HE one great characteristic of all varieties of neuralgia is debility of the nervous system, and whatever tends to produce structural or functional enfeeblements of the nerves induces neuralgia, hence all the causes inducing loss of nerve power may be cited as causes of neuralgia. This affection, when not directly the result of some physical cause interfering with the integrity of the nerve system in which the pain is situated, is invariably due to loss of nerve power Its very existence is evidence of deficient energy. The remote factor may be malaria, syphilis, rheumatism, gout, or any other cause capable of devitalizing the organism, and as a consequence that of the nerves also. Our remedial measures should therefore be directed principally to improving the nutrition of the nervous system generally, and to the removal of any constitutional taint that may be present. The first indication is filled by CELERINA and a generous diet. In facial neuralgia and brow ache it should be administered in connection with quinine, or other tonic remedy, and if malarial influence be suspected, full doses of some reliable anti-malarial remedy should be given. The CELERINA treatment is also applicable to sciatic and spinal neuralgias. Neuralgia in men is frequently an expression of loss of nerve power, and the direct consequence of dissipation and excesses of various kinds, but over-work and intense intellectual exertion will also produce it. Where the pain is located is of little moment, the treatment should be general. In these case CELERINA seldom fails to give relief. Women suffer more frequently and more intensely from neuralgia than men. They are liable to 'c affected by all the causes which induces it in men, besides the derangements in health associated with menstruation-menorrhea especially. Hyperfecundation (rapid child-bearing), freement miscarriage, hemorrhage, prolonged lactation and changes curring at the climacteric period of life, all tend to induce a neuralgic condition of the nerves The general treatment should be directed to the removal of the cause whenever this is possible. In these cases CELERINA, combined with ALETRIS CORDIAL will be found to exercise a magical influence.

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[Entered at the Post-office at Wilmington, N. C., as second-class matter.]

VOL. XXXVIII.

WILMINGTON, NOVEMBER 20, 1896.

Original Communications.

No. 10.

THE EFFECTS OF EMANCIPATION UPON THE MENTAL AND PHYSICAL HEALTHOF THE NEGRO OF THE SOUTH*

BY J. F. MILLER, M.D., Superintendent Eastern Hospital, Goldsboro, N. C.

From the Afro-American Encyclopedia, I gather the following statistics:

"African population of the United States,

Of this number, there are pure Africans,

Of mulattoes (one-half pure)

Of quadroons (one-fourth pure)

Of octaroons (one-eighth pure).

In round numbers, six millions live in the South.

7,470,040.

6,337,980.

956,989.

105,135.

69,936."

I observe that the States of Louisiana, Mississippi and South Carolina have more negroes than whites.

The literature of insanity and physical degeneration among this population thus far is comparatively meagre; and it will devolve upon us of the South who are in the midst of these people, to write it.

This writer has been thoroughly reconstructed and readjusted to the changed political relations of the negro. He has no controversy with man, nor complaint against the great Disposer of human events for the results of the late war between the States. Nor has he any prejudice against the manumitted slave or his posterity. In common with the great mass of Southern people, he is the negroe's friend.

*Read before the Southern Medico-Psychological Association, at Asheville, N. C., Septem

ber 16, 1896.

286 Miller-The Effects of Emancipation Upon the Mental and Physical, etc.

That inimitable American wit and humorist, Mark Twain, says that Adam is a very much neglected man; that he deserves a monument and that he would subscribe liberally for the purpose; that the world is indebted to him more than to any other man, for he gave us both hell and heaven.

The faithful negroes of the South deserve a monument also for their loyalty to their owners and fidelity to duty under the most trying circumstances during the years of the late civil war.

But relegating to the domain of politics and sociology, the many vexed questions embraced in the so-called negro problem, the alienist and the student of scientific medicine may well inquire: What has been the effect of freedom upon the mental and physical health of the negroes of the South? Has it been damaging or otherwise?

It is the purpose of this paper briefly to answer this question.

To do so,

I must needs state some facts and figures heretofore given by others who have written on this subject.

THE HEALTH OF THE NEGRO PRIOR TO EMANCIPATION,

From close personal observation, embracing a professional life of nearly forty years among the negroes and from data obtained from professional brethren in different sections of the South, I have no hesitancy in declaring that insanity and tuberculosis were rare diseases among the negroes of the South prior to emancipation.

Indeed, many intelligent people of observation and full acquaintance of the negro have stated to me that they never saw a crazy or consumptive negro of unmixed blood until these latter years.

The fact of their comparative exemption from these ailments prior to emancipation is so well established that I deem it unnecessary to lengthen this paper by additional testimony that could be readily furnished from physicians of large practice among the negroes prior to emancipation.

INSANITY AND TUBERCULOSIS SINCE EMANCIPATION.

It is now proper to inquire what is and has been the history of the negro as to these ailments since emancipation.

Abundant testimony from practicing physicians throughout the South, is not wanting to establish the fact that negroes no longer enjoy immunity from these ailments.

Let us look at the testimony of our hospitals for the insane. Until the opening of the Eastern North Carolina hospital for the accommodation of the colored insane of the State, August 1, 1880, the State of North Carolina had but one hospital for the care and treatment of all her insane population. Accommodations being thus limited, it is fair to assume that many of the colored insane were confined in jails and county homes or cared for by their friends. Therefore the number of patients received from the Raleigh asylum

Miller-The Effects of Emancipation Upon the Mental and Physical, etc. 287

into the Eastern hospital at its opening does not fairly represent the number of insane among the colored population of the State at that time. But during the year, there were admitted into the Eastern hospital from the Raleigh asylum and from the State at large one hundred insane negroes.

This embraces the accumulation of the first decade and a half after the close of the civil war. At this writing, another decade and a half later, there are under treatment in the Eastern hospital three hundred and seventy-five negroes, and I have reason to believe that here are quite as many outside as there were in 1880.

In a paper read by Dr. T. O. Powell, Superintendent of the Georgia Lunatic asylum, before a meeting of this association held at Atlanta, I gather the following facts:

"The census of 1860 will show that there were only forty-four insane negroes in the State of Georgia, or one insane negro in every 10,584 of population, and consumption in the full blooded negro was rarely seen.

The census of 1870 shows that there were 129 insane negroes in the State of Georgia, or one in every 4,225.

The census of 1880 gives 411 colored insane or one to every 1,764 of population.

The census of 1890 gives 910 colored insane or one to every 943 of popu

lation."

According to the figures of the United States Census Bureau, the number of colored insane of the United States were, in 1850, 638, giving a ratio of 175 per million inhabitants; in 1860, 766, giving a ratio of 169 per million inhabitants; in 1870, 1,822, giving a ratio of 367 per million inhabitants; in 1880, 6,157, giving a ratio of 912 per million inhabitants; in 1890, 6,766, giving a ratio of 880 per million inhabitants.

Commenting upon the above statistics, Dr. J. W. Babcock, Superintendent South Carolina Insane Asylum, says: "We cannot lose sight of the fact that on the basis of the census as compared with insanity in the whites, mental diseases in the negro has arisen from one-fifth as common in 1850 to one-half as common in 1880 and 1890."

These statistics, I presume, are approximately correct and can be substantiated by the testimony of the superintendents of the various asylums represented in this association, and I respectfully submit that there is nothing necessary in the way of additional testimony to establish the fact that insanity among the negroes of the South has wonderfully increased since the close of the late war.

I have no reliable statistics at hand as to the extent of tuberculosis among the negroes since the war, outside of insane asylums; but the testimony of hospitals that tuberculosis among the negroes has increased pari passu with insanity. Indeed the one is often the accompaniment of the other, if not its legitimate sequence.

288 Miller-The Effects of Emancipation Upon the Mental and Physical, etc.

Statistics of all our Southern hospitals for the insane furnish abundant testimony that consumption in its various forms is a scourge of the colored insane as well as of the white.

The statistics of the Eastern North Carolina Hospital for Colored Insane, on this subject are as follows: The average mortality from tuberculosis since the opening in August, 1880, to the present time, September 1, 1896, is 25 per cent. of the whole number of deaths.

The per cent. was much less in the early years of its management. While the general mortality has been somewhat reduced, there has been a gradual increase from consumption. Up to 1884, the percentage of deaths in this hospital from tuberculosis was 14 per cent. of the whole, and in 1895, it was 27 per cent.

On this subject, Dr. Powell says: "From observation and investigation, I am forced to believe that insanity and tuberculosis are first cousins or at least closely allied. The sudden outburst of insanity with the colored race of the South came associated with tuberculosis. Hence in obtaining histories of cases as they are brought to our institutions, the hereditary predisposition to consumption is carefully inquired into.

In comparing the death rate in the Georgie asylum between the whites and negroes, although the care and treatment are the same, the proportion of deaths from this disease is larger in the colored race, and I find the results are the same in other institutions where both races are treated."

Dr. T. J. Mitchell, Superintendent Mississippi State Lunatic Asylum, says of his hospital that "for the fiscal year 1892, there were forty-four deaths, fourteen having died of consumption.

Fiscal year of 1893, twenty-nine deaths, sixteen having died from consumption.

Fiscal year of 1894, there were forty deaths, eighteen having died from consumption.

Fiscal year of 1895, there were thirty-five deaths, eleven having died from consumption.

Ten months of fiscal year of 1896, there were forty-eight deaths, twentythree having died of consumption.

These figures apply to the colored only, among whom consumption is much more prevalent than among the whites."

From the above, I find that the death rate in the hospital at Jackson, Miss., for the past five years, from consumption is a fraction over 42 per cent. of the whole number of deaths.

The Central hospital at Petersburg, Va., through the courtesy of Dr. W F. Drewry, furnishes me with the statistical report of the whole number of deaths from all causes, and also the number of deaths from consumption than from any other hospital in which the colored insane are treated. The percentage of this hospital is a fraction over 12.