0154 I 00 60 5896 146 0248 0213 80 61 5221-5 143 0274 0270 71 62 4752 180 0379 0324 67 63 4302 176 0409 0377 66 64 3908 155 0397 0429 66 65 3551 147 0414 0478 67 66 3191 186 0583 0525 70 67 2806 164 °S8S °S73 72 68 2485 157 0632 0630 73 69 2191 140 0639 0678 71 70 1929 148 0767 0722 73 71 1676.5 126 0752 0777 72 72 1464 5 116 0792 0821 69 73 1284 5 121 0942 0860 71 74 1098 5 98 0892 0903 76 75 938 5 98 1044 0982 1 75 76 803 5 68 0846 1038 t 72 77 693 5 84 1211 ^m 1 74 78 572 65 1136 1252 69 79 478 66 1381 1358 73 80 381 67 1759 1403 76 81 291 42 1443 1559 77 82 234 32 1368 1625 83 83 194 38 1959 1725 1 85 84 140-5 24 1708 1858 84 85 i°3-5 20 1932 i 2026 81 86 76 16 2105 2227 76 87 57 19 3333 1 2463 70 88 35 5 1429 2732 63 89 25 9 3600 3035 57 Table Xlll. Comparison of the actual mortality^ all ages combined, with that predicted by the American and Ah'-zv Actuariei Tables, for different years of Insurance. Probable DFATHq ^'^■"° "'' Actual to UEATHS. ProbAIILE. Years of Years of Life Exposed. Actual Deaths. Insur- ance. 247 American. New Actuaries'. '^™^ rican. New Actuaries'. I 49647-5 485-79 491.19 508 503 n 86929.5 564 872.79 891.76 646 632 3 74939 57° 776.86 801 .30 734 711 4 66224.5 566 708.26 738-51 799 766 5 58277 541 643.84 676 .90 840 799 6 49609 500 567.21 600.83 882 832 7 39409 408 465.42 496.07 877 822 8 28636 317 348.45 373-32 910 849 9 19968.5 200 248.97 267 .96 803 746 lO 15289 5 176 194.74 210.36 904 837 II 12542 5 153 165 . 10 178-93 927 855 12 10710 5 152 146.83 159-59 I 035 952 13 9485 5 129 136.01 148. II 948 871 14 8574 5 90 128.84 140-43 699 641 15 7519 5 92 118.97 128.73 773 715 i6 6580 5 95 no. 18 120.06 j 862 791 17 5736 97 101-53 110.52 955 878 i8 4944-5 92 92.53 100.64 994 914 19 4137 77 82.57 90.67 933 849 20 3473 66 74.03 80.9s 892 81S 21. 2967 48 67.91 73-10 707 657 22 2635-5 56 64.07 68.76 874 814 23 2345 62 60.72 64.80 I 021 957 24 2072 62 56.87 60.47 I 090 I 025 25 1738.5 57 51.45 56.00 I 108 I 018 26 1291 34 40.54 42.48 839 800 27 961.5 29 32.00 33-64 906 862 28 666 15 24.32 25-31 617 593 29 456 12 17.93 18.52 669 648 30 240.5 6 10.53 10.63 570 -564 31 106.5 2 5-IO 5.22 .392 •3«3 Totals, 578112 5 5515 6900.36 7265.76 .799 •759 Table XIV. Shoiving the 7iuinbcr of entrants at the different ages, the number of deaths ont of the same in after years, and the ratio of the actual deaths to the deaths expected by the American Table. Age at Entrance. Number of Entrants. Rati( Deaths. tual bable 3 of Ac- to Pro- Deaths. Age at Entrance. 20 80s 24 850 48 21 1425 49 947 49 22 2003 62 812 5° 23 2588 lOI 965 51 24 3°45 106 828 52 25 3855 128 770 53 26 3828 156 887 54 27 4128 170 888 55 28 4342 174 784 56 29 4341 168 746 57 30 4717 213 814 58 31 4394 199 820 59 32 4353 202 785 60 Z7, 4387 202 793 61 34 4344 219 820 62 35 4236 213 782 63 36 4110 203 774 64 37 3754 213 838 65 38 3555 195 1 785 66 39 3302 194 809 67 40 3480 189 757 68 41 2885 160 744 69 42 2704 173 803 70 43 2429 178 ; 898 71 44 2232 169 878 72 45 2105 147 765 73 46 1864 126 769 74 47 1562 98 635 75 Number of Entrants. 1513 1321 1296 973 923 763 680 529 464 391 357 235 202 147 123 80 61 41 14 20 II 10 6 5 I 2 I I Deaths. 119 120 115 90 84 64 82 54 57 5° 38 34 32 25 19 18 14 8 6 5 3 I 4 2 I I o I Ratio of Ac- tual to Pro- bable Deaths. 795 828 80s 849 720 653 832 708 823 833 573 846 957 686 716 956 949 538 554 406 716 224 932 725 833 1-538 Table XV. 1 lie ratios of actual mortality to that predicted by the American Table diiring each quinquennium following the date of Insurance. Age at Entrance. ISt' Five Years. 2d Five Years. 20 to 24 ■775 1.003 25 to 29 .714 •983 3° to 34 .716 .911 35 to 39 .694 ■843 40 to 44 •723 .896 45 to 49 .674 .801 5° to 54 ■730 •753 55 to 59 •633 •833- 60 to 75 .806 .781 Ratios during 3d Five Years. 1-143 .787 • 931 000 880 730 741 869 1. 105 4th Five Years. 5th Five Years. 6tli Five Years. I .066 I . 229 •45° .848 i^°55 I .000 .917 .806 ■731 .860 ■938 .969 ■977 ■936 ■532 1 . 126 .916 .516 .870 1.264 .871 .902 1. 189 .862 .582 .172 .833 Average for whole time. 879 812 806 797 811 758 774 747 789 Table XVI. The influence of duration of Insurance on the ratios of actual to probable mortality, by the American Table. Ratios of Actual to Probable Mortality among Persons who had BEEN Insured. Age at Death. i 5 years or less. 6 to 10 years. II to 15 years. 16 to 20 years. 21 to 25 years. 26 to 31 years. 20 to 24 .810 .861 .... 25 to 29 .690 '•135 • 529 30 to 34 .689 .984 1.088 35 to 39 ■754 ■965 .907 . 762 40 to 44 .662 .807 ■930 I .005 I .098 45 to 49 .769 .867 .877 .917 .875 ■935 5° to 54 •673 •837 1 .017 .820 1. 018 •957 55 to 59 .690 .817 .805 .911 • 803 .708 60 to 64 •75° ■757 • 799 1.015 .911 .980 65 to 69 .926 .790 ■ 599 1 . 127 1-045 .681 70 to 74 .651 .782 .921 .831 1. 136 •519 75 to 79 .602 1 . 124 1 .096 ■ 954 1 .067 .663 80 to 84 ■713 .877 ■ 347 .927 .742 •763 Total Experience. .885 ■ 947 •751 20 21 22 23 24 25 26 27 28 29 3° 31 32 33 34 35 36 37 38 39 4° 41 42 Tablk XVIT. First Years Experience, Mutual Life. Exposures. 383 681 947-5 1240.5 1470 1856 1847 1990 2114 2II3-S 2291 2142 2121 2135-5 2122 .5 2069 2003 1830 1746 1622 1705 1414 1330 Deaths. I 4 3 2 5 8 7 7 12 4 6 1 1 4 6 IS 9 II 8 7 1 1 5 Rate. |Adjus,tL-d Rate. Computed Deaths. .00261 .00587 .00317 .00161 .00340 .00431 .00379 •00352 .00568 .00189 .00262 -00514 .00189 .00281 .00707 •00435 -00549 .00437 .00401 .00678 .00293 .00212 ,00376 00317 00321 00325 00329 00334 00340 00346 00352 00359 00367 00375 00384 00394 00405 00417 00430 00444 00460 00477 00495 00515 00537 00562 Sum OF Deaths. Actual. Computed. I I . 2 5 3-4 8 6-5 10 10.6 : 15 15^5 23 21.8 30 28.2 37 35^2 49 42.8 S3 50.6 59 59-2 70 67.4 74 75^8 80 84.4 95 93-3 104 102 . 2 115 III . I 123 "9-5 130 127.8 141 I3S-8 146 144.6 149 152.3 154 IS9-8 Table XVll. — Continued. Age. Exposures. Deaths. Rate. Adjusted Rate. Computed Deaths. Sum Actual. OF Deaths. Computed. 43 1198.5 8 .00667 .00588 7 162 166.8 44 1095 8 .00731 .00617 6 8 170 173-6 45 1027 8 .00779 .00647 6 6 178 180.2 46 913-5 5 .00547 .00681 6 2 183 186.4 47 764-5 9 .01177 .00719 5 5 192 191-9 48 745 6 .00805 .00759 5 6 198 197-5 49 647-5 6 .00927 .00803 5 2 204 202 . 7 50 635 5 .00787 .00852 5 4 209 208.1 51 473 s .01057 .00905 4- 3 214 212 .4 5^ 455 5 .01099 .00962 4 4 219 216.8 53 375 2 -o°533 .01025 3 8 221 220.6 54 335 2 .00597 .01093 3 7 223 224.3 55 258 3 .01163 .01168 3 226 227.3 56 225-5 I .00443 .01250 2 8 227 230.1 57 188. s 2 -oi°55 •01339 2 5 229 232.6 58 175 2 .01143 .01436 2 5 231 235-1 59 114 ^ .00877 -01543 1 8 232 236.9 60 99-5 4 .04020 -01659 1 7 236 238.6 61 73 2 . 02740 .01785 I 3 238 239-9 62 61 I .01639 .01923 I 2 239 241 . 1 63 39-5 2 .05063 .02074 8 241 241.9 64 3° I -°3333 .02238 7 242 242 .6 65 20 I .05000 .02418 5 243 243-1 Table XVIII. Mutual Life Experience from ages o to 36. Average age at entrance, 29. Age. Exposures. Deaths. 29 30017 30 52185-5 .^I 44297 32 38852 33 34023.5 34 28753-5 3.S 22863.5 36 16771.5 37 "953-5 3S 9369 39 7778.5 40 6689 41 5924-5 42 5392 43 4729-5 44 4148 4.S 3607 46 3131-5 47 2616 48 2199.5 49 1869.5 ,Sc^ 1671.5 51 1499-5 .S2 1334-5 ,S3 1116.5 M 833 ,S,S 618 S6 419 .S7 286 .S8 152-5 59 62 119 299 286 266 274 250 203 152 82 78 64 70 60 49 40 44 35 41 27 26 20 18 26 32 18 16 14 10 6 o I Adjusted Rate. .0040 .0057 .0065 .0068 .0081 .0087 .0089 .0091 .0069 .0083 .0082 .0105 .0101 .0091 .0085 .0106 .0097 .0131 .0103 .0118 .0107 .0108 0173 .0240 .0161 .0192 .0227 .0239 .0210 .0000 .0161 .0037 -°053 .0066 .0076 .0083 .0086 .0086 .0085 .0085 .0087 .0088 .0091 .0092 .0096 .0098 .0101 .0101 .0106 .01 10 .0115 .0125 ■ 0145 .0164 .0182 .0193 .0197 .0194 .0184 .0167 .0143 .0112 1st Year's Rate. Ratio. .0037 I .00 .0038 I .40 .0039 I .69 .0040 I .90 .0041 2 .02 .0042 2.05 .0043 2 .00 .0044 1-93 .0046 1.85 .0048 1.80 .0050 1.76 .0052 1-75 .0054 1.70 .0056 1. 71 .0059 1.66 .0062 1.63 .0066 1-53 .0068 1.56 .0072 1-53 .0076 1-51 .0080 1-56 .0085 1. 71 .0090 1.82 .0096 . 1 .90 .0102 1.89 .0109 1. 81 .0117 1.66 .0125 1.47 •0134 1.26 .0144 ■99 ■0154 -73 Table XIX. Mutual Life Experience from ages 37 to 43. Average age at entrance, 40. Age. Exposures. Deaths. Rate. Adjusted Rate. 1st Year's Rate. Ratio. 40 10845. s 47 .0043 .0052 .0052 I .00 41 19241 126 .0065 .0062 .0054 I -15 42 16922 119 .0070 .0072 .0056 I .29 43 15119 138 .0091 .0080 .0059 1.36 44 13455 "3 .0084 .0088 .0062 1.42 45 H638 116 .0100 .0096 .0066 1-45 46 9324 92 .0099 .0102 .0068 1-5° 47 6808 65 .0095 .0108 .0072 1.50 48 4686 52 .0111 .0114 .0076 1-5° 49 3578 50 .0140 .0125 .0080 1.56 5° 2930-5 32 .0109 .0139 .0085 1 .64 51 2488. s 42 .0169 •0143 .0090 1-59 52 2219 40 .0180 .0149 .0096 1-55 S3 1992 23 .0115 .0158 .0102 1-55 54 ^752.5 33 .0188 .0161 .0109 1.48 55 1517 22 .0145 .0160 .0117 1-37 56 1352 26 .0192 .0176 .0125 1. 41 57 II52 15 .0130 .0186 •0134 1-39 58 974-5 23 .0236 .0194 .0144 1-35 59 824.5 22 .0267 .0218 .0154 1.42 60 710 9 .0127 .0247 .0166 1.49 61 628.5 21 •°334 -0255 .0179 1-43 62 554-5 15 .0271 .0273 .0192 1.42 63 492-5 12 .0244 .0297 .0207 1-43 64 424-5 18 .0424 .0319 .0224 1.42 65 322.5 9 .0279 •0338 .0242 1 .40 66 250 8 .0320 -°355 .0261 1.36 67 179 3 .0167 .0370 .0283 1-31 68 128.5 6 .0467 .0382 .0307 1.24 69 67 4 -0597 -0393 ■0332 1. 18 70 33 I -0303 .0400 -°359 1 . II Table XX. Mutjial Life Experience from ages 44 to 54. Average age at entra7ice, 49. Age. Exposures. Deaths. Rate. Adjusted Rate. 1st Year's Rate. Ratio. 49 7465-5 61 .0082 .0080 .0080 I .00 5° 13215-5 log .0083 .0086 .0085 I .01 51 11690 128 .0109 .0094 .0090 I .04 52 10468.5 116 .0111 .0104 .0096 1.08 S3' 9247-5 108 .0117 .0116 .0102 I. 14 54 7922 94 .0119 .0130 .0109 I. 19 55 6246.5 88 .0141 .0147 .0117 I .26 56 4406 75 .0170 .0165 .0125 1.32 57 2914-5 49 .0168 .0184 -0134 1-38 58 2071.5 37 .0179 .0192 .0144 1-33 59 1635-5 46 .0281 .0192 .0154 1-25 60 1375 30 .0218 .0186 .0166 1 .12 61 1210 23 .0190 .0188 .0179 i-°5 62 1076.5 II .0102 .0206 .0192 1.07 63 942 14 .0149 .0243 .0207 1. 17 64 836.5 25 .0299 .0292 .0224 1.30 65 709 30 .0423 .0348 .0242 1 .46 66 607.5 30 .0494 .0388 .0261 1-5° 67 5°4-5 25 .0496 -0431 .0284 1-52 68 4II-S 15 -0365 .0468 .0307 i-53 69 355 15 .0423 -0523 ■0332 1.58 70 311-5 15 .0482 .0591 .0360 1 .64 71 271-5 18 .0663 .0659 .0390 1 .69 72 230 18 .0783 .0698 .0423 1.65 73 183-5 17 .0927 .0702 -0459 I-S3 74 129-5 8 .0618 .0671 .0499 1-34 75 88.5 6 .0678 .0606 .0542 1 . 12 76 65 2 .0308 .0506 77 39-5 .0000 ■0371 78 19 I .0526 .0201 .... 79 II-5 .0000 .0000 Table XXI. Mutual Life Experience from ages 55 to 75. Average age at entrance, 59. Age. 1 59 Exposures. j 1 Deaths. 20 Rate. Adjusted Rate. 1st Year's I ^ate. R alio. .00 1319-5 .0152 .0154 .0154 I 60 2287.5 3° .0131 .0171 .016 6 1-03 61 2030 37 .0182 .0192 .017 8 1.08 62 1785 46 .0258 .0217 .019 2 1.13 63 1551 46 .0297 .0248 .020 7 1 . 20 64 1295-5 40 .0309 .0282 .022 4 1 .26 65 975 25 .0256 .0321 .024 2 1-33 66 65°-S 25 .0384 .0366 .026 I 1 .40 67 414-5 17 .0410 .0414 .028 3 1-46 68 271 1 1 .0406 .0462 .030 7 1-51 69 198 II •0556 .0479 •033 2 1.44 70 158 10 -0633 .0524 -°35 9 1.46 71 132 6 ■045 s -°556 •°39 1-43 72 114 7 .0614 -0565 .042 3 1-34 73 95-5 5 .0524 .0612 • 045 9 1-33 74 79 4 .0506 .0682 .045 9 1-37 75 68 6 .0882 -0733 -054 P 1-35 76 53-5 6 . II2I •0745 77 42 2 .0476 •0835 78 37-5 3 .0800 .0868 79 32-5 4 .1231 -°995 80 24 2 ■0833 .1065 81 19-5 3 ■1538 . 1206 82 15 .0000 -1345 83 14 4 -2857 • 1463 84 6 I .1667 •1559 85 5 I . 2000 •1635 86 3 .0000 .1689 87 .0000 . 1722 88 3 I .5000 •1733 89 1 .0000 .1723 Table XXII. Experience of the Neiv Actuaries' , males, from ages 20 to 24. Average age at entrance, 22. ! ; Ratio of Mutual Age. Exposures. Deaths. i Rate. Adjusted Rate. Life to New Actuaries'. 22 7279 22 .0030 i -0033 I .00 23 12857.5 76 .0059 .0051 .96 24 10845.5 79 .0073 .0065 1 •97 25 - 9366.5 53 -0057 .0077 •94 26 8116 69 .0085 .0085 9i 27 7152 68 .0095 .0091 91 28 6363 62 .0097 .0094 88 29 5641 56 .0099 .0094 85 30 5011-5 41 .0082 .0097 81 31 4472.5 45 .0101 .0097 89 32 3959-5 44 .0111 .0104 88 33 3504-5 29 .0083 .0110 91 34 3095 43 .0139 .0120 87 35 2717 32 .0118 .0129 84 36 2415-5 2,(> .0149 .0140 76 37 2148 28 .0130 .0141 79 38 1923 i(> .0187 .0146 72 39 1693-5 20 .0118 .0144 72 40 1486.5 25 .0168 -0137 77 41 1293-5 14 .0108 .0136 83 42 1166.5 8 .0069 .0142 85 43 1053-5 22 .0209 -0137 97 44 917-5 17 .0185 .0136 I. 02 45 830-5 8 .0096 .0146 96 46 734 8 .0109 .0153 86 47 636 11 .0173 •0157 74 48 549 9 .0164 .0157 58 49 490 7 .0143 •0155 37 5° 433 5 -OI15 .0149 10 51 376 8 .0213 .0140 52 327 4 .0122 1 .0128 Table XXIII. Alutual Life Experience from ages 20 io 24. Average age at entrance, 25 Age. Exposures. Deaths. Rate. Adjusted Rate. ist Year's Rate. Ratio. 22 4722 IS .0032 •0033 -0033 I .00 23 8018. s 53 .0066 .0049 -0033 1.48 24 6524-5 56 .0086 .0063 •0033 I. 91 25 5527-5 36 .0065 .0072 .0034 2.12 26 4697 24 .0051 .0079 -°035 2.26 27 3842 40 .0104 .0083 ■°°35 2-37 28 2941-5 17 .0058 .0083 .0036 2.31 29 2031 18 .0089 .0080 .0037 2.16 30 1425 II .0077 .0079 .0038 2.08 31 1096.5 9 .0082 .0086 .0038 2 .26 32 908 6 .0066 .0092 .0039 2.36 17, 775-5 7 .0090 .0101 .0041 2.46 34 688 II .0160 .0104 .0042 2.48 35 623-5 8 .0128 .0108 .0043 2-51 36 539-5 4 .0074 .0107 .0044 2-43 37 463 4 .0086 .0111 .0046 2.41 38 391 2 .0051 0105 .0048 2.19 39 326. S 8 -0245 .0104 .0050 2.08 40 255-5 2 .0078 .0106 .0052 2 .04 41 205 -5 I .0049 .0113 .0054 2 .09 42 168. s 2 .0119 .0120 .0056 2.14 43 146 I .0068 -0133 .0059 2.25 44 133 3 .0226 .0139 .0062 2.24 45 II9-5 2 .0167 .0140 .0065 2-15 46 95 I .0105 .0132 .0068 1-94 47 58 I .0172 .0116 .0072 1. 61 48 38 .0091 .0076 1 . 20 49 26 .0057 .0080 -71 50 18 .0015 .0085 .18 51 12-5 .0091 52 7 .0096 Table XXIV. Mortality experience of tlie Mutual Life, excluding the first five years of Insurance. J — ' Ratio of Actual Deaths to Years of Life Actual Age. Exposed. Deaths. Probable Exposed. Deaths, Probable ^^^^ Deaths, New Am erican. Actuaries'. o to lO 131-5 I . . . . to 10 II 27 . . . . II 12 26 . . . . 12 13 23 13 14 20 14 IS 18 15 16 17-5 16 17 20 17 18 16 18 19 28. s 19 20 52-S I .019048 j 2. 441 2 •933 20 21 75 . . . . 21 22 112-5 I .008889 t I. 124 I .284 22 23 189.5 3 .015831 I. 389 2 .279 23 24 333-5 24 25 537 7 .013035 I. 5i6 862 25 26 878.5 10 .011383 I. 4.00 604 26 27 1396 9 . .006447 787 879 27 28 2050.5 18 .008778 I.( D62 157 28 29 2754-5 26 .009439 I. t3i 205 29 30 3641 21 .005768 .( 384 715 30 31 4398 38 .008640 I.t =15 051 31 32 5180.5 37 .007142 A 329 854 32 33 5986 58 .009689 I. [II 133 33 34 6678 67 -010033 I- 36 146 34 35 7572-S 6g .009112 I.C 321 013 35 36 8117 66 .008131 .{ ?95 872 36 37 8569-5 73 .008519 .( J23 901 37 38 8945 -5 81 .009055 .t )62 906 38 39 9442 86 .009108 .c )5o 887 39 40 9731 95 -009763 .c )97 930 40 41 9826 74 .007531 53 70s 41 42 9772.5 79 .008084 ./ 88 741 42 43 9760.5 76 .007786 .7 40 690 43 44 9599.5 104 .010834 I.C 00 924 44 45 9645 84 .008709 .5 80 707 45 46 9304 92 .009888 .i 55 760 46 47 8896.5 104 .011690 .c 74 852 47 48 8445 99 .011723 .c 37 813 48 49 8039 88 .010947 .i 35 724 49 5° 7594.5 95 .012509 .5 08 793 1 SO Table XXW.— Continued. Age. Years of Life Actual Ratio of Actual Deaths TO Age. Exposed. Deaths. Probable Probable Exposed. Deaths, Deaths, New American. Actuaries'. SI 7094 86 .012123 ■834 , ■ 734 51 52 653° 88 .013476 876 778 52 53 6138 86 .014011 858 765 53 54 5686 100 -017587 I . Oil 904 54 55 5245-5 97 .018492 996 895 55 56 4621. s 69 .014930 751 680 56 57 4II9 69 .016752 785 716 57 58 3605 61 .016921 738 680 58 59 3232 67 .020730 839 776 59 60 2849 68 .023868 894 831 60 61 2534 69 .027230 943 877 61 62 2183. 51 -023362 747 694 62 63 1887. 5 50 .026490 780 726 63 64 1600 57 -035625 966 905 64 65 1350-5 46 .034061 849 805 65 66 1126 48 .042629 975 938 66 67 93° 40 .043011 903 884 67 68 753-5 36 .047777 919 918 68 69 611 23 -037643 663 672 69 70 507-5 24 .047291 763 776 70 \ 71 406 ^3 .056650 837 847 71 72 319 24 •075235 I 020 I 021 72 ] 73 249-5 15 »o6oi2o 750 737 73 74 172 15 .087209 I 002 968 74 75 136-S II .080586 854 1 822 75 76 TOO II . IIOOOO I 075 I 040 76 77 72.5 12 ■165517 I 490 I 462 77 78 50.5 3 .059406 492 491 78 79 38-5 3 .077922 592 602 79 80 30-5 5 ■163934 I 135 I 182 80 81 18 2 .mill 701 745 81 1 82 14-5 2 -137931 791 i 858 82 83 9 I . iiim 580 638 83 84 6 84 85 5 I . 200000 849 : 987 85 86 3 ... 86 87 3 i ° 87 88 2 88 89 2 — 1 89 90 2 I .500000 I .100 1 I 800 90 91 I 91 92 I I I .000000 I ■587 . 3 ■333 92 Totals.. . 242095 3027 •012503 .887 . .826 Table XXV. Synopsis of Table AWII'., in groups of five years. Probable Deaths. 1 Ratio of Actual to Probable. Age. Years of Life Exposed. Actual Deaths i American. New Actuaries'. American. ! New 1 Actuaries'. 1 o to 14 1 ! 227-5 r 1 2.15 1-45 -465 .690 15 to 19 100 .76 ■51 .000 .000 20 to 24 763 5 6 .07 5-42 .824 -923 25 to 29 7616.5 70 62.85 57-6i I . 114 I . 215 30 to 34 25883.5 221 223.86 218.78 .987 I .010 35 to 39 42646.5 375 395-32 413-42 -949 .907 40 to 44 48689.5 42S 5°o-43 536.75 -855 •797 45 to 49 44329-5 467 533 605-54 .876 .771 50 to 54 33°42.S 4S5 5°7-46 573-33 .897 -794 55 to 59 20823 i(>Z 439-77 482.31 .825 •753 60 to 64 11053-5 295 340.61 366.06 .866 .806 65 to 69 4771 ^93 221.57 227.27 .871 •849 70 to 74 1654 lOI 117.42 117.66 J .860 .858 75 to 79 398 40 42.33 43-5-' -945 .919 80 to 84 78 10 12.78 11.94 .782 .838 85 to 89 15 I 4-37 1 3-37 1 .229 ! .297 90 to 92 4 2 2.07 1. 16 .966 1.724 Totals, 24209s 3027 3412.82 3666.10 ; ..S87 .826 Table XXVI. Mutual Life Experience — exeludmg the first five years of Insurance. by Interpolation. Adjusted Age. 4 d. d. Age. 25 95304 903 ■009475 SI 26 94401 814 .008623 52 27 93587 842 .008997 53 28 9274s 796 .008583 54 29 91949 735 .007994 55 3° 91214 730 .008003 56 31 90484 750 .008289 57 32 89734 733 .008169 58 33 89001 771 .008663 59 34 88230 782 .008863 60 35 87448 789 .009023 61 36 86659 784 .009047 62 37 85875 767 .008932 63 38 85108 755 .008871 64 39 84353 738 .008749 65 40 83615 716 .008563 66 41 82899 701 .008456 67 42 82198 713 .008674 68 43 81485 710 .008713 69 44 80775 735 .009099 70 45 80040 773 .009658 71 46 79267 816 .010294 72 47 78451 830 .010580 73 48 77621 868 .011183 74 49 76753 901 .011739 75 5° 75852 930 .012261 76 74922 73957 72928 71851 70746 965 1029 ro77 1105 "44 1180 68422 1207 67215 I26I 65954 1352 64602 1426 63176 1523 61653 1670 59983 1784 58199 1897 56302 2008 54294 2126 52168 2132 50036 2195 47841 2243 45598 2322 43276 2426 40850 2656 38194 2763 35431 2921 32510 3063 29447 2982 .013913 .014768 •015379 .016170 .016954 .017641 .018761 .020499 .022073 .024107 .027087 .029742 ■ 03259s ■035665 ■039157 .040868 .043868 .046884 .050923 .056059 .065018 .072341 .082442 .094217 . IOI267 Table XXVII. Mortality Table deduced from the experience of tlic Mutual Life, excluding the first five years of Insurance. Age. Log 4 4 d. -'f ■ Expectation. Age. lO 5 .0000000 lOOOOO 810 008102 49-39 10 II 4 9964672 99190 804 008105 48 79 II 12 4 9929327 98386 798 0081 10 48 18 12 13 4 9893964 97588 792 0081 15 47 57 13 14 4 9858578 96796 786 008120 46 95 14 IS 4 9823169 96010 780 008127 46 34 15 16 4 9787732 95230 775 008134 45 71 16 17 4 9752264 94455 769 008142 45 08 17 18 4 9716761 93686 763 008151 44 45 18 19 4 9681218 92923 759 008161 43 81 19 20 4 9645630 92164 753 008173 43 17 20 21 4 9609991 91411 748 008186 42 52 21 22 4 9574295 90663 744 008200 41 86 o 2 23 4 9538534 89919 739 008217 41 21 23 24 4 9502699 89180 734 008236 40 54 24 25 4 9466781 88446 730 008258 39 88 25 26 4 9430769 87716 727 008282 39 20 26 27 4 9394650 86989 723 008310 38 53 27 28 4 9358411 86266 719 008341 37 85 28 29 4 9322036 85547 717 008376 37 16 29 30 4 9285507 84830 714 008416 2>(> 47 30 31 4 9248803 841 1 6 711 008560 35 77 31 32 4 9211903 83405 710 008512 35 08 32 ■hi 4 9174779 82695 709 008569 34 37 Zi 34 4 9137404 81986 708 008634 Zh 67 34 35 4 9099744 81278 708 008708 32 95 35 36 4 9061761 80570 708 008791 32 24 i(> 37 4 9023413 79862 709 008885 31 52 37 38 4 8984652 79153 712 008992 30 80 38 Table XXVII. — Continued. Age. Log 4 4 d:. ^-'f Expectation. Age. 39 4-8945425 78441 715 .009112 30.07 39 40 4 8905671 77726 719 .009248 29^35 40 41 4 8865319 77007 724 .009402 28.61 41 42 4 8824292 76283 730 .009577 27.88 42 43 4 8782501 75553 739 .009773 27^15 43 44 4 8739847 74814 748 .009996 26.41 44 45 4 8696215 74066 759 .010248 25.67 45 46 4 8651478 73307 772 •010533 24^93 46 47 4 8605491 72535 787 .010855 24.19 47 48 4 8558091 71748 805 .011219 23^45 48 49 4 8509091 70943 825 .011631 22.71 49 5° 4 8458283 70118 848 .012096 21.97 50 51 4 8405429 69270 875 .012622 21 . 24 51 52 4 8350261 68395 904 .013217 20.50 52 53 4 8292476 67491 937 .013890 19.77 53 54 4 8231731 66554 975 .014650 19.04 54 55 4 8167638 65579 1017 .015508 18.32 55 56 4 8099758 64562 1064 .016479 17.60 56 57 4 8027594 63498 1116 •017575 16.88 57 58 4 7950586 62382 1174 .018814 16.18 58 59 4 7868098 61208 1237 .020214 15-48 59 60 4 7779412 59971 1307 .021794 14^79 60 61 4 7683716 58664 1383 .023578 14. 10 61 62 4 7580091 57281 1466 .025592 13-43 62 63 4 7467497 55815 1555 .027866 12.77 63 64 4 7344760 54260 1652 .030431 12 . 12 64 65 4 7210549 52608 1753 •033323 11.49 65 66 4 7063362 50855 i860 •036585 10.87 66 67 4 6901496 48995 1973 .040261 10.26 67 68 4 6723029 47022 2088 .044401 9.67 68 Table XXVII. — Continued. Age. Log 4 4 d. ^-f Expectation. .Age. 69 4-6525784 44934 2204 .049063 9 . 10 69 70 4.6307300 42730 2321 •054309 8.54 70 71 4.6064794 40409 2433 .060207 8.00 71 72 4-5795116 37976 2538 .066834 7.48 72 73 4-5494706 35438 2632 .074273 6.98 73 74 4-5159536 32806 2710 .082616 6.50 74 75 4.4785049 30096 2768 .091961 6 .04 75 76 4.4366094 27328 2799 . 102417 5.60 76 77 4.3896840 24529 2799 . 114098 5^19 77 78. 4.3370696 21730 2762 . 127128 4^79 78 79 4. 2780204 18968 2687 -141633 4.42 79 80 4.2116933 16281 2568 •157750 4.06 80 81 4-1371342 13713 2408 -17561S 3-73 81 82 4.0532642 11305 2209 .195366 3-42 82 83 3.9588628 9096 1975 -217135 3-13 83 84 3-8525499 7121 1716 .241048 2-85 84 85 3.7327642 5405 1445 .267217 2 .60 85 86 3-5977398 3960 1171 .295729 2-37 86 87 3-4454796 2789 911 .326644 2-15 87 88 3-2737243 1878 676 -359979 1 .96 88 89 3.0799188 1202 476 •395697 1-77 89 90 2.8611732 726 315 •433702 1. 61 90 91 2 .6142183 411 195 ■473814 1 .46 91 92 2-3353572 216 III •515771 1.32 92 93 2 .0204079 105 59 •559209 1 .20 91, 94 I .6646401 46 28 .603664 1.08 94 95 I .2627040 18 12 .648565 .98 95 96 0.8085491 6 4 .693252 .88 96 97 0-2953304 2 2 .736988 -73 97 Table XXVIII. Net Annual Preiniums to insure $10,000. According to Age. According to Age. Difference. Diiference. Actual American Actual American Experience. Table. Experience. Table. (l) (2) (3) (4) (0 (2) (3) (4) 25 92.28 142.11 49-83 46 205.13 282.73 77.60 26 94-79 145-7° 5° 91 47 215-63 294 99 79-36 27 97-49 149.48 51 99 48 226.89 308 09 81.20 28 100.37 153-46 53 09 49 238-98 322 07 83-09 29 103.44 157-67 54 23 50 251-95 336 97 85-02 3° 106.74 162.11 SS 37 51 265.88 352 87 86 99 31 no. 26 166.80 56 54 52 280.84 369 84 89.00 32 114.02 171.76 57 74 53 296.92 387 94 91 .02 33 118.05 177 .00 58 95 54 314.21 407 28 93-07 34 122 .36 182. ss 60 19 55 332-80 427 92 95-12 35 126.97 188.42 61 45 56 352-81 449 97 97.16 36 131. 91 194.64 62 73 57 374-35 473 53 99.18 37 137-19 201 . 24 64 05 S8 397-55 498 72 101 .17 38 142 .84 208. 24 65 40 59 422.5s 525 68 103-13 39 148.89 215.66 66 77 60 449-50 554 52 105 .02 40 155-36 223-54 68 18 61 478-59 58s 39 106.80 41 162.29 231.92 69 (>!, 62 509-98 618 44 108.46 42 169.72 240.84 71 12 63 543-88 653 85 109.97 43 177.68 250-33 72 65 64 580.52 691 80 111.28 44 186.20 260.44 74 24 65 620. 14 732 48 112.34 45 195-33 271.22 75 89 o (M O QO O CD O C c CO o o OS 5^ ^^ ^ o o o w o 00 JVl JM tM -* ■i5 o 01 ^( o CO o o o o o o o O w o 00 CO ^ w o 00 IM M T-1 r-l ^ H rH o CD O o Irt 05 o CO o o o -Si ,^ ^ g NtI ^ o o o o o o o 05 o o o o o o o o o o I^ CO in ^ CO I l:r ^ ><. ^ o o o c o o o o o tn o o c o o o o o o o en GO 1^ CO m ^ CO OJ o o w u :z; n < w Hi H U) C J t/j ;^ Q 1 — 1 W K, PC o d- Pd < o w H u <; >- w H « J o r< u< H q:: w o J S OQ < —1 H < p cr: H w u < « < H <^ O o 2; t-^ H w < p:^ a: H >- PQ o o o o o o o O 05 00 t^ CO ira ^ c^ CO s 00 w ' CM -^ CI n N W o CM C^ " -rH CVJ o -H - 03 00 ■ (^ CO ■ in ■en CM CO o Q g o o © O o o o 00 r- CP in ^ M w -' w Q tn Ho w w , U) H >- <; D t: < o ^ H W S •< X , ^ f^ y <; ►-( -J w > PQ Q ^< n. w ^ ° "i^ m ^ cc S OD w g =^ 5 ;z: -H <; -3 (^ o g O H f-; w o b^ P^ z < < ^ w w Q K >- K E- O "^ >. u ;?^ ^ o W •Oil o o o O O O O O O g CD QC r^ eo ic ^ OJ ^ o w •—3 w PQ P Q w w <; :=) w w >-r-i H- 1 in H P3 < 1— ( ^ W Ph w < 1=1 O w K •< pq p S (/) ^ !=> fs w U^ »-H s < o w p ° X f- w ^ M- S O O !-. Qi ^ "" ° s^ ^ o !^ o in in O o in o in o o o in o o n o in o o o o o m o tn O q C^J a; +- O QO +- =0 O o'* r^ ^ t^ o o -? t^ -p r^ lO O 05 CO ^ ;o O 0^ CD V CD in o <^ in -p 10 o o'^ lO ■P LO in o05 lO o ^ fO +^ rt o o-^ fc -H rt fj H^ OJ o o-^ W -p OJ in ^ OS PQ / Q / 1 ,/" o X . URANCE WI TABLE. .^^W>/' /^ EARS OF INS AMERICAN ■^ i / IRST FIVE Y BY THE \ \ ' ■--_ .\ \^ ;z; Q ^^ ""•"'^ D X UJ O •< ^S \ 1 i c ir If 1 O o in o o o o in o o o in o 0^1 o c in c ? in ;z H •< ce en ^ w c/l »— < z; cr; 1 — 1 < p-i 1=3 o H O CO <; < ^ w w >^ z u > w t; M-. H H (X) >- K PQ o o o . o o in o \n o ir^ lO •^ -* o I': o o O o o o in c in C' m -M M —1 -H """ 1 1 1 i 1 - _. _ _ - y / •v // •y ■■"1 ■••■■■" ^ ■^ ■■' ^ ....■••■■•■■' - J \ ^''-^^^ \ o o e o o o o o o o o o in o in o m o in c \n O' CC in m ^ -* ro M CI OJ ■-^ tH in MORTUARY EXPERIENCE The Mutual Life Insurance Company of New York, TABULATED REPORTS AN ANALYSIS OF THE CAUSES OF DEATH. BY G. S. WINSTON, M.D., W. R. GILLETTE, M.D., E. J. MARSH, M.D. VOLUME n. New York : PRINTED BY ORDER OF THE BOARD OF TRUSTEES. 1877. TRUSTEES AND OFFICERS Mutual Life Insurance Co. of New York. DECEMBER 31. 1875. Richard A. McCurdy, Frederick S. Winston, Vice-President. President. 14 4 BRO ADV/AY. Frederick S. Winston, John V. L. Pruvn, Robert H. McCurdy, William Betts, Samuel M. Cornell, Samuel E. Sproulls, Lucius Rodinson, William H. Popham, Samuel D. Babcock, Wm. Smith Brown, Henry A. Smythe, William E. Dodge, BOARD OF TRUSTEES. George S. Coe, William M. Vermilye, John E. Develin, Martin Bates^ William A. Haines, Seymour L. Husted, Oliver H. Palmer, Henry E. Davies, Richard A. McCurdy, Francis Skiddy, James C. Holden, Herman C. Von Post, George C. Richardson, Alexander H. Rice, William F. Babcock, F. Ratciiford Starr, Frederick H. Cossitt, Lewis May, Oliver Harriman, Thomas Dickson, Henry W. Smith, JOiiN H. Sherwood, Egisto p. Faedri, George H. Andrews. ROBERT A. GRANNISS. WILLIAM H. C. BARTLETT, LL.D., zd Vice-President. Actuary. LEWIS C. LAWTON. \ erastus c. benedict, S Assistant Actuaries. FREDERIC SCHROEDER. Asst Secretary. I. F. LLOYD, Secretary. MEDICAL DEPARTMENT. GUSTAVUS S. WINSTON, M.D., WALTER R. GILLETTE, M.D., ELTAS J. MARSH, M.D. DEPARTMENT OF LAW. WILLIAM G. DAVIES. Assistant, OLIVER H. PALMER, Solicitor. WILLIAM BETTS, LL.D., LUCIUS ROBINSON, \0/ Counsel. HENRY E. DAVIES, W. J. EASTON, Auditor. JOHN A. FONDA, Cashier. TO THE POLICY-HOLDERS OF THE Mutual Life Insurance Co. of New York, AND OTHERS INTERESTED IN THE SCIENCE OF , LIFE INSURANCE. Two years ago, this Company published its mortuary experi- ence for thirty years, as prepared by its Medical Officers. It contained an analysis from its records of the causes of death in the Company, the periods of insurance, and other important facts. This record was so interesting, and of so much importance to us in the information it gave, that we then proposed and prom- ised a more detailed and specific study of our experience, to be developed and published in due time thereafter. This specific study has been completed by our Medical Offi- cers, and U^is volume is the result of their investigations. Of the fidelity, accuracy, and ability of this work there need be no question. It states the various causes of death, each cause analyzed sep- arately, examined with care, and its results exhibited. Consumption, as a disease, occupies a large share of this vol- ume, on account of its pre-eminent importance in our experience, over twenty per cent of all the deaths in the Company having been occasioned thereby. The effects of the presence or absence of hered- itary family influences, and the physique and proportions of the consumptives, are ascertained and developed. Next in the order of frequency. Typhoid Fever and Apoplexy are considered and analyzed, with a view to eliciting points which may aid us in our future selection of risks. In the former published report only the proportionate rate of mortality for each disease was given. Since then the report of our Actuary gives the actual number of lives exposed at each period of life, and we have therefore now been able to calculate the real rate of mortality. Wherever practicable, a comparison has been drawn between the mortality rates of our insured and those of other Life In- surance Companies, and also of the adult male population of this city. The results of these comparisons will gratify our policy-hold- ers, as they show that our endeavors to make a careful selection of the risks of the Company have been eminently successful, and that our methods of selection have been, as a rule, wise and ef- ficient. We have been enabled to correct the errors necessarily made in the early history of the Company, from want of experience as to risks in different localities, and will not hereafter be exposed to the results of that class of losses by epidemics peculiar to the Southern States. This Company has now completed the period of a generation, embracing within its limit of time, it is believed, events bearing upon the lives, health, and condition of the population of the coun- try, equal in number, variety, and importance, to any like period of its history. We have had foreign and interstate wars, pesti- lence in epidemic form, periods of great apparent prosperity, and revulsions both severe and long protracted. The mental and phys- ical strain in such eventful times, with the disappointments and pecu- niary embarrassments occasioned thereby, have greatly increased certain kinds of diseases and losses which have carried off large numbers of the insured. With peace and the prospect of its continuance, and with re- turning prosperity, it is safe to believe that these abnormal sources of loss will measurably disappear, and that the same care and dis- cretion in the selection of future risks, will result not less favor- ably in the second generation of the Company's history than in the first. F. S. WINSTON, President. New York, October, 1877. REPORT ON CONSUMPTION. In our Preliminary Report the mortality experi- ence of the Company was analyzed according to causes of death, the number dying from each cause, the nativity, place of residence, and age of the de- ceased, and the length of time for which the insurance had run prior to each loss, and tables and diagrams were given showing clearly these various relations. Our remarks were therefore necessarily general ; but in conclusion it was stated that on some future occasion it would be advisable to analyze the records of death from the more important diseases separately, in order to ascertain, as far as practicable, the constitutional characteristics to which each cause of death is most likely to attach itself, and the circumstances which are favorable to its development, endeavoring, from these considerations, to deduce rules for estimating the probability of its attacking and proving fatal to any given individual. Such an examination and analysis is now pre- sented. Consumption merits our first attention, for the reason that it causes more deaths and greater losses in the Company than any other disease. The words " Consumption" and " Phthisis" are em- ployed synonymously, defining them in the broad meaning as " a destructive disease of the lungs, gene- rally chronic, attended with cough and emaciation." The disease embraces several varieties; but any attempt to subdivide them would be useless, owing to the want of accuracy and minuteness in the death- certificates. In specifying the cause of death, the word "Consumption" has been generally employed; but occasionally the name is varied according to the learning and care, the diagnostic skill, and the patho- logical viev^rs of the certifying physician. The following names therefore are grouped by us under the title of Consumption : Consumption, Consumption of the Lungs, Laryn- geal Consumption, Tubercular Consumption, Tuber- culosis, Acute Tuberculosis, Haemoptysis, Hemor- rhage of the Lungs, Abscess of the Lungs, Disease of the Lungs, Chronic Pneumonia. Our previous report assigned to Consumption 17.61 per cent of the total mortality in the Company's experience ; but it was there stated that a more critical examination might increase the number to twenty per cent, and this we have since found to be ahnost pre- cisely the case. Further examination and reflection have convinced us that the deaths from Haemoptysis, Abscess of the Lungs, Disease of the Lungs, Chronic Pneumonia, and a few others registered as Exhaustion, were .in reality Consumption, and we have therefore transferred them to this disease, thus increasing the total number of deaths from nine hundred and twenty to one thousand and thirty-one, and the proportion from 17.61 to 19.74 per cent of the mortality from all causes. Perhaps some cases of consumption may have escaped under the designation of Bronchitis, Pleurisy, etc. ; but as there have been few deaths from these diseases, the error is small, and probably compensated by similar errors of diagnosis on the other side. This broad use of the word Consumption, and the admitted errors of diagnosis, may appear to some to invalidate these statistics, but as similar objections have been urged against the value of almost all medi- cal statistics, this claim can only be of force when they are used for unfair comparisons, and to de- duce results beyond their range of pjroof Interesting and valuable information may be obtained by compar- ing different series of facts as collected in statistical tables, but care should be taken to compare them only in those respects in which they are essentially similar. They must have been collected with similar care and accuracy, and under similar circumstances, or the differ- ences must be known and allowed for. For instance, we propose presently to compare our figures with those in the Reports of the United States Census, the New York Board of Health, and the statistics of some other Life Insurance Companies. The figures representing the actual mortality in the Census reports are notoriously and inevitably inaccurate, and therefore can only be used with many allowances and within narrow limits ; those of New York City are accurate in numbers, but in some other respects less reliable; while those of other Insurance Companies may be presumed to pre- sent a close resemblance to our own, with similar ele- ments of error, having been collected under essentially the same conditions, although occasional circum- stances affecting individual companies may prevent a perfect comparison. So, too, when we examine numerous facts of personal and family history as collected from the Company's records, we shall take statements of these facts made by a large number of individuals under pre- cisely similar circumstances, and even allowing that they may not be absolutely correct, still the same proba- bility of error will run through the whole series of cases, and therefore cannot interfere with the com- parison which it is proposed to make. PREVALENCE. The great prevalence of Consumption in all parts of Europe and the United States is acknowledged in the writings of physicians, and verified by the mor- tality statistics of different nations. It is difficult, how- ever, to ascertain its actual and comparative frequency in different cities and countries from the want of accurate statistics. Calculations have been made and tables have been compiled from the most trustworthy authorities and statistics, by Schnepp,* Oesterlen,f and others ; but the sources of information are of very unequal value, and generally far from accurate. * Archives G6n6rales de MSdecine, Juin, 1865. f Oesterlen, Handbuch der Medicinischen Statistik, p. 375, They agree in showing the extreme frequency of this disease in all civilized countries. As a general estimate, it may be said that Consumption is a cause of death in from lo to 15 per cent of those dying from all diseases, and that it annually destroys about 35 in every 10,000 adult inhabitants. Niemeyer* says : " It is supposed that from a seventh to a fifth of all deaths are the results of this disease, and that in nearly the half of all cadavers we find ti'aces of the nutritive, disorders from which pulmonary consump- tion proceeds." The mortality reports of New York City have an established reputation for completeness and accuracy, and we shall therefore make use of them as the stand- ard for estimating the prevalence of Consumption among the" population at large, while recognizing the probability that the disease may be more frequent in this city than in the rural districts or other sections of the country. To compare these statistics, however, with the experience of our Company, we must make due allowance for the limitations of sex and age among the insured, and must not compare this special class with a mixed population of males and females, adults * Text-book of Practical Medicine, Vol. i., p. 216. and children. For instance, we said above that Con- sumption occasioned from lo to 15 per cent of the deaths from all causes. A very large proportion, how- ever (nearly 50 per cent) of this total mortality is made up of deaths of young children, among whom Consumption is rarely a cause of death ; calculating the proportion for adults alone, it reaches nearly 30 per cent, or, in other words, nearly one third of all the deaths occtirring among adult males {in New York City) are caused by Consumption. According to the United States Census of 1870, the proportion for the entire country is about one fourth, but the Census figures are less reliable than those above. Since, then. Consumption is so frequent a cause of death, Life Insurance Companies must expect to have some of their insured die from this disease, although they may hope, by proper care, to make the numbers small. To this end, very earnest efforts have been directed by the adoption of stringent rules, and the publication of minute instructions to Medical Ex- aminers. And this precaution has been merited not only by the frequency and fatality of the disease, but also by the fact of its great prevalence among the young, on whom the losses to the Company are of course heaviest. lO A reduction of the Consumption mortality of the insured below that of the population at large may properly be expected, by the rejection of all persons already in the pronounced stages of the disease, who of course would scarcely offer themselves for insurance ; by the detection and consequent exclusion of those in the earliest stages of the disease by the Medical Ex- aminer ; and, finally, by the more difficult elimination of those who may be suspected of liability to Consump- tion by reason of an existing predisposition, as indi- cated either by inheritance, physical development, or injurious habits and occupations. The following table shows the amount of the Consumption mortality occurring among the adult male population of New York City and the insured in this Company : TABLE I. SHOWING THE MORTALITY FROM CONSUMPTION IN NEW YORK CITY AND IN THE MUTUAL LIFE. New York Mutual Life Insurance Co.. Percentage of Con- sumption to total Mortality. 29.38 19-74 Annual Number of Deaths from Con- sumption in 10,000 Lives. 73 19 II We here find a considerable decrease in tiie pro- portion of Consumption to the general mortality, and a very remarkable decrease in the number of deaths among a given number of individuals. The dispro- portion is much greater than can be accounted for by the first named cause, and indicates the beneficial results of careful medical selection. It is proposed to consider first the Age, Nativity, Residence, and Duration of Insurance as bearing upon Consumption. These subjects were partially discussed in our former report, but it is necessary to tabulate the cases anew, on account of the addition made to their number, and in some instances to elab- orate remarks thereon in accordance with the im- portance of the subject. AGE. The following Tables II. and III. show the num- ber dying of Consumption at each year and decennial period of life : 12 TABLE II. TABLE SHOWING THE NUMBER OF DEATHS FROM CON- SUMPTION AT EACH YEAR OF LIFE, IN THE EXPERI- ENCE OF THE MUTUAL LIFE INSURANCE COMPANY. Age at Death. Number of Deaths. Age at Death. Number of Deaths. Age at Death. Number of Deaths. 20 6 40 32 60 9 21 4 41 35 61 7 22 9 42 33 62 5 23 10 43 34 63 4 24 IS 44 31 64 25 17 45 31 65 2 26 16 46 28 66 I 27 24 47 21 67 2 28 27 48 23 68 2 29 53 49 28 69 I 30 33 5° 13 70 I 31 36 SI 10 71 I 32 36 52 18 72 I 33 44 S3 18 73 34 49 54 13 74 2 35 52 55 9 75 36 48 56 8 76 2 37 29 57 S 38 37 58 10 39 37 59 6 13 TABLE III. CONSOLIDATED FROM TABLE IL IN GROUPS OF TEN YEARS. Age in Decennial Periods. Number Dying from Consump- tion. Age in Decennial Periods. Number Dying from Consump- tion. 20 to 29 years 30 " 39 " 40 " 49 " 181 401 296 "3 60 to 69 years 70 " 79 " Total 33 7 1031 50 " 59 " It has already been shown that, in the experience of this Company, a large number of deaths from Con- sumption have occurred after middle life, and also that there was reason for believing that the opinion, pre- vailing among the laity and in the profession, concern- ing the great frequency of Consumption in youth, and its comparative rarity after middle life, was erroneous, as it was found to occur with very slightly, if at all, di- minished frequency at the more advanced ages of life. In demonstration of this, we will now give some statistics, drawn from the population at large. The first table is taken from the report of the United States Census of 1870. In this, as stated before, the actual number of deaths from Consumption is un- doubtedly very much smaller than it should be, owing to the method of collecting the facts ; but there is every probability that the omissions are in equal pro- portions through all ages, and therefore the relative percentage for each age is not disturbed. TABLE IV. SHOWING THE MORTALITY FROM CONSUMPTION IN THE ADULT MALE POPULATION OF THE UNITED STATES, ARRANGED IN DECENNIAL PERIODS OF LIFE, FROM THE U. S. CENSUS 1870. Age in Decennial Periods. Male Population of the United States. Annual Number of Deaths from Con- sumption. Annual Number of Deaths from Consump- tion in 10,000 Liv- ing. 20 to 20 vears 3,351,617 2,452,999 1,829,599 1,209,855 658,153 259,318 60,042 7,842 6,591 5,054 3,787 3,042 1,863 664 23 27 27 31 46 71 III ■?o " "^O '' AO " AQ " cjo *' i;q ** 60 " 6g " 70 " 70 ** 80 " 89 " 15 The proportion of deaths from Consumption to the living population is thus seen increasing steadily with each decennial period of life, from 23 per io,ooo at 20 to 30 years of age, to 27 at 30 to 50, 31 at 50 to 60, 46 at 60 to 70, 71 at 70 to- 80, and 1 1 1 at 80 to 90. The next is a similarly constructed table, drawn from the mortality records of New York City. There is no table of the city population in decennial periods of life in the United States Census of 1870, and we have therefore calculated one from the total male population as given in that Census, and divided into ages on the same proportion as given by the State Census of 1865. The deaths are the yearly mean of five years from 1868 to 1872 inclusive. i6 TABLE V. SHOWING THE MORTALITY FROM CONSUMPTION IN THE ADULT MALE POPULATION OF NEW YORK CITY, GROUPED IN DECENNIAL PERIODS OF LIFE. Age im Decennial Periods. Male Population, New York City. Annual Number of Deaths from Con- sumption. Annual Number of Deaths from Consump- tion in 10,000 Liv- ing. 20 to 29 years 75,044 74,884 56,877 26,760 11,939 3,892 524 528 375 226 131 59 70 ^0 « ^Q " 71 66 40 " 40 " CO " eo " 84 I 10 60 " 69 " 70 and upwards 151 In this table is found mucli the same result as be- fore. The proportion of deaths is larger, as should be expected from the greater accuracy of the records, and the percentage increases in the same regular manner with advancing age, with the exception of a small decrease for the period between 40 and 50 years. In both instances the mortality from Consumption is nearly constant between the ages of 20 and 60 years, after which it very rapidly and greatly increases. 17 TABLE VI. SHOWING THE ANNUAL NUMBER OF DEATHS FROM ALL CAUSES AND FROM CONSUMPTION, IN NEW YORK CITY AND IN THE MUTUAL LIFE, CALCULATED FOR I0,000 LIVING AT EACH DECENNIAL PERIOD OF LIFE. Annual Number of Deaths among 10,000 Living at Each Age. Age in Decennial Periods. From all Causes. From Consumption. New York. Mutual Life. New York. Mutual Life. 20 to 29 years 30 " 39 " 40 " 49 " 5° " 59 " 60 " 69 " 70 and upwards 170 197 231 351 589 1,430 62 72 87 139 299 699 70 71 66 84 no 150 24 20 17 14 18 30 TABLE VII, SHOWING THE ANNUAL NUMBER OF DEATHS FROM CON- SUMPTION OCCURRING AMONG ADULT MALES IN ENGLAND (from OESTERLEN). Age. 15 to 25 years. 25 " 35 35 " 45 45 " 55 55 " 65 65 " 75 75 " 85 Male Lives. 10,000 10,000 10,000 10,000 10,000 10,000 10,000 Deaths from Consumption. 33 41 40 39 37 27 II 19 TABLE VIII. SHOWING THE ANNUAL NUMBER OF DEATHS FROM CON- SUMPTION AMONG 10,000 INSURED AT EACH QUIN- QUENNIAL PERIOD OF LIFE, IN THE EXPERIENCE OF THE MUTUAL LIFE, AND OK CERTAIN GERMAN INSUR- ANCE COMPANIES. Proportion of Deaths from Consump- tion to every 10,000 Insured. Age. Mutual Life Insurance Company. 12 German Life Insurance Companies. 21 to 25 years 23 23 22 17 17 16 IS 16 18 18.6 19 39 42 37 ^0 26 " ^0 " -21 '' -ZK " ^6 *' 40 *' Al '^ AC '"' a6 *' CO " ^8 qi " eq " 35 32 32 35-7 56 " 60 " 61 and upwards All ages . , 20 These three tables differ somewhat in their repre- sentation of the actual frequency of Consumption at each period of life ; but they agree in many essentials, and lead to the same conclusions, viz. : that Consump- tion is an extremely frequent cause of death at every period of adult life ; and that there is no special prevalence of the disease in youth, but that its fatality is nearly the same at all ages from 20 to 60 years. The proportion in New York City is as follows : Out of every 10,000 inhabitants between the ages of 20 and 30 years, 70 would die annually of Consumption ; from 30 to 40 years, 71 ; 40 to 50 years, 66; 50 to 60 years, 84. After this period, the English reports show a very decided decrease in the frequency of Consump- tion, and the American an equally decided increase up to extreme old age. The tables from the population at large represent the natural law of the prevalence of Consumption more correctly than Life Insurance statistics, which are drawn from a limited class of the community. It will presently be shown that the influence of medical selection is especially perceptible at certain ages, and hence we are not surprised at finding the Life Insur- ance experience differing somewhat from that of the 21 city population. There is a much smaller proportion of deaths from Consumption at all ages, and the course of the disease attains a maximum of frequency of 24 in 10,000, between the ages of 20 and 30 years ; then gradually diminishes till it reaches the figure of 14 in. 10,000, between 50 and 60; and then again rapidly increases. Table VI. indicates the difference in the annual number of deaths from all causes, and from Consump- tion, among an equal number of insured and non- insured. We find among the insured a general mor- tality of from one third to one half that of the popula- tion at large, while the mortality from Consumption alone is for the earlier years of life about one third, and for the later years about one sixth, that of the general population. This would apparently 'indicate that a careful selection of cases for insurance greatly diminishes the mortality below that of the general population, and that it is of veiy special value in de- tecting those who are liable to death from Consump- tion. The benefits of selection are only slight in early years, but very decided in middle age. In Table VIII. we have placed by the side of our own experience that of several German Life Insurance 22 Companies, as given by Dr. Oldendorf* Ttiese are the only figures that we have found where the pro- portion of deaths from Consumption has been cal- culated on the number insured. In the German ex- perience nearly twice as many deaths occur from Consumption as in our own, and the disease prevails nearly equally, with irregular fluctuations, at all peri- ods of life. We. have now proved conclusively the fallacy of the common opinion concerning the comparative fre- quency of Consumption in youth and its rarity at and after middle age. This erroneous idea, however, is so widely spread and firmly fixed, that we propose to quote opinions of medical writers, to show that the best authorities corroborate our conclusions. When the accurate study and diagnosis of diseases of the lungs was first made possible by the discovery of auscultation, Laennec wrote : " The ancients thought that Phthisis made its attacks particularly between the ages of 1 8 and 35, and it cannot be denied that this is the period at which it is most commonly manifest, and most easily recognized. Bayle, however, found in the hospitals of Paris that it was most common from the * Report on the Mortality from Consumption in German Life Insurance Companies. 23 fortieth to the fiftieth year. But no age is exempt from it. It is very frequent in old age."* Sir Thomas Watson, after quoting from the tables of Louis and Bayle, says : " You see from this account how erro- neous the common notion is, that Consumption does not occur at an advanced period of life, and that a person who has reached his thirtieth or fortieth year is therefore safe from that disease." f In our previous report, Drs. Fuller, Chambers, and Sieveking were quoted to the same effect. Dr. Walshe, in a very elaborate statistical report on Consumption as occurring in the Brompton Hospital, states that the twenty years comprised between the ages of 15 and 35 supply nearly 67 per cent of the whole number of cases, but warns that " we must not, however, conclude that these numbers consequently exhibit the relative tendency to the disease at different ages, or, in other words, teach us the injlit.ence of age on its generation. In order to establish the amount of this influence, the number of phthisical persons should be compared with the total number living at each corresponding age." % * Diseases of the Chest, p. 338. f Principles and Practice of Physic, Vol. II., p. 248. \ Br. and For. Med.-Chirurg. Rev., No. V., p. 226. 24 In 1853, Dr. Christison, in one of the earliest and best medical reports on Life Insurance mortality sta- tistics, wrote : " Notwithstanding considerable discrep- ancies in the details now referred to, there is suffi- cient correspondence among the facts as a whole to satisfy any one that Consumption is far from being so infrequent after middle life, or even in advanced age, as had been until lately supposed." * On the other hand, Drs. Flint, Hughes Bennett, and Niemeyer agree in stating that it is most fre- quent between the ages of 20 and 30 years. Niemeyer says : " Towards the period of puberty, and still more between the twentieth and thirtieth year, the malady attains its greatest frequency, becoming rarer as life advances, without becoming quite unknown even in extreme old age." f From the foregoing quotations, it will be seen that while there has been a widespread opinion in the pro- fession that youth is the " har\rest-time for Consump- tion," a majority of the most observant and careful physicians have warned against this fallacy, and shown that the disease is prevalent at all periods of adult life. * Monthlj- Journal of Medical Science, Aug., 1853. •)■ Op. cit., vol. i., p. 216. 25 This prevailing but erroneous opinion has origi- nated, as suggested by Dr. Walshe, from merely count- ing the number of cases occurring at each year, or period of life, without taking into consideration the number of individuals living at corresponding ages to furnish the observed number of cases. For instance, there are nearly three times as many persons living at the ages of 20 to 30 years as at 50 to 60 years, and consequently three times as many cases of Consump- tion at the earlier period as at the later would only indicate an equal prevalence of the disease at both periods. Moreover, the percentage of Consumption mortality to the total mortality is very great at the earlier decades of life, and this has been supposed to prove its comparative prevalence at that period. It would show this, if the other causes of death were constant at all ages, but in reality only indicates the rarity of many other causes of death, such as apoplexy, heart and kidney diseases, among the young. The increased percentage is therefore caused not by excess of Phthisis, but by the small number of other fatal diseases. The following table gives the percentage of deaths from Consumption to the total mortality, for each decennial period, as occurring in New York City, the 26 Mutual Life, Scotland, and Scottish Insurance Com- panies : TABLE IX. SHOWING THE PERCENTAGE OF DEATHS BY CONSUMPTION ON THE TOTAL MORTALITY FROM ALL CAUSES, FOR EACH DECENNIAL PERIOD OF ADULT LIFE. Age. 20 to 29 years 30 " 39 40 " 49 5° " 59 60 " 69 70 " 79 80 " 89 New York City. Mutual Life. Population of Scotland. 40.84 37-09 47.20 35-13 28.06 33-65 28.46 19.62 22 .40 23-99 10.27 14-50 18.57 6. 10 6-45 12 .72 5-Si 1.70 5-56 •35 Ten Life Assurance Companies of Scotland. 33 24 13 7 60 10 60 40 30 65 35 In the above there is a general similarity between all the columns of figures — namely, a very high com- parative mortality in early life, diminishing steadily with advancing years. Between the insured and the uninsured the rate of decrease varies considerably, that for the insured being much the greater. For instance, between 20 and 30 years of age the proportion of 27 deaths from Consumption to the total mortality is nearly equal in both cases, being 40.84 per cent in New York and 37.09 in the Mutual Life; while between 60 and 70 the proportion among the insured is about one third, being 18.57 P^^ cent for the city, and only 6.10 for the Mutual Life. This would tend to prove again that the effect of medical selection in eliminating Consumptive risks is comparatively small among the young, and much greater at and after middle aare. We have thus far examined the relation of Con- sumption to age by comparing the number dying of this disease with the number living, or exposed to risk at each year of life. We have found that medical selection was probably of more value in eliminating Consumption risks from Insurance Companies after middle age than in youth and early manhood. To investigate this subject more fully, we have taken the number of -those entering insurance at each age (de- cennial groups), and ascertained the number of these who have subsequently died of Consumption. 28 TABLE X. SHOWING THE NUMBER DYING OF CONSUMPTION IN EVERY 1000 ENTERING INSURANCE AT EACH DECENNIAL PERIOD OF LIFE. Age at Insurance. Under 20 years. 20 to 29 30 " 39 40 " 49 5° " 59 60 " 69 70 " 79 No.of Deaths from Consumption per 1000. 14 13 II 8 7 7 We learn from this table that, of those admitted to insurance at every age, some will die of Consump- tion. The number is largest in early life, but consid- erable for all periods. Out of every thousand persons insuring below 20 years of age, 14 have died of Con- sumption ; of those insuring between 20 and 30, 13 ; and the number slowly decreases until we find that, of those insured after 50 years, 7 out of every thousand have died of this disease. Hence, it would appear that it is much less easy to detect a liability to Consumption among the young than among the middle-aged. The reason of this is not altogether apparent. It is partly due to the numerous cases of chronic Phthisis which cause death after many years' duration ; partly because slightly suspicious symp- toms, injurious occupations, deficient physical develop- ment, etc., which may be overlooked in a youth, under the hope of their not being firmly fixed, or certainly hurtful, have, in full manhood, established themselves as causes of premature decline. The hope that we have indulged in favor of the young man has proved to be delusive by the time middle age is reached. These considerations have been so clearly stated by Dr. Christison, that we will give his words : " When a man has reached the age of 40 or, still more, of 50, the value of his life is much more easily judged of than at ages considerably earlier. His hab- its, the influence of occupation, his personal liabiHty to disease, the constitutional infirmities of his family, and other less important circumstances, are, in gene- ral, developed by that time, and easily ascertained. Hence, a large proportion of indifferent lives, pro- posed for insurance about middle age, and afterwards, may be at once set aside as hazardous with very or- dinary care. These swell the list of deaths from Con- sumption later in life in the general population, but 30 they are easily shunned in the practice of Insurance Companies. . . . Whatever may be the frequency of Consumption in the general population after mid- dle life, it becomes progressively a less frequent cause of death among lives accepted for insurance at a later and later period of life, and therefore great and in- creasing facilities must exist for escaping Consump- tive risks proposed after middle age." "''' It is well known that Life Insurance Companies have ignored this fact of the prevalence of Consump- tion at all periods of life, and have established rules of selection based on the popular opinion that the danger of death from Consumption exists to an appreciable extent up to the middle period of life only — an opinion expressed by one medical writer as follows: " It is known that Consumption prevails more extensively between the ages of 20 and 40, and that after the subject, having an hereditary tendency, passes the age of 40, the danger that he will become affected diminishes rapidly till the age of 50 or 55, when it may be considered as practically past." The following query will therefore probably suggest itself: How happens it, that, if Life Insurance examinations have been guided by rules based on such incorrect ideas, * Op. cit. 31 the companies have not suffered more seriously from their ignorance, and subsequently corrected their prac- tice as a result of their disastrous experience ? To this our answer would be : First, that the law of the constant high mortality from Consumption, at all ages, is undoubtedly true, and Insurance Companies have suffered serious loss from ignoring it, for we have seen that, among those insuring at advanced life, the Consumption mortality is half as great as among the young. Second, that they have been protected from greater losses, not by virtue of these rules, but in spite of them, and solely on account of the greater facility in detecting a liability to Consumption among those advanced in life ; and individuals with a tend- ency to Consumption, who might have been insured according to the rules, have been, in practice, ex- cluded by the examination of the physician. NATIVITY. To ascertain the influence of nationality as a cause of Consumption, it would be desirable to know the birthplace of all who have been insured, and the number born in each country. There is no such 32 classification of tiie insured, however, and we are therefore reduced to the mortality records. In these we can obtain the nativities, and can learn the propor- tion that Consumption bears to the general mortality in each national group. This will probably give us a correct idea of the predisposition of each class to Consumption. TABLE XI. SHOWING THE PERCENTAGE OF DEATHS FROM CON- SUMPTION TO THE GENERAL MORTALITY AMONG THE INSURED, GROUPED ACCORDING TO NATIVITY. Nativity. Mortality from all Causes. Consumption. Percentage. Total Deaths S.224 1,031 19.74 United States Germany 3-917 S°i 238 227 93 248 792 86 57 28 16 52 20.22 17.06 23-99 12-33 17 .20 20.97 Ireland England and Wales.. Scotland Other Countries and Unknown The natives of the United States show a slight, and the Irish a large, excess of Consumption above the average. On the other hand, the Germans and Eng- lish fall below the average — the latter to a very con- 33 siderable extent. Whether these results depend solely upon national characteristics, or upon circumstances of age, occupation, and residence, eannot readily be deter- mined. When the nationalities are subdivided into groups, formed on these considerations, the numbers become too small for a basis of calculation. The same conclusions, however, have been reached by Gen. F. A. Walker, from a study of the last Census, and substantiated in part by the reports of the New York Board of Health, and we therefore regard them as correct. RESIDENCE. The remarks which have been made with refe- rence to nationality apply with equal or more force to climate and place of residence. There are no means of ascertaining the number of insured living in each State, and the years of life passed there, and these facts are necessary to enable us to draw reliable con- clusions as to the influence of such localities in pro- ducing disease. From the following table of the total mortality and the number of deaths from Consumption in each State may be drawn some probable conclu- sions. In doing so, however, it is necessary to guard 34 against some sources of error ; for instance, certain localities attract consumptives by reason of the salu- brity of the climate, and a portion of them dying there, the ratio of deaths from Consumption will be greatly increased. Under these circumstances, the mortality statistics would create a false impression, and represent a healthy region to be an especially dangerous one. Examples of this will be given presently. TABLE XII. SHOWING THE NUMBER OF DEATHS FROM CONSUMPTION IN EACH STATE, AND THE PROPORTION TO THE TOTAL MORTALITY. Residencf, at Death. Maine New Hampshire Vermont Massachusetts Rhode Island Connecticut New York New Jersey Pennsylvania Delaware Maryland District of Columbia. Number of Deaths. All causes. Consumption, 59 36 37 424 73 197 1,471 330 406 8 96 27 16 8 13 83 1 1 52 290 74 82 17 5 Percentage. 27.1 22 . 2 35-1 19.6 15- 26.4 19.72 22 .4 20.2 25- 17.7 18.5 35 TABLE 'Kll.—Contimied. Residenxe at Death. Virginia West Virginia North Carolina South Carolina Georgia Florida Alabama Mississippi Louisiana Texas Ohio Indiana Illinois Michigan Wisconsin Iowa Minnesota Kentucky Tennessee Missouri Arkansas California Oregon Other Western States and Territories Canada Foreign Countries Number of Deaths. Percentage All causes. Consumption. 84 IS 17.8 13 2 15-3 4 I 25- 28 7 25- 48 7 14.6 14 6 42.3 31 7 22 . 2 17 2 II. 8 42 5 II. 9 '9 4 21 . 284 59 20.8 I II 21 19. 227 45 20. "^ii 26 20. T19 29 24-3 71 7 9.8 43 20 46-5 68 11 16.2 i(> / 1 1 . 1 M3 17 II. 9 7 273 49 18. 7 I 14-3 67 8 11.94 36 6 16.67 13s 19 14-59 36 TABLE XIII. SYNOPSIS OF TABLE XII. Residence at Death. Number of Deaths. Percentage. All causes. Consumption. Maine to Connecticut New York 826 1,471 744 423 622 366 254 280 67 36 135 183 290 78 125 82 32 50 8 6 19 22.15 19.72 21 . 2d New Jersey, Pennsylvania, and Delaware Maryland to Texas 18.44 Ohio, Indiana, and Illinois.. Michigan to Minnesota Kentucky, Tennessee, Mis- souri, and Arkansas California and Oregon Other Western States and Territories 20. 10 22.40 12.6 17.86 11.94 16.67 14.59 Canada .... Foreign Countries It appears from these tables that the disease pre- vails with remarkable uniformity in all sections of the country, varying but slightly from the general average. The group of States — Kentucky, Tennessee, Missouri, and Arkansas — gives the lowest mortality, and one considerably below the average. The New England States are slightly above it. In the percentage for 37 individual States there is a wider range of difference, but this probably is accidental, on account of the small number of total deaths in each State. The greatest proportional number of deaths occurred in Florida and Minnesota, a fact explained by the reputation these States enjoy as beneficial to, and consequently a favorite resort of, consumptive patients. We have ascertained that of the 20 consumptives dying in Min- nesota, only 6 were residing in the State at the date of insurance, and that of 6 dying in Florida, none were residents of the State when insured. When these 14 deaths are deducted, the Consumption mortality of Minnesota is equal to the average of that of the other States. DURATION OF INSURANCE. In our preliminary report we gave tables of the numbers dying from all causes, and from individual diseases, arranged according to the duration of insur- ance. As a result of this comparison, it was found that the proportion of Consumption mortality was very small during the first year of insurance, and after 38 that time rapidly increased. In addition to these tables, another is now given, in which the number of deaths is calculated upon the number of lives exposed. TABLE XIV. SHOWING THE NUMBER OF DEATHS FROM CONSUMPTION IN EACH YEAR OF INSURANCE. Year of Insur- eg o -r: ^5 ANCE. I St year 57 2d ' 117 3d ' ■33 4th ' 143 5th ' 116 6th ' 108 7 th ' 61 8th ' 57 9th ' 37 loth 34 nth 25 Year of ANC Deaths from Consumption. 1 2th ye ar 30 13th ' ' .... 21 14th ' ' .... II 15th ' ' .... 10 1 6th ' ' 14 17th ' ' •••• 13 1 8th ' ' .... 7 19th ' ' ••■• 7 20th ' ' ... 9 2ISt ' .... 2 22d ' ■••• 3 Year of Insur- ANCE 23d year 24th 25th 26th 27th 28th 29th J ° o 39 TABLE XV. CONSOLIDATED FROM TABLE XIV., AND SHOWING PRO- PORTION OF CONSUMPTION MORTALITY TO TOTAL MORTALITY AND TO YEARS OF LIFE EXPOSED. Duration of Insurance. I St year 2d " 3d " 4th " Sth " 6th to loth year Above lo years. Deaths from Consumption. 57 117 133 143 116 298 168 Percentage on Total Mortality. 10.67 20.07 24.19 25-49 23-73 22 . 70 14-33 No. of Deaths to 10,000 Years of Life Exposed. 7 17 21 25 24 28 23 In Table XV. we have given the yearly numbers for the first five years, and after this period, as they become small and subject to greater fluctuations, we have consolidated them in groups. The figures in the last column are not absolutely correct, but closely approximate the truth. In the Actuary's report, from which is taken the number of lives exposed at each year of insurance, the numbers are calculated for the calendar year, while our deaths are calculated from the date of insurance ; we have therefore compared 40 our first year's experience with the Actuary's second year, and so on. This is very nearly correct, and the error lies in representing the mortality as slightly higher than it actually was. The effect of medical selection in eliminating con- sumptive risks has been shown by the great diminu- tion of the number of deaths from Consumption below that occurring in the population at large. We stated that this elimination acted upon two classes : ist, those already in a more or less advanced state of dis- ease ; 2d, those likely to become consumptive at some future date. The exclusion of the latter class would give us a less rate of Consumption mortality at all periods ; the rejection of the former a reduced rate for the few years following insurance. Table XV. shows the duration of this influence. For the first year, the actual and proportional number of deaths is very small, for, of over 100,000 lives that have been insured in the Company, only 57 have died of Consumption within a year of the date of insurance. This mortality is very small, and can easily be ac- counted for by unavoidable eiTors of judgment on the part of examiners, and the occurrence of acute cases of disease. In the second year, the proportion more than doubles, in the third it becomes threefold, and 41 increases still further in the fourth and fifth years. After this time the number becomes much smaller, and the proportions fluctuate considerably, so that we have consolidated the years in two groups. From 5 to lo years, the proportion is somewhat greater than for the preceding and following periods, but we are unable to see any reason for this difference. As a final conclusion, we would say that the influence of selection, by the rejection of consumptive lives, lasts only for the first three years of insurance, and that after the third year the proportion of deaths from Consumption is nearly the same for all periods of insurance. The percentages on the total mortality show, to a certain extent, the same result. But these figures are more likely to be modified by the influence of age, and they are therefore not so trustworthy. 42 OCCUPATION. Business occupations and habits of life are un- doubtedly powerful factors in the causation of Phthisis, but unfortunately our records can give us little infor- mation as to the extent of their influence. We have a nominal record of the occupation of every person who has been insured, but it is often expressed by such a general term as to convey no definite meaning. For instance, four classes — merchants, clerks, agents, manufacturers — form half of our total mortality list, and yet each of these classes is too comprehensive to represent any definite mode of life. Of the minor occupations, the representatives are too few to allow any generalizations. Still another difficulty arises from the frequent change of occupation, many persons being engaged in one form of business at the time of insurance, and another at the time of death. For these reasons we have not thought it profitable to form any elaborate table of the occupations of all those who have died of Consumption, but have limited our observations to a few special cases, in which there is little probability of error, and which at the same time indicate marked susceptibility or insusceptibility to Consumption. 43 TABLE XVI. SHOWING THE MORTALITY FROM ALL CAUSES, AND FROM CONSUMPTION IN CERTAIN SPECIFIED OCCUPATIONS. Occupation. Total Mortality , Carpenters Butchers Lawyers Farmers Physicians Clergymen Tailors Millers Teachers Printers Jewellers and Silver- smiths Hatters Deaths from all Causes. Deaths from Consumption. Percentage. S>224 1,031 19.74 67 5 7.46 25 2 8.00 180 17 9-44 262 26 9.92 132 IS 11.36 137 26 18.98 54 14 25.92 29 59 31 59 19 17 10 20 9 27.58 28.81 32 .26 33-89 47-37 We find carpenters and butchers presenting an extremely low rate of Consumption mortality. Next come lawyers, farmers, and physicians, all much below the average mortality from this disease ; clergymen are very slightly below the average. Above it, and with a proportion increasing in the following order, are tailors, millers, teachers, printers, jewellers, and hatters. 44 FIGURE-PROPORTIONATE HEIGHT AND WEIGHT. Thus far we have considered the mortality from Consumption as influenced by circumstances of age, nationality, residence, duration of insurance and occu- pation, and to establish their definite relations we have employed our own general mortality experience, and the tables of mortality of the population at large. We propose now to investigate a portion of the subject to which these tables are inapplicable, namely, the ten- dency to this disease arising from such personal pecu- liarities of applicants as family history, figure, as shown by weight in relation to height, and the record of previous sickness. These subjects have been considered by various writers, and opinions have been formed and expressed, but often from insufficient and one-sided data, which therefore, even if correct, are not satisfactorily estab- lished. We think that the most satisfactory method of investigation will be to compare two sets of cases, one composed of deaths from Consumption, the other of an 45 equal number of deaths from other causes, correspond- ing to the first in the proportion at each period of life. As the individuals of both sets have been selected under the same rules and circumstances, they will be in every respect comparable. We have 1031 deaths from Consumption; our second set of cases is made up of 357 deaths from casualties, 322 from typhoid fever, 352 from other acute zymotic diseases. By reference to Table IV. of the Preliminary Report, it will be seen that the mor- tality from these causes corresponds closely to that of Consumption for each period of life. In examining applicants for Life Insurance, Mili- tary Service, or for any position where the present and prospective health is of great importance, the figure, and development of the frame are properly regarded as affording grounds of decision. The amount and quality of bones and flesh are an indication not only of muscular strength, but, to a certain extent, of the health of the entire organization. They show whether the organs of digestion and assimilation are performing their functions satisfactorily, and in due proportion to the destruction and wear of the tissues. An experienced examiner can generally judge of this by his eye alone, but to prevent deception by clothing 46 and as a means of guidance for the less experienced, it is advisable to take actual measurements of height and weight, ascertain their proportion, and compare it with a standard of normal development. For this purpose, tables have been computed, and are published by various Insurance Companies. These tables represent the mean measurements of a given number of healthy men, and it must be remembered that it is not even the usual height and weight, and that of the entire number from whom the observations are made, few, or perhaps none, of the individuals were of this exact size, but that they ranged on each side of it. On taking the standard authorized by this Com- pany, and comparing it with the average weight of Consumptives, we, to our surprise, found the latter so much lower that we supposed there might be some error in the formation of this table. Such error might arise if the standard were taken from some class of in- dividuals of greater weight, or other age, than those of applicants for Life Insurance in this Company. We therefore determined to form another standard table, computed for each decennial period of life, and we found materials for two such tables. The first, from the statistics of the U. S. Sanitary Commission, in which the measurements of several thousand soldiers, 47 enlisted during the late war, are given ; these measure- ments were carefully made, and in recording the weight an allowance was deducted for clothing. The second, from the records of the 1031 Non-Consumptives men- tioned above ; in these the measurements were taken and recorded in the usual manner of Life Insurance examinations, from the statements of the applicant in the majority of instances. For these reasons we would expect to find the proportional average weight less among the soldiers. In our experience the records of measurements are not complete. We find in the 103 1 Consumptive cases, 619 records of measurement ; in the 1031 Non- Consumptive cases, 649 records. None of the tables that we have computed are of any value for extremes of height. That taken from the Sanitary Commission is calculated only for heights ranging from five feet four inches to five feet ten inches, both inclusive ; while the tables from the Insurance records include too few cases beyond these same limits to be of any value, except when corroborating the results obtained from the more numerous cases. In tables XVII. and XVIII. are given the re- corded height and weight of every case, insured be- tween the ages of thirty and forty years. Consumptives 48 and Non-Consumptives separately. In the centre line is the old standard table, and all weights rang- ing above this standard are placed above the line, and those below it below the line. We have prepared similar tables for the other de- cennial periods, but instead of presenting these in de- tail, will give a consolidated table of the total numbers above and below the standard. Next we will give a comparison between the standard and the average weight computed for each series of observations. 49 TABLE XVII. SHOWING THE HEIGHT AND WEIGHT AT THE AGES OF 30 TO 39 YEARS — NON-CONSUMPTIVES. felt 51 5.^ 5-3 5-4 s-s 5.6 5-7 S.8 5-9 5. 10 S.ii 6 fee 6.1 6.2 6.3 1 199 ig8 195 j 195 1 200 187 ! 177 187 ! 175 185 170 180 170 207 179 200 170 194 175 242 I4Q 182 170 I go 175 220 iqs 174 168 185 174 215 190 170 167 175 174 208 l8q 165 it.7 173 173 194 ^ 17s 161 193 J72 170 192 ! 170 160 163 170 168 190 ; IS5 158 ibo 170 167 18.5 230 ISS 1S8 160 162 lbs 185 220 169 150 155 160 160 165 180 210 igo IS.S 150 154 160 160 165 178 197 170 150 149 154 155 160 165 174 194 150 147 148 150 150 160 Ib3 173 I go 140 147 I4fa 149 150 I5q 162 170 180 ISO 151 138 144 145 146 150 158 160 170 1 80 185 150 145 136 140 143 145 148 155 160 105 195 220 180 120 12"; I^O 135 140 143 145 148 IS5 160 158 165 155 170 165 i 163 175 133 139 140 143 146 153 126 137 140 140 146 152 158 150 157 135 135 140 145 150 158 150 156 135 130 140 145 150 155 150 155 i 132 129 140 144 150 155 145 150 130 125 139 142 148 153 145 138 125 I2S 135 138 148 153 142 133 1 124 124 135 138 146 145 140 122 120 134 137 145 145 140 120 118 134 13b 145 143 138 ! i 120 132 130 136 135 143 143 142 140 138 132 1 128 134 142 140 130 120 130 130 130 138 136 135 138 135 135 I 130 133 134 130 130 134 126 128 130 125 130 i i 1 1 125 50 TABLE XVIII. SHOWING THE HEIGHT AND WEIGHT AT THE AGES OF 30 TO 39 YEARS. — CONSUMPTIVES. d. 5-i 5.2 5-3 S-4 5-S 5.6 5-7 5.S 5.9 5- 10 S.ii 6 feet 6.1 6.2 6.3 150 165 160 155 149 145 213 168 168 158 155 155 155 183 180 168 158 174 173 164 196 177 175 175 19b 180 175 136 lOo 145 145 I "JO 155 I Co 172 173 133 143 149 145 145 150 155 160 lbs 170 183 igo 120 I2S 130 135 140 143 14s 148 155 160 1 6s 170 no 130 128 140 142 146 152 158 163 168 170 170 17b 130 125 140 140 145 150 158 158 165 ib7 125 123 135 140 145 150 155 155 lbs lbs 120 Iiq 134 140 145 150 155 155 I bo 100 Iiq 134 136 142 150 154 155 160 i "7 134 136 141 150 150 155 148 i : 114 131 135 140 149 150 154 142 130 135 140 148 150 150 136 1 130 135 140 145 150 145 122 130 135 138 145 148 145 I2g 135 i3« 140 147 145 I2g 134 137 140 146 135 126 130 13b 140 145 135 125 130 135 140 145 135 125 I2g 135 140 142 135 125 129 135 140 140 130 123 129 134 140 140 120 129 133 138 138 Ilq 127 133 138 136 112 125 125 120 144 132 131 130 130 130 130 126 125 125 125 125 125 123 138 135 135 135 135 134 133 133 130 130 128 128 123 135 135 134 134 130 125 122 118 _ 118 51 TABLE XIX. SHOWING THE RELATIVE WEIGHT AMONG CONSUMPTIVES AND NON-CONSUMPTIVES, GIVING THE NUMBER OF EACH ABOVE AND BELOW THE NORMAL STANDARD, AND AR- RANGED ACCORDING TO AGE. NON-CONSUMPTIVES. Consumptives. Age. Number above standard Weight. Number below standard Weight. Number above standard Weight. Number below standard Weight. Total 336 58 139 100 29 323 123 119 55 26 ^33 2 35 48 34 15 I 484 9 200 179 77 16 3 Under 20 years 20 to 29 '■ 30 " 39 " 40 " 49 " 5° " 59 " 60 " 69 " 52 TABLE XX. SHOWING THE RELATIVE WEIGHT AMONG CONSUMPTIVES AND NON-CONSUMPTIVES, GIVING THE NUMBER OF EACH ABOVE AND BELOW THE NORMAL STANDARD FOR EACH INCH OF HEIGHT. Height. 5 feet 5 feet I inch. . . 5 feet 2 inches. 5 S S 5 5 5 S 5 5 6 feet 6 feet I inch... 6 feet 2 inches. 6 " 3 " • 6 " 4 " . 3 4 5 6 7 8 9 lo II NON-CONSUMPTIVES. Number over Weight. 2 s 15 18 3° 48 50 37 59 32 20 3 5 Number under Weight. 3 6 20 22 39 S3 51 54 38 24 7 3 Consumptives. Number over Weight. I I 3 3 7 19 16 29 14 20 II 6 3 2 Number under Weight. 2 12 22 61 57 86 71 79 48 31 6 4 3 I 53 TABLE XXI. SHOWING THE AVERAGE WEIGHT IN PROPORTION TO THE HEIGHT, ACCORDING TO THE STANDARD TABLE, THE SANITARY COMMISSION STATISTICS, AND THE MEASURE- MENTS OF NON-CONSUMPTIVES AND CONSUMPTIVES IN THE RECORDS OF THE MUTUAL LIFE, CALCULATED FOR EACH DECENNIAL PERIOD OF LIFE. 20 TO 29 YEARS. 5 ft. S.I 5-2 5-3 5.4 5-S s.s 5 7 S.8 5-9 S.io S.ii 6 ft. 6.1 6.2 6.3 Standard Sanitary Com- mission Non - Consump- 121 120 140 125 120 130 ii3 123 '35 131 137 119 J40 135 133 128 143 .38 139 123 145 142 142 134 148 143 139 J38 155 151 145 141 160 >55 lis 146 i6s 154 148 170 154 154 161 149 186 Consumptives . . . 177 30 TO 39 YEARS. Standard Sanitary Com- mission Non - Consump- tives Consumptives. ., 120 1 25 130 135 135 140 134 143 140 MS 145 .48 148 IS5 IS5 160 157 .65 170 150 147 .48 137 148 147 150 156 161 169 177 192 180 13s 125 128 131 137 142 144 147 IS5 161 171 180 176 40 TO 49 YEARS. Standard Sanitary Com- mission Non - Consump- tives Consumptives . ,. 120 325 130 135 ,36 140 138 143 141 14s 147 148 146 155 155 160 158 i6s 170 146 149 146 154 150 159 152 .63 162 169 172 186 160 125 139 136 137 142 142 149 155 155 185 153 163 50 TO 59 YEARS. Standard Non - Consump- tives Consumptives. . . 120 125 130 135 140 143 145 148 155 160 165 170 150 151 142 153 161 153 164 .69 130 "7 136 150 143 1 55 145 155 159 54 A glance at these tables will show that, while the Non-Consumptives are almost equally divided, half be- ing above and half below the standard, nearly eighty per cent of the Consumptives arc below it. On exam- ining the figures still farther, we find that a large majority of both classes under thirty years of age are below the standard, and from this we would infer that the standard is fixed at too high a figure for this period of life. After thirty, however, we find the ma- jority of the Non-Consumptives above the standard, and a large majority of the Consumptives below it, although in the decade from fifty to fifty-nine years there is not much difference. Of the 619 Consump- tives, 135 were above the standard weight, and 484 below it; of the 649 Non-Consumptives, 326 were above and 323 below the standard. Or deducting all under thirty years of age, we have t^^t^ Consump- tives, of whom 98 were above and 275 below; 470 Non-Consumptives, with 268 above and 2CO below the standard. In Table XXL, wc have given three tables of the mean weight for each inch of height, and for each decennial period, computed from the Sanitary Com- mission statistics and our own records, and have placed with them the standard now in use. On exam- 55 ination of these, we find that under the age of thirty years, the averages of all three series are below the standard — a result which proves that the standard is fixed too high for this class of persons. The averages of the Sanitary Commission and Non-Consumptives approach each other closely, while that of the Con- sumptives falls considerably below them both. In the next two decades, thirty to forty, and forty to fifty, the standard and the Sanitary Commission run closely together, while the Non-Consumptives average higher and the Consumptives lower than these. For the period between fifty and sixty years, the tables are based on too few numbers to merit much consideration. We may draw the conclusion from this table that the standard now in use is not correct for the early ages of life, the weight being greater than is usually attained at that period ; above thirty years of age, however, it is sufficiently correct. When used for Life Insurance examinations, an addition must be made for clothing. We also consider it proved by our tables that a weight below the average is a very sus- picious circumstance, as indicating a tendency to Con- sumption, and would advise that all persons presenting such disproportionate figure should be most carefully scrutinized. 56 CHEST MEASUREMENTS. The records of chest measurement are of much less value than those of height and weight, and we will therefore devote only a few remarks to them. In the examination of applicants, measurements of the circumference of the chest are taken at the greatest, medium, and least expansion. The mobility of the chest, or the difference between the greatest and least expansion, is of most importance in estimating the vitality, but it requires considerable skill on the part of the examiner to obtain its true measure. In the ma- jority of our records, the medium measurement only is given, and this is often unreliable, from the variable amount of the clothing worn by the applicant, and the want of skill of the examiner. We have carefully gone over all our records, and prepared tables similar to those of weight and height. We shall not give them, however, but merely state, as a final result, that a comparison of the Non-Consumptives and Consumptives shows throughout an average chest measurement from one to one and a half inches less for the Consumptives. 57 PREDISPOSITION AND FAMILY TAINT. Most medical writers, when discussing tlie causes of Consumption, assign the greatest weight to what they call predisposing causes, or, as applied to the individual, a predisposition to the disease. This, it is said, may be either congenital or acquired ; the chief stress being laid on some unknown condition of the system which attaches to the individual from the time of birth, although other causes, such as improper food and air, unhealthy place of residence, or injurious occupation, may in after-life produce the same constitutional condition. Temporary and accidental circumstances working upon such a predisposition evoke the disease Consumption. The signs of the consumptive diathesis have often been described, and are commonly supposed to be easily discernible by an experienced eye. They are usually given in vague or general terms, or, when a more minute description is attempted, so many excep- tions of every kind are noted that the signs become of little practical value as a means of ascertaining the presence or absence of a tendency to the disease. The 58 experience of Military Service and Life Insurance com- panies give abundant proof of this, for in them, after a careful selection of such men only as present marks of sound health and prospective longevity, very many still die of Consumption. In describing this diathesis, the terms " hereditary," " congenital," and " family" are applied to it, and often used interchangeably, though their meanings are very different. This misuse of terms has occasioned much confusion. The term " hereditary" can only be properly ap- plied v^^here the same disease has existed in one of the progenitors ; " family" is more comprehensive, as it includes not only these, but also the cases in which brothers and sisters were affected. Some persons seem to think that the presence of a disease in several members of a family is of itself a proof of its pre- vious existence in a common ancestor, but this is a mere supposition. Such instances may as well be supposed to occur from the influence of a common cause acting upon all in the same manner, such as food, air, soil, or perhaps influences derived from parents, though not hereditary. " Congenital " predis- position may be hereditary, or may arise from the last- 59 mentioned source of influence — as Dr. Bennett writes, " weak parents beget weak offspring." The study of the influence of heredity, and espe- cially the hereditary transmission of certain tendencies to disease among human beings, is surrounded by so many difficulties, and in its discussion there has been so much assertion, supported with such loose logic and scanty proof, so many absurdities built upon a slight foundation of truth, that a few remarks on the subject will not be out of place. The general laws, embracing all phenomena of heredity, are two — namely : 1. Every organism produces others of like kind with itself; but, 2. No organism is exactly like either parent. Variations originating under this second law, or subsequently acquired, may cease with the individual, or be transmitted to a succeeding generation. By the operation of the first law, the uniform type of the species is preserved within a comparatively narrow range of variations allowed by the second law. In this general sense, the law of heredity is universally acknowledged, and it is only called in question when applied to minor personal qualities. Every individ- ual is born with the general structure and powers of 6o his species, also with some personal qualities or modi- fications, derived from ancestral influences. From birth to the end of life, he is constantly undergoing changes and becoming modified by the operations of external causes, and his individual characteristics are thus eflfected. Now, being thus eventually constituted, the ques- tion to be determined is, what portion was innate and what acquired, and then, further, of the congenital por- tion, what has been inherited from parents, what de- rived otherwise from the same source, and what may be personal variation. The existence of hereditary transmission is most strikingly shown by the examples of variation. The transmission of a uniform type is too. common an occurrence to attract attention, but wherever a marked deviation from the type takes place, and the pecu- liarity is transmitted to another generation, then our attention is at once aroused. The best instances of this are seen among the lower domestic animals, because their period of gestation and maturity being short, we can observe several generations, and whenever varia- tions occur, can control the breeding and other ex- ternal circumstances, and thus preserve all the devia- tions which may be of advantage. In this way, stocks 6i have been altered and many varieties of each species permanently preserved. In the human race, there are a few equally marked instances — where, for example, certain blemishes, as supernumerary digits and exag- gerated features, have been handed down from parent to child. These, though equally conspicuous, are less permanent, because, instead of being fixed by inter- breeding, they soon disappear through mixture of uncontaminated blood. Undoubtedly, other qualities, both mental and physical, are transmitted ; but the observations are usually less trustworthy and the de- ductions less rigid, as these qualities are more or less originated or influenced by culture, education, and surrounding circumstances, and the resemblances are matters of opinion as much as of fact, being often a question more or less dependent upon the judg- ment or prejudice of the observer. There are additional difficulties surrounding the study of the transmission oi disease in the human being. All inherit a body subject to death, and to suffering and disease under given circumstances. Violence will break a bone ; poison will kill any or all, though the amount required to produce the effect may vary. It is possible that, under the influence of acquired disease or long-acting noxious surroundings, the physical 62 structure might be so altered and debilitated as to be unable to produce offspring endowed with the normal vigor of the race. Such offspring might be born with a structure similar to that of the parent, or with a general weakness or vulnerability of constitution that would make them unable to resist attacks from which others would soon rally. Or they might pass through the usual period of life, and themselves give birth to offspring of the same feeble constitution. This would not be the necessary result, however, for the offspring might revert to the primitive normal type, or the other and more robust parent might determine its structure. These constitutional weaknesses, taints, diatheses, are what are usually called hereditary diseases, although in rare cases a disease existing in the parent may also be transmitted to the offspring. It is probable that an external cause is always necessary for the production of active disease, and whenever the effect is greatly disproportionate to the cause, the presence of a constitutional predisposition may be inferred. The predisposition may have been inherited or acquired, and the only proof of inherit- ance is the previous existence of the same disease in an ancestor. The disease, or at least the predisposition, must 63 have existed in the parent previous to the birth of the child — a consideration which would appear self-evident, and yet is practically neglected on account of the extreme difficulty of obtaining information on the subject. In statistical inquiries, the deaths of parent and child from the same disease is generally admitted as evidence of transmission, but it is by no means proof. It is extremely difficult to obtain reliable informa- tion concerning the diseases and causes of death of even two or three successive generations of a family. Physicians can seldom observe for themselves the complete histories of two generations, and are obliged to depend upon the statements of their patients. In the few instances of blemishes and easily recognized causes of death, there is little liability to error ; but for most diseases in which the diagnosis may have been obscure and a technical name describes a group ' ' of symptoms, such unprofessional statements and oral traditions are of little value. From these general considerations upon the he- reditary nature of diseases, we will proceed to the subject of Consumption. From early times, physicians have reported, as the result of observation, that numerous members of some one family died of Con- sumption, while those of other families were seldom 64 affected with this disease. Sometimes parents and children, sometimes more numerous branches of a family suffered. As a result of this kind of observa- tion, a general belief was firmly established that Con- sumption was an hereditary disease. It was difficult, however, to sustain this belief by rigid proof Such proof could be afforded by two methods of inquiry. Either by taking an equal number of consumptive and non-consumptive persons, and tracing their de- scendants for at least two complete generations; a comparison of the number of Consumptives in each set of cases would show the existence or non-existence of hereditary influence, and its extent. However, the collection of such a set of family histories has never been made, and, in fact, is almost impossible. As we have before said, three generations cannot pass under one observer, and, in absence of professional records, little reliance can be placed on recollections and traditions. Or the second method of statistical in- quiry would be to examine into the family history of a number of Consumptives, and ascertain how many of the blood relatives, near and remote, had died of this disease. This method has been frequently adopted, and by it the hereditary nature of Consumption has appeared to be proved. The force of the proof is 65 weakened, however, by certain sources of error which have not been allowed for. The number of con- sumptive cases has been given, and the number has appeared large, but we have no statement of the total number of relatives and the expected Consumption mortality among them, and without such a com- parison the mere numbers are of little value. It seems to have been forgotten that Consumption is an extremely common disease, and that, therefore, among any large number of deaths in one or several families, there is a reasonable expectation of finding many from this disease. We have already stated that Consum.ption is gen- erally considered by physicians to be a hereditary dis- ease, although some deny the value of this influence in its causation. A few quotations will indicate these differences of opinion. Laennec writes : " The uni- versal and habitual experience of practitioners proves that the children of phthisical parents are more subject to this disease than others are." ""'■ Sir Thomas Watson says : " No one, of the least observation, can doubt that the disposition to Con- sumption is very often transmitted from parent to * Op Cit., p. 337. 66 child. . . . Like other hereditary tendencies, it may skip over one or two generations, and reappear in the next, just as family likenesses are known to do." ■"- Dr. Fuller writes : " M. Roche has gone so far as to say that the children of consumptive parents almost necessarily prove victims of the disease ; and if the statement were restricted to those persons whose parents were both consumptive, my own experience would have led me to concur with M. Roche. But the proportion of cases in which a transmitted tenden- cy to the disease is developed in the children is not so large when one parent was healthy. In that case, as far as my observation has gone, the disease is developed, sooner or later, in about three fifths of the offspring." f Quotations of similar import might be multiplied indefinitely, but these will suffice. On the other hand. Dr. Walshe considers the hereditary nature of Con- sumption unproved and doubtful, and in the careful and elaborate report before quoted, in answer to the ques- tion, Is Phthisis an hereditary disease ? says : " Popu- lar feeling has so long and so absolutely replied to * Op. Cit., Vol. I., p. 227. t Diseases of the Air Passages and Lungs, pp. 3C4-5. 67 this query in the affirmative, that it may appear an empty labor to submit the question to investigation. But in point of fact, proof has never been afforded of the justness of the general conviction. . . . The final conclusion, then, deducible from this analysis of 446 cases, is, that Phthisis m the adult hospital popu- lation of this country, is, to a slight amount only, a disease demonstrably derived from pareiits. There is no reason to believe that the law differs among the middle and higher classes of society." •■' Dr. J.Hughes Bennett says: " Although, therefore, there can be no doubt that weakness in parents is a cause of weakness in the offspring, we are of opinion that it (hereditary influence) is by no means so gen- eral or influential a source of Phthisis as is usually supposed." f Drs. Flint and Niemeyer also think that the heredi- tary influence has been overrated, and that it is less important in the causation of the disease than has commonly been considered. While -thes2 opinions (except that of Dr. Walshe) seem to be the result of general though careful ob- * Op. Cit., p. 240. \ Reynolds' System of Medicine, Vol. III., p. 546. 68 servation, the statistical method has not been neglect- ed. Numerous histories have been recorded by Drs. Walshe, Cotton, Williams, and others. Drs. Walshe's and Cotton's records were taken from hospital patients, and Dr. Williams' from those in private practice. CTbjection has been made to the first mentioned on the ground that hospital patients belonged to a class ignorant of their family history, and hence their state- ments are unreliable. Dr. Williams' cases were ob- served in private practice among the middle and upper, and consequently more intelligent classes ; in these respects resembling Life Insurance risks. We will give their tables in connection with our own, but desire first to briefly examine Dr. Williams' figures for the reason above given, and because the same crit- icism will apply to many similar observations which have been adduced to prove the extent of hereditary influence. The following was the result of Dr. Williams researches.^'' * Med. Cliirurg. Trans., Vol. LIV. , p. 95. 69 Of 1000 Consumptives : lo had grandparents affected. 43 " fathers " 67 " mothers " 10 " both parents " 48 " uncles and aunts affected. 72 " father's or mother's family affected (particulars un- known). 224 '• brothers or sisters affected. 10 " cousins " 484 total — some member of family affected. The first thinsf that strikes us in examininar this table is that nearly half the cases had some other member of the family affected with Consump- tion, and this large proportion would apparently indicate the existence of a family taint. Looking farther at the particulars, we find that of these looo Consumptives, only 10 had grandparents and 10 had cousins similarly affected. This shakes our pre- vious conclusion, and would prove either that Con- sumption does not affect an entire stock or family, or that the statements of the patients were unreliable. To our mind it proves the latter. Consumption is, as we have shown, so extremely common a disease, that it is impossible to believe that only 10 of the 4000 grand- 70 parents of looo persons were consumptive. If we ad- mit that the statements are inaccurate, and there- fore no proof of the absence of hereditary influence, we should reject them altogether, and not use them to swell the total number of consumptive relatives. The same reasoning will apply to aunts and uncles ; the number is larger, but the proportion small. In the case of mem- bers of the immediate family, parents, brothers, and sisters, the number of Consumptives is very consider- able, and affords probability of the existence of family taint, though it does not afford proof Taking the low percentage of Consumption among our selected lives, 20 per cent or 400 out of 2000 parents might be expected to die of Consumption, and only a number larger than this would be disproportionate — presum- ing that all the parents had ended their lives. We do not know how many parents, brothers, and sis- ters had died, and consequently cannot tell how the reported numbers compare with the average. The figures show a strong probability of this hereditary influence, but the most important deductions to be drawn from them in our opinion are, ist, That, as a general rule, it is useless and misleading to extend our inquiry beyond a very narrow family circle ; and, 2d, That, m more than half the cases of Constimption, the most careful inquiry, extended to all the branches 71 of a family, will fail to find another member simi- larly affected. Having found, then, that statistical proof of the existence of a family predisposition to Consumption has not yet been afforded, we will proceed to the con- sideration of our own. records, and see if they can throw any additional light on the subject. Before presenting them, however, we will remark that they cannot be compared with those last given and other similar ones, or taken as establishing the frequency of family taint in general. Our cases were all healthy lives, selected after medical examination, and one of the rules of this examination tended to exclude per- sons' with a decided family taint. Hence we should expect to find here a much smaller number of tainted families than among Consumptives in general. The value of our tables will consist in presenting a comparison of an equal number of two classes. Consumptives and Non-Consumptives, whose his- tories have been taken and recorded under simi- lar circumstances, so that even if the histories are not precisely accurate, the errors are the same in both sets of cases, except that, if it be established that Consumption is hereditary, the rule of selection above referred to would bear particularly upon the first class. 72 TABLE XXII. TABLE SHOWING THE FREQUENCY OF FAMILY TAINT AMONG CONSUMPTIVES AND NON-CONSUMPTIVES. Some Membeh OF Family Consumptive +: )-> R . (^ ^ f" S b^ tH CQ W few b> J s u u It H [S '^ fa g H 1=3 h ^ Consumptives IO3I 38 40 7 16 22 71 194 837 Non-Consumptives . IO3I 18 20 2 12 5 45 102 929 In 2 cases among the Consumptives both parents were consumptive. They are entered under the col- umn of " father." TABLE XXIH. CONSOLIDATED FROM TABLE XXII. Parent Consumptive. in tn m Total with Family Taint. Father. Mother. Total. Consumptives Percentap^e 45 20 56 32 lOI 9-79 52 5-04 93 9.02 5° 4-85 194 18.81 Non-Consumptives 102 10.89 7i These figures sustain the general opinion regarding the influence of hereditary and family predisposition in causing Consumption more fully than any hitherto published, and we consider them as affording positive proof of its correctness. We find that of an equal number of Consumptives and Non-Consumptives, similar in every respect, nearly twice as many of the former had consumptive blood-relations as of the latter ; or to speak more accurately, 1 8.8 1 per cent of the Consumptives, and only 10.89 P^^ c^'^t of the Non-Consumptives, had near relatives who had died of Consumption. The difference is too great and constant through all the subdivisions, and drawn from too large a series of cases, to be the result of chance, and we must consider it the expression of a law. Our table shows the number of Consumptives in each class of relations, but the numbers of each sepa- rately are too small for the deduction of laws. In Table XXIII. we have consolidated these subdivisions in two groups, showing, first, those having parents, and, second, those having brothers and sisters only, dying from Consumption. The proportion for each group is nearly equal in both classes, the number of 74 parents affected being only slightly greater than the number of brothers and sisters among both Consump- tives and Non-Consumptives. From this we would infer that there are other causes of family predisposi- tion equally powerful with hereditary influence. It does not come within the range of our inquiries to ascertain what these causes may be, but it is probable that they might arise from a common rearing and education. We may also conclude that in deciding the value of any life for insurance, the previous occur- rence of Consumption in any member of a family, whether parent, brother, or sister, is of equal import- ance In Table XXII. it will be seen that the number of consumptive mothers is greater than that of consump- tive fathers. The same fact has been observed by Dr. Williams and others, and from their observations the inference has been drawn '' that Consumption is more likely to be transmitted by a mother than a father." This is not sustained by our table, which shows a similar preponderance of consumptive moth- ers among both Consumptives and Non-Consump- tives, and perhaps the circumstance can be best explained by the observation of Dr. Walshe, " that the procreative power of phthisical males is below the 75 average, and the fecundity of phthisical females mate- rially above it."'"' For convenience of reference, a table from three authorities, showing the frequency of family taint, is here inserted. TABLE XXIV. o, a i S S tf) Oj 3 c 3 m a u > u a, ° B ■a c ■3 o W 5J ^.i Si li H o '3 " S" H h s a CQ H Z Mutual Life. 1 03 1 45 56 2 71 194 837 Dr. Williams 1000 43 67 10 224 344 656 Dr. Cotton.. 1000 112 102 27 126 367 633 We have thus been able to verify the general opinion of physicians, and to establish by statistical proof the existence of a family predisposition to Consumption. We have demonstrated that the occur- rence of the disease in one member of a family is a reason to suspect and fear its subsequent occurrence in another member, and that, in Life Insurance exami- nations, whenever an applicant states that a parent, brother, or sister has died of Consumption, it must * Op. Cit. 76 be judged a suspicious circumstance in estimating the probability of his own longevity. This opinion, how- ever, has been so often enforced, and is so firmly estab- lished as a rule of guidance in the selection of lives, that we will not dwell upon it farther, but will rather point out some other conclusions of equal importance, and which there is danger of overlooking. These are : 1. That, as a general rule, it is useless to investigate family histories beyond the immediate family circle. 2. That in a majority of instances no indication of family taint can be found within this circle ; in Life Insurance experience it was absent in 84 per cent, and in Dr. Williams' cases from private practice in 66 per cent. The following calculation will give an estimate erf the amount of the influence of family taint in the causation of Consumption. This estimate, however, is only approximative, as it is deduced from se- lected lives. Allowing the same rate for Consump- tive families in all our Non-Consumptive cases, as has been found in the 1031 selected cases, we would have for our total mortality experience : in the 5224 cases a family taint of Consumption in 649. Of these, 194, or 30 per cent, died of Consumption ; 455, or 70 per cent, died of other dis- n eases. Thirty per cent of those having Consumptive families have died of Consumption, against our general average of tv^^enty per cent of deaths from this disease. On the other hand, more than two thirds died of other diseases than Consumption. These figures all tend to the same result — namely : that hereditary or family taint is of only secondary importance in the causation of Consumption, being absent in the large majority of cases. The practical conclusions are, that in the selection of risks for Life Insurance, the existence of family taint is to be allowed a due but not an excessive value in forming a judgment ; that it must always be consid- ered an unfavorable element, but affords no sufficient ground for rejecting an otherwise good risk. This refers solely to cases where one member of a family has died of Consumption ; the danger will probably be much greater where two or more have been consump- tive, although our numbers arc too few to establish this point. On the other hand, the absence of such family taint does not improve the value of a life otherwise doubtful. It has been stated, and the statement has been supported by some statistics, that Consumption is developed at an earlier age among those having a 78 family predisposition than among those free from it. We have prepared the 'following table with refer- ence to this point : TABLE XXV. SHOWING THE PROPORTION OF CONSUMPTIVE CASES WITH FAMILY TAINT AT EACH DECENNIAL PERIOD OF LIFE. Age at Death. Total 20 to 29 years. 30 " 39 40 " 49 SO " 59 60 " 69 70 " 79 Total Deaths from Consump tion. 1031 181 401 296 113 33 7 Number of Cases with Family Taint. 194 34 ' SI 24 7 Percentage. 18.81 18.78 18.95 17.23 21 .24 21 .21 28.59 The proportion of those having family taint is nearly the same for all ages, the higher percentage at a late period of life probably arising from the small number of cases. Hence we would conclude, that family taint is of equal importance in estimating risk of life at all ages, and is not to be neglected be- cause an applicant has reached 40 or 50 years. A remark has been quoted to the effect that weakness in parents is a cause of Consumption in 79 offspring, and such an opinion has been supported by several medical authorities. This is a subject very difficult to investigate satisfactorily, and we have thought that the following table might be a contribu- tion to its study. It may be presumed that the con- stitutional strength of the parents would be shown by their longevity, the presence of any disease or debility causing premature death ; we have therefore prepared a table in which the Consumptives and Non-Consump- tives are compared on the basis of the longevity of their parents. TABLE XXVI. SHOWING THE NUMBER OF CASES AMONG CONSUMPTIVES AND NON-CONSUMPTIVES, IN WHICH THE PARENTS DIED UNDER OR OVER 50 YEARS OF AGE. Parents Dying at or Under 50 Years of Age. Both. One. Neither. Total. Consumptives Non-Consumptives. . 43 37 234 214 3°7 314 584 56s We find here the proportion of parents dying at an early age to be nearly the same for both classes, and these statistics fail to sustain the opinion above quoted. 8o PREVIOUS DISEASE-HEMOPTYSIS. In Life Insurance examinations, the medical history of an applicant is carefully investigated, in order to ascertain whether he may have suffered from any dis- ease, and if so, to judge whether it were of a nature to threaten a recurrence of similar attacks, whether it appeared as a precursor of some other form of disease, or whether it may have resulted in some permanent impairment of his constitution. Such histories are then entered upon the record for future reference. We have examined these records of our series of Consumptives and Non-Consumptives to see if there were any symptoms or diseases specially indicative of approaching Consumption. We have found no marked difference between the two groups of cases ; and the Consumptives have had only a very few more entries against them of previous respiratory disease, such as Cough, Asthma, Catarrh, Lung Disease, Pleurisy, and Bronchitis. To one other symptom we have devoted special attention : Haemoptysis, or spit- ting of blood. This is properly considered, and has often been demonstrated, to be one of the mpst certain indications of approaching Phthisis, and it is consid- 8i ered by all Life Insurance Companies to be of such fatal omen as to exclude those who have once suffered from it, except under very special circumstances. We believe that they all refuse to admit any applicant who may have raised blood from his lungs within a period varying from five to ten years previous to his appli- cation, and even after this period he must give indica- tions of exceptionally sound health. We therefore give the following list of all the cases in our mortality experience in which there is any record of Hsemoptysis previous to insurance, and in it we include spitting of blood to any amount, and from any source whatever. TABLE XXVII. CASES OF HAEMOPTYSIS. Cause of Death. of Oc- rrence /ious to J ranee. Age at Insur- Quantity. Cause, Source, etc. ance. Consumption.. . . 44 4.6 I year. 35 11.5 Slight. I " 39 3.8 I " 30 4-1 " Over-exertion. 2 years. 39 13-3 R.R. accident. 2 36 15.10 11 3 " ■^2 5-5 From nose. 5 " 37 1.08 82 CASES OF HEMOPTYSIS. — Continued. Cause of Death. Time of Oc- currence previous to Insurance. Age at Insur- ance. ■SI "si H Quantity. Cause, Source, etc. Consumption 6 years. 43 2.6 Pneumonia. 7 " 37 9-3 8 " 41 8.1 9 " 37 15-2 Slight. 10 43 6. II " Strain. lo " 38 II. II 11 43 9-7 " Severe exercise. 12 36 1-5 13 " 36 39 2.2 8.9 41 6-5 Some. Throat. 33 3-5 3 or 4 times. Unknown. 32 3-5 3 times. Over-exertion. " 29 1. 10 Violent exercise. Pneumonia 12 52 19. Several times " 15 '■ 36 9.10 Slight. " 15 " 48 4-4 " ** 20 " 34 4-9 ■■ 32 " 51 26 12.9 22.4 " 42 4-5 2 or 3 times. Jumping. Bronchitis 36 13-7 After a fall Congestion of Lungs I year. 35 4.10 Twice. Typhoid Fever. . 6 years. 30 40 •4 5. II Slight. Yellow Fever. . . . 29 9-3 Some. " " 3 " 32 I. II Dysentery 35 4.8 Slight. ** 8 " 29 II. 4 Cholera 12 37 12. Erysipelas 42 •9 " Not from lungs. Small-Pox 28 5-1 Twice. Typhoid Fever and Pneumonia. 83 CASES OF HEMOPTYSIS. — Continued. Cause of Death. Time of Oc- currence previous to Insurance. Age at Insur- ance. |1 = " J. "is Quantity. Cause, Source, etc. Disease of Stom- ach and Bowels lo years. 3S 22.4 Inflammation of Bowels 12 " 27 16. 1 Inflammation of Bowels i6 " 50 17.8 Inflammation of * Bowels 34 17-3 Inflammation of Bowels 36 21.6 Ulceration of Bowels 37 25.10 Bright's Disease. in boyhood 31 10.2 " " 9 years. 40 3.6 Apoplexy 15 " 50 2.6 " 20 43 3- " 47 5-9 Slight. Acute bronchitis Insanity 30 IS. 2 Inflammation of Brain 36 .8 Congestion of Brain 43 I. Congestion of Brain 54 1-7 Softening of Brain 40 46 10.3 20. Disease of Brain. DroDSv few weeks 49 30 12.10 it *^*w^-j_j .......... Casualty 10 years. 5-4 Throat. " 12 " 42 15- extending over all por- tions of the country. Second, that of 1854 and 1855, prevailing in the first year chiefly in New York and its vicinity, and in the second year in the Mississippi Valley. Third, that of 1866, in the Middle and West- ern States. The years mentioned are those of the chief severity of the disease, although there were a few cases in the succeeding years. CARBUNCLE. Thirteen deaths have been reported from Car- buncle. It is a comparatively rare disease before middle life, and seldom fatal, except in constitutions impaired by age or disease. In our experience, the youngest was in a person aged 39 years, and insured 114 only 6 months. The total number of deaths appears small, but it is larger than we should have expected to find among selected lives. PYEMIA. There have been 1 1 deaths reported by Pyaemia, but the death certificates are, not fiill enough to admit of any useful analysis. ALCOHOLISM. Thirty-one deaths have been attributed directly to the use of Alcohol, the cause of death being stated either as " Delirium Tremens" or " Intemperance." In addition, one person committed suicide while suffering from Delirium Tremens, which case is included with the suicidal deaths. 115 A majority of these cases occurred under 40 years of age, 90 per cent under 50 years, and none after sixty years, showing that the excessive use of alcohol as a habit is acquired at an early age, and that no constitution can long withstand its destructive in- fluence. An extremely large propoition, 6 of the 31, or nearly 20 per cent, died within the first year of insurance, indicating that the applicants had probably concealed their habits of life by false statements to the medical examiner. A slight proportional excess oc- curred among foreigners, especially the English and Irish, although the native element is large. The smallest number of deaths occurred in the New Eng- land States, and the largest in the West. These figures represent only the deaths resulting from the use of alcoholic drinks as a sole cause, and they are of little importance in comparison with the more numerous cases, where life has been indirectly shortened — those in which chronic diseases of various organs and tissues have been produced, or a thus debili- tated constitution has given way before acute disease. These acute diseases — pneumonia, meningitis, injuries or the pathological conditions of certain organs, as the ii6 liver, kidneys, etc. — are stated on the certificates of pliysicians and friends to be the causes of death, while the real cause, the habit of body induced by the indul- gence in alcoholic liquors, is, out of charity to the family of the deceased, withheld. These cases are known to be numerous, and are fully appreciated by all Insurance Companies, but un- fortunately we have no way of investigating them statistically from this Company's mortality records. OTHER DISEASES. There have been 3 deaths from Purpura Hsemor- rhagica at the ages of 2)7 < 47. and 52. The records give no particulars of interest. One death from Malignant Pustule has been re- ported. The case was that of a broker in New York City, aged 2 7 years, and in the third year of insurance, who died after an illness of three days. There was also i death reported from Glanders, * in a produce-dealer, 42 years of age, living in Maine, 117 who is said to have contracted the disease from a horse. There was also i death reported to have been caused by Goitre, but the cause of death was really doubtful. The patient, aged 55 years, insured i6i years, had had a goitre for many years, but for a short time had become very much debilitated, and died suddenly. No post-mortem was made. CONSTITUTIONAL DISEASES. Constitutional Diseases are those depending upon some general taint of the blood or body. They differ from zymotic diseases in that they are individual, and not epidemic, that they do not proceed from a specific poison, and that they are usually chronic in their form. They show their constitutional nature by affecting several organs of the body, and by a ten- dency to recur. The exact nature of the taint is in no case known. It may be inherited, or may be acquired ii8 subsequent to birth by circumstances affecting the habits of hfe of the individual. The most important of the class are the tubercular diseases, the chief of which, Consumption, we have already discussed. The other diseases are Cancer, Rheumatism, Gout, Anaemia, Gangrene, and Dropsy. MISCELLANEOUS DISEASES. In addition to Consumption, which we have already described. Marasmus and Consumption of the Bowels, Lumbar and Psoas Abscess, Hip-Joint Dis- ease, Tubercular Meningitis, and Scrofula, causing in all 30 deaths, make up this group. There have been 1 1 deaths recorded from Maras- mus, and 6 from " Consumption of the Bowels." We unite these cases, although the term Marasmus is often applied indefinitely to cases in which there is a wasting away for want of proper assimilation and digestion, whether the cause be tubercular or some other form of disease. The cases have occurred at all ages, as follows : Between 20 and 29, 2 ; 30 and 39, 4 ; 119 40 and 49, 3 ; 50 and 59, 5 ; 60 and 69, i ; 70 and 79, 2. The cases recorded as Consumption of the Bowels have been chiefly at the earlier, and those of Marasmus at the later periods of life. There have been 4 cases of Lumbar and i of Psoas Abscess, and 2 of Hip-Joint Disease. They were all, except i, under 40 years of age: between 20 and 29, 2 cases ; 30 and 39, 4 ; 50 and 59, i case. One death is reported from Tubercular Meningitis. There have been 5 deaths from Scrofula, the local manifestation of the disease not being mentioned. The ages of death were as follows: 28, 29, 41, 50, and 56, CANCER. There have been 91 deaths caused by Cancer. We are unable to give a table of the different organs affected, because in the majority of cases the certificate of death is indefinite in this respect. In our Pre- liminary Report we gave an analysis of the more important facts in relation to this disease, and we can now only corroborate our previous statements. We 120 found that it was most frequent in proportion to the advance of age and to the duration of the insurance, although there were several deaths soon after insur- ance had been effected. The following tables show the number of deaths in proportion to the number of lives exposed : TABLE VIII, SHOWING THE PERCENTAGE OF DEATHS FROM CANCER ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 LIVES AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY, AND IN THE MUTUAL LIFE. Age in Decennial Periods. Pekcentage on Total Mortality. Annual Mortality i.\ 100,000 Lives. New York City. Mutual Life. New York City. Mutual Life. 20 to 29 years 30 " 39 " 4.0 " 40 " ■31 .68 1-7S 3.01 2.84 1. 61 •41 .98 I-I3 3 -45 3-33 I-S7 3 13 40 105 , 167 231 3 7 9 45 89 86 Co " qo '* 60 " 69 " •70 and unwards 121 TABLE IX. SHOWING THE PERCENTAGE OF DEATHS FROM CANCER ON THE MORTALITY FROM ALL CAUSES, AND THE MOR- TALITY IN 100,000 INSURED LIVES AT DIFFERENT PE- RIODS OF INSURANCE. Duration of Insuranee. I St year 2d " 3d to 5th year . 6th " loth " . Above 10 years Percentage on Mortality from all Causes. 1-31 •51 .87 2.74 2 .64 Annual Mortality. Number of Lives E.\posed. Number of Deaths. 100,000 100,000 100,000 100,000 100,000 31 40 The first table shows an enormous difference in the mortality among insured lives and the general population — a difference that would not seem to be entirely accounted for by the medical examination. It may be said in round numbers, that there are twice as many deaths from Cancer among the male popula- tion of New York as in the experience of this Com- pany. The number of deaths increases with the age : under 50 years there are few deaths, 3 between 20 and 30, 7 122 between 30 and 40, and 9 between 40 and 50 years ; after this the number rapidly increases, so that between 50 and 60 there are 45 deaths, between 60 and 70, 89 ; and above 70 years, 86 deaths in 100,000 Hves. These results are what we should have expected, and are in accordance with the statistics of Walshe, Paget, and others. In the second table, we have the deaths in reference to the period of insurance. This, too, is what we expected from our previous tables and the pathology of the disease. We had previously shown that the mortality from Cancer compared with that from all causes was small for the first 5 years of insurance, and became very much greater after that period. Can- cer is usually chronic in its course, often taking years before the final fatal result. Hence the medical ex- amination eliminating those already affected with the disease, it will be only after a few years have elapsed that there can be many deaths from Cancer. We find, however, one marked exception to this rule : the mortality in the first year after insurance is remarkably high, being double that of the second year. This may be merely a matter of chance, on account of the small number of figures ; but it is most probable that the disease existed at the time of insurance, and that the 123 applicants denied or concealed their symptoms from the scrutiny of the medical examiners. The disease has caused more deaths proportionally among foreigners than among natives. The percentage of deaths from all diseases is, for natives, 75, and foreigners, 25 ; from Cancer it is 65 and 35 respectively. There are only 3 cases in which there is any family histor)^ of the disease. In these 3 cases, a mother, brother, and sister, respectively, had died of the disease. Although, as we have seen, the difference in the mortality from Cancer among the insured and general « population is very great, still it is not a disease which we would expect to be much influenced by medical selection. The etiology of Cancer is too obscure to enable us to detect the probabilities of its approach. Age, inheritance, occupation, and perhaps climate and nationality, have some influence on its causation ; but, in the words of Sir James Paget, " After all, when we have assigned to these conditions their full weight in producing the cancerous constitution or state of the blood, that which may strike us most of all is the compai-atively small influence which any known inter- nal or external conditions possess." 124 RHEUMATISM. There have been 20 deaths attributed to Rheu- matism as the sole cause of death, and in addition there are 3 cases called " Rheumatism of the Heart," and 7 of " Acute Rheumatic Inflammation of the Heart," which we have included among the diseases of that organ. We have but scanty information con- cerning most of these cases, some being reported as " Inflammatory Rheumatism" and " Rheumatic Fever," while others are merely designated as " Rheumatism." The ages at death v/ere as follows : 20 to 29 years, 2 cases ; 30 to 39, 5 ; 40 to 49, 7 ; 50 to 59, 5 ; 70 to 79, I case. Twelve of the 20 were between 30 and 50 years of age. Among all these deaths from Rheu- matism and Rheumatic Disease of the Heart, in only 3 cases had there been an attack of Rheumatism pre- vious to insurance, and in no instance is there any record of Rheumatism in "other membersvof the fam- ily. A very large proportion — 8 out of 20 — were for- 125 GOUT. There have been 7 deaths from Gout. The num- bers are too few for any useful analysis, therefore we will merely give some particulars of the cases. There are, unfortunately, no means of ascertaining the injury, or the deaths caused by Gout indirectly, either by the kidney disease, or the general deterioration of the sys- tem that it may produce — conditions which are far more important than the knowledge of the few cases in which the Gout is the direct cause of death. The ages at death have been as follows : Between 30 and 39 years, i death ; 40 and 49, i ; 60 and 69, 3 ; 70 and 79, 2 ; or 2 deaths under 60 years of age, and five above that period. Two died under 5 years of insurance, and 5 above that period. Only 2 had suffered from Gout previous to insurance, and in no instance is there any family record of the disease. 126 ANEMIA. There have been 7 deaths from Anaemia. All but 2 died above 50 years of age, as follows : 29, 45, 55, 59, 60,64, and 69 years. One died in the first year of insurance, i in the fourth, i in the fifth, and 4 after a duration of 10 years. One is stated to have been scrofulous at the time of insurance ; he was 34 years of age when insured, and died at 60, after a dura- tion of 26 years' insurance. GANGRENE. There have been 4 deaths from Gangrene. In 5 cases the foot was the part affected, and in i the hand. The ages at death were 41, 44, 55, and 62 years. DROPSY. Although Dropsy may be considered as a symp- tom, and not as a disease proper, still it is frequently 127 stated to be the cause of death, when the underlying disease is hidden from the physician's observation, and consequently unknown, and when the accumula- tion of water becomes the immediate cause of death. There have been 82 such deaths from Dropsy. They have occurred chiefly at advanced ages ; very few below 40 years, but after that age rapidly increased in frequency. So, too, there were few deaths within 5 years of insurance. There has been little difference of prevalence from nationality or locality of residence. In fact, our statistics show nothing more than that it belongs to advanced life, like its most frequent causes, cardiac and renal diseases. DISEASES OF THE NERVOUS SYSTEM. The class of diseases of the nervous system is based chiefly on anatomical or regional considerations, and includes all diseases of the encephalic and vertebral cavities, and the nerves issuing therefrom, whether the part involved be the nervous tissue proper, or the blood-vessels, membranes, or adventitious growths. Diseases of the brain (encephalon) practically repre- 128 sent for us diseases of the nervous system, for although the other portions are not unfrequently the seat of dis- ease, they cause an extremely small proportion of mortality. Whatever tissue or part of the brain Ife affected, the disease is manifested chiefly through interference with the functions of the nervous element, and as several conditions may give rise to similar symptoms, the diagnosis of the special form is often obscure. We have in our records 84 death certificates which give " Disease of the Brain " as the cause of death, the attending physicians thus acknowledging their ignorance of its special nature ; and in our opinion this modesty might have been still further extended with benefit, as sometimes the diagnoses are evidently mere guesses, while in other instances a prominent symptom, as convulsions, or result of disease, as paraly- sis, is given as the cause of death. Unfortunately, too, the definition of the terms is unsettled, and the same name does not always repre- sent the same disease to different physicians. For instance, the name Apoplexy is used by some to des- ignate cases of cerebral hemorrhage, while to others, and probably the majority, it represents a group of symptoms, an acute seizure, producing stupor, abolish- i2g ing consciousness and the faculties of sensation and motion. Softening of the Brain and Epilepsy are also undefined terms. It is necessary to keep in mind these imperfections when analyzing and studying our mortality records. Other statistics have been collected under the same difficulties, as they represent the knowledge and opinions of average physicians. They therefore admit of mutual comparison, and by such comparison, and by keeping within the proper limits, we hope to draw some interesting and useful deductions. It was seen by the tables in the Preliminary Report, that nervous diseases increased among the causes of death directly with advancing years. This, however, was only the proportion to the deaths from all causes, and we have therefore examined the subject again, and give the following additional figures : TABLE X. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE NERVOUS SYSTEM ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 LIVES AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY, AND IN THE MUTUAL LIFE. Percentage on Total Mortality. Annual Deaths in 100,000 Lives at each Period. New York City. Mutual Life. New York City. Mutual Life. 20 to 29 years 6.84 8. S3 II .06 14.08, 14.00 7-58 12.17 17-56 20.99 23-84 22 .96 87 135 197 389 829 2004 50 83 149 288 30 " 39 " 40 " 40 " CO " ^q ' 60 " 60 " 694 1336 70 and upwards The first portion of this table shows the percentage of deaths from diseases of the nervous system on the mortahty from all causes. We find the proportion in- creasing steadily from 5 per cent between 20 and 30 years of age, to 14 per cent between 60 and 70. After 70 years the proportion ceases to increase. This is for the population of New York City. In our own expe- rience the figures are different, but the increase is at about the same rate. In the second portion of the table we have calculated the number of deaths that have occurred in every 100,000 lives. We see here the same regular increase with advancing years, but at a far more rapid rate. Between 20 and 30 years there are 87 deaths; between 40 and 50, 197 deaths; be- tween 60 and 70, 829 deaths; and above 70, 2004 deaths. This is for New York City. For the Mutual Life the numbers are less, but the rate of increase is nearly the same. These figures probably represent the true proportion of increase, and it may approximately be said that the mortality from diseases of the nervous system nearly doubles with each decade of life. We find, too, that the increase continues up to extreme old age, and that the slight diminution after 69 years, seen in the first portion of the table, is only apparent, per- haps arising from the rapid increase of deaths from other causes. The difference between the general population and the insured in the rate of mortality from diseases of the brain is shown in the table given above. In the first portion of the table we find that in the general popula- tion, 10^ per cent of all deaths are caused by diseases of the nervous system, while among the insured the proportion is i6^ per cent. It further appears tiiat this difference exists at all periods of life, and conse- quently does not depend upon a difference of age between the two classes. We have found a similar difference reported between the mortality of the Scottish Life Insurance Companies and the population of Scotland. Hence it might be supposed that brain diseases were more frequent among the insured than in the general population. The second portion of the table shows this supposition to be erroneous, and that the greater mortality is only comparative, arising, probably, on account of a diminished mortality from some other disease, as, for instance, consumption. In the second portion of the table we have the number of deaths in an equal number of lives of both classes. This shows us the true mortality rate, and we find it considerably lower among the insured than in the general population. In 100,000 insured lives there are annually 150 deaths from diseases of the brain, and in a general city population of the same number there are 224 deaths. This difference exists at all periods of life, and in each decade we find about one third less deaths among the insured than in the general population. It was to be expected that the mortality rate should differ in the two classes. The medical examination ^33 and selection ought to detect some impaired constitu- tions, and those already suffering from the chronic forms of disease. But, on the other hand, the indi- viduals who insure their lives belong, generally, to a class of society which is engaged in the active compe- tition of professional or business life, and consequently have brain work and mental strain, with excitement and depression, anxiety and worry, more than the laboring class which forms so large an element of a city population. This might be expected to produce an excess of mortality from brain diseases, and perhaps would do so, were there not counterbalancing advan- tages in favor of the insured, arising from their superior knowledge' of the laws of health, their greater personal comfort in shelter, food, and clothing, their ability to take care of themselves in time of sickness, and above all, from their general temperate habits. In this latter respect they have a vast advantage over the city popu- lation. The excessive use of alcoholic stimulants is known to have a powerful effect on the nervous sys- tem, and Insurance Companies succeed generally in excluding those addicted to alcohol from their risks. This, probably, is one of the main elements in causing the diminution of nervous diseases. We believe that there is a general opinion to the 134 effect that brain diseases are on the increase of late years, and that this is attributable chiefly to the ex- cessive wear and excitement of the present methods of working and living. The following table, taken from the Health Report of New York City, for the year 1873, is of interest in this connection : TABLE XI. ABSTRACT OF RECORDS OF APOPLEXY AND PARALYTIC DISEASES FOR THE SEVEN DECADES ENDING DECEM- BER 3IST, 1873. Paralytic Apoplexy. ''ears Periods. Estimated Diseases. Tex "V ui c *" Population. ual er i Liv 15 t^ •-= 3 Si-1 Deaths. Ann Numb 100,000 Deaths. Ann Numb 100,000 1804 to 1813 inclusive. 95,000 313 33 212 22 1814 " 1823 130,000 523 40 319 25 1824 " 1833 250,000 969 39 389 16 1834 " 1843 350,000 1145 33 523 15 1844 " 1853 " 560,000 4529 81 1060 19 1854 " 1863 720,000 2719 38 , 1756 24 1864 " 1873 1,000,000 3758 38 1501 15 135 The number of deaths represent registered facts, but the registration during many years was incomplete, and therefore not altogether reliable. The table shows, however, the mortality statistics of New York City give no evidence of any increase in brain diseases, but rather render it highly probable that there has been no such increase. We will now proceed to the consideration of the individual diseases. APOPLEXY HAS caused 30.8 deaths — a larger number than is attrib- uted to any other disease of the nervous system. The term is used in death certificates rather in ac- cordance with symptoms than lesions. It usually rep- resents cases in which loss of consciousness, sensation, and voluntary motion occur rather suddenly, and, after an interval of a few hours or days, are followed by death. It may happen to a person apparently healthy at the time, or at the termination of life of one sick with cerebral or other disease. In the majority of instances it is supposed that the symptoms are due to an effusion of blood into the brain, although other 136 lesions produce similar effects. If, instead of death, recovery ensues, it is usually only partial and attended with paralysis, and then when the patient eventually dies, the death certificate gives " Paralysis" or " Brain Disease" as the cause. The percentage of deaths from Apoplexy on the' total mortality was extremely small at an early age — only 1.64 per cent between 20 and 30 years, and in- creased up to nearly 10 per cent between 60 and 70 years. TABLE XII. SHOWING THE ANNUAL MORTALITY FROM APOPLEXY AMONG 100,000 LIVING MALES, AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY, AND IN THE MUTUAL LIFE. Age. 20 to 29 years. . 3° "39 " ■■■ 40 "49 " • • • SO "59 " • • • 60 "69 " . . . 70 and upwards, Number Lives. 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths Annually. New York City. 13 37 74 176 419 925 Mutual Life. 10 17 59 116 277 431 137 This table shows us the true mortality rate of Apoplexy as affected by age. The two experiences of New York City and the Mutual Life agree in estab- lishing a steady increase with age, though at different rates, from 20 years to extreme old age. The former, which represents the general popu- lation, gives the following rate : Of 100,000 males between 20 and 30 years of age, 13 die of Apo- plexy annually ; of the same number between 30 and 40, there are 37 deaths; between 40 and 50, 74 deaths; 176 deaths between 50 and 60; 419 deaths between 60 and 70, and 925 deaths between 70 and 80. The deaths thus more than double for each de- cennial period. In the Mutual Life there have been fewer deaths, but the rate of increase is about the same. The influence of selection is seen in diminish- ing the total deaths to two thirds of that of the gen- eral population, and this diminution is apparently nearly the same at all ages. This result has been effected only by the selection of generally sound and healthy lives, and not by any special elimination of persons of apoplectic tendency. The high rate of mortality during the first year after insurance shows that there are no signs by which a special tendency to Apoplexy, or even an approaching attack of the dis- 138 ease, can be foretold. Table XV. of the Preliminary Report showed that the percentage of deaths from Apoplexy on the general mortality was as high dur- ing the first year of insurance as subsequently, in this respect resembling acute fevers and accidents. The following table shows the rate of mortality in propor- tion to the numbers exposed : TABLE XIII. SHOWING THE NUMBER OF DEATHS FROM APOPLEXY IN PROPORTION TO THE NUMBER OF LIVES, AT DIFFERENT PERIODS OF INSURANCE. Duration of Insurance. Number of Lives. Number of Deaths. ist year 2d " 3d to 5th year. . 6th « loth " . . Above 10 years 100,000 100,000 100,000 100,000 100,000 43 27 SI 66 124 In 100,000 persons in their first year of insur- ance, 43 will die of Apoplexy ; of the same number in the second year of insurance 27 will die ; from the third to the fifth year the annual mortality will be 51 ; 139 from the sixth to the tenth year, 66 ; and after lo years, 124. We find that the annual mortahty is much greater in the first than in the second year, and nearly as great as in the third. After the fifth year the mortal- ity increases considerably. But here another element — namely, the increase of age — comes into considera- tion, and this will account for a large part, or all, of this increase. The falling oflF in the second year is remarkable, and only partly to be explained by sup- posing that individuals with some slight admoni- tions of failing health, and for this very reason, apply for insurance. Presenting no special marks of dis- ease, they are approved by the medical examiners as healthy and safe lives ; while, meanwhile, their own suspicions, scarcely acknowledged by themselves, turn out to be correct. Degeneration of their physical structure continues, and within a few months they die of Apoplexy. We have further ascertained that this high mortality during the first year is com- mon to all ages, and at each decennial period the deaths are more numerous in the first than in the second vear after insurance. The influences of Nationality and Residence were considered in the Preliminary Report, and we have I40 nothing further to add on these subjects. We found that the Scotch gave by far the largest proportion of deaths from Apoplexy, the Germans next, and the Irish the smallest. The different sections of the country gave but slight differences in their rates of mortality. The older writers on medicine have given " a par- ticular conformation of body" as one of the marks of a predisposition to Apoplexy. This conformation is described as follows : "A "large head, a short, thick neck, a florid complexion, broad shoulders, short stat- ure, with a tendency to corpulency."* A belief in this apoplectic build still prevails among the laity and among a large portion of the profession. It has, however, been denied by recent writers, as FHnt, Nie- meyer, Hughlings, Jackson, and others. Dr. Flint writes : " Formerly much importance was attributed to a so-called apoplectic constitution, consisting of short- ness of the neck, with considerable embonpoint, and what is known as a full habit. An analysis of a con- siderable number of cases shows that no reliance is to be placed on these or any other external characters as denoting a predisposition to Apoplexy. The * Gregory's Practice of Physic, Vol. II. p. 33. HI larger number of persons attacked are either spare or of an ordinary habit of body."* We have analyzed our records with reference to this point, and will give the results. The records do not give all the particulars embraced in the above description of the apoplectic figure, but only two, namely, height and weight. These, however, are the essential ones, an excess of weight in proportion to the height being necessary to fulfil the description. Of our 307 cases of Apoplexy, in 153 the height and weight are recorded. We will compare them with the tables constructed from the casualty and fever deaths and employed in the Report on Consump- tion. These, we think, fairly represent the average of height and weight of our Company's risks. The standard with which they are compared is that now used by the Company in its Instructions to Medical Examiners. ■* Flint's Practice of Medicine, p. 583. 1-42 TABLE XIV. SHOWING THE NUMBER OF PERSONS DYING OF APOPLEXY AND SOME OTHER DISEASES, ABOVE AND BELOW THE NORMAL STANDARD OF WEIGHT, AND ARRANGED AC- CORDING TO AGE. Apopttxy. Casualties, etc. Age. Above Standard. Below Standard. Above Standard. Below Standard. 2 to 29 years 4 27 ■4-I 24 6 102 6 23 2 I SI 58 137 100 29 327 123 121 •JO " ^g " 40 " 40 *^ 55 26 CO " qq " 60 " 60 " Total 325 We see here that the proportion of apoplectics above the standard weight was far greater than that of those dying of casualties. Of the former, two thirds were above the standard ; of the latter, only one half. This diflference is specially marked if we consider only the aged. For the young there is no great difference in the weights ; but taking persons above 50 years, it is very decided. Of 55 persons 143 dying of casualties 29 were above the standard, and 26 below it; while of 33 persons dying of Apoplexy, 30 were above the standard and only 3 below it. This proves that persons dying of Apoplexy at ages above 50 years, are, as a very general rule, of heavier weight than the average. The number of cases is not large enough to render a table of the average weight for different heights at all reliable or useful, although we have found such an average to be almost uni- formly higher for those dying of Apoplexy than for those dying of casualties. Now, with regard to height, the following table gives the number dying of Apoplexy for each inch of height, and also the number dying from casualties, etc. 144 TABLE XV. SHOWING THE NUMBER OF DEATHS FROM APOPLEXY AND CASUALTIES, ETC., ARRANGED ACCORDING TO HEIGHT. Height. Number of Deaths from Casualties. Apoplexy. e feet 2 3 8 21 36 52 87 103 88 "3 70 44 II 7 2 647 I 5 " I inch 5 " 2 inches c " ■, " 2 5 " 4 " 5 10 c " c " c " 6 " 21 C " -J " 22 c " 8 " 29 17 3° 10 c " " c " lO " C '• II " 6 " 3 I 6 " I inch 6 " 2 inches I 6 " T. " 6 " 6 " I Total 153 Uniting tiiese into groups for convenience, and calculating the proportion for 100 of each class, we have the following table : 145 TABLE XVI. SYNOPSIS CONSOLIDATED AND CALCULATED FROM TABLE XV. Height, Number of Deaths from Casualties. Apoplexy. From K feet to K feet a inches 5 43 31 21 lOO 5 54 31 10 " 5 " 4 inches to s feet 8 inches. " 5 " 8 " " s '■ lo " ** c " TO *' iiDwards Total 100 We may consider the persons dying of casualty, etc., to represent the average specimen of our Insur- ance risks, and we have the following result : There have been more deaths from Apoplexy in persons between 5 feet 4 inches and 5 feet 8 inches high, and much fewer in those above 5 feet 10 inches, than might have been expected ; out of a similar number of cases, there have been 2 1 deaths from casualties to ID deaths from Apoplexy in persons above 5 feet 10 inches. Hence it would appear that tall persons are not as liable to Apoplexy as those of medium height. This difference between apoplectics and others as regards their respective heights and weights is shown 146 by the following table, in which the actual weight and height of each case is given. The arrangement of the table has been described in the Report on Consump- tion, and is similar to those (Nos. XVIII. and XIX.) there given. TABLE XVII. SHOWING THE HEIGHT AND WEIGHT OF PERSONS DYING OF CASUALTIES, ETC., AND OF APOPLEXY, AT THE AGE OF 50 YEARS AND UPWARDS. CASUALTIES, ETC. HEIGHT. feet. 5-1 5-2 5-3 5-4 S-S 5-6 S-7 5-8 5-9 S.io 5.JI 6 feet. 6.6 185 175 185 170 158 158 180 170 188 153 155 180 168 163 200 . 148 149 150 165 160 175 159 146 145 150 164 160 200 172 lbs. 120 I2S 130 135 140 143 14s 148 iSS 160 165 170 142 143 150 155 152 150 140 133 146 155 140 146 134 128 140 153 130 128 150 128 126 150 145 140 140 130 147 APOPLEXY. HEIGHT. feet. 5-1 5-2 5.3 5-4 s-s S.6 5-7 5.8 5-9 5.10 S.ii 6 feet. o.e 193 232 I go I go 185 175 193 185 162 180 180 218 160 1-3 17S 214 153 157 165 170 188 205 150 162 157 155 170 178 175 210 lbs. 120 125 130 135 140 143 145 148 155 160 16S 170 124 140 140 This table illustrates at a glance what we have pre- viously stated, that while the average insured persons, as represented by those dying from accidental causes, are in nearly equal numbers above and below the standard of weight for their respective heights, those dying from Apoplexy have been, with very few excep- tions, above the standard. We have instances enough to show that persons of all sizes, extremes of high and low stature, and little or great weight, have died of Apoplexy, yet the large majority of such deaths have 148 been in persons of medium height and excessive weight. This is particularly the case with persons of advanced age, and we are justified by our experience in stating that persons who, at or above the age of 50, are below the usual standard of weight seldom die of Apoplexy. Thus far we find the old opinion of " an apo- plectic conformation of body" sustained and verified. We would suggest that a possible explanation of this discrepancy of views between the older and more modern writers lies in the meaning attached to the term " Apoplexy." The older writers used it in the broad sense and definition that we have adopted, while recent writers have had in view that particular form due to " Cerebral Hemorrhage." This explana- tion seems to us plausible, but we have no means of verifying it. An hereditary predisposition has also been as- signed as one of the causes of Apoplexy. This is sup- posed to be either an inheritance of the conformation of body described as the mark of an apoplectic con- stitution, or a transmission of a direct tendency to the disease from parent to child. It is not necessary for us to enter into a discussion of this important subject, as unfortunately our records of family histories are too 149 few and incomplete to be of much weight in evidence. As far as they go, however, they completely fail to support such an opinion. In 169 of our cases there is a more or less complete family history, and in only 12 of these is there any record of Apoplexy or Paralysis. In i case both parents died of either Apoplexy or Paralysis. In 9 cases one parent died of either Apoplexy or Paralysis. In 2 cases one brother died of either Apoplexy or Paralysis. CONGESTION OF THE BRAIN. One hundred and eleven deaths have been reported from Congestion of the Brain. The disease resembles apoplexy in some of its symptoms, but the diagnosis is more obscure and the meaning of the term unde- fined. On account of this indefiniteness of pathology and diagnosis, it requires but slight statistical consid- eration. Some of the cases reported as Congestion of the Brain are probably Bright's disease, and others are the result of alcoholism. Like apoplexy, it is sud- den in onset, short in duration, and attended with un- consciousness. It differs from it in showing a greater ISO prevalence in the earlier years of life. Fourteen per cent of the cases of apoplexy, and 38 per cent of cases of Congestion of the Brain, occurred under forty years of age. In proportion to the number living, however, there is a very slight increase in the number of deaths with advancing age. It has occurred with equal frequency at all periods of insurance. A com- paratively small number of cases have been reported from the Eastern States and a large number from the West. SOFTENING OF THE BRAIN. There have been 69 deaths from Softening of the Brain. One case only occurred under 30 years of age. After this period it increases in frequency with advanc- ing years, though not neai'ly so rapidly as apoplexy, as is seen by the following table: 151 TABLE XVIII. SHOWING THE ANNUAL MORTALITY FROM SOFTENING OF THE BRAIN, AMONG 100,000 LIVING MALES, AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY, AND IN THE MUTUAL LIFE. Age. 20 to 29 years. . . 30 "39 " ■■■ 40 "49 " . . . SO "59 " ••■ 60 "69 " . . . 70 and upwards Number OF Lives. 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths Annually. New York City. 6 12 19 44 134 334 Mutual Life. r 9 II 25 35 43 There are no other points calHng for special notice, except that we do not find the same high mortaUty during the first year after insurance from this disease as we found for apoplexy. 152 DISEASE OF THE BRAIN. In 85 cases the medical certificates have stated that death was caused by " Disease of the Brain," the particular form of disease being unrecognized. On account of this indefiniteness and obscurity it is unnecessary to consider them further than we have already done in the tables of our Preliminary Report. PARALYSIS. One hundred and twenty-five deaths have been attributed to Paralysis. This does not include those forms of Paralysis caused by disease of the spinal cord. The term, as used in death certificates, is gen- erally applied to chronic cases in which Paralysis has remained after partial recovery from cerebral hemor- rhage, or resulted from softening or other disease of the brain. It is also sometimes used in acute cases of the above diseases, where the paralysis is the most promi- nent symptom, and which are consequently called " Paralytic Strokes." 153 We have already seen that the above-mentioned diseases generally occur after middle age, and conse- quently we may expect that patients who survive those lesions with resulting Paralysis will die at still more advanced ages. This is shown by the following table : TABLE XIX. SHOWING THE ANNUAL MORTALITY FROM PARALYSIS, AMONG 100,000 LIVING MALES, AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY, AND IN THE MUTUAL LIFE. Age. 20 to 29 years . . 30 " Z9 " ■■■ 40 "49 " ■ • ■ 50 "59 " • • ■ 60 "69 " ... 70 and upwards, Number of Deaths Annually. Number Living. New York Mutual City. Life. 100,000 4 4 100,000 9 s 100,000 25 14 100,000 49 51 100,000 168 100 100,000 647 488 The number of cases continues large up to extreme old age. The percentage on the mortality from all causes increases rapidly in the last two decades ; the 154 number of deaths in 100,000 lives exposed increases from 5 in 100,000 between 30 and 40 years, to 51 in loo.oDO between 50 and 60, and 647 between 70 and 80 years. This increase is greater and more rapid than we found even for apoplexy. For the same reasons, its appearance at advanced age, and its chronicity as a sequel to acute disease, it comparatively seldom occurs in the first years of in- surance, but generally among those who have been insured for a number of years, as shown by the follow- ing table : TABLE XX. SHOWING THE NUMBER OF DEATHS FROM PARALYSIS, IN PROPORTION TO THE NUMBER OF LIVES, AT DIFFERENT PERIODS OF INSURANCE. Duration of Insurance. ist year 2d " 3d to 5th year. . 6th " loth " . . Above 10 j'cars Number of Lives. 100,000 100,000 100,000 100,000 100,000 Number of Deaths. 6 9 14 29 72 We find that Paralysis causes less than i per cent of the deaths of those in their first year of insur- 155 ance, and nearly 5 per cent of those insured more than 10 years; and that 6 out of 100,000 insured will die of Paralysis in the first year of insurance, while 72 out of 100,000 of those insured more than 10 years will die annually from the cause. A proper inference from this and the preceding table is, that when Paralysis figures high among the causes of death in the mortality of an Insurance Company, it denotes that its deaths have been chiefly among the aged, and after a considerable duration of insurance. INFLAMMATORY DISEASES OF THE BRAIN. We have included under this title all deaths designated on the certificates as caused by Inflamma- tion of the Brain, MeningitiSj Cephalitis, Encephalitis, Phrenitis, Brain Fever, and Abscess of the Brain. The number of these cases is 70. The diagnosis of these diseases is often obscure, and perhaps has not always been reliable, but we find that as a class they possess some characteristics which separate them from the diseases we have been considering. The most no- ticeable difference is the age at which they occur. 156 TABLE XXI. SHOWING THE ANNUAL MORTALITY FROM INFLAMMATORY DISEASES OF THE BRAIN AMONG 100,000 LIVING MALES AT EACH DECENNIAL PERIOD OF LIFE IN NEW YORK CITY AND IN THE MUTUAL LIFE. Age. Number OF Lives. Number of Deaths Annually. New York City. Mutual Life. 2 to 29 years 100,000 100,000 100,000 100,000 100,000 100,000 25 32 33 48 67 103 16 -!0 " ^0 " 9 15 I 2 do " AQ " CO " =;q " 60 " 69 " 44 70 and upwards We find in the Company's experience no regular increase of mortality with age, as we found for other brain diseases ; but that it is as high between 20 and 30 years as subsequently. The whole series is irregular, and the proportion of deaths is greatest between 50 and 60 years, but this is probably owing to the small number of the cases. There is certainly no such regular increase as we found for apoplexy 157 and paralysis, and the number among the very young is far greater than in other brain diseases. We have found, too, that the mortality is about equal at all periods of insurance. In the population of New York, the mortality shows a steady though slight increase with age. EPILEPSY AND CONVULSIONS. There have been 30 deaths from these diseases. We have grouped them together, because, although they are distinct diseases, the difference is frequently neglected by physicians, and persons dying from a first attack of Convulsions are said to have Epilepsy, and the reverse. Epilepsy means convulsive attacks, periodically recurring ; while Convulsions may arise from various causes. When the cause of the Convul- sion is not ascertained, we are obliged to be satisfied with a diagnosis of " Convulsion." The deaths have occurred nearly equally at all ages and all periods of insurance, and we have nothing further to add to the tables in our Preliminary Report. 158 INSANITY. Seventy persons are reported to have died insane, in 31 of whom the Disease of the Brain was the direct cause of death, and 39 committed suicide. These are all the cases in which there is any record of insanity, although it is possible that there may have been other insane persons who have died of fever, pneumonia, or other acute disease, and their deaths been recorded under these titles ; or the cause of death may have been called " Disease of the Brain." The number of suicides in proportion to the total number is very great, and it certainly is very remarka- ble that more insane persons should die by suicide than by disease. The majority of them may have shown some premonitory symptoms, and aroused suspicions in regard to their sanity, but the suicide was the first pronounced and undoubted symptom of insanity. We will enter into this subject more fully when we come to deaths by suicide, and for this reason we shall tabulate separately the two sets of cases. 159 TABLE XXII. SHOWING THE NUMBER OF DEATHS FROM INSANITY, BY DISEASE AND BY SUICIDE, AND THE PROPORTION IN 100,000 LIVES AT EACH DECENNIAL PERIOD OF LIFE. By Disease. By Suicide. Age. Number of Deaths. Propor- tion in 100,000 Living. Number of Deaths. Propor- tion in 100,000 Living. 20 to 29 jxars 6 10 8 7 3 5 9 35 I 14 10 10 4 ^0 " ^9 " 7 5 I 2 40 " 49 " CO " CO " 60 " 69 " 70 and upwards 18 There were no deaths by disease under 30 years of age, and but few under 40 years. The largest number occurred between 40 and 50. The proportion to the number of lives increases up to 70 years ; after this, there were no deaths. The number of deaths, by suicide is largest between 30 and 40 years — the very period when those by disease are fewest. The deaths by suicide were also largely in excess during the first year of insurance. i6o The numbers are too few to exhibit any influence arising from Nativity, Residence, or Occupation. The only instances of any hereditary influence are one case in which the father died at the age of 5 1 of " depres- sion from failure in business," and another in which the father died at 63 years of age of " Brain Disease." In addition to these cases of Insanity, there have been 3 other deaths attributed to mental or emotional diseases of the nervous system : 2 from '' Mental Anxiety in business," and i from " Fright." MISCELLANEOUS. There have been several cases of special diseases of the nervous system which do not come under any of the above titles, and are yet too few to require any thing more than mere mention. These comprise 3 cases of Neuralgia, 2 from Progressive Muscular Atrophy, and i each from Cerebro-Spinal Sclerosis, Cerebral Embolism, and Cerebral Anaemia. i6i DISEASES OF THE SPINAL CORD. Thirteen deaths have been occasioned by some disease of the spinal cord, but the certificates are too indefinite to allow any satisfactory classification or identification. The names used are as follows : Disease of Spine, Disease of Spinal Cord, Spinal Disease, In- flammation and Congestion of Spinal Cord, Myelitis, Inflammation of Spine, Paraplegia. The number for each decennial period of life was as follows : between 30 and 39, 5 cases ; 40 and 49, 4 cases ; 50 and 59, 2 cases; 60 and 69, i case; 70 and 79, i case. The pro- portion of deaths under 50 years of age is far greater than that which we found from diseases of the brain ; probably because very many of these spinal diseases were inflammatory and not degenerative. DISEASES OF THE CIRCULATORY SYSTEM. These consist almost entirely of diseases of the heart ; diseases of the arteries and veins forming only a very small percentage of the total. Thus, there have l62 been 307 deaths from disease of the heart, 19 from diseases of the arteries, and 4 from diseases of the veins. In only one third of the cases is the special lesion or variety of disease mentioned, and in two thirds the certificates merely state " Heart Disease" to be the cause of death. It is, therefore, useless to analyze the varieties separately, and we will take the whole class of Heart Diseases together. They may be divided into three groups, when con- sidered in relation to their symptoms and course : ist, acute inflammatory lesions ; 2d, permanent impair- ment of tissue, resulting from these inflammatory lesions, or degenerative changes of tissue ; 3d, sudden deaths and angina. The large majority belong to the second group. Their course is chronic, and they produce symptoms of impeded circulation and lessened vitality for some length of time before death. The lesions may exist, however, for years, without any perceptible effect on the health, though they may generally be detected by a medical examination. In our Preliminary Report, we investigated par- tially the influence of age on the causation of Heart Disease. We then found that the comparative mortal- ity from Diseases of the Heart was small in the early 1 63 ages of life, and increased with each succeeding de- cade, from less than 2 per cent under 30 years, to nearly 1 3 per cent after 70 years. We will now give a table, showing the number of deaths in proportion to the number living. TABLE XXIII. SHOWING THE ANNUAL MORTALITY FROM DISEASES OF THE HEART AMONG 100,000 LIVING MALES AT EACH DECENNIAL PERIOD OF LIFE IN NEW YORK CITY AND IN THE MUTUAL LIFE. Age. 20 to 29 years . . 30 " 39 " •• 40 " 49 " ■• SO " 59 " ■• 60 " 69 " .. 70 and upwards Number OF Lives. 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths Annually. New York City. 75 90 127 227 452 899 Mutual Life. 12 26 41 106 367 732 Taking the mortality of New York City as an illustration of the average frequency of Heart Disease, we find that, out of a population of 100,000 males be- tween 20 and 30 years of age, there are 75 deaths 1 64 annually from Diseases of the Heart ; in the same num- ber between 50 and 60 years, there are 227 deaths; and in the same number between 70 and 80, there are 899 deaths. The number of deaths is thus small in youth, increases regularly and rapidly, so that, in old age, Heart Disease is one of the most common causes of death. In the experience of the Mutual Life, the mortality at all periods of life is less than in the gen- eral population, though here, too, the deaths are very numerous after 60 years of age. The difference between the rates of the insured and the general population is greatest in early life, the deaths being only 12 in the Mutual Life to 75 in New York City, between 20 and 30 years of age ; after 60, however, the difference is less, though still marked, there being 452 deaths in New York to 367 in the Mutual Life, and after 70 years, 899 deaths in New York to 732 in the Mutual Life. Since, then, Diseases of the Heart are such fre- quent causes of death among elderly people. Insurance Companies must always show a high mortality from them, and the proportionate mortality will be great just in proportion to the success of the company in escaping early deaths. It will also depend somewhat upon the age of the company, as the oldest companies i65 will have the greatest number of advanced lives. Thus, we find, in the Mutual Life, the proportion of deaths above 60 years of age has been 13 per cent, and the mortality from Heart Disease nearly 6 per cent of the mortality from all causes ; in the Scottish Widows' Fund Life Insurance, nearly 50 per cent of the deaths have been above 60 years of age, and the mortality from Heart Disease has been nearly 16 per cent. The latter company has been in existence 60 years, and has a large number of advanced lives at risk.* It was seen in Diagram XVI. of our Preliminary Report that the mortality rate from Diseases of the Heart increased in proportion to the duration of insurance. The rate was 3.18 per cent of the mortal- ity from all causes, during the first year of insurance, and 8.88 per cent after the tenth year. The actual rate of increase is still better seen by the following table : * Edinburgh Medical Journal, Dec, 1874. 1 66 TABLE XXIV. SHOWING THE NUMBER OF DEATHS FROM HEART DISEASE IN PROPORTION TO THE NUMBER OF LIVES, AT DIFFER- ENT PERIODS OF INSURANCE. Duration of Insurance. I St year 2d " 3d to sthyear. . 6th « loth " . . Above 10 years Number of Lives. 100,000 100,000 100,000 100,000 100,000 Number of Deaths. 32 46 83 141 During the first year, the annual mortality is 22 in 100,000 lives ; during the second year, 32 ; from the third to the fifth year, 46 ; from the sixth to the tenth year, 83; and above ten years, 141. This increased mortality after prolonged insurance is chiefly due to the influence of advancing age, but also partly to the influence of medical examination in eliminating those suffering from this class of disease. The thoroughness of this examination and elimination is seen in the very small number of the deaths during the first and second years of insurance, only about 25 in 100,000 lives. Some of these cases, coming on soon after insurance i67 were due to acute inflammatory attacks from rheuma- tism, and others to chronic forms of disease, thus show- ing that serious disease of the Heart may commence insidiously and make considerable progress without giving any symptom or sign to attract the attention of the medical examiner. The relation of Rheumatism to Heart Disease has often been discussed, and is of considerable import- ance in life insurance examinations. Unfortunately, we have but few records bearing on this subject. Of the 307 deaths from Heart Disease, in 34 only was there any record of Rheumatism; in 21 cases there had been Rheumatism previous to insurance ; there were 7 cases of Acute Rheumatic Inflammations of the Heart, and 6 other cases in which the disease was attributed to Rheumatism. These numbers are too few to require further consideration. There have been 19 deaths from Aneuiism, includ- ing I case recorded as " a rupture of the aorta into the pericardium." In 16 cases the aorta was the seat of the disease, and in the other 3 there is no record of the vessel aff'ected. The age at death was as follows : 4 cases between 30 and 39 years, 5 between 40 and 49, 6 between 50 and 59, and 3 between 60 and 69 years. The earliest age was 32 years, at which there i68 were 2 deaths. Four died within i year after insur- ance, at the ages of 32, 43, 47, and 53 years. Of the 4 cases of Phlebitis, i was stated to be inflammation of the portal vessels ; in the others there is no special record. DISEASES OF THE RESPIRATORY SYSTEM. The number of deaths from diseases of the Res- piratory Organs was given in our Preliminary Re- port as 648. We have removed from this class all deaths recorded as being caused by Hemorrhage, Abscess, or Disease of the Lungs, and Chronic Pneu- monia, and transferred them to Consumption. There were no cases under these titles, and the number of deaths from diseases of the Respiratory System proper is therefore reduced to 538. The acute inflammatory affections. Pneumonia, Bronchitis, and Pleurisy, are the chief diseases of this class, producing about five sixths of the total mortal- ity ; the remaining sixth being caused by the same dis- eases in a chronic form and a few rarer diseases, as. Laryngitis, Emphysema, etc. 169 PNEUMONIA. Three hundred and fifty-eight deaths have been caused by Pneumonia. It prevails as a frequent cause of death at all periods of life, but its fatality is extreme in advanced age. We showed in our Preliminary Re- port, Diagram V., that it caused about 4 per cent of the mortality between 20 and 30 years, and nearly 1 2 per cent after 70 years. The following table gives a still better idea of its actual importance as a source of mortality : TABLE XXV. SHOWING THE ANNUAL MORTALITY FROM PNEUMONIA AMONG 100,000 LIVING MALES AT EACH DECENNIAL PERIOD OF LIFE IN NEW YORK CITY AND IN THE MU- TUAL LIFE. Age. 20 to 29 years. . 30 " 39 " •■ 40 " 49 " •■ 50 " 59 " ■ • 60 " 69 " .. 70 and upwards Number Living. 100,000 100,000 10,0000 100,000 100,000 100,000 Number of Deaths Annually. New York City. 83 125 172 355 511 1181 Mutual Life. 25 42 64 no 248 647 170 The influence of age on the mortality from Pneu- monia is seen equally in both columns, although the actual number of deaths differs greatly in the two. In our own experience we have, between 20 and 30 years of age, 25 deaths annually out of 100,000 living; between 50 and 60, no deaths ; and above 70 years, 647 deaths out of the same number of lives. In New York City the mortality is far greater ; between 20 and 30 years, there were 83 deaths in 100,000 lives, and of 100,000 living above 70 years of age there was the enormous mortality of 1181. This difference between the mortality of insured lives and the general popula- tion, is due to medical selection and to certain obvious distinctions between the two classes. Pneumonia, like Typhoid Fever, may attack the most healthy and robust, and no medical examination can detect a liability to it, but it is more particularly fatal among the weak, sickly, and intemperate, and these cases are easily excluded from insurance risks. Poverty and destitution, with their necessary accompaniments, also increase the fatality of the disease, and the poor and destitute do not insure their lives. We found also in our Preliminary Report that the percentage of mortality from Pneumonia to the mor- tality from all causes was nearly equal at all periods of 171 insurance, varying from 7 to nearly 9 per cent. The following table shows its frequency in proportion to the lives : TABLE XXVI. SHOWING THE NUMBER OF DEATHS FROM PNEUMONIA IN PROPORTION TO THE NUMBER OF LIVES AT DIFFER- ENT PERIODS OF INSURANCE. Duration of Insurance. ist year 2d " 3d to 5th year. 6th " 10 " . Above 10 years. Number of Number of Lives. Deaths. 100,000 52 100,000 52 100,000 62 100,000 79 100,000 97 The proportional number of deaths is equal during the first and second years after insurance ; but after this period the mortality increases with the duration of the insurance, from 52 per 100,000 in the first year, to 97 after ib years' insurance. This increase is considerable, and probably arises merely from the correspondingly advanced ages of the lives at the respective periods. The influences of Nationality and Residence were considered in our Preliminary Report, and we will now merely repeat that they were both found to be ihcon- siderable in amount. 172 PLEURISY. Our records furnish little information concerning Pleurisy beyond that given in our Preliminary Report, and the mortality from it is not large enough to require ' any extended remarks. There have been 41 deaths in all. The death certificate states that the form of the disease was Hydrothorax in 12 cases, and Empyema in 3 cases. In some instances the disease was acute, and in others chronic, lasting one or two years. The following table shows the ages at death : TABLE XXVII. SHOWING THE NUMBER OF DEATHS FROM PLEURISY AT EACH DECENNIAL PERIOD OF LIFE, AND ACCORDING TO THE DURATION OF INSURANCE. Age in Decennial Periods. Number of Deaths. Duration of Insurance. Number of Deaths. 20 to 29 years 30 " 39 " 40 " 49 " 50 " 59 " 60 " 69 " 70 and upwards. .... II 14 7 8 I I st year 2 2d " 5 17 10 7 3d to Sth year 6th" 10th " Above 10 years 41 41 173 BRONCHITIS. Forty-six deaths have occurred from Bronchitis. Thirteen cases are stated to have been acute, and 23 chronic, while in 10 no particulars are given. The fol- lowing table shows the ages and periods of insurance : TABLE XXVIII. SHOWING THE NUMBER OF DEATHS FROM BRONCHITIS AT EACH DECENNIAL PERIOD OF LIFE, AND ACCORDING TO THE DURATION OF INSURANCE. Age in Dfxenniai, Periods. Number of Deaths. Duration of Insurance. Number of Deaths. 20 to 29 years 30 " 39 " 40 " 49 " 5° " 59 " 60 " 69 •' 70 and upwards 4 12 8 17 2 3 I St year 4 4 14 9 15 2d " 3d to 5th year 6th " loth " Above 10 years 46 46 We have noticed a great difference in the relative frequency of these acute inflammatory diseases, as they occur in our experience and in that of Scotch insured 174 lives. This difference is of considerable interest, and is well shown in the table given below. The proportion of deaths from diseases of the respiratory organs to the deaths from all causes is nearly equal in both cases ; in the Mutual Life, out of a total of 5226 deaths, 648, or 12.41 per cent, were from respiratory diseases ; and in Scottish Widows' Fund, out of 5633 deaths, 727, or 12.91 per cent, were from this same class of diseases. The percentages are thus almost exactly equal, but the individual diseases differ greatly. TABLE XXIX. SHOWING THE FREQUENCY OF PNEUMONIA, BRONCHITIS, AND PLEURISY IN THE EXPERIENCE OF THE MUTUAL LIFE AND IN THAT OF THE SCOTTISH WIDOWS' FUND LIFE INSURANCE COMPANY. Diseases. Total respiratory diseases Pneumonia Percentage Bronchitis Percentage Pleurisy Percentage Scottish Widows' Fund Life. 175 Nearly half (43 per cent) the deaths among the Scotch are caused by Bronchitis, and less than one fourth (23 per cent) by Pneumonia, while in our own experience more than one half (63 per cent) are caused by Pneumonia and a very small portion (7 percent) by Bronchitis. The difference in these two reports is due partly to an actual difference in the prevalence of the two diseases, and perhaps partly to a difference in the nomenclature and pathological opinions of the mem- bers of the profession in the two countries. The pro- portion of Pleurisy is nearly equal in both. CONGESTION OF THE LUNGS. In 61 cases the medical certificates give Congestion of the Lungs as the cause of death. These cases were sufficiently analyzed in our Preliminary Report. The term is indefinite • in its meaning, and does not denote any particular form of disease. In two cases the dura- tion of the disease was less than one hour, and in 7 cases, more than one month, with extremes of 30 minutes and 5 years. In some cases it probably signi- fies Bronchitis or Pneumonia. It is a little more fre- quent after 50 years than before that age. 176 DISEASES OF THE LARYNX. There have been 14 deaths from various kinds of diseases of the Larynx : 8 are recorded as Laryngitis, 2 from Chronic Laryngitis, 2 from Chronic Disease of the Larynx, and 2 from CEdema of the Glottis. The ages were as follows : three cases between 20 and 29 years, four between 30 and 39, three between 40 and 49, three between 50 and 59, and one between 60 and 69 years. MISCELLANEOUS. The remaining cases are too few of each disease to permit any analysis, and we will therefore merely give them a brief mention. Epistaxis, i case, age 39, particulars unknown. Asthma, 7 cases. Three died young, i at 29 and I at 33 years, i at 39 years, while the others were past 50 years of age, and i was 70. The case which died at 33 years had suffered from Acute Rheumatism before his insurance. Emphysema. There have been 2 deaths from Em- 177 physema of the Lungs, at the ages of 41 and 56 years, and after a duration of insurance of 10 or 12 years. Pulmonary Apoplexy, 4 cases, ages 46, 47, 50, and 63 years. Gangrene of Lungs. Three cases, ages 35, 43, and 53 years. CEdema of Lungs. One case, German, aged 42, insured 7 years and living in Germany at time of death. Duration of disease 4 hours. No other partic- ulars given. DISEASES OF THE DIGESTIVE SYSTEM. There have been 493 deaths from Diseases of the Digestive Organs. These are chiefly affections of the stomach, bowels, and liver, and a few others, undefined and miscellaneous. We have here to encounter the same difficulties, perhaps in a still greater degree, which we have expe- rienced in other cases arising from indefiniteness of the terms employed, and the difficulties of an accurate diagnosis. The list of individual diseases is large, and the number for each disease small, and we will there- 178 fore group them together according to the organ affected, in the same manner as in the Preliminary Report, and will only occasionally give the particulars of the individual diseases. The following table will show the differences between the insured and non-in- sured in the comparative prevalence of this class of diseases. TABLE XXX. SHOWING THE PERCENTAGE OF DEATHS FROM DIGESTIVE DISEASES ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 LIVES, AT EACH DECENNIAL PERIOD OF LIFE, IN NEW YORK CITY AND IN THE MUTUAL LIFE. Age in Decennial Periods. 20 to 29 years. 30 " 39 40 « 49 SO " 59 60 " 69 70 and upwards. Percentage on Total Mortality. New York City. 3-54 4-74 6.40 6.60 6.68 5-69 Mutual Life. 6-35 8.96 10.01 10.27 11.46 4-73 Annual Mortality IN 100,000 Lives. New York City. 60 93 149 232 394 874 Mutual Life. 41 64 86 138 336 388 179 We find here that the percentage of Digestive Dis- eases as compared to the mortality from all causes is considerably greater among the insured than in the population at large, and this difference exists at all periods of life. It does not, however, indicate a greater mortality, as is proved by the second portion of the table. It is there seen that out of an equal num- ber of living persons, the number dying yearly is much less among the insured; between the ages of 20 and 30 years of age, there are 60 deaths in the New York City population, to 41 in the Mutual Life ; between 40 and 50, there are 149 deaths in New York, and 86 in the Mutual Life ; and between 60 and 70 there are 394 deaths in New York, and 336 in the Mutual Life. DISEASES OF THE STOMACH. There have been 78 deaths from Diseases of the Stomach, as follows: Inflammation of Stomach, 31 cases; Ulceration, 16; Hemorrhage, 9; Tumor, 2; undefined disease, 20. The following table will show the influence of age : i8o TABLE XXXI. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE STOMACH ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 LIVES AT EACH DECENNIAL PERIOD OF LIFE. Age in Decennial Periods. 20 to 29 years. . 30 " 39 " ■■ 40 " 49 " •• 5° " 59 " •• 60 " 69 " .. 70 and upwards -, >^ ntag rtali m uses (D C3 ^^■i^o Oi c "5 .41 1.26 I .26 2.18 2.03 2.96 Annual Mortality. Number of Lives Exposed. 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths. 3 9 10 29 64 259 We find an increase of mortality with each decade of life, and the rate of increase is very great after 50 years of age. There are 3 deaths in 100,000 lives between 20 and 30 ; 29 deaths between 50 and 60 ; 64 between 60 and 70; and 259 in those above 70 years. The rate of increase of Disease of the Stomach is greater than for all diseases of the digestive organs. In our Preliminary Report we found that the rate of mortality, as compared with the mortality from all i8i causes was nearly equal at all periods of insurance. There was an increase during the second year, but this was probably accidental. We repeat the table there given, and also repeat the rate of ixiortality in propor- tion to the numbers insured : TABLE XXXII. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE STOMACH ON THE MORTALITY FROM ALL CAUSES, AND THE MORTALITY IN 100,000 INSURED LIVES AT DIFFERENT PERIODS OF INSURANCE. Duration of Insurance. I St year 2d " 3d to 5th year. 6th " loth " . Above 10 years ofr _, ntag rtali uses CJ rt tiS'i^ ft. c H I-3T 2.23 1.44 1 .22 1 .62 Annual Mortality. Number of Lives Exposed. 100,000 100,000 100,000 100,000 100,000 Number of Deaths. 9 17 13 16 26 We find that there are few deaths from Diseases of the Stomach during the first year of insurance, and that they become more frequent in proportion to the tim.e insured, from 9 in 100,000 living in the first year. I 82 to 26 in 100,000 after 10 years of insurance. The number of deatiis in the second year is disproportion- ally great ; but we consider and treat this as purely accidental, on account of the small number of cases. In our Preliminary Report it was shown that the only apparent influence of Nationality is, that the Germans give the lowest and the Irish the highest rates of mortality, and for the influence of place of Residence, that the mortality from this class of diseases was highest in the Southern States. We have nothing further to add to these conclusions. DISEASES OF THE BOWELS. There have been 146 deaths from Diseases of the Bowels, as follows : Inflammation of Bowels, 94 ; Con- gestion, 4; Ulceration, 16; Hemorrhage, 16; Ob- struction, 6 ; Perforation, 2 ; Internal Strangulation, I ; undefined disease, 7. The term " Inflammation of Bowels " does not always indicate the same disease, signifying sometimes " Peritonitis," and sometimes " Diarrhoea," and we shall not, therefore, analyze this disease by itself, although the number of cases is large, i83 but will take the whole group together, as we have done in our Preliminary Report. In fact, we shall have but little to add to the tables and remarks in that report, except tables giving the mortality out of the whole number of lives insured. We shall give first the table showing the influence of age : TABLE XXXIII. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE BOWELS ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 LIVES AT EACH DECENNIAL TERIOD OF LIFE, IN THE MUTUAL LIFE INSURANCE CO. Age. 20 to 29 years. . 30 " 39 " .. 40 " 49 " .. 5° " 59 " •• 60 " 69 " . . 70 and upwards iJ -iZ r- "' C ^ S 3 (i> O O ri cu c H o 3-07 3.22 2.52 2-55 3-U •79 Annual Mortality. Number of Lives Exposed. 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths. 21 23 21 33 89 44 i84 We find that the mortality is almost exactly equal for the first three decades — about 20 deaths in 100,000 lives ; after 50 years it increases somewhat, and rises exceptionally high between 60 and 70 years to 89 deaths in 100,000 lives. This increase, though decided, is still very small, compared with that occurring in Diseases of the Stomach. TABLE XXXIV. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE BOWELS ON THE MORTALITY FROM ALL CAUSES, AND THE ANNUAL MORTALITY IN 100,000 IN- SURED LIVES AT DIFFERENT PERIODS OF INSURANCE. Duration of Insurance. I St year 2d " 3d to 5th year. 6th" loth " .. Above 10 years 2 2 e m oj o o rt > ntag rtali uses Qj ri SS^u CU c H 1.23 1.47 2.52 3-91 5-54 S-Si Annual Mortality. Number of Lives Exposed, 100,000 100,000 100,000 100,000 100,000 100,000 Number of Deaths. II 20 52 173 345 194 This shows the rarity of Kidney diseases in the earlier periods of life, and their frequency after 50 years of age. Between 20 and 30 years of age there are annually 8 deaths, and between 30 and 40, 1 1 deaths in 100,000, while between 60 and 70, there are in the same number 173 deaths, and after 70 years, these figures are even doubled. TABLE XXXVIII. SHOWING THE PERCENTAGE OF DEATHS FROM DISEASES OF THE KIDNEYS ON THE MORTALITY FROM ALL CAUSES, AND THE MORTALITY IN 100,000 INSURED LIVES AT DIFFERENT PERIODS OF INSURANCE. Duration of Insurance. I St year 2d " 3d to 5th year.. 6th " loth " . Above 10 years «, s^ ^i 1 c " S 3 S rt tiS^o .v- S^i^tJ^^^'iii^'I'i :S^^^V till ft