Morbidity

Rate of Sickness.

Tendency to disease. The ratio of sickness among the Jews has not yet been satisfactorily studied, although the ratio of deaths—the mortality—among them, and of the various diseases that cause such deaths, has been fairly well investigated in various countries. The physical organization of the Jews has been considerably influenced by their religion through the strict dietary laws, sanitary regulations, etc., which are part and parcel of the faith. It is further influenced by the peculiar sociological conditions under which the bulk of them live in the eastern European ghettos, and by the facts that they are mostly townfolk, are largely engaged in mercantile pursuits, are not addicted to the abuse of alcoholic beverages, and are generally devoted to their families. All these conditions, according to present knowledge of the causation of diseases, exercise a determining influence on the liability to many of the latter. In fact, when Glatter investigated the morbidity of the Hungarians ("Das Racenmoment in Seinem Einfluss auf Erkrankungen," in Casper's "Vierteljahrsschrift für Gerichtliche Medicin," 1864, xxv. 38-49) he found the following proportions of ill persons in the county of Pest:

Race.| Percentage of Population.| Percentage of Sick.  
---|---|---  
Magyars| 53.4| 45.9  
Germans| 22.4| 29.0  
Slavonians| 18.2| 12.6  
Servians| 2.8| 1.9  
Jews| 3.2| 11.6  
  
These figures, if they are to be relied upon, show an exceptional morbidity for the Jews as compared with their non-Jewish neighbors, Servians excepted; but there are no available data wherewith to confirm or to deny their accuracy because the Jewish sick-benefit societies in various countries have not published the statistics of their operations. The only available method of estimating the morbidity of the Jews is a consideration of the causes of death recorded in various publications.

Contagious Diseases.

The most important diseases are those classed as contagious and infectious. As is well known, they are most frequently met with in overcrowded communities, where the people live under economic and social privations and amid insanitary conditions. The medieval and even the modern ghettos are especially the locations where the conditions would seem to be most favorable to the spread of contagious diseases; but, as a matter of fact, all available statistics point strongly against the correctness of such a contention. While it is known that the Black Death in the Middle Ages did not entirely spare the Jews, as is supposed by some, historical evidence, it must be conceded, strongly tends to show that they, as compared with their neighbors, were attacked bythe disease to a much less extent (see Black Death). In more modern times it has been observed, as remarked above, that although most Jews live under adverse sanitary and hygienic conditions, they are not more liable—indeed, in many places they are even less liable—than their neighbors to attacks of contagious diseases. Thus, according to Fracastor, in an epidemic of typhoid fever in 1505 Jews were wholly exempt; and, according to Rau, the same immunity was observed at Langeons in 1824 (Rau, "Ueber die Behandlung des Typhus," in "Heidelberger Klinische Annalen," 1826, ii.). Körösi's extensive statistics for Budapest, Hungary, show the mortality from typhoid fever during the period 1886-90 to have been as follows per 100,000 population:

Catholics| 66  
---|---  
Lutherans| 76  
Calvinists| 49  
Other Protestants| 61  
Jews| 46  
  
In Posen Cohn reports ("Sterblichkeitsverhältnisse der Stadt Posen," in "Vierteljahrsschrift für Gerichtliche Medicin," 1869, p. 292) that from 1856 to 1865 the proportion of deaths from typhoid fever in 1,000 deaths from all causes was: Catholics, 9.96; Protestants, 9.40; and Jews, 5.26.

In the United States Billings ("Report on Vital Statistics of the Jews") records 57 deaths as due to typhoid fever in 2,062 deaths from all causes—a rate of 2,764 per 100,000, as against 3,216 for the general population of the country. Statistics for the city of New York show that the mortality from typhoid during the six years ending May 31, 1890, was as follows per 100,000 population, the cases being classified according to the birthplace of the mother:

English| 43.77  
---|---  
Germans| 28.01  
Italians| 26.16  
Irish| 25.56  
French| 18.29  
Bohemians| 18.04  
Americans (whites)| 17.40  
Hungarians (mostly Jews)| 12.36  
Russians and Poles (mostly Jews)| 9.19  
  
Both of these sets of statistics confirm Körösi's observations that the death-rate from typhoid fever among the Jews is lower than among their non-Jewish neighbors.

Influenza ("la grippe") appears to be more frequently a cause of death among the Jews than among non-Jews in Prussia. The mortality from the disease among the Jews in 1890-94 was 1,786 per 100,000, as against only 1,445 per 100,000 among the general population. Whether this high mortality indicates a greater tendency on the part of the Jews in Prussia to contract influenza or a more frequent fatal issue of the disease among them can not be determined from the official statistics (see H. Singer, "Allgemeine und Specielle Krankheitslehre der Juden," pp. 73-74, Leipsic, 1894).

Smallpox is a very contagious disease, from which the Jews appear to suffer less than others. In Posen the mortality from it among children during the period 1856-65 was, according to Cohn (l.c. p. 284), as follows per 1,000 deaths due to all causes:

Catholics| 31.3  
---|---  
Protestants| 22.6  
Jews| 9.0  
  
Körösi shows that in Budapest, during the epidemic of smallpox in 1886 and 1887, the mortality per 100,000 population was:

Catholics| 106  
---|---  
Lutherans| 81  
Calvinists| 74  
Other Protestants| 77  
Jews| 33  
  
This can easily be explained by the fact that the Jews are great believers in the efficacy of vaccination as a preventive of smallpox, and that they readily submit to it. This was assigned as the cause of the almost complete absence of this disease among the Jews of New York city in the epidemic of smallpox during the period 1900-3.

In connection with the contagious diseases of children, the subjoined table, compiled from Körösi's figures, is of interest:

Mortality (per 100,000 Children Under Ten Years) of Children Under Five Years of Age from Contagious Diseases in Budapest During the Period 1886-90.| Diphtheria.| Croup.| Scarlet Fever.| Measles.| Whooping-Cough.  
---|---|---|---|---|---  
Catholics| 559| 265| 283| 183| 97  
Protestants| 509| 286| 310| 146| 83  
Jews| 345| 215| 316| 118| 69  
Among Children.

It is seen that the children of Jews succumb less frequently than those of non-Jews to diphtheria, croup, measles, and whooping-cough; but that they more often die from scarlet fever. An analysis of the figures recorded in the annual reports of the board of health of New York city showed that during the three years 1897, 1898, and 1899 the mortality from diphtheria and croup in the four wards which are largely inhabited by Jews (the seventh, tenth, eleventh, and thirteenth) was 59.55 per 100,000 as against 64.20 for the general population of the city. The figures for scarlet fever and measles were not so favorable for the Jews. The mortality from the former disease was 21.15 among the Jews and 21.69 among the general population; from measles, among Jews 34.14, and among the general population 24.17 (see M. Fishberg, "Health and Sanitation of the Immigrant Jewish Population of New York City," p. 27, New York, 1902). That the Jews are not everywhere less liable to diphtheria and croup is testified to by Billings ("Report on Vital Statistics of the Jews in the United States," pp. 13-15); also by Stokvis, who reports that in Amsterdam from 1856 to 1862 the mortality from diphtheria and croup among the children of Jews was 13.7 per cent and among those of the non-Jewish poor only 4.04 per cent, whereas it was 5.88 per cent among the rest of the children of the city. Glatter also found in Pest that in 1863 the Jews showed a mortality from diphtheria of 4.2 per cent, while the Christians showed only 2.6 per cent. A low mortality from measles among Jewish children has been reported by Lombroso for Verona, Italy, as compared with the Catholic population of that city. He attributes it to the frequent epidemics in the foundling asylums, which are filled almost exclusively with non-Jewish children.

Diseases of Respiratory Organs.

Jews are also less liable to tuberculosis and cholera, as has been shown by considerable evidence.Leprosy is another contagious disease which, as Biblical evidence tends to show, was very prevalent among the Jews in antiquity, but is now uncommon among them (see Cholera; Consumption; Leprosy).

From diseases of the respiratory organs the Jews, according to Billings, suffer more than the general population of the United States, as is seen from the following figures per 1,000 total deaths from all causes:

| Men.| Women.  
---|---|---  
Jews| 164.95| 129.90  
General population of the United States| 155.13| 135.45  
  
As these figures include croup, however, which properly belongs to the group of contagious diseases, no reliable conclusion can be formed.

Of the acute respiratory diseases, pneumonia is the most important, and a consideration of its frequency will give a clue as to the whole class of diseases. In New York city during the six years ending May 31, 1890, the mortality from this disease was as follows per 100,000 population, the cases being classified according to the birthplace of the subject's mother:

Italians| 455.89  
---|---  
Bohemians| 350.29  
Irish| 343.99  
Russians and Poles (mostly Jews)| 170.17  
  
In Budapest Körösi also notes a lower mortality from pneumonia among Jews, as is shown by the following table of deaths per 100,000 population:

Catholics| 405  
---|---  
Protestants| 307  
Jews| 186  
  
In Verona, Italy, according to Lombroso, the mortality from pneumonia among the Jews was 8 to 9 per cent as against 50 per cent among the Catholic population of that city. The proportion of deaths from this disease in those wards in New York which are largely inhabited by Jews is less than in the other parts of the city.

The lesser liability of the Jews to pneumonia may be ascribed to various conditions. One explanation which has been offered is that their peculiar indoor occupations do not expose them to the inclemency of the weather and to frequent chilling of the body. Besides, it must be remembered that alcoholism is an important factor in the etiology and prognosis of pneumonia. Chronic drunkards are more liable to be attacked by the disease, and when attacked the prognosis is more grave than in moderate drinkers or total abstainers. The Jews, not being addicted to the abuse of alcoholic beverages, are thus favorably circumstanced as regards liability to pneumonia, and when attacked are more likely than others to recover.

Of the other diseases of the respiratory organs the Jews are known to be very liable to chronic bronchitis, pulmonary emphysema, and asthma (see "Discussion sur la Pathologie de la Race Juive" in "Bulletin de l'Académie de Médecine de Paris," Sept. 8, 1891). This also can be ascribed to the fact that they are mostly townfolk and to the indoor occupations in which they are chiefly engaged.

Heart-Disease.

According to Lombroso, the Jews of Verona show a very large mortality from heart-disease. Nine per cent of the total number of deaths among the Jews were due to this cause; while among the Catholic population only 4 per cent of deaths from heart-disease were observed. Lombroso explains this phenomenon by the fact that in Verona the Jews live in tall buildings, often on the seventh and eighth floors; and he tersely remarks that they thus have "all the disadvantages of mountaineers without any of the hygienic benefits of a mountain climate." The Jews also have among them a larger proportion of old persons; and, as Lombroso remarks, heart-disease is the "privilege" of old age. Finally, as other factors must be considered their passionate temperament and the anxious struggle for existence to which they are exposed by reason of constant persecution. That this contention has a firm basis is proved by the fact that, as Lombroso points out, the Jewish women are affected with heart-disease to a much less extent than the men. In Budapest Körösi found that the Jews suffered from heart-disease to about the same extent as the non-Jewish population. The mortality from diseases of the circulatory system in that city during the period 1886-90 was as follows per 100,000 population:

Lutherans| 198  
---|---  
Catholics| 134  
Calvinists| 100  
Other Protestants| 104  
Jews| 106  
  
In the United States Billings' statistics confirm Lombroso's observations. Among 60,630 Jews the mortality from diseases of the circulatory system per 1,000 total deaths of which the cause is known was as follows:

| Men.| Women.  
---|---|---  
Jews| 77.33| 89.69  
General population of the United States| 39.90| 39.51  
  
It is thus seen that the mortality among the American Jews from diseases of the circulatory system is double that of the general population of the United States.

Considering the fact that articular rheumatism is an important etiological factor in organic heart-disease, it is of interest to state that this disease also is very frequent among the American Jews. The death-rate from rheumatism per 100,000 deaths from all causes, according to Billings, was 679 among the Jews, while according to the Census Reports for 1900 it was only 488 among the general population of the United States. These figures do not afford much support to the theory that the Jews suffer less from acute pulmonary diseases because, by reason of their indoor occupations, they are less exposed to the inclemency of the weather. If this theory were well founded, rheumatism, a disease much favored by exposure, should also be infrequent among them.

Chronic rheumatism is very commonly observed among the Jews, while gout is quite infrequent, although Lagneau, Lancereaux, Féré, and other French physicians assert the contrary. These observers state that the nervous diathesis of the Jews manifests itself in a very striking manner in various pathological conditions such as gout, lithemia, chronic rheumatism, psoriasis, diabetes, gall-stones, nephrolithiasis—in fact, in all the conditions which Frenchphysicians class under the terms "arthritisme" and "hẹrpetisme" (see "Bulletin de l'Académie de Médecine de Paris," Sept. 8, 1891; C. Féré, "La Famille Neuropathique," p. 105, Paris, 1894).

Arteriosclerosis is another condition frequently observed among the Jews. It may be attributed to their excessive activity in business pursuits with its concomitant care, anxiety, and worry. But it must be confessed that among the poorer classes of Jews (and they are in the majority) it is not so often encountered as some physicians believe. In general, it may be stated that this condition is only another manifestation of the early physical decay of the average Jew, who, although precocious intellectually, displays a strong tendency to grow old prematurely: "A man is as old as his arteries."

Intermittent claudication, a disease recently described by neurologists, which has its origin largely in the constriction of the arteries of the lower limbs in nervous individuals suffering from arteriosclerosis, is more frequently observed in Jews than in non-Jews. Physicians in Russia especially have reported many cases among the Jews of that country. Higier found among 18 cases that 17 were Jews ("Deutsche Zeitschrift für Nervenheilkunde," 1901, xix.). Non-Jews in Russia and Poland are rarely found to be affected with this disease. W. Erb observed that a large proportion of his patients were of Russian-Jewish origin, 14 out of 45 being Jews ("Münchener Medicinische Wochenschrift," 1904, No. 21, p. 905). The cause of this disease is unknown; it occurs mostly in males between 20 and 40 years of age, and generally in individuals in the higher walks of life (H. Idelson, "Ueber Intermittierende Hinken," in "St. Petersburger Medizinische Wochenschrift," 1903, No. 5).

Varicose veins are very common among the Jews, especially among the women. This may be attributed to their indolent habits, deficient muscular development, and, in the women, frequent pregnancies. The results of varicose veins in the legs are very often seen in surgical clinics frequented by Jews—eczema and ulcers of the legs, which heal with great difficulty.

Hemorrhoids.

Another manifestation of varicose veins is hemorrhoids, which are more common to Jews than to any other people. In fact, in eastern Europe "the Jew with hemorrhoids" is proverbial; and among the Ḥasidim in Galicia and Poland a Jew without hemorrhoids is considered a curiosity. Physicians who have had experience among the Jews testify that it is rare to find a Jew who has passed middle age without having his hemorrhoidal veins more or less enlarged. The Jews of eastern Europe attribute this condition to the habit of sitting during the greater part of the day on the hard benches of the bet ha-midrash while studying the Talmud, and to constipation of the bowels, from which they commonly suffer. While hemorrhoids are only very rarely observed in young people of other nations, this can not be said of the Jews. Among the latter, individuals under twenty-five years of age have quite often to be treated for hemorrhoids.

Hemophilia is stated by many physicians to be more frequently met with among Jews than among non-Jews. It is mostly observed in Jewish boys, and very rarely in girls. Perhaps it is because circumcision reveals it in boys that it is considered so frequent among Jews; though statistics also point to its frequency among them (see N. Rothschild, "Ueber das Alter der Hämophilie," Munich, 1882; Grandidier, "Die Hämophilie," Leipsic, 1877; Julius Moses, "Die Blutkrankheit," Greifswald, 1892). The disease appears to have been well known to the Jews in ancient times, since there is an ordinance in the Talmud that in case two children of the same mother die as a result of circumcision a third child born to her shall not be circumcised. The reason given is that in some families the blood does not clot readily, and any wound inflicted may prove fatal.

As regards diseases of the nervous system, the Jews suffer more than others from hysteria and neurasthenia and from the functional neuroses generally. From the organic nervous diseases they suffer only as frequently as, and according to some observers even less often than, non-Jews (see Nervous Diseases). Mental diseases are met with among the Jews from two to four times more often than among their non-Jewish neighbors. The same is the case with idiocy, which is very common (see Idiocy; Insanity).

Infantile Diarrhea.

Diarrheal diseases are the most general of the gastro-intestinal diseases of children. Occurring as they do mostly among the poor who live amid insanitary conditions, in overcrowded dwellings, it might reasonably be expected that Jewish children in the large cities of Europe and America would suffer severely from them. But statistics show quite the contrary. In Budapest Körösi reports the mortality from infantile diarrhea during the period 1886-90 to have been as follows per 100,000 infants under five years:

Catholics| 4,143  
---|---  
Lutherans| 3,762  
Calvinists| 3,293  
Other Protestants| 3,498  
Jews| 1,442  
  
Mortality from this disease among Jewish infants is thus seen to be only about one-third that of the Christian infants of the same city. The same has been observed in the United States. In the city of New York, where the immigrant Jews live in the most overcrowded districts, Fishberg has calculated, from the reports of the Department of Health, that during 1897, 1898, and 1899 the annual mortality in the entire city from diarrheal diseases was 125.54 per 100,000 population; whereas in the four wards largely inhabited by Jews it was only 106.79, notwithstanding the insanitary surroundings and overcrowding in ill-ventilated tenements. Similar conditions are presented in the statistics of the Eleventh Census. The mortality from diarrheal diseases among the different races inhabiting New York city during the six years ending May 31, 1890, was as follows per 100,000 population:

Bohemians| 766.73  
---|---  
Italians| 425.58  
Americans (white)| 398.34  
Hungarians| 328.07  
Germans| 281.36  
Irish| 237.64  
Russians and Poles (mostly Jews)| 195.55  
General population| 316.85  
  
In London, where the sanitary and hygienic surroundings of the Jews in the East End are not betterthan those of the East Side of New York, the same conditions have been observed: the Jewish infants suffer from diarrheal diseases to a much less extent than others of the same social status. Physicians testified to this effect before the Royal Alien Immigration Commission, and stated that the lower mortality of Jewish children was in great measure due to their greater power of resistance to contagious diseases and to the gastro-intestinal diseases of infancy.

Rickets, Atrophy, and Scrofula.

The reasons for the lower mortality of Jewish infants from diarrheal diseases, notwithstanding the insanitary surroundings under which they are reared, are to be found in the devotion of the Jewish woman as a mother. The care bestowed on her children by a Jewish mother, even when laboring under severe stress of poverty and privation, is proverbial. The anxiety displayed by the parents, even in cases of slight illness among their children, is well known to every physician who practises among them. The artificial feeding of infants is very rare among Jewesses, and among healthy ones is almost unknown. The result is that diarrheal diseases, which mostly attack children who are artificially fed, find few subjects among Jewish infants. Another result of this condition is the excellent general health of the latter, when compared with infants of the poor of other races. This can best be estimated by a consideration of the mortality among children from rickets, atrophy, and scrofula. Körösi calculated the mortality of children under three years of age from the first two diseases and for those under ten years of age from the last-named disease per 100,000 children, to be as follows:

Class of Population.| Between 2 and 3 Years Old.| 3 to 10 Years Old.  
---|---|---  
_______________________| _______________  
Rickets.| Atrophy.| Scrofula.  
Catholics| 131| 620| 70  
Lutherans| 122| 533| 45  
Calvinists| 68| 596| 87  
Other Protestants| 92| 568| 69  
Jews| 103| 242| 20  
  
Billings found that the mortality among the American Jews from scrofula and tabes to be 1.04 per 1,000 deaths due to all causes as against 6.74 for the general population of the United States. All of this tends to show superior health and vitality among Jewish children as compared with those of other races of the same economic and sociologic condition. This was confirmed in a striking manner by the evidence given before the Inter-Departmental Committee on Physical Deterioration in London, England, in 1904. Dr. Hall stated that in Leeds he found 50 per cent of the children in a poor-school afflicted with rickets, but only a percentage of 8 in a school attended by children of the better classes. In a school of poor Jewish children he found only 7 per cent. It has been affirmed by Drs. Eustace Smith, Eichholz, and others that this superiority of the Jewish children in England, in spite of their inferior sanitary and hygienic surroundings and their overcrowded dwellings, is due to the fact that Jewish mothers bestow more care upon their children during infancy and childhood, and also because it is exceptional to find a Jewish mother acting as the breadwinner (see "Jew. Chron." Aug. 19, 1904).

Diseases of Digestive Organs.

Of the gastro-intestinal diseases of adults Billings' statistics of American Jews show that the mortality was as follows per 1,000 total deaths:

| Men.| Women.  
---|---|---  
Jews| 60.60| 82.48  
General population| 47.12| 44.02  
  
These figures show a greater frequency of this class of diseases as a cause of death among Jews. It appears also that cancer is more liable to attack the gastro-intestinal tract in Jews than in non-Jews. Nearly 45 per cent of all cases of cancer occur in the stomach, intestines, liver, pancreas, rectum, etc., as against 23 per cent among non-Jewish patients (see Jew. Encyc. iii. 529-531, s.v. Cancer). In Italy also Lombroso reports that diseases of the digestive organs are more frequently causes of death in Jews than in the Catholic population of that country; and the same thing has been observed by Glatter in Hungary. Lombroso attributes these conditions to overcrowding in badly ventilated dwellings, and also to the fatty foods which the Italian Jews are wont to eat and which are unsuitable for people living in warm climates. Hepatitis has also been a very frequent cause of death among the Jews of Verona, according to Lombroso. It must, however, be mentioned that cirrhosis of the liver is very rarely seen among the Jews generally. This is best explained by the infrequency of alcoholism and of syphilis, which are the most important factors in the etiology of cirrhosis.

Nervous dyspepsia is very common among the Jews. Javorski ("Wiener Medizinische Wochenschrift," 1880, Nos. 49-52) called attention to the frequency of hyperchlorhydria among the Polish Jews in Galicia, and attributed it to their peculiar diet. Physicians who practise among Jews know that derangements of the function of digestion are quite often met with, particularly on Sunday, due to the ingestion, during the Sabbath, of food which has been prepared on Friday and kept in the oven for from twelve to twenty-four hours ("sholent"; see Jew. Encyc. iv. 256, s.v. Cookery in Eastern Europe). The chronic diseases of the stomach are to be attributed to the fact that the Jew generally, owing to his deep absorption in business pursuits, rarely has regular meal-times and takes very little time to masticate his food. Among the Russian Jews excessive tea-drinking, a habit acquired in their native country, is much to blame for the frequent occurrence of the various forms of chronic indigestion. It should be mentioned, however, that chronic alcoholic gastritis is, for obvious reasons, quite rare.

Diseases of Urino-Genital System.

The diseases of the urino-genital system appear to be less frequent among the Jews than among their non-Jewish neighbors. From Billings' statistics it is found that the mortality from diseases of the urino-genital system among 60,630 American Jews and Jewesses was as follows:

Class of Population.| Men.| Women.  
---|---|---  
Jews| 33.44| 27.84  
General population of the United States (1880)| 22.44| 10.77  
Population of cities in the United States| 38.13| 32.88  
Population of Massachusetts (1888)| 42.77| 27.21  
  
As is well known, this group of diseases is more frequent among townfolk; and as the Jews who are here under consideration live almost exclusively in cities, they must be compared with people living under similar conditions. It appears that when contrasted with the general population of the United States, the Jews show a higher mortality; but when compared with the city dwellers, the mortality among them is much smaller than that among others. This is confirmed by a consideration of the census figures for the six years ending May 31, 1890, in which the mortality from diseases of the urinary system is given for the city of New York as follows, per 100,000 population, the cases being classified according to the birthplace of the mother:

Irish| 272.45  
---|---  
English| 206.13  
Bohemians| 154.85  
French| 150.65  
Germans| 141.78  
Americans (white).| 124.14  
Italians| 73.38  
Hungarians (mostly Jews)| 51.68  
Russians and Poles (mostly Jews)| 48.34  
  
The lowest mortality is thus seen to be recorded among the Hungarians, Russians, and Poles, who were almost exclusively Jews. The best reason for this is furnished by the fact that the lowest mortality from alcoholism during the same period in New York city was also observed among the Jews—1 in 100,000 population, as against 31 among the Irish, 10 among the Germans, and 9 among Americans. Körösi's statistics for Budapest confirm this view. During the period 1886-90 the mortality from Bright's disease per 100,000 population was as follows:

Catholics| 67  
---|---  
Lutherans| 68  
Calvinists| 56  
Other Protestants| 63  
Jews| 39  
  
It is thus seen that the lowest mortality from Bright's disease was observed among the Jews. The best explanation of this is evidently the rarity of the abuse by them of alcoholic beverages.

Of the other diseases of the organs of generation, syphilis is one from which the Jews suffer but little as compared with their Gentile neighbors. Jonathan Hutchinson states that such is the case in London, England, where at the Metropolitan Free Hospital, in the Jews' quarter, in 1854 the proportion of Jews to Christians among the outdoor patients was nearly as 1 to 3, yet the ratio of cases of syphilis among the former to those among the latter was only as 1 to 15. Jacobs also reports that under Cohen's service at the Metropolitan Free Hospital during 1882 and 1883 the percentage of syphilis was as follows:

| Jews.| Non-Jews.  
---|---|---  
Men| 17.8| 62.0  
Women| 20.0| 62.6  
Children (congenital syphilis), per cent of total number of cases| 3.3| 15.8  
  
This shows a larger percentage of syphilis among the non-Jews. This relative immunity of the Jews from syphilis has been observed in other countries (see J. K. Proksch, "Gesch. der Venerischen Krankheiten," 1895, i. 125), and has been attributed to circumcision (see Wunderbar, "Biblisch-Talmudische Medizin," p. 26, Riga, 1850; Collin, "Die Beschneidung der Israeliten," p. 9, Leipsic, 1842).

In Chicago E. A. Fishkin has observed that among the patients of the dispensary of the United Hebrew Charities the proportion of syphilis was only 0.9 per cent of the total number of patients afflicted with skin-diseases, as against 11.8 per cent among the general population of the United States (according to the returns of the American Dermatological Association); but the cases observed were those of individuals younger than forty, and three were minors ("Jour. American Medical Association," Aug. 23, 1902).

Of the diseases of the eye, the Jews suffer more than others from trachoma (granular lids), follicular conjunctivitis, glaucoma, and, according to some authorities, retinitis pigmentosa. This last is a hereditary disease of the eye characterized by the deposition of pigment in the retina, which leads to contraction of the field of vision, and ultimately to total blindness. Its frequency among the Jews is attributed to consanguineous marriages (see R. Liebreich, "Abkunft aus Ehen unter Blutvervandte als Grund von Retinitis Pigmentosa," 1860, in "Deutsche Klinik," No. 6). Of the disturbances of vision, myopia, astigmatism, and color-blindness, as well as blindness, are known to be more frequent among the Jews than among others (see Blindness; Eye—Pathology).

Diseases of the Skin.

Of the diseases of the skin, eczema is said by Hardy to be more common among the Jews than among others; but many other dermatologists with extensive experience among the Jews assert the contrary ("Bulletin Médical," 1891, p. 851). Fishkin found that among the immigrant Jews in Chicago, the proportion of eczema among his total number of cases of skin-diseases was 34.5 per cent as against 29.8 per cent among the general population of the United States (according to the statistics of the American Dermatological Association), which shows that the Jews are more liable to the disease ("Jour. American Medical Association," Aug. 23, 1902).

Parasitic diseases of the skin and scalp are said to be more common among the Jews in eastern Europe than among their non-Jewish neighbors. This is particularly emphasized in reference to scabies and favus ("plica Polonica" and "plica Judaica," for instance). In the United States this is not observed to be the fact when the immigrant Jews are compared with others of the same social status. These diseases being generally observed among the poor and degraded, a reason is found for their frequency among the eastern European Jews. In western Europe and in America, where the social and economic status of the Jews is superior, parasitic diseases of the skin are as uncommon among them as among others.

Psoriasis is also said to be more frequently metwith among the Jews than among others. Among the patients of the dispensary of the United Hebrew Charities in Chicago, Fishkin has observed especially that psoriasis, which is rarely seen in non-Jewish children, is more commonly met with among those of the Jews. Another disease of the skin often seen in Jewish children is impetigo, which also can be explained from the insanitary conditions under which many Jews live. On the other hand, the syphilitic dermatoses are uncommon, which fact accords with the infrequency of syphilis among them.

A survey of the evidence shows that the morbidity and mortality of the Jews are not due to any biostatic characteristics of a purely anatomical or physiological nature. The Jews are more nervous, have a larger proportion of insane, etc., from social causes, not because the structure of their nervous systems is in any way peculiar anatomically or physiologically. They are less liable to certain contagious diseases, but not because of some physiological immunity of their tissues. All their pathological characteristics can be shown to be due to the peculiar social and economic conditions under which they live. In the ghettos of eastern Europe, where the Jews are more or less isolated from their Gentile neighbors, their morbidity and mortality differ perceptibly from those of the rest of the population. These differences are usually due to their avoidance of alcoholic excesses and to their devotion as husbands and wives or as parents; some of the most important factors in the production of pathological processes in civilized communities being thus eliminated. The dietary laws, which the Orthodox Jews of eastern Europe rigidly observe, have a beneficial influence, while the Sabbath, which affords them a complete mental and physical rest, and which they do not spend in the barroom and in dissipation as others are apt to spend it, has a good effect on their physical condition, affording them recuperation after the week's work, and thus rendering them less liable to sickness. The fact that the Jews are mostly townfolk, engaged in indoor and domestic occupations, renders them more liable to certain chronic diseases, while the fact that a large proportion of them is engaged in mercantile pursuits, in occupations which do not necessitate frequent exposure to the vicissitudes of the weather, and is not employed in dangerous trades, has an important bearing on the question of their morbidity.

Bibliography:

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J. M. Fi.