Part 48

In this hospital great care is given to surgical work of all kinds and especially to abdominal surgery and gynecology. Colored physicians all over the South may send or bring their surgical cases here and get every advantage that can be provided by the best first-class hospitals and infirmaries all over the country. We have the best graduate-trained nurses in constant attendance and the resident physicians are men of the race who have made marvelous progress for two decades in all branches of their work.

Since the establishment of the hospital we have had a record of which few similar institutions can boast. During the first year we have had more than 140 surgical cases, including abdominal section and other major operations and yet the death-rate was less than 3 per cent from all causes.

Our operating room is well appointed, with an abundance of sunlight by day and gas light at night. Many of the physicians of the South have sent us cases for which we are very grateful. We have had cases from Alabama, Arkansas, Mississippi, Texas, Kentucky, Missouri, Florida, and Georgia. Until the other cities of the South are able to afford the facilities and accommodations and the skill and experience of the Mercy Hospital we feel that it is the duty and should be the great pleasure of every colored physician to send his surgical cases to this hospital. I consider this one of the great factors to solve this vexed problem.

The causes of the great mortality among the Negroes of the large cities of the South are due to ignorance; vice; debauchery; poor food, illy prepared; unsanitary environments; their habitation in the over-crowded tenement houses; in old stables; damp cellars; and low, damp sections and in narrow, filthy alleys, where the foul air, improper nourishment, poor ventilation and the want of personal cleanliness, furnish the proper condition for the development of disease and death. Correct these conditions and educate the people up to a thorough knowledge of and a strict compliance of the laws of health and the problem is solved. The death-rate among our people will not only be lessened, but I believe the Negro will outlive any other people on earth.

SIXTH PAPER.

WHAT ARE THE CAUSES OF THE GREAT MORTALITY AMONG THE NEGROES IN THE CITIES OF THE SOUTH, AND HOW IS THAT MORTALITY TO BE LESSENED?

BY HENRY R. BUTLER, A. M., M. D.

HENRY R. BUTLER, A. M., M. D.

Dr. Butler was born in Cumberland county, North Carolina, April 11, 1862. His early life was spent on the farm, during which time he received at odd times three months' free school instruction.

In 1874 his parents moved to Wilmington; there he worked in saw mills, lumber yards, with the cotton compresses and as a stevedore. He spent his nights studying under Prof. E. E. Green, now Dr. E. E. Green of Macon, Ga. January 3, through the assistance of his instructor, he entered Lincoln University, Pa., and was graduated June 18, 1887, receiving the degree of A. B.; October, the same year, he matriculated in Meharry Medical College, Nashville, Tenn., graduating with the degree of M. D. February 27, 1890. The same year the degree of A. M. was conferred on him by Lincoln University. While at Nashville he won the H. T. Noel gold medal for proficiency in operative surgery and dissecting. He arrived in Atlanta March, 1890, and began the practice of medicine. He was one of the organizers of the first drug store owned and operated by colored men in Georgia. It was known as Butler, Slater & Co. He was organizer and first president of the Empire State Medical Association of colored physicians. He was appointed surgeon of the Second Georgia Battalion, colored volunteers, in 1891, with rank of first lieutenant, by the Honorable W. J. Northern, then governor.

May 5, 1893, he married Miss Salina May Sloan of Atlanta, a graduate of Spellman Seminary, who has been a most faithful, loving and helpful companion. He took a special course in the diseases of children in 1894 at the Harvard School of Medicine, Boston, Mass. In 1895, in the same school he took a special course in surgery. November 1, 1900, H. R. Butler, Jr. came, adding new blessings and happiness to his home and life. Dr. Butler is the first and so far the only colored man to be a regular contributor to the great Southern daily, The Atlanta Constitution. He has held that position since 1895. He was three years president of the Y. M. C. A. of colored men. He was four years physician and surgeon in charge at Spellman Seminary, and is now holding a similar position in Morris Brown College, and is organizing a nurse training department to that institution. He owns some valuable real-estate, besides a beautiful home on Auburn avenue. He has a large and lucrative practice. He is Grand Master of Masons of the Jurisdiction Georgia, is grand Medical Register of the Knights of Pythias. His life is truly full, every moment of his time is taken.

The causes of excessive mortality among the colored people in Southern cities are said to be many and have been discussed from just as many points of view by students of the social status of this people.

But after several years of professional service among these colored people, which service gave me an opportunity to more closely study them, their faults, habits, needs, methods of living and their knowledge of hygiene and its laws, I have calmly reached the conclusion that the want of money is the main cause of the excessive mortality of this people. It is true that there are several minor causes, but all have their origin in the one mentioned.

Among the most prominent of these minor causes may be mentioned Ignorance and Poverty. Let us briefly consider the first of these.

The colored people have made wonderful progress in the acquirement of knowledge since emancipation, and this improvement has played no small part in reducing their excessive death-rate. Yet from this height we look down and see the great masses of these people still held in the death-like grip of ignorance. To these, education has taken no knowledge of clean homes, pure air, ventilation, soap and water and other things conducive to good health. These are they who to-day are falling so rapidly before the great reaper, death.

It is a truth known to the profession, health departments and students of this subject that most of the deaths of the great human family occur between birth and the ages of five years. The children of the colored race are not an exception to the above statement.

If the children of the intelligent, good, better and best die fast, it stands to reason that those of the ignorant, bad and poor would die even faster, and this is just what I have found to be the case.

Ofttimes, among the lowly masses, ignorance is the first to take charge of the babies at birth; it sticks a slice of fat meat in their innocent little mouths immediately after birth; it rocks the cradle; it fills their little stomachs with all kinds of decoctions, of teas and whiskies to bring out the "hives;" yea, ignorance feeds these little ones on all kinds of solid foods before they are able to digest them, until it finally feeds the grave with the bodies of its little victims.

Even when manhood and womanhood are reached, ignorance, ghost-like, stands forbidding the ventilation and cleaning of homes; it says: "It's too cold to bathe;" it sends men and women to bed in wet and damp clothes and does many other acts that multiply the graves in the old church-yard on the hill.

We come now to consider poverty. Oh, what an enemy it is, and has been, to the human family! It makes its home mostly among the ignorant, and especially among the masses. In the cities of the South the great masses are colored people. Hence it is among these that poverty sits enthroned--a sceptered king ruling amid disease and death. It retards the masses of the race in their march to the city of improvement; it prevents them from having larger and cleaner and better homes; with its bony fingers it points them to the cheap renting huts in alleys, dens, dives and basements of cities, and commands them to enter and die; it follows them into the market places and fills their baskets with cheap adulterated and semi-decayed food-stuffs; aided by prejudice and man's inhumanity to man, it drives the colored people from the healthy country districts into the crowded, sickly settlements of the Southern cities, where they soon sicken and die.

Poverty, supplemented by ignorance, and the want of the true Christian spirit, stands in the doorways of the public hospitals, infirmaries and libraries where aids to health are to be found and forbids these people to enter either on account of their color or the "want of space." Poverty keeps these people from building such institutions for themselves.

Again, the colored people of Southern cities constitute the great labor force, hence most of the diseases that result from exposure are more prevalent among them than they are among the white race.

Those diseases that result from improper foods, poor sanitation, want of pure air, need of better homes and want of public parks and baths, together with those untimely deaths due to the want of proper medical attention, good nursing and surgical operations at the right time are more extensive among the colored masses because they are the ones that suffer the privations mentioned to a greater extent than any other people.

Along with the observations already mentioned on this subject, and which observations have led me to reach the conclusion that "the want of money" is at the base of this excessive mortality, is this encouraging fact--that the colored people are not dying now as fast as they were even a decade ago. The reason of this is not far to seek. The truth of the matter is, these people are growing in wealth and intelligence and in proportion as they have acquired these essential qualities their mortality has decreased.

I have observed in my practice that those who live in good, clean, well ventilated homes have no more sickness and deaths than white citizens of equal intelligence and wealth. I now call to mind, here in Atlanta twenty homes of colored citizens which are fitted and furnished with all modern conveniences, including heating and baths. The owners are well-educated and spend much time and money in keeping their homes and yards clean and in good sanitary condition. What I wish to say is this, in twelve years' time only two deaths have occurred in that circle of twenty homes, and one of these was a baby whose death was due to an accident, and the other was an aged person whose death was the result of Bright's disease. Does not this speak volumes to prove the truth of my position? What I have observed here in Atlanta relative to the real causes and prevention of this excessive mortality is true in other Southern cities.

It is no doubt plain to the reader that I have not mentioned here a single cause upon which this excessive mortality rests, but that which money can remove. That being true, what is the conclusion of the whole matter? It is simply this:

1st. Pay the masses sufficient wages to remove their ignorance and poverty, to build better homes and to furnish and equip them with baths and other things necessary and conducive to good health, to purchase proper food-stuffs, fuel and comfortable clothing.

2d. The cities should enlarge their present hospital facilities, or build others especially for these people, cities and towns that have no such facilities should provide them at once, parks, public baths and libraries should be opened by the cities for the poor.