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164     THE COLORED AMERICAN MAGAZINE

times without; in fact, anything which common sense would teach you lowers the body's resistance, makes a person apt to tuberculosis infection, and puts the odds against the man.

It has been noted that certain diseases have often been followed by tuberculosis in patients. This has been due most probably to a weakened condition of the lungs or other parts of the body brought about by these diseases, making these organs more susceptible. Sometimes consequent changes in the contour of the body bring about changes in the internal organs. The diseases mentioned as often followed by tuberculosis are rickets, adenoid groths in the nose, rheumatism, smallpox, measles, whooping cough, typhoid fever, syphilis and pneumonia.

The last and to us the most important contributing or secondary cause to be considered is that of race. Some races are more susceptible to the ravages of the disease than others. This is particularly true in regard to the Indian and the Negro. In some parts of the country fifteen and sixteen times as many Indians as white persons have died from tuberculosis. The comparison between the white race in the Negro is not so great. About three times as many Negroes, particularly in the cities, as white persons die of consumption.

The first and most natural question will be why is this so. This is an unanswered question. Many theories have been propounded which have finally come back to the statement that the Negro is particularly susceptible to the disease, which is a fact we already know. It is a fact that the Negro of Africa who has not been in touch with the emigrating Europeans now roaming and settling over the continent has not been attacked by the disease. The same is true of the Indian. Tuberculosis was unknown to that race before the settling of this country by Caucasians.

Different investigators have given different views. An eminent investigator in Atlanta, Ga., claims that the reason that Negroes are particularly prone to tuberculosis is because they live uncleanly, both as to their homes and as to their bodies. I have felt that such a view was tinged with race prejudice. I may be wrong, but it is so hard to believe that anything comes out of Georgia that is not polluted by race prejudice. Uncleanliness may be true of a portion of the Negro race in this country, but Dr. Osler, the most eminent physician among English speaking people to-day, had an investigation made in Baltimore, where the Negro population is very large, and found that among any given number of Jews and Negroes more Jews lived in unsanitary surroundings then Negroes. And yet Jews are least susceptible to tuberculosis of all the races.

I don't mean to say that unsanitary surroundings have no influence upon the disease. To a man who has a peculiar susceptibility to the disease, unsanitary surroundings are an added poison. But all Negroes do not live in unsanitary surroundings. It is my personal experience that no class of people in the same financial status lives as well as the Negro. I have been a medical examiner for a large insurance Society in Philadelphia, and have visited many hundred

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THE COLORED AMERICAN MAGAZINE     165

homes and have found unsanitary surroundings in but a remarkably small percentage of them. The fact is that the Negro is weak in that portion of his system which should combat the disease. Dr. Flick makes this statement which may offer food for thought:

"The newer the race in the order of history and civilization, apparently, the more prone is it to consumption."

As I have told you the Jews, oldest of civilized races, are least susceptible, then the Latin races, descendents of Roman civilization, then the Anglo-Saxon, then the Negro and India most of all. I believe this to be due to the law of immunity. This is an intricate scientific problem which I shall endeavor to make plain to you. Suppose we take an island of the seas inhabited by strange people. Say a disease as measles was never known to them. Nobody on the island ever had it, nobody with the disease ever had visited the spot. One day some explorers landed there, and one of them had the measles. The disease spread rapidly and more than half of the inhabitants died. The other half resisted the disease by virtue of qualities in their systems not possessed by the others.

It is a fact that some men have more resisting powers against certain diseases than others, as they have against certain drugs. One man can take more alcohol than another before being overcome, or it may be morphine. This resisting power may be brought about by inheritance, or by development, as in the case of drugs by constant use. To revert to our island inhabitants, the first epidemic carried away all of the weak ones of the island and left the stronger and hardier ones. Their children inherited the same hardiness. Several years later a second epidemic visited the same island. Naturally, not so many persons died from this epidemic. They were becoming immune to this disease. Many who had it possessed sufficient resisting power to successfully combat the disease.

I believe this to be the case of the Negro and tuberculosis. This disease is one which accompanies civilization. The Jews have had their days of tuberculosis. The weak and susceptible have been overcome by the disease. The hardy have survived, and have given that inheritance to their children. And the same will happen to the Negro in time to come. He is new and civilization, new in tuberculosis. The weak are falling, the strong will be left. Their offspring will inherit their strength.

But what is our duty? Let the weak die anyway? No, God would hold us accountable. It is clearly our duty to make an effort to save all who may be. And that is why all should be enlisted in this fight for humanity.