MEDICAL INVESTIGATIONS 
I N 
LIFE INSURANCE; 
BEING A SERIES OF 
SPECIAL RE P 0 R TJ 
TO THE 
BOARD OF DIRECTORS 
OF THE 
United States Life Insurance 
Company, 
2 61 BROADWAY, 
B Y 
THE MEDICAL STAFF OF THE COMPANY. ANNUAL REPORT 
OF THE 
MEDICAL EXAMINER 
OF THE 
United States Life Insurance Co. 
IN THE CITY OF NEW YORK. 
TO THE BOARD OF DIRECTORS, 
For the year ending Dec. 31, 1873. 
Gentlemen : 
At the request of your President, I have instituted a careful 
inquiry into the death-record of this company from its incor- 
poration in 1850 to the present time—December 27th, 1873. 
Such an inquiry, it was believed, would, on the one hand, throw 
light on at least some of the errors of the past and so enable us 
to avoid them in the future, while on the other, it would more 
clearly define the rules regarding health, personal habits and 
family history in accordance with which a financial success in 
3 assuring lives had already been attained. Many of our agents, 
too, were disposed to consider the rulings of the home office un- 
necessarily severe, and it therefore seemed very desirable, if 
possible, to show in the past experience of the company a 
justification for the course followed. 
As a preliminary step to such a study it was found necessary 
to gather together into a single volume, in systematic order, all 
the facts contained in the applications, the Medical Examiner’s 
reports and the “ proofs of death,’’ of those who had died during 
this period. This part of the work has been done in a very 
satisfactory manner by Mr. ]. A. Marsh of this city, and is sub- 
mitted herewith for your inspection. 
The number of deaths involved in this inquiry is one 
thousand. The causes by which they were encompassed are 
set forth in the following table : 
Table I. 
Abscess (of arm, parotid gland, and perineum) . . . .3 
Anaemia ........ 2 
Aneurism . ... . . . . -4 
Apoplexy ........ 53 
Assassination ........ 4 
Asthma ........ 2 
Bladder, inflammation of . . .... 3 
Brain, acute disease of ...... 36 
Brain, chronic disease of . . . . . . 32 
Bronchitis ........ 7 
Bowels, inflammation of . . . . . .24 
Calculus (biliary and cystic)...... 2 
Cancer . . . . . . . . 22 
No. of 
Cases. 
4 Casualties (war, shipwreck, poison and drowning) ... 54 
Cerebro-spinal meningitis . . . . . .7 
Cholera, Asiatic . . . . . . .17 
Cholera morbus ........ 9 
Consumption . . . . ... . 268 
Delirium tremens . . . . • • .10 
Diabetes ........ 7 
Diarrhoea ........ 9 
Diphtheria ........ 5 
Dropsy ......... 20 
Dysentery . .... ... 27 
Epilepsy. . . . . . . - .2 
Erysipelas ........ 10 
Exhaustion, from undue mental labor . . . . .1 
Fever, continuous ....... 60 
Fever, intermittent and remittent . . . .8 
Fever, congestive ..... . .10 
Fever, yellow ........ 1 
Gastritis ........ 9 
Heart, diseases of . . . . • -49 
Hemorrhage, internal from strain ..... 2 
Hernia, strangulated . . . . . . -4 
Hydrbthorax ....... 2 
Intemperance (forms of disease not stated) . . . .6 
Kidneys, chronic disease of . . . , . .25 
Lead disease ........ 1 
Liver, abscess of . . . . . • 4 
Liver, cirrhosis of ....... 5 
Liver, cancer of ...... 2 
Liver, diseases of (forms not stated) . . • • • 27 
Lungs, abscess of, from embolism . • • ■ 1 
Malignant pustule . . . ... .2 
No. ot 
Cases. 
5 No. of 
Cases. 
Parturition ....•••• 2 
Peritonitis ........ 4 
Pleurisy ........ 2 
Pneumonia ........ 81 
Puerperal fever ....... 1 
Purpura hemorrhagica ... . . . . 1 
Rheumatism, acute articular ..... 7 
Scarlatina ..... . . . 1 
Small-pox ........ 9 
Stomach, ulcer of, with hemorrhage . . . . .3 
Suicide . . . . . . . .19 
Sunstroke ........ 2 
Unknown (found dead, etc.) . . . . . 10 
1,000 
It will thus be seen that the most fatal element in our list of 
diseases is consumption, which alone has been productive of 
nearly 27 per cent, of the deaths. The zymotic diseases— 
intermittent, remittent, scarlet, typhoid and yellow fevers, small- 
pox, diphtheria, erysipelas, cerebro-spinal meningitis, cholera, 
dysentery and diarrhoea—constitute the second largest group, 
including 198 cases, or nearly 20 per cent. 
Next in order come the various diseases of the brain, such as 
apoplexy, congestion, inflammation and softening of the brain, 
acute mania, epilepsy and sunstroke. This group numbers 125 
cases, or nearly 13 per cent, of the entire mortality. If we add 
to it the cases of suicide and delirium tremens, the group will 
number 155 cases, or over'15 per cent. 
The acute diseases of the lungs—pneumonia, bronchitis and 
6 pleurisy—constitute the fourth largest group, containing 90 
cases or 9 per cent. 
Finally, the diseases of the heart and larger blood vessels 
comprise 53 cases or 5 per cent. 
Table II.—Relations of Height to Weight. 
(Based upon 1639 American Lives.) 
Height. 
No. of 
[Indiv. 
Involved. 
Aggregate 
Weight 
lbs. 
Average 
Weight. 
lbs. 
Average 
Weight 
(Hutchinson.) 
lbs. 
Average 
Weight. 
(A.Standard.) 
lbs. 
4 ft. 
9 in. 
I 
121 
4 ft. 
io in. 
4 ft. 
ii in. 
2 
235 
117 
5 ft. 
8 
IO25 
128 
5 ft- 
I in. 
6 
738 
I23 
120 
120 
5 ft- 
2 in. 
14 
1770 
126 
126 
125 
5 ft- 
3 >n- 
33 
4268 
129 
133 
130 
5 ft- 
4 in. 
78 
IO374 
133 
139 
J35 
5 ft- 
5.in. 
91 
I2452 
136 
I42 
140 
5 ft- 
6 in. 
179 
25261 
141 
145 
i43 
5 ft- 
7 in. 
257 
37694 
146 
I48 
i45 
5 ft- 
8 in. 
334 
50678 
151 
155 
148 
5 ft- 
9 in. 
197 
OO 
O 
Ln 
O 
156 
162 
i55 
5 ft- 
io in. 
224 
35482 
158 
169 
160 
5 ft- 
II in. 
102 
16913 
165 
174 
165 
6 ft. 
81 
14008 
172 
178 
170 
6 ft. 
I in. 
20 
3462 
173 
6 ft. 
2 in. 
9 
1508 
167 
6 ft. 
3 in. 
3 
630 
210 Before entering into the particulars of these five groups, allow 
me to lay before you some statistics collected in the course ot 
the present inquiry. It was found, for instance, that out of the 
thousand individuals, whose policies had matured by death, the 
heights and weights of 742 had been recorded by the medical 
examiner. As this number did not appear t,o me to constitute 
a sufficiently large basis upon which to found a table, I collected 
from the volumes of the medical examiner’s reports the heights 
and weights of 897 other individuals (all males and all accepted 
risks), thus making a total of 1639 males whose average age was 
nearly 37 years. 
The table of average heights and weights now in use among 
all life companies in the United States, is, I believe, a modifica- 
tion of Dr. Hutchinson’s table. The correctness of the modified 
table for American purposes is fully confirmed by the results of 
the present investigation, as set forth in the preceding table. 
GROUP I. 
Diseases of the Heart and Larger Blood-vessels. 
In stating that there were but 53 cases in this group, I am 
confident that the number falls short of, rather than exceeds, the 
truth. 
Of the two cases of asthma, 2 cases of hydrothorax, 20 cases 
of dropsy, 25 cases of chronic disease ot the kidneys and 27 cases 
of the liver, it is highly probable that quite a number were 
8 secondary to disease of the heart. The facts stated in the death- 
certificates are not, however, sufficiently explicit for me to 
venture upon any more accurate diagnoses than those given in 
Table I. 
The average age at death of the entire group is 49 years, dis- 
tributed among the different periods of life as follows : 
Table III.—Diseases of the Heart and Larger Blood-vessels. 
20 
25 
30 
35 
40 
45 
5° 
55 
60 
65 
70 
Ages 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
24 
29 
34 
39 
44 
49 
54 
59 
64 
69 
74 
No. of cases 
I 
2 
3 
5 
7 
5 
8 
14 
5 
2 
1 
It will thus be seen that this form of disease is pre-eminently 
one of mature age, 56 per cent, of the deaths having occurred 
during or after the 50th year of life and nearly 80 per cent, 
after the 40th. Another feature of some practical importance is 
the fact that out of the 49 cases (excluding the 4 cases of aneu- 
rism), 15 gave a previous history of ‘'rheumatism.’ None of 
these cases made any complaint of palpitation of the heart, short- 
ness of breath or any other suspicious symptom at the time they 
were insured, and it is to be presumed that no physical signs 
were at that time discoverable which might have thrown light 
upon the causes of their subsequent deaths. Hence the only 
indication of the disease of which they were eventually to die, 
lay in the circumstance of their having had “rheumatism.” 
9 The fact, then, that 30 per cent, of all our losses through disease 
of the heart were known, at the time of issuing the policies, to 
have had rheumatism, would suggest the propriety of making 
an inquiry into the history of our rheumatic risks, similar to that 
which has been made farther on in the case of those having a 
consumptive element in their family histories. This investigation, 
however, must be reserved till some future time. 
The ages at death of the four cases of aneurism average 50 
years. 
10 GROUP II. 
Acute Diseases of the Lungs. 
There is very little to say concerning the diseases of this group, 
except that they carry off some of our healthiest risks in the very 
prime of life. 
I know of no way of guarding against loss from this source 
unless it be by the exercise of caution in accepting persons whose 
occupation exposes them to sudden and great changes in tem- 
perature. Tables IV. and V. will show the seasons of the year 
when the disease is most prevalent, and the ages at which it is 
most likely to occur. 
Table IV.—Acute Diseases of the Lungs. 
Prevalence according to seasons. 
Month 
d 
d 
Feb. 
1 
March. 
April. 
May. 
CD 
C 
1-^* 
do 
«! 
oT 
a? 
0 
0 
! Nov. 
No. of cases 
13 
IS 
9 
10 
7 
7 
4 
3 
2 
2 
10 
Table V.—Acute Diseases of the Lungs. 
Ages 
15 
to 
20 
to 
25 
to 
30 
35 
to 
40 45 
to to 
5° 55 
to to 
60 65 
to to 
O O 
■*-* 
75 
to 
80 
to 
85 90 
to to 
J9 
24 
29 
34 
39 
44 
49 
54 59 
64 
69 
74 
79 
84 
89 
94 
No. of cases 
I 
2 
7 
10 
17 
13 
14 
11 4 
q 
0 
0 
1 
0 
0 
1 
Ages at Death. 
11 00 00 
Lrx Ln (_ 
VO CO 
00 
rx C 
*4 
00 00 
rx Or L 
3d 
n C 
c 
oo 
rx L 
*0 
00 
/i l 
to 
>0 
a Li 
-< 
io 
r> 
0 
01 
p 
i 
i 
i 
i 
i 
j i 
! 
Congestion of 
Brain. 
Apoplexy. 
— j Softening. 
to <-• 
Inflammation of 
brain. 
to 
Chronic disease 
o! brain. 
Insanity. 
- 
Acute Mania. 
Nervous pros-l 
tration from 
overwork. | 
- 
Epilepsy. 
Cancer of brain. 
j Abscess of brain. 
m — | Suicide. 
►» h m j Del. Tremens. 
1 
O 
3 
2 
2 
8 
X 
2 
3 
2 
Totals. 
GROUP III. 
Diseases of the Brain and Nervous System : Delirium Tremens and Suicide.  
I 
I 
1 
1 
1 
3 
3 
2 
5 
3 
2 
1 
6 
2 
1 
1 
1 
5 
6 
3 
1 
1 
1 
12 
1866 
1 
7 
1 
1 
1 
1 
12 
1 
1 
1 
1 
4 
1868 
2 
4 
4 
3 
1 
1 
15 
1869 
1 
3 
1 
1 
2 
1 
4 
13 
1 
3 
1 
2 
1 
3 
11 
2 
5 
1 
2 
1 
3 
1 
15 
1 
8 
2 
1 
1 
1 
1 
15 
1 
4 
4 
I 
1 
1 
3 
15 
Totals 
!9 
53 
20 
14 
5 
8 
3 
1 
2 
1 
1 
19 
10 
!56 There are several questions of interest which arise during the 
study of this group of diseases, but unfortunately the number of 
cases which it comprises is comparatively small and the details 
of the individual histories are in many instances incomplete. 
Neverthless the results are suggestive of certain inquiries that 
might profitably be made, were the material at one’s command 
larger. 
The relative frequency of the different diseases and their dis- 
tribution among the different years of the past are set forth in 
the preceding table. 
Leaving out the cases of suicide, and separating the ages into 
periods of five years each, I find the apoplexies, congestions, 
softenings, etc., of the brain to have been distributed as 
follows : 
Table VII.—Diseases of Brain and Nervous System. 
Ages at Death. 
20 
25 
3° 
35 
40 
45 
5° 
55 
60 
65 
70 
75 
Ages 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
24 
29 
34 
39 
44 
49 
54 
59 
64 
69 
74 
79 
No. of cases. 
2 
6 
9 
19 
26 
22 
22 
14 
12 
2 
2 
1 
The height and the weight were recorded in 116 out of the 
156 cases. The)' are as follows : 
14 Table VIII.—Diseases of Brain and Nervous System. 
Relations of Height to Weight (116 cases.) 
Height 
5 •1 
5-2 
5-3 
5-4 
5-5 
5-65-7 
5-8 
5-9 
5 10 
5 -11 
6 ft 
6.1 
Weight 
127 
— 
132 
i37 
144 
i59 i57 
157 
166 
160 
172 
181 
145 
Amer. standard.... 
120 
— 
130 
i35 
140 
M3 145 
148 
155 
160 
165 
170 
— 
As to the question of whether the disease was or was not in 
some instances hereditary, 1 would reply that in io cases the 
father was known to the company, at the time the policy was 
issued, to have died of apoplexy or softening of the brain, by 
suicide or by intemperance ; that in 4 other cases the mother 
was known to have died of suspected brain trouble ; that in 
four others still a parent, together with a brother or sister, were 
known to have died from the same causes; while finally, in six 
other cases, one or more brothers or sisters were known to have 
been victims of brain trouble. Thus it is possible that in a 
little over 15 per cent, of all these cases there was an hereditary 
taint predisposing the applicants to the diseases of which they 
eventually died. 
In 18, ora little over 11 percent, of the cases, the family history 
was tainted with consumption. In 22, or 14 percent, of the 
cases, the applicants had been at some previous time afflicted 
with “rheumatism.” 
The suicides are grouped in the following manner, according 
to their ages and methods of destroying life : 
15 TABLE IX.—Suicides. 
Ages at Death. 
Ages 
20-24 
25-29 
30-34 
1 1 1 1 
35-39 40-44 45-49 5°-S4 55-59 
No. of cases 
1 
2 
4 
j 
2 4 
4 
I 
1 
TABLE X.—Suicides. 
Modes of Death. 
No. of cases 
Modes of Death 
Jumping out 
ot Window. 
to 
Drowning. 
- 
Stabbing. 
to 
Strychnine. 
to 
Cutting throat. 
Shooting. 
Hanging. 
Not stated. 
GROUP IV. 
Zymotic Diseases : Typhoid Fever, Scarlet Fever, Yellow 
Fever, Intermittent and Remittent Fevers, Cerebro- 
Spinal Meningitis, Cholera, Erysipelas, Puerperal 
Fever, Diphtheria, Small-Pox, Diarrhoea, 
and Dysentery. 
The recent epidemic of yellow fever in some of the South- 
western cities has been seriously felt by some of our neighbors, 
but as our own company has never issued policies on persons 
16 residing in the Southern States, except in isolated cases, it is not 
surprising that there should have been only one death from 
that disease. The epidemic referred to, however, would prob- 
ably not have proved so fatal to the better classes, had not the 
cities in which the disease prevailed been in such a deplorable 
sanitary condition. In the future it would perhaps be to the 
Company’s interest to note the sanitary condition of the towns 
and cities in which risks are to be taken, and avoid all places 
where sanitary laws are persistently disregarded. 
In regard to the continuous fevers, such as typhus and 
typhoid, a glance at Table XI. will show that among our 
policy-holders no period of life has been specially liable to these 
diseases. 
TABLE XI.—Continuous Fevers. 
Ages at Death. 
15 
20 
25 
30 
35 
40 
45 
5° 
55 
60 
65 
Ages 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
19 
24 
29 
34 
39 
44 
49 
54 
59 
64 
69 
No. of cases 
2 
8 
5 
8 
8 
9 
6 
4 
7 
2 
I 
The only provision that can be made by the Company to 
avoid an excessive mortality from this source is by not issuing 
policies, at least on the life plan, to men whose pecuniary cir- 
cumstances compel them to live in the crowded tenement 
houses of our larger cities. 
17 GROUP V. 
Consumption. 
Our “proofs of death” are not sufficiently accurate to enable 
me to make a distinction between tubercular disease of the lungs 
and chronic bronchitis,—a form of disease so nearly like the 
tubercular variety in all its outward manifestations that 1 scarcely 
believe it will ever be possible in insurance statistics to call it by 
any other name than consumption. For practical purposes, 
however, it is not necessary to make such a distinction. 
Consumption has at all times in the history of the Company 
been the cause of a large percentage of its losses, no less than 
268, or nearly 27 percent., of the entire number of deaths 
having been due to this disease. The yearly losses from this 
source are as follows : 
18 TABLE XII. — Consumption. 
i 
Number of deaths according to years. 
Year. 
Total Number 
Deaths. 
Deaths by Con- 
sumption. 
Percentage. 
1850 
3 
.. 
1851 
5 
1852 
38 
1853 
24 
6 
25 
1854 
25 
7 
28 
1855 
29 
5 
17 1-4 
1856 
l6 
7 
43 3-4 
1857 
25 
6 
24 
1858 
25 
IO 
40 
1859 
18 
II 
6l I9 
i860 
23 
n 
30 1-2 
1861 
22 
5 
22 2-5 
1862 
33 
II 
33 1-3 
1863 
28 
12 
43 
1864 
33 
IO 
30 1-3 
1865 
53 
13 
24 1-2 
1866 
57 
14 
24 I 2 
1867 
53 
15 
28 1-^3 
1868 
62 
16 
25 5~6 
1869 
82 
23 
28 1-20 
1870 
70 
27 
38 4-7 
1871 
92 
28 
3° 4-9 
1872 
93 
*3 
14 1-8 
1873 
91 
22 
24 J-5 
24 Years. 
IOOO 
268 
27 per cent. 
The first thing here that attracts our attention is the fact that 
while the mortality from consumption in the country at large is 
19 generally considered to be only 15 per cent, of the entire mor- 
tality, in the community of policy-holders, all selected lives, it 
is nearly twice as great. 
The unfairness, however, of this comparison will appear at 
once if we take into account the fact that the community of 
policy-holders differs from the population at large in having 
among its number no individuals under 18 or 20 years of age 
and very lew over 65. Hence from the total number of deaths 
for 1870, as ascertained by the last census, and from the 1000 
deaths in the Company’s experience, we should deduct all those 
which occurred before the 20th or after the 64 th year of life. 
The same should be done in the case of the deaths from con- 
sumption. Placing the results together in the form of a table, 
we have the following :— 
TABLE XIII. 
. Total deaths from 
all causes. 
20 to 65 years. 
Deaths from Con- 
sumption. 
20 to 65 years. 
Ratio. 
Community 
at 
100,472 
24,978 
25 per cent. 
Large. 
Company’s 
Experience. 
969 
263 
27 per cent. 
In other words, the Company’s mortality from consumption 
is but little greater than that which prevails in the community 
20 at large. But I am told by the Actuary that a still further 
deduction—one, however, that is hardly susceptible of being 
computed in numbers—should be made on account of the 
withdrawal every year of a large number of healthy lives from 
the community of the insured, while those who remain com- 
prise among their number an undue proportion of diseased or 
weak lives. In a community thus peculiarly constituted we 
should certainly expect a proportionately heavier mortality from 
consumption than among the population at large. 
Making due allowance for this, and bearing in mind the 
eagerness of phthisical persons to insure their lives, and the dif- 
ficulty of diagnosticating the disease in its early stages, especially 
when the applicant withholds important facts from the examiner's 
knowledge, I am rather surprised that the comparison should 
result so favorably for the company. 
21 TABLE XIV.—Consumption. 
Ages at Death. 
Degree of Hereditary Taint. 
No. of Cases. 
Average Age at ( 
Death. 
Average Age of i 
Parents at Death. 
Average Age of 
I Brothers and Sis- 
ters at Death. 
Hereditary by mother and father, and one 01- 
more brothers or sisters 
2 
51 1-2 
48 
39 
I 
vO 
CO 
Hereditary by the mother and father 
I 
Hereditary by the mother 
18 
43 i-6 
Hereditary by the father 
13 
38 
36 
Hereditary by the mother and one or more 
brothers or sisters 
10 
45 1-2 
56 1-2 
26 
Hereditary by the father and one or more 
brothers and sisters 
2 
39 
5i 
40 
Hereditary by one or more brothers or sisters. 
30 
4i 
31 
Totals 
VO 
41 
45 
30 
22 I would call attention in this place to the fact that the mor- 
tality from consumption, among our outside risks, has been 
decidedly heavier in proportion to the total number of lives at 
risk than that which has occurred in this city and vicinity. 
Before discussing this question further, let us glance at some 
of the facts that may be gathered from a closer study of these 
268 deaths (see p. 16 ). 
In the first place, we find that the average age at which they 
insured their lives is 34 years, whereas the average age at which 
the remaining 732 became insured is years. The average 
age at death of the 268 is 39 years, while among the other 732 
it is 44 years. In 76 cases (29 per cent.) there seems to have 
been a consumptive taint in the family. These cases are classi- 
fied in the preceding table. 
It is a fact well known to the officers of insurance companies 
that the terms “childbirth,” “change of life,” “exposure,” 
“grief,” “fever,” “inflammation of the lungs,’’and “general 
debility,” used by the applicant to designate the cause of death 
of some member of the family, are in many instances synony- 
mous with consumption. This is particularly true of the 
applications for insurance that come from agents in the country. 
Physicians who make but half-a-dozen examinations in a year 
are slow to learn the importance of a thoroughly sifted family 
history. I believe it is no exaggeration to say that about half 
of these cases would prove, upon careful inquiry, to have been 
genuine cases of consumption. With this in view I have con- 
structed the following table, which shows that in an additional 
24 per cent, of the deaths there was a doubtful family record. 
23 TABLE XV.—Deaths from Consumption among those with a 
Doubtful* Family EIistory. 
Degree of Doubtful Taint. 
No. of Cases. 
Average Age at 
Death. 
j Average Age of 
Parents at Death. 
Average Age of 
] brothers and Sis- 
ters at Death. 
Hereditary by the mother 
34 
39 43 
Hereditary by the father 
14 
42 49 
Hereditary by one or more brothers or sisters. 
17 
44 
27 
Totals 
65 
41 44 3-5 
27 
Ages at Death. 
* The causes of death, as stated, being “ childbirth," “ change of life,” “ fever,” &c. 
It will, therefore, not be far from the truth to say that in 
about 40 per cent, of our consumptive losses, the taint in the 
family history played an important part in determining the 
eventual cause of death. Further on I will revert to this ques- 
tion and follow it out more closely. 
The ages at which these 268 consumptives died are arranged 
in periods of five years each in the following table :— 
TABLE XVI.—Consumption. 
Ages at Death. 
15 
20 
25 
3° 
35 
40 
45 
50 
55 
60 
65 
70 
75 
Ages. 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
19 
24 
29 
34 
39 
44 
49 
54 
59 
64 
69 
74 
No. of 
Cases. 
3 
9 
22 
55 
62 
43 
36 
21 
9 
4 
2 
1 
1 
24 From this table it will be seen that 60 per cent, of the deaths 
occurred between the ages of 30 and 45, or 73 per cent, between 
the ages of 30 and 50. 
Our only way of judging of the physical condition of the 268 
individuals at the time they were insured, is by ascertaining 
their average heights and weights at that time. On investiga- 
tion, however, I find that the heights and weights as ascertained 
at the time the policies were issued, have been recorded in only 
209 instances. In these cases the average weights for the differ- 
ent heights are as follows :— 
TABLE XVII.—Consumption. 
Relations of Height to Weight. 209 cases. 
Height. . ..'5.x 
5-2 
5-3 S-45-5 
5-6 
5-7 
CO 
5-9 
5-10 
5 •11 
6ft. 
6.1 
6.-2 
6-3 
Weight. ...1116 
112 128 133 
i34 
141 
143 
148 
148 
44S 
145 
161 
160 
185 
Am. Stand. 120 
130 135 140 
1 
143 
i45 
148 
i55 
160 
165 
170 
As it is not likely that the weights of the remaining 59 cases 
would materially disturb the average here given, I believe we can 
safely assume that these results represent correctly the average 
heights and weights of the entire group. Here, then, we find a 
second important general characteristic of these consumptive 
cases—a tendency to leanness, especially noticeable among the 
tall individuals of the group. This diminution in weight is even 
more marked than is the increase among the group of diseases 
of the brain and nervous system. Until we shall have reversed 
the investigation and ascertained what has been the mortality 
25 among all, or at least a large number, of our lean risks, it would 
not be safe to lay down any general rule regarding them. It is 
evident, though, that this class of risks must be accepted with 
caution. 
An investigation into the physical histories of the group prior 
to insurance, reveals only two points of interest : 7 per cent, of 
the number had been more or less subject to “rheumatism, 
and 5 per cent, had previously had “ spitting of blood.” 
So far then as we have gone in this inquiry, the results ob- 
tained would seem to indicate the necessity for separate inquiries 
in regard to the mortality among :— 
1. Those who have had “spitting of blood,” and those who 
have had a consumptive taint in their family histories ; 
2. Those who have been over or under the standard weight; 
and 
3. Those who have had “rheumatism.” 
The last two of these inquiries will have to be postponed till 
some future time, but the results of the first are submitted 
below. 
An Inquiry into the Mortality of 800 Policy-holders, who 
WERE SUPPOSED, AT THE TIME THE POLICIES WERE ISSUED, 
TO HAVE A PRE-DISPOSITION TO CONSUMPTION, 
EITHER INHERITED OR ACQUIRED. 
The 800 cases, upon which the following calculations are 
based, represent very nearly the total number of risks of this 
26 kind which the Company has upon its books for the city of New 
York and vicinity, prior to 1872. About 700 of the number 
w'ere examined by the former medical director of the Company, 
Dr. Clements, and the balance by the physicians mentioned in 
the early part of this report and by myself. To facilitate the 
arrangement into groups or classes, all the facts of importance, 
either in an actuarial or a medical point of view, were written 
upon a separate card for each case. The groups into which the 
entire number were divided are the follovdng : 
1. Those who had previously had spitting of blood, 70 cases. 
2. Those who had previously lost a parent from consumption, 
386 cases. 
3. Those who had previously lost one or more brothers or 
sisters, 229 cases. 
4. Those who had previously lost a parent and one or more 
brothers or sisters from consumption, 107 cases. 
5. Those who had previously lost both parents from con- 
sumption, 8 cases. 
GROUP I. 
Spitting of Blood. 
The facts relating to this group are briefly the following: In 
the first place, if the proportion of height to weight is any in- 
dication of a good physique, the 53 cases in which these items 
have been recorded, must have been well selected. The 
averages are as follows : 
27 TABLE XVIII.—Spitting of Blood. 
Relations of Height to Weight. 53 cases. 
Height 
5 •1 
5-2 
5-3 5-4 5-5 
5-6 
5-7 
5-8 
5-9 
5-105.11 
6.00 
I25 
*59 
141 
i39 
151 
l59 
r55 
i73 
160 
American Standard... . 
120 
r35 
i43 
!45 
148 
155 
165 
165 
170 
In the second place, I find that in only two cases had the in- 
sured had spitting of blood more than once. In eight instances 
no record seems to have been kept of the time that had elapsed 
since the last attack. In the remaining 62 cases the lengths of 
time were recorded, and may be classified as follows : 
TABLE XIX.—Spitting of Blood. 
Length of time since the occurrence. 
Total No. of Cases... 
A. —No. of Cases 
B. —No. of Cases. . 
Length of Time. 
2 
I 
3 
i year. 
C-K) | HH 10 
2 years. 
4 
4 
2-5 years. 
zz 
c 
6i 
5-10 years. 
£ | 3 j 10-15 years- 
1 
Ln | 15-20 years. 
ON 
1 
1 
on | 20-25 years. 
N3 
1 
I 
N j 25-30 years. 
" 1 
►h | 30-40 years. 
00 1 to O'. 
1 
Not stated. 
to | ■ to 
Sev’ral times. 
A. Those whose policies have not become claims. 
B. The deaths. 
28 Fifty-nine of the cases were apparently free from any hereditary 
taint that might complicate the problem. The deaths in the entire 
group were u in number; one from dysentery, one from soften- 
ing of the brain, one from intemperance, and eight from consump- 
tion (nearly 73 per cent.). There were 8 deaths among the 59 
non-hereditary cases, or 1 to 7$ persons ; while among the 11 
cases, complicated by an hereditary taint, there were 3 deaths, 
or 1 to 31 persons. The average age at which the 70 were 
insured is 364- years ; the average age of the eleven at death 
is 431 years. 
29 GROUP II. 
One Parent Consumptive. 
The average age at which these 386 cases were insured is 33 
years, while the average age at which the parents died of con- 
sumption is 42 years. Or, if we make two subordinate groups, 
one of 161 cases in which the consumptive taint came through 
the father, and the other of 225 cases in which it came through 
the mother, we shall find that in both groups the applicants 
averaged 33 years of age, but that in the former the fathers 
averaged 45 years at death, while in the latter the mothers 
averaged only 40 years. 
Again, the relations of height to weight, in 320 individuals of 
the group, are as follows : 
TABLE XX.—One Parent Consumptive. 
Relations of Height to Weight. 320 cases. 
Height 
4- ii 
5.00 
5-i 
5-2 
5-3 
5-4 
5-5 
5-6 
Average Weight 
117 
109 
"5 
107 
117 
130 
i34 
134 
American Standard 
120 
125 
130 
135 
140 
143 
Height 
5-7 
5-8 
5-9 
5 10 
5 -11 
0.00 
6.1 
6.2 
Average Weight 
141 
i52 
iS5 
154 
171 
158 
170 
i73 
American Standard 
145 
148 
155 
160 
165 
170 
30 The deaths in this group were 22 in number; 8 from con- 
sumption (36 1-2 per cent.), 6 from brain troubles (27 1-3 per 
cent.), one from inflammation of the bowels, one from cancer 
of the face, one from cancer of the bowels, one from abscess of 
the liver, one from dysentery, one from typhoid fever, one from 
fatty degeneration of the heart, and one from congestive ma- 
larial fever. Or, making the same division as before into two 
subordinate groups, we obtain the following results : 
Hereditary by the mother, 225 policies. 15 deaths. 
Hereditary by the father, 161 policies. 7 deaths. 
GROUP III. 
One or More Brothers or Sisters Consumptive. 
This group comprises 229 cases. The average age of the 
applicants at the time they became insured is 36 years; the 
average age of 285 brothers and sisters, alleged by them to have 
died of consumption, is 36 years. The relations of height to 
weight are as follows : 
TABLE XXI.—One or More Brothers or Sisters Consumptive. 
Relations of Height to Weight. 181 cases. 
Height 
5-2 
5-3 
5-4 
5-5 
5-6 
5-7 
5 8 5-9 
5.10 
511 
6.00 
6.1 
6.2 
Average Weight.. . 
13° 
*5° 
132 
134 
145 
i43 
148 147 
i55 
161 
i73 
156 
190 
American Standard 
125 
130 
135 
140 
i43 
i45 
148 155 
160 
165 
170 
31 The deaths in this group are 12 in number; namely, 4 from 
consumption per cent.), 3 from disease of the brain (25 
percent.), 2 from accidental causes, 1 from “dropsy,” 1 from 
chronic inflammation of the bladder, and 1 from cirrhosis of the 
liver. 
GROUP IV. 
A Parent and one or more Brothers or Sisters Consumptive. 
The 107 applicants of this group were 35 years of age, on an 
average, at the time their policies were issued by the company. 
The average age at which the parents died is 47 years. The 
relative heights and weights are as follows : 
TABLE XXII.—One Parent and one or more Children Con- 
sumptive. 
Relations of Height to Weight. 85 cases. 
Height 
5-2 
5-35-4 
5-5 
5-6 
5-7 
5-8 
5-9 
5-10 
5” 
6.00 
6.1 
6.2 
Average Weight... 
119 
125 131 
140 
141 
146 
!59 
i53 
167 
160 
191 
181 
American Standard 
I25 
r30| 135 
140 
i43 
145 
148 
i55 
160 
i65 
170 
The deaths which occurred in this group are 15 in number, 
10 among the 67 who received the consumptive taint through 
the mother, and 5 among the 40 who received it through the 
father. The causes of death are the following : 
32 Six, or 40 per cent., died from consumption ; three, or 20 per 
cent., died from brain troubles; two from typhoid fever; one 
from Bright’s disease of the kidneys; one from abscess of the 
liver ; one from accidental, and one from unknown causes. 
GROUP V. 
Both Parents Consumptive. 
The eight applicants of this group were, on an average, 35 
years of age at the time they were insured, while their parents 
at death averaged 52 years of age. They were all of, good pro- 
portionate weight. The only death that occurred in the group 
was due to consumption. 
Conclusions. 
Thus far I have simply endeavored to present, in a condensed 
form, as many of the facts as I was able to gather concerning the 
physical condition, family history and death-record of the 800 
individuals involved in the present inquiry. The great practical 
question, however, is : Has it paid to insure these more or less 
imperfect lives? If it has not, why should we continue to lose 
money on this class of cases ; if it has, then it will be well worth 
our while to define the conditions, or laws in accordance with 
which success has been obtained ; and this our analysis will, to 
a certain extent, enable us to do. 
Through the kindness of the Actuary, Mr. William D. Whit- 
ing, I am enabled to furnish you with the answer to this most 
33 important question. It is embodied in the following communi- 
cation : 
December 23, 1872. 
Albert H. Buck, M. D. : 
Sir—I have carefully examined the cards, containing the names 
of parties insured in this company, whose family history, as taken 
from the applications, shows a taint of consumption, handed me 
by yourself I have eliminated therefrom all duplicate risks, 
when more than one policy has been issued upon the same life, 
thereby increasing the reliability of the results notwithstanding 
the smaller basis for calculation obtained. 
The results, grouped as requested, are as follows, compared 
with the expected mortality according to the actuaries’ or 17 
office experience tables. 
TABLE I. 
One Parent 
One or more Brothers and Sisters.. . 
One Parent and one or more Brothers 
and Sisters 
Both Parents 
Insured spat blood 
Totals 
CO 
o 
o 
>-> to eo 
''t O to 00 
O 00 <o o 
No. of Pols. 
5999 
n 10 
CO 00 
as o\ o c\ 
On OJ 00 '-r -t* 
«f- ,f4_j 
Exposure. 
■i 
Oj 
On 
O 
_ to OJ 
Cn 'O kh On 
X. 00 On 
On On Cn to K) 
Table Moi t. 
i 
o' ! 1-1 « -> n 
i-1 i-h (_n to to 
Actual Mort 
(X) 
N) 
00 
00 
Oj On Oi Ob 
CO OJ o Cn I-H 
On OJ O VO 
***4 OJ hO O OJ 
Ratio of actual 
to expected 
Mortality. 
34 In order to show the relative mortality, where there is but one 
membei of the family dying by consumption, and where there 
is more than one member, free from the confusion of minuter 
classifications, I have arranged the same risks in the following 
order : 
TABLE II. 
One person in family 
More than one person in family 
Insured spat blood 
Totals 
00 
8 
Ln 
vO 
vO 
vO 
HH Cn 
v/u 
O W 04 
No. of Pols. 
HH 
O 
vO to "4 
Or CO On 
t4- iH-1 
Exposure. 
04 
ov 
o 
~ 4^ 
Gv o 
►h Ln 00 
Ov Cn vO 
Table Mort. 
Ov 
1 
| Actual Mort. 
co 
to 
00 
CO 
vo cv 1 Ratio of actual 
00 pv ov to expected 
on co *-< 1 mortality. 
GV -P* 1 
No one of these “spitting blood” is included in any other 
group, as these cases were selected for the purpose of showing 
this important item separately, without regard to family history. 
The enormous mortality shown, I believe for the first time, will 
of itself fully justify the extra labor. 
I have also made a subdivision of the ist and 3d groups for 
the purpose of elucidating the relative mortality when the father 
was the party dying of consumption as contradistinguished from 
the mother dying of the same disease, as suggested by you. 
The results, as a priorily expected, are as follows : 
35  
No. of Pols. 
Exposure. 
Table Mort. 
Actual Mort. 
Ratio to Table. 
Father died of consumption 
161 
1220 
14.86 
7 
47.II 
Mother “ “ 
225 
i644i 
20.66 
72.6t> 
Father and one or more Brothers and 
Sisters 
40 
326 
3-74 
5 
I33-69 
Mother and one or more Brothers and 
Sisters 
67 
44 H 
5.61 
10 
178.24 
TABLE III. 
Or, consolidating the same without regard to brothers and 
sisters into only two groups, we have : — 
TABLE IV. 
Father dying with consumption. ..... 
Mother “ “ 
to to 
vO O 
N) HH 
No. of Pols. 
10 HH 
o Ln 
CO 
ON ON 
iH* 
' 
Exposure. 
18.60 
26.27 
Table Mort. 
tO HH 
<-n tO 
' 
Actual Mort. 
VO ON 
<-n -f± 
hh Ln 
Ratio to Table. 
In conclusion, I would say that the most valuable results of 
the above, in a mathematical point of view, are those in tables 
II. and IV., on account of the number of policies involved 
securing greater uniformity in the law of averages. For the 
same reason groups Nos. 4 and 5 of Table I. should be taken 
with much caution, especially group 4, consisting of but 8 
persons, and having no value except to show that as far as it 
36 goes it is in the direction which would be surmised a priori. I 
am very much pleased to find that, taking these risks as a whole, 
the mortality has been very favorable to the company. 
Yours truly, 
Wm. D. Whiting, 
A ctuary. 
From these calculations, therefore, ijt would seem that the ex- 
cessive mortality of three of the groups (spitting of blood, both 
parents, and one parent together with one or more children), 
comprising 185 cases, is more than counterbalanced by the 
small mortality of the other two, which comprise in all 615 
cases. It would perhaps be rash to draw the inference that 
hereafter cases, belonging to the three groups in which the 
mortality has proved excessive, should not be admitted to the 
privileges of life insurance, but we can scarcely go amiss in re-' 
jecting hereafter all cases of “ spitting of blood,” no matter how 
long the time that may have elapsed since the occurrence of 
this symptom. As to the group of two consumptive parents, if 
we hereafter admit cases belonging to it, the applicants should 
be not less than 45 years of age. 
In the group of one consumptive parent together with one or 
more consumptive brothers or sisters, the average age of the 
applicants is 35 years, which would imply that a fair proportion 
of the number were still younger ; in point of fact 60 of this 
group were 30 years of age or younger. It would probably not 
be too severe a rule to accept applicants of this class only on 
condition that they have attained their 35th year, and that the 
37 consumptive brothers or sisters had died at a still earlier age. 
Otherwise the risk should be postponed until he shall have 
attained the age at which the brothers or sisters died of con- 
sumption. In doubtful cases some weight may be attached to 
the fact that the mortality is greater among those who receive 
the consumptive taint through the mother than among those 
who receive it through the father. 
We cannot wonder at -the low mortality in the group of one 
or more consumptive brothers or sisters, when we observe what 
care has been taken to insure only those who had passed, or at 
least attained the ages of their deceased brothers or sisters. 
As regards the group of a single consumptive parent, the re- 
sults attained are so astonishingly favorable that I am afraid to 
recommend a course in harmony with the logical deductions 
one would naturally make. Until these results have been cor- 
roborated by future investigations, it would appear wiser to 
follow the rule that, where one parent has died of consumption, 
the applicant should be at least 30 years of age. 
As regards the physical condition of those applying for in- 
surance, our statistics justify us only in speaking of the relations 
of height to weight. (It is, of course, taken for granted that we 
are dealing only with individuals who in all other respects are 
healthy.) In cases, therefore, where the hereditary taint alone 
seems scarcely a sufficient reason for declining the risk, the fact 
of his being below the standard weight should render us 
cautious in recommending him. 
Respectfully submitted by 
ALBERT H. BUCK, M.D. 
38 ANNUAL REPORT 
OF THE 
MEDICAL EXAMINER 
OF THE 
United States Life Insurance Co. 
For the year ending Dec. 31, 1874. 
January, 1875. 
John E. DeWitt, President: 
Sir—In the last annual report of the Medical Director, 
allusion was made to the subject of Rheumatism, and some few 
general observations with regard to it were made at that time, 
with a promise of a fuller and more complete inquiry at some 
future period. 
During the past year the subject has been taken up, and as 
careful an investigation made as it was possible to make with the 
dates and information at our command. 
39 The result of this investigation is given below, and while it 
does not furnish sufficient grounds for the adoption of any fixed 
rules with regard to the acceptance or rejection of rheumatic 
risks, yet it confirms, so far as it goes, the impressions of medi- 
cal men in relation to the effect of rheumatism, and will serve 
to make the Medical Examiners of this company at least, ex- 
tremely careful in the selection of risks which have any history 
of rheumatism. 
It is to be regretted that the applications heretofore used (and 
in this respect all companies were alike) were such that the par- 
ticulars necessary to a full understanding of rheumatic attacks in 
applicants, could be obtained in but comparatively few cases, 
and it is owing to this, that we are unable to show, as we wished 
to do, the effect of rheumatism at the different periods of life, 
because the dates at which the individuals suffered the attacks 
are rarely mentioned, nor is even the character of the disease 
specified in the great majority of instances } still, with all this 
against us, we have been enabled to present some facts which 
are, to say the least, suggestive. We are glad to say that in the 
new application recently adopted by the Chamber of Life In- 
surance, these defects of the old forms are remedied, and here- 
after we shall be able to command far greater accuracy of 
detail. 
Our investigations have been made on 844 cases, who report 
in their applications that they have suffered from rheumatism at 
some time in their past lives. This includes all grades of 
rheumatism, from “slight muscular” up to “acute inflam- 
40 matory. ” Many of these cases have, of course, lapsed ; so that 
as a whole, we can follow the 844 but a little way from the 
threshold; and owing to this fact, our observation has ex- 
tended to but 7-I- years’ average to each individual. There- 
fore, we can only say of them, as a whole, that they came from 
all classes of the people,—were engaged in the various pursuits 
of life,—and were of all ages upon which policies are usually 
written. 
Of these 844 we have the height and weight in 674 instances, 
but in the remaining 170 these records are wanting. It is 
scarcely probable, however, that these 170 would disturb the 
averages to any great extent. 
Table of height and weight in the 674 cases. 
Height 
5*. 
5-i 
5-2 
5.3 
5-4 
5-5 
5-6 
5-7 
Number 
IO 
2 
4 
14 
24 
33 
65 
103 
Average Weight 
1284 
1414- 
131 
126 
142 
138 
142-i 
148 
American Standard 
115 
120 
125 
130 
135 
140 
143 
i45 
Height 
5-8 
5-9 
5HO 
5 -11 
6 ft. 
6.1 
6.2 
6-3 
Number :... 
141 
84 
92 
59 
3° 
9 
3 
I 
Average Weight 
152 
163 
164 
164 
i73 
186 
208 
235 
American Standard 
148 
155 
160 
i65 
170 
175 
i-O 
CO 
195 
We find that the average weight does not vary materially from 
the standard, yet it is in the main a little above it. 
41 Having stated the above, we find little else to attract our at- 
tention till we come to the deaths among these rheumatic cases; 
and these we find were 114 in number, i. e., there were 114 of 
which we were cognizant. Of those who died after they had 
allowed their polices to lapse, or of the cause or manner of their 
deaths, of course we cannot speak ; but it is just to presume that 
a fair proportion of these died from the causes which we shall 
hereafter show to have been so fruitful among the 114 of which 
we are speaking. These 114 deaths were from all causes. 
The heights and weights of these are given in the following 
table, and do not differ materially from the table of the 844 cases 
above. In 15 of these cases the weights and measurements are 
missing ; we have therefore made our table upon the 99 re- 
maining. 
Height 
5 ft- 
5-i 
5-2 
5-3 
5-4 
5-5 
5-6 
I' 
5-7 5-8 
5-9 5-i° 
5-11 
6 ft. 6.1 
Number 
2 
2 
4 
6 
9 
18 14 
l8 i 15 
1 
8 
2 I 
Average Weight.. 
”5 
132 
135 
142 
145 
157 155 
165! 162 
l6l 
159 230 
Am. Standard 
US 
120 
125 
130 
135 
140 
M3 
145 i48 
155 160 
165 
170 175 
The average age, at death, of the 114 were 46 years and 9 
months, distributed among the ages as follows : 
Ages.... 
25 to 35 
35 to 45 
45 t° 55 
55 to 65 
65 to 75 
No 
20 
26 
40 
22 
I 14 
6 
As we have said, these 114 deaths were from all causes, but 
when we examine more critically into these causes of death 
42 among individuals who have had rheumatism, and compare 
them with the same causes among others who have not had 
rheumatism, we find that deaths arising from diseases of certain 
organs, occur far more frequently among those having, than 
among those not having, rheumatism. 
This is in accordance with the views generally held by 
medical men, viz., that rheumatism, and especially certain 
varieties of it, is quite likely to be followed by disease of certain 
organs, more particularly the heart; and that, in many instances, 
the latter disease eventuates in some affection of the brain or in 
a dropsical difficulty. 
We will use, therefore, only three of the causes of death in 
making our comparison, for the reason that, while many and 
various diseases come in for notice, these three, viz., heart dis- 
ease, brain disease, and dropsy, so conspicuously figure as to 
make it evident that they are the ones upon which the com- 
parison should be instituted. 
This comparison is based upon 1,000 deaths, 114 of which 
furnish a history of rheumatism ; and 886 are without any such 
history, so far as we can learn. 
There died, in 1,000, of— 
Heart Disease. 
Per Cent. 
Brain Disease. 
Per Cent. 
Dropsy, 
Per Cent. 
With rheumatism (i 14 cases).... 
21 
CO 
22 
I9.29 
4 
3-5° 
Without rheumatism (886 cases). 
35 
3-95 
IOI 
”•39 
16 
1.80 
Totals 
56 
20 
43 Of the above it is but reasonable to suppose that most of the 
deaths attributed to brain disease and dropsy should, by right, 
have been included among diseases of heart; and it is by no 
means improbable that some of those dying of heart disease or 
brain trouble, who come under the head of »o«-rheumatics, 
ought properly to have been in the other group. 
Thus we see that those individuals who are afflicted with 
rheumatism contribute to deaths from heart disease about 
where those without it contribute but 1 ; brain disease, i| to 
one ; dropsy, i| to one. 
“ Rheumatism ” is a thing so common that, were we arbi- 
trarily to exclude all who say they have had rheumatism we 
should almost be unable to do business. Nor is this necessary, 
for it is only certain kinds of rheumatism that we believe so apt 
to be followed by heart trouble; and we now hope, through the 
form of the new application, to get such particulars of informa- 
tion as will enable us to decide intelligently when to admit and 
when to exclude rheumatic applicants. 
The plan pursued in this investigation was as follows : 
The risks were divided into four different classes, according 
to the several grades of rheumatism, as nearly as could be deter- 
mined by the statements of the applicants, and the tabulated 
statement below, prepared by the Actuary of the Company, will 
show all the points of interest, and is self explanatory. 
44  
Lives. 
Exposure. 
Expected 
Mortality. 
Actuul 
Mortal. 
Ratio. 
Duration 
of Pols. 
294 
2l6o^ 
30.57 
54 
I . 766 
7-35 
Do. slight, oc- 
3°6 
2I43f 
29-35 
31 
I.056 
7.00 
Rheumatism, acute, 
fever, inflammatory. 
104 
68if 
8.98 
11 
1.225 
6-55 
Rheumatism in limbs . 
140 
I073i 
14.68 
18 
I .266 
7.66 
Totals 
844 
6058} 
83-58 
114 
I.364 
7.18 
I will only add that, in consequence of the vague manner in 
which many applicants speak of their rheumatism, and the gen- 
eral temptation to conceal the severer forms, or make them 
appear as insignificant as possible, it is very reasonable to believe 
that the above ratios do not express the actual facts, but that 
many of the cases which were designated as “ rheumatism ” 
simply, or “rheumatism of limbs,” or “'slight rheumatism,” 
ought to have been classed among the <£ acute inflammatory ” 
cases. 
We give it, however, as it is, believing that we have at least 
an approximation to the facts, and that hereafter, when we shall 
be able to get the details in rheumatic cases more fully, we can 
make a much more exhaustive statement. 
The above report is respectfully submitted by 
A. HUNTINGTON, M.D., 
Acting Medical Officer. 
45 ANNUAL REPORT 
OF THE 
MEDICAL DEPARTMENT 
OF THE 
United States Life Insurance Co., 
For the year ending Dec. 31st, 1875. 
To the Board of Directors of the United States Life 
Insurance Company : 
Gentlemen—In reviewing the experience of this Company 
during the past year, it gives me pleasure to state, in the first 
place, that the losses from death have not exceeded the “ex- 
pected mortality/’ For the year 1874 these losses amounted to 
$348,760 ; while for the year that has just terminated they 
47 reach but $317,745, not to mention the fact that $25,000 of 
this amount is covered by re-insurances in other companies, 
while the previous year there were no re-insurances to offset the 
loss. In other words, the reported losses by death for 1875 fell 
short of those for 1874 by $56,015. 
It also gives me pleasure to state that the system of appointing 
medical examiners, adopted a few years since, continues to give 
entire satisfaction. To the care and judgment exercised by our 
medical supervisors in the different States, the success of this 
system is chiefly due. 
In conclusion, I would respectfully call your attention to the 
accompanying very interesting and thorough report of my 
colleague, Dr. A. Huntington. 
Respectfully submitted by 
ALBERT H. BUCK, M. D. 
New York, January 1st, 1876. 
To the Board of Directors : 
Gentlemen—In the last Annual Report of this department, 
we gave the results of an investigation into the subject of Rheu- 
matism, and its bearing upon life insurance, as exemplified in 
the experience of this Company. 
During the year just closed, we have been engaged in a study 
of those risks which, when compared with the American stand- 
48 ard of heights and weights, show either an excess or deficiency 
of fifteen per cent, or more of weight. 
The standard to which we have alluded is here introduced. 
It is so plain that no explanation is required. 
I.—American Standard, or Table of Relative Heights and 
Weights : 
5 ft- 
5-1 
5-2 
S'3 
5-4 
5-5 5-6 
5-7 
5-8 
5.9 
5.10 
5.1; 6 ft. 
6.1 
6.2 
6-3 
lbs. 
lbs. 
lbs. 
lbs. 
lbs 
lbs. lbs. 
lbs. 
lbs. 
lbs. 
lbs. 
lbs. , lbs. 
lbs. 
lbs. 
lbs. 
115 
120 
125 
130 
135 
14° 143 
145 
148 
i55 
l60 
165 170 
175 
l8o 
185 
The time over which this survey extends begins with the 
organization of the Company in 1850, and ends on the 31st of 
December, 1873, a period of 23 years. 
In order to be thorough in the search, we have found it 
necessary to scrutinize the record of examination in each in- 
dividual application made during the period above-named, there 
being in all 30,000 of these. 
The method pursued in collecting the material used in this 
examination was as follows : 
First. All the records of the Medical office were examined in 
the order of their sequence, that is, according to years, begin- 
ning with the first volume and following in regular rotation to 
the end. 
Every recorded examination was carefully scanned, and all 
the items bearing upon the subject under investigation minuted 
on cards prepared for the purpose. 
49 Second. We took all the applications on file in the Company’s 
vaults, beginning with number i, and pursued the same course 
with them as with the Medical Examiner’s records. Thus, every 
examination and every application was compared with a table 
showing at a glance the standard height and weight, and also 
the excess or deficiency which the addition or substraction of 15 
per cent, of the standard would give. 
The reason that fifteen per cent, was taken was because a cer- 
tain amount of departure from the average or standard was to be 
expected, and it would therefore be unwise to make our in- 
vestigations on any except those cases showing a considerable 
variation one way or the other. 
Several prominent writers on the selection of lives for insur- 
ance give twenty per cent, as the maximum of excess or defi- 
ciency in weight beyond which it is unsafe to go. We have 
therefore taken fifteen as a fair per centage of over-or under- 
weight, as our basis in the study of the subject. 
Our accumulation of material, then, embraces all those in- 
dividuals who have been covered by insurance in this Company, 
whose weight was fifteen per cent, or more above or below the 
standard requirement. We say our material embraces all those 
individuals, etc. This is true in the main, yet we experienced 
in the collection of this material the same imperfect and un- 
finished condition of the applications and medical examinations 
that we spoke of in our last report. Could we have had all 
these records complete, our number of cases would have been 
larger, and the general averages rather more reliable ; still, the 
50 number collected is large enough to give us a tolerably accurate 
insight into the subject. 
After the culling out of the cases from the mass was com- 
pleted, the cards were arranged in a convenient order, and all 
the duplicates eliminated. This left a total of 1,496 cases, and 
of this number, 1,110 were overweights, and the remainder, 386, 
were light or underweights. 
It will at once be seen that there is a wide difference between 
the numbers grouped under the two heads as above. There are 
nearly three overweights to one underweight. This is not the 
relation that these two classes bear to each other in the com- 
munity at large, but the reason for it here is this : light weights 
have always been regarded as more unsafe risks for life insur- 
ance than overweights, and as these cases are collected from 
those persons on whom insurance has been written, we should 
naturally expect to find just what we do, viz., that the under- 
weights are greatly in the minority. 
Whether this discrimination against underweights and in 
favor of overweights is wise or just, will appear further on, as the 
exhibit we shall give throws light upon it. 
The material thus collected was taken up, each grand division 
of over-and underweights by itself, and again subdivided into 
heights and ages. This can best be shown by the following 
tables, which we will style the “ Tables of Material: ” 
51 II.—Table showing the per cent, of Overweight at the Different Heights for the Ages from 20 to 65, arranged 
in Groups of 5 years each. 
(The red numbers refer to the number of individuals upon which the calculation is based.) 
Totals. 
HEIGHT. 
5 ft- 
5.1 
5-2 
5-3 
5 4 
5-5 
5-6 
5-7 
5-8 
5-9 
5.10 
5-11 
6 ft. 
6.1 
6.2 
6-3 
Individuals and 
Average per 
cent, accord- 
ing to age. 
AGES. 
1 
1 
3°% 
3°% 
54 
1 
I 
•4 
3 
5 
J3 
5 
9 
7 
0 
25% 
20% 
20% 
3''% 
30% 
ry p 0/ 
25®/ 
9ft°/ 
20% 
23% 
0 0 
0 
* 
I 
1 
1 
1 
11 
t3 
27 
21 
16 
13 
7 
4 
123 
3°% 
3°% 
20% 
20% 
20% 
25.V 
o-c/ 
25% 
25% 
25 V 
25% 
20% 
25% 
25% 
24% 
8 
5 
2 
I 
4 
*7 
21 
47 
37 
30 
25 
13 
, 
2 
I 
217 
30% 
4°“o 
40V 
2^ 
25'“o 
25^ 
0/ 
25^ 
20% 
20% 
25% 
20% 
25% 
3°% 
30% 
20% 
27% 
•J 0 
5 
3 
6 
3 
6 
12 
24 
59 
38 * 
42 
20 
23 
3 
3 
I 
250 
25% 
3°”o 
35°o 
»0°/ 
25^ 
3°“o 
25®/ 
or9 0/ 
20% 
3°^ 
40% 
20% 
21% 
3 0 
3 '0 
3 
2 
5 
5 * 
18 
24 
38 
21 
27 
18 
20 
2 
2 
I 
206 
35% 
45-“o 
25“/ 
0 - 0/ 
25^ 
3°% 
25% 
25%" 
3°%" 
25% 
20% 
20% 
28% 
3 0 
I 
3 
6 
8 
8 
17 
25 
23 
20 
i r 
I2\ 
5 
2 
IS0 
3°% 
30X 
25% 
25^0 
9r°/ 
30% 
25% 
25V 
25 “o' 
25^ 
zS^o 
60% 
3°% 
J 0 
I 
t 
I 
6 
TO 
l6 
l I 
12 
9 
5 
72 
51 to C5 Inclusive 
3°% 
3i% 
4°% 
3°2o 
30^ 
3°% 
20/o 
20%* 
3°“o 
20% 
- 
2Q% 
3 
I 
I 
3 
5 
9 
3 
3 
3 
4 
25^ 
45^o 
35°o 
25% 
3°“o 
25% 
3°"o 
30% 
20% 
28% 
61 to 65 Inclusive 
2 5 “o' 
I 
20% 
2 
22% 
Totals. 
26 
*» 
8 
>7 
22 
27 
78 
122 
255 
159 
165 
106 
86 
7 
II IO 
Individuals and per cent, of over- 
weight according to height 
29 V 
34^ 
3±% 
29 V 
28% 
29% 
26%- 
21% 
25^ 
24%" 
25% 
24% 
23% 
21% 
3°^o 
3°-% 
21% As will be seen by a glance at the above, the overweights at 
the younger ages are few, as we might reasonably expect, and so, 
too, the average percentage of excess is lower, being only 23 
p. c. and 24 p. c. (except in the group of ages under 20 ; and 
as in this group but one life appears, it is hardly to be considered ; 
the same is also true of the older group, 61 to 65), where but 
two lives appear. 
The total average of excess of weight in the whole 1,110 in- 
dividuals is 27 per cent, for all the ages combined. The total 
average excess for each height, from 5 feet up to 6 feet 3 inches, 
will be found at the foot of its proper column. 
Immediately following, we append a similar table for the 
underweights. 
53 in. Table showing the per cent, of Underweight at the Different Heights for thf Ages from 20 to 65, arrangfd 
in groups of 5 years each. 
(The red numbers refer to the nu7nber of individuals upon which the calculation is based.) 
— 
Totals. 
HEIGHT. 
5 ft- 
5-t 
5-2 
5 3 
5-4 
5-5 
5-6 
5-7 
5-8 
5-9 
5-io 
5-11 
6 ft. 
6.1 
6.2 
6-3 
Individuals and 
average per 
cent, accord- 
ing to age. 
, 
6 
8 
4 
1 
0 
1 
AGES. 
25% 
20% 
20% 
20% 
20% 
20% 
15% 
20% 
1 3 
20% 
20% 
15% 
19% 
5 
9 
IO 
I I 
f 2 
'4 
5 
•83 
f Inclusive 
15% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
9 
20% 
19% 
90 
L° “b 
7 
7 
8 
IO 
14 
IO 
*4 
1 
25% 
25% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
25% 
21% 
I 
8 
10 
4 
7 
6 
12 
6 
1 
60 
2 c-% 
15% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
20% 
l 
20% 
20% 
i 
6 
4 
11 
6 
9 
8 
4 
1 
I 
56 
15% 
15% 
2 
20% 
20% 
20% 
I 
15% 
20% 
20% 
20% 
15% 
20% 
20% 
18% 
2 
7 
4 
3 
5 
4 
28 
20% 
1 
20% 
20% 
15% 
20% 
20% 
20% 
1 
20% 
19% 
2 
1 
2 
2 
1 
12 
46 to 50 Inclusive 
20% 
25% 
20% 
20% 
20% 
20% 
20% 
25% 
20% 
51 to 55 Inclusive. .. 
25% 
15% 
15% 
20% 
20% 
19% 
56 to 60 Inclusive 
25% 
20% 
25% 
•5% 
21% 
61 to 65 Inclusive 
20% 
20% 
Totals. 
I 
1 
I 
8 
3° 
38 
60 
40 
51 
45 
60 
3° 
l6 
8 
2 
386 
Individuals and per cent, of under- 
weight according to height 
25% 
20% 
25-Y 
20V 
19* 
21 
20% 
IQ% 
18% 
21% 
20% 
20% 
IO% 
20% 
20% 
20% The deficiency of weight in the younger ages here would not 
excite particular comment, because we naturally look for lighter 
weights in young people than in those of middle age, and the 
table of standard weights, too, is based upon observations made 
on given heights of all ages; therefore it is only because the 
average per cent, of deficiency is so widely different from the 
standard that we are enabled to attach any importance to it. 
It will be seen that 20 per cent, deficiency is the average for 
all ages combined, and about the same for each height. The 
individuals, therefore, who compose this class, are on the ex- 
treme border of the ground usually considered allowable for 
writing insurance ; and the heavy weights in the preceding table 
average a still higher percentage of departure from the standard, 
both in the combined ages and for each division of height, 
being over 27 per cent. 
Having thus arranged our material for observation, it will be 
in order to inquire what are the results of the business done by 
the Company on these two classes of risks during the interval 
between 1850 and 1874. 
This we now proceed to do. 
Through the kindness of Mr. W. D. Whiting, the Actuary of 
the Company, we have been furnished with the following : 
New York, December ioth, 1875. 
Dr. A.'Huntington : 
Sir—The result of my examination into the 1,496 instances 
55 of 15 per cent, excess or deficiency in weight as compared to 
height, out of the 33,000 persons insured in this Company, is, 
after eliminating duplicates, as follows : 
Lives. 
Exposure. 
Expected 
Deaths. 
(Actuaries 
Mort.) 
Actual 
Deaths. 
Ratio of 
Actual to 
Expected. 
Average 
Duration 
of Insur- 
ance (Yrs.) 
Overweights, 15 p. 
c. and over ... 
I, IIO 
6.826 
95- 61 
103 
107.6 
6.15 
Underweights, 15 
p. c. and under. 
386 
2.44O 
26.05 
42 
l6l .2 
6.22 
Totals 
L496 
9.266 
121.66 
145 
119. I 
6.l8 
: 
— 
— 
Yours truly, 
WM. D. WHITING, 
Actuary. 
Attention is here called to the ratios of actual to expected mor- 
tality. 
In both classes it will be seen that the actual is greater than 
the expected mortality, to an extent that makes it marked; and 
in the class of underweights very decidedly so. Both of these 
classes, then, have been ?ion-paying to the Company, and the 
latter to a much greater extent than the former. 
Out of these 1,496 cases there have been 145 deaths, 103 of 
which were contributed from the 1,110 overweights, and the 
remaining 42 were contributed from the 386 underweights. 
56 An analysis of the causes of death in each of these classes is 
given below : 
Cateses of death among Overweights. No. of Cases. 
Apoplexy, and diseases of brain 17 
Bright’s disease 2 
Consumption 6 
Dysentery, and diseases of bowels 11 
Dropsy, diseases of heart and liver 28 
Erysipelas, pyaemia, diphtheria and fevers 8 
Pneumonia and congestion of lungs 7 
Poison, accident and violence 10 
Rheumatism 3 
Tumors and cancer 5 
All other causes 6 
Total 103 
Cateses of death among' Underweights. No. of Cases. 
Apoplexy, and diseases of brain 4 
Bright's disease i 
Consumption 25 
Dysentery, and diseases of bowels 3 
Dropsy, diseases of heart and liver 5 
Erysipelas and fevers 2 
Pneumonia 1 
All other causes 1 
Total 42 
57 It will be observed at once, that among the overweights, the 
most common and fruitful causes are diseases of brain, heart 
and liver, amounting in all to nearly 44 per cent, of the whole 
number of deaths in this class. Among the underweights, on 
the other hand, we are struck with the excessive preponderance 
of consumption alone, over all other causes, per cent, of 
the deaths in this class arising in consequence of this one 
disease. 
By comparing the above with the analysis of the first 1,000 
deaths in the Company at large, we have this showing : 
Percentage of deaths in Company at large, from 
diseases of brain, heart and liver 23 per cent. 
From same diseases, in class of overweights 44 per cent. 
Now among the underweights, the comparison is : 
From Consumption, in Company at large 27 per cent. 
From consumption, in class of underweights 59! per cent. 
These results, in their nature, are not different from what we 
should expect to find, but in the extent to which they go, they 
are so marked, that we are forced to the conclusion that persons 
belonging to either of these classes should be admitted to the 
company only after the most rigid examination; but beyond this, 
until the question has been further investigated, we would no 
advise the establishment of any arbitrary rule in regard to thes 
risks. 
In this connection, it will be interesting to see how much of 
consumptive taint was found in the family history of the indi- 
viduals comprising the two classes we are observing. 
58 Ages 
Under 20 
21 tO 25 
26 to 30 
31 to 35 
36 to 40 
41 to 45 
46 to 50 
51 to 55 
56 to 60 
61 to 65 
Totals. 
Total No. of individuals showing an excessive weight. 
1 
54 
123 
217 
250 
206 
150 
72 
35 
2 
II IO 
No. of individuals whose family history shows a con- 
sumptive taint 
O 
4 
12 
28 
45 
29 
22 
8 
7 
O 
155 
Percentage 
0% 
8% 
IO% 
!3% 
18% 
14% 
15% 
T1/o 
2% 
0% 
14% 
Ages 
Under 20 
21 to 25 
26 to 30 
31 to 35 
36 to 4c 
41 to 45 
46 to 50 
51 to 55 
56 to 60 
61 to 65 
Totals. 
Total No. of individuals showing a deficiency in wght. 
45 
83 
90 
60 
56 
28 
12 
6 
4 
2 
386 
No. of individuals whose family history shows a con- 
sumptive taint 
3 
15 
10 
' 9 
II 
4 
I 
I 
I 
I 
36 
Percentage 
7% 
19% 
10% 
15% 
20% 
14% 
8% 
17% 
25% 
50% 
IV.—Table showing the per cent, of Cases having a Consumptive Taint in the Family History, the 
Individuals being grouped in Classes according to Age. 
A, OVERWEIGHTS. 
B, UNDERWEIGHTS. These family records are no doubt incorrect, or, rather, de- 
ficient in the amount of taint which they exhibit, for it is well 
known that many applicants are careful not to mention such 
taint when it is present in the family, because of the fact, which 
is pretty well understood in the community, that a consumptive 
record is a great barrier to the obtaining of insurance; still, 
these deficiencies being as likely to affect one class as the other, 
it will probably make but little difference in our relative per- 
centages. 
Among the overweights nearly 14 per cent, show a taint in 
the record, and among the underweights about per cent.,— 
not much difference—yet, notwithstanding this, we find con- 
sumption feeding upon the underweights, while it scarcely 
touches the overweights—only 6 per cent, of the deaths in that 
class being due to this cause. 
In the company at large the hereditary taint, as exhibited in 
the family histories of applicants is a trifle over 5 per cent. We 
should not, perhaps, have been surprised to find the amount of 
consumptive taint among the underweights exceeding that of 
the company at large, but we are somewhat surprised to find it 
thus among the overweights, and are at a loss to give any ex- 
planation, except that it may in part be accounted for by sup- 
posing that individuals with a consumptive family history may 
have been admitted by the examiner, on the ground that their 
great weight contraindicated and to some extent counterbalanced 
their hereditary proclivities. (It must be borne in mind here 
that we are speaking only of the percentage of taint as shown in 
60 thp family records, and not of the mortality, for it will be remem- 
bered that we found the deaths among the overweights were to 
a very small extent due to consumption or anything akin to it.) 
The above may serve to partially explain away the amount of 
taint shown among the overweights. The rest must be attri- 
buted to accident. 
The fact, however, proves, so far as it goes, that the conclu- 
sions of examiners, that a consumptive taint, when joined to 
heavy weight in the person of the applicant, does not count so 
heavily against the risk, are correct. 
The results thus obtained go to sustain the heretofore gener- 
ally received opinion that extremes of over-or underweight are 
not healthy risks for Life Insurance Companies to write upon, 
and while this is true of both classes, it is very emphatically true 
of the underweights, as the remarkable excess of actual over ex- 
pected mortality will show. Among the overweights the most 
common manner of death, as we have seen, is by diseases of 
brain, heart and liver ; but while the mortality in this class of 
risks is considerably above the expectation, it does not approach 
the excess shown among the underweights from diseases of lungs. 
We are not to reason from this that all light weights are espe- 
cially subject to consumption merely because they are light 
weights, but we are to apply still more rigidly to practice the 
fact we already knew, viz.: that consumption very, very often 
does send out its warning voice far in advance of its actual 
coming, and as “ coming events cast their shadows before,” so 
we believe, in many cases, this interference with the tissue- 
61 making powers of the human system foreshadows the coming 
of this scourge of humanity—tubercular consumption. 
For this reason we are to consider marked underweight in an 
applicant as a very serious matter, even though it be attended 
by no visible impairment of the health. 
With overweights we are to use great caution in the selection, 
but are not to look on them with the same degree of apprehen- 
sion as on the other class. 
Hoping that the time and labor spent in the study of this 
subject may prove of value to the Company, this report is 
respectfully submitted by 
A. HUNTINGTON, M.D. 
62 ANNUAL REPORT 
OF THE 
MEDICAL DEPARTMENT 
OF THE 
United States Life Insurance Co. 
For the year ending Dec. 31, 1876. 
To the Board of Directors of the United States Life 
Insurance Company : 
Gentlemen : 
Nothing of special importance has transpired in the medical 
department during the year which has just come to a close. 
The reported losses by death amount to $261,860, whereas, 
during the previous year, they amounted to $317,745, a gain of 
$55,885, for the year just terminated. 
63 I might also state that the experience gained during the past 
year has led us to resort more frequently than ever before to the 
chemical and microscopical examination of the urine as a 
means of gaining additional light upon the character of the 
risks submitted to us. The thermometer, too, has in several 
instances afforded us valuable aid ; and while it does not yet 
appear practicable to inaugurate a rule requiring the use of this 
instrument in the examination of every applicant for life insur- 
ance, I would take this opportunity of urging upon our ex- 
aminers the desirability of resorting to this test in every case 
where they are in doubt regarding the significance of certain 
apparently trivial symptoms, or where the general aspect of the 
applicant or his family history would lead them to look closely 
for the slightest indication of pulmonary phthisis. 
Finally, I would call your attention to the very interesting 
researches which form the subject of my colleague's report. It 
will undoubtedly be read with pleasure by many not directly in- 
terested in the bearings ot this subject upon life insurance. 
Respectfully submitted by 
ALBERT H. BUCK, M.D. 
New York, January 4th, 1877. 
To the President and Directors of the United States 
Life Insurance Company : 
Gentleinen : 
For several years past it has been the custom of your medical 
officers to present, in conjunction with the regular annual 
64 mortuary report, a paper on some subject, coming properly 
within the sphere of our observation, and germane to the busi- 
ness of Life Insurance. 
In our last paper we discussed the importance of closely 
observing the relations existing between the height and weight 
of applicants as compared with a given standard ; and indicated 
what we considered the points of special importance brought 
out. 
This year we have been occupied with a sort of general 
survey of the subject of longevity, and have interested ourselves 
in trying to find some more satisfactory answer to the old but 
ever important question: How may we judge who of those 
presented to us have a reasonable expectation of reaching old 
age? And intimately connected also with the foregoing, arises 
this second question: How far length of days is an inheritance 
bequeathed to us, or how far is it due to habits, climate, occu- 
pation and the like ? 
To aid us in the study of these questions we thought it would 
be well to collect the histories and experience of as many male 
lives as possible who had reached the age of three score years 
and ten. To this end we prepared a blank consisting of a series 
of questions, w'hich were arranged under two main heads relating 
respectively to the family and personal histories of the man. 
These main heads were again sub-divided: the first part re- 
ferring to the family and personal histories of the individual at 
the time he was thirty years of age ; and the second part to the 
subsequent changes that had occurred in those histories. The 
65 inquiries in regard to family history included grand-parents, 
parents, brothers and sisters, their ages, causes of death, &c., &c.; 
while in the personal history the inquiry related to distinctive 
personal features, resemblance to parents and its degree, occu- 
pation, residence, condition in life, health, habits, hours of 
rising and retiring, kind of diet, &c. 
These blanks were placed in the hands of our medical exam- 
iners and chief agents in different parts of the country, and al- 
though there has not been that response to our efforts that we 
hoped for, still a goodly number of reports have been gathered, 
and we now propose to look into them and see what they show. 
First, then, a word as to the material; this embraces one 
hundred and eighty cases of old men gathered from all walks in 
life, and following many different professions, trades and call- 
ings. All of them are now of course over 70 years of age, and 
we find the average age reached to be 77.5-12 years, the great- 
est being 96. Ten of the others are over 90, and fifty-eight 
over 80. 
By a study of the individual histories of these 180 persons, we 
have been enabled to gain a little insight into the causes of 
long life, or at least to judge somewhat correctly how much 
these old men are indebted to their forefathers for their length 
of days, and how much of it was due to their own care of them- 
selves conjoined with the surrounding circumstances under 
which they had lived. 
In this study we have endeavored to ascertain, first, what 
66 there was in the families of these septuagenarians that might 
reasonably be expected to interfere with their prospect of life, 
i. e., what of transmissible taint calculated to abridge life they 
had inherited from their parents, (the question of the trans- 
missibility of certain diseases, or rather of the tendency to cer- 
tain diseases, is too well established to require argument here). 
With this view we have searched their family histories for the 
presence of—first, consumption ; second, cancer; third, insan- 
ity (syphilis for obvious reasons could not be considered). Can- 
cer and insanity appear so faintly in the records as to be practi- 
cally of no account ; and, consequently, we are narrowed down 
to the first—consumption, and this, after all, is for us the most 
important of the three. 
The investigation of the family histories, with regard to this 
strongly hereditary affection, was made from the records as they 
appear at the time when the writers of them (the old men from 
whom we obtained the blanks) were thirty years of age ; and 
the reason why this age was selected, is, because that is the time 
in which, as writers of life insurance, we are most interested, for 
it is around about this age that the bulk of insurance is effected. 
It is about this time, too, that the development of the body is 
matured, and the health, habits, modes of life, and the results 
to which they tend, are tolerably well declared. 
Proceeding, then, on this ground, we have taken all the 
records showing the presence of consumption in the family at 
the age named, and have arranged them in groups after the fol- 
lowing manner: 
67 First.—Those cases showing the presence of the disease in 
the parent and other members of the family. 
Second.—-Those in which only one parent had died of the 
disease. 
Third.—Those in which several of the brothers or sisters, 
or both, had been consumptive ; and 
Fourth.—Those cases exhibiting the presence of the disease 
in only one brother or sister. 
In no case have we found both parents dying of consumption 
before the respondent* in the case had reached 30 years, and in 
the few cases that occurred at a later period, the parents were 
well advanced in years, so that it was questionable whether there 
was really any constitutional tuberculosis present. 
By a study of the tables appended to this report, we find in 
all twenty-eight (28) cases showing one or more members in 
each of the 28 families to have died of consumption before our 
respondents had arrived at 30 years of age. 
These cases are distributed as follows, among the groups: 
Group One three cases. 
Group Two twelve cases. 
Group Three five cases. 
Group Four eight cases. 
[As before stated, there were no instances in which both 
* For the sake of convenience, we shall use the term we have 
occasion to allude to the individual who furnished the information contained in the blank. 
68 parents had died of consumption before the respondent had 
reached thirty. In case two of group three, the parents are re- 
ported as dying of “bronchitis ” and “ consumption ” respective- 
ly, at advanced ages; and in case six of group four, both 
parents are reported as dying of cancer at very advanced ages.] 
Let us now take up these groups and apply the rules by 
which we judge of applicants for life insurance to-day, and see 
what would have been our probable decision as medical exam- 
iners, in regard to the respondents in these cases, had they ap- 
plied to us for insurance, all of whom have proved themselves 
good risks, for the very obvious reason that they are all alive, 
and have greatly exceeded their expectancy—the expectancy of 
life at age 30 being 62 years. 
In group one, case one would have been rejected, because the 
mother and three sisters were already dead of the disease, the 
applicant himself resembling the mother, and being of light 
weight. 
Case two would probably have been refused a life policy but 
granted a ten or fifteen year endowment, two of his family having 
died of consumption ; but he being 30 years of age, sound, 
above average weight, a farmer, and resembling the father in a 
marked degree, would have been considered entitled to the kind 
of policy named ; his grand-parents, too, were old. It will be 
noticed that a brother and sister subsequently died of the dis- 
ease, while he escaped. Case 3, judgment same as in case 2, 
viz.: short endowment; for although he resembled the mother, 
69 his age, being above standard weight, of good habits and health- 
ful occupation, would have rendered him eligible. 
This completes group I., and we believe our decisions in 
these cases would have been the proper ones to make, according 
to the light we should have had at the then ages of the appli- 
cants. We should, indeed, have thrown out entirely what sub- 
sequently proved to be one good risk, but of course, being able 
to make an estimate only of the probabilities of the future, our 
conservative course would have been the safe one for the Com- 
pany to follow at that time, and life policies could have been 
granted subsequently if the advancing lives of the applicants 
seemed to warrant it—say after the ages at which the parents died. 
Group II.—Number one doubtful ; if inquiry had developed 
the fact that the mother's “ feebleness ” was not at all due to 
consumptive trouble, he would have been granted an endow- 
ment at least, and probably a life policy for a reasonable amount. 
Number eight declined, or a short endowment only might have 
been issued. Numbers two, three and four declined. Numbers 
five, nine, ten and eleven accepted. Number six a short en- 
dowment probably. The acceptance of number seven would 
have depended on the history and character of his “rheumatism.” 
Number twelve, accepted if not too much below standard 
weight. 
Group III.—Number one would have been postponed till 
later in life, on account of family histoiy and his light weight. 
Numbers three, four and five would have received endowments 
only. 
70 Group IV.—Cases one and seven would have been accepted, 
provided they were not too much below the standard in weight. 
Cases two, three, four, five, six and eight would, in all pro- 
bability have been accepted. 
Thus, we find the result in these twenty-eight cases, whose 
histories show a consumptive taint, to be, ten accepted for life 
policies and six for endowments. Six would have been rejected 
altogether, and in regard to the remaining six there is a doubt 
as to what the decision would have been. 
Attention is called to the fact that only twenty-eight cases 
(15i) per cent.), out of the one hundred and eighty, are re- 
ported as having a consumptive taint known to exist at the 
time the respondent was thirty years old ; and out of these 
twenty-eight, sixteen would probably have received policies, 
leaving only twelve, and some of them doubtful, to be rejected 
on the ground of consumptive taint, out of the whole one 
hundred and eighty—certainly a remarkably small number, only 
about six and two-thirds per cent. 
We find, chen, in the first place, that in these one hundred 
and eighty individuals who have lived so far beyond their ex- 
pectancy, there was much less than the usual amount of con- 
sumptive taint (for the experience of all life offices shows that 
the percentage of applicants with a consumptive taint in their 
family histories is considerably greater than that found here) ; 
and secondly, we notice that the degree of taint was not so great, 
but that a large number out of even these twenty-eight cases 
would have been found insurable. So, therefore, applying to 
71 these cases, as we have done, the rules which guide us at the 
present time in forming our judgment of applicants with a con- 
sumptive record, we find that our practice of dealing with them 
is sustained as being reasonably safe to the company, and at the 
same time not unjust towards the applicants themselves; for, 
according to our rules of judgment, nearly all of these applicants 
would have been admitted to the benefits of insurance, and their 
subsequent long lives remain as evidence of the wisdom of the 
selection. 
May we not reason, then, first, from the small number of this 
class of cases (among the entire group of the one hundred and 
eighty) that the long lived do not come from those families 
which have in them the taint of consumption ; and, second, 
while the above is true as a whole, yet, from the fact that the 
few persons, in whose family histories such a taint existed, still 
lived to reach old age, may we not also reason that there are not 
unfrequently individuals in those families who either are not 
touched by the taint, or else have within themselves a power 
of overcoming it, which, assisted by healthful habits, occupation 
and surroundings, renders them superior to the destroyer ; and, 
thirdly, may we not reason still further from the small number 
of rejections which the application of our rules would have 
caused among these cases, that at the age of thirty, a thoroughly 
competent examiner, taking cognizance of all the points which 
our rules require, may select with reasonable certainty and safety 
his exceptions from among the mass of those applicants with 
tainted record, who are placed under his observation ? 
72 Again, we are led to the conclusion that at thirty years of age 
with the majority of men, the fact is pretty well established 
whether or not there is a consumptive taint in the family, for 
am ong our old men, where we find deaths from the disease recorded 
subsequently to that age, they mostly occur as sporadic cases, 
and at such advanced ages, as to warrant us at least in question- 
ing whether they ought to be considered at all as cases of 
hereditary consumption. 
Out of our whole 180 cases, there were 146 who reported in 
what respects they resembled either father or mother. The 
showing is as follows : 
There were 75 who resembled their fathers in features, and 
82 who resembled them in build. Of those who resembled 
their mothers in features there were 71, and of those who resem- 
bled them in build, 59. There were some who resembled 
both parents equally. 
In regard to the color of eyes, we find the count to stand as 
follows in the order of their frequency : 
There were 100 having blue eyes, 41 having grey, 25 with 
black, and only 14 with brown eyes. 
Four instances only of myopia (near-sightedness) are reported. 
One case of “ poor sight ” is named, and one pair of black eyes 
were extinguished at fifteen years of age. 
The color of hair was given with the following order of 
frequency : brown most frequent, 83 cases ; black next, 70 cases, 
then light hair, 14; and last, auburn, 11 cases. (Gray hair, at 
73 30 years of age was reported in but two instances.) Among all 
these, 156 were blessed with a full head of hair, and only 24 
showed any evidence of baldness. In answer to the very com- 
mon belief that people with hairy bodies (Esaus) live longer 
than those with smooth skins, we find but 30 of these 180 
septuagenarians who were hirsute. 
Twenty-one cases speak of having poor teeth, and only eight 
had hernia, two of which were double. 
In reply to the question as to how their bodily vigor com- 
pared with the average of men at 30, there were 85 who judged 
themselves to have been above the average, and 11 who were 
below ; all the rest reported as average. 
- In answer to the same question in regard to their weight, 
there were 32 above average and 36 below; the remainder, 
average. 
To the question, “ Was your voice full and strong ?’’ there 
were only 8 answers in the negative. 
Now, we come to an important item, that showing the habits 
of these old men, in the use of alcoholic spirits. At 30 there 
were 54 total abstainers from its use (a rather unusual thing in 
those days) against 84 later in life. 
Of habitual, yet moderate users, at 30 there were 14, against 
13 in later life, and of occasional moderate users at 30 there were 
105 cases against 69 later on. Those reported as intemperate 
users at 30 were 7 in number, and in later life 6, so reported, 
and it may be well to state in this connection, that in a letter 
74 received during the summer from a medical gentleman in the 
far West, he informed me that he would be able to furnish quite 
a number of cases whose history would show that they had been 
hard drinkers of whiskey all their lives, and yet had lived to be 
old men. 
Accordingly I looked forward to the arrival of the blanks with 
considerable interest, for it seemed as though these were to be a 
regular shower of bombshells into our preconceived ideas of the 
effects of whiskey drinking. It proved, however, that when the 
Doctor came to investigate these cases more closely, he found to 
his surprise, that out of his “ Old guard of whiskey braves,” as 
he called them, only one or two had reached the age required 
in the blanks, although the whole lot of them were “old looking, 
grey, bent and feeble ; but now to offset this I have the history of 
an individual kindly furnished by a physician in one of the 
Eastern States. I will use the Doctor’s own words in the 
description. 
“He is between 85 and 90, has always lived poor and fared 
hard ; has probably been drunk many thousands of times, and 
has used tobacco immoderately all his life ; still, I often meet 
him on my drives, sometimes with his fishing tackle, sometimes 
with his gun, and at others with his axe, and I think he prepares 
for the stove all the wood used.” 
What a rare picture of a man, so old yet so fond of fishing- 
tackle and gun, and still able to use them. 
In reply to our inquiry, we learn that 151 of our respondents 
75 were leading a married life at the age of 30, and only 29 were 
single; and that, subsequently, 25 out of these 29 entered into 
the matrimonial estate, so that 176 out of the 180 have led a 
married life, more or less, and only four “fought it out" on 
the line of single blessedness ; and now, if this statement shall be 
read by any bachelors, and it does not induce them to repent 
and get married, then statistics have no influence as a converting 
power. 
Under the head of Occupation at 30, we find 17 following the 
liberal professions, 26 engaged in mercantile pursuits, 62 work- 
ing at trades, and 77 more or less engaged in agricultural life, 
(under the head of trades, we include a few whose business was 
on the water). Subsequently to 30, we do not find any great 
number changing their trades or callings. 
In regard to the use of tobacco (concerning whose influence 
on health and life there seems to be quite a difference of 
opinion) the record of these old men stands as follows : 
At 30, there were 64 who did not use it in any form, and 113 
did use it either in the form of smoking or chewing, or both ; 
not once was snuff-taking reported ; the remaining three cases 
made no report under this head (and we may say here, that on 
any of the points, where the figures are given, and they do not 
foot up 180, there were no reports given under- those heads by 
the missing cases). 
In the way of sickness previous to 30, quite a number report 
“fevers,” “typhus” and “typhoid,” “ bilious,” etc. ; several 
report “rheumatism,” one “lumbar abcess,” one “spinal 
76 disease and renal calculi;’’ several report “pneumonia,” one 
“spotted fever,” and two had “spat blood.” After 30, the 
characters of the illnesses reported do not differ very materially 
from those of earlier life, except that they occur more frequently 
in the records ; this, however, we should look for, because the 
number of years covered, from 30 to the present time, is much 
greater, and this period embraces the most active part of the 
life of man. Accidents and bodily injuries, we notice more 
frequently, and so also, “all the ills that flesh is heir to.” 
Under the head of residence, the majority of our respondents 
report themselves as having spent the greater portion of their 
lives in “the country ” as distinguished from “the city,” but 
this is a matter of very little importance in our investigation, 
owing to the fact that the inquiry was not pushed to the same 
extent in city places as in the country. 
Thirty-three cases are reported as having suffered more or less 
from malarial poisoning during their past lives. Almost all re- 
port “ no vacation or systematic recreation,” but on the contrary, 
a pretty uniform and steady attendance to business during the 
whole of their lives. 
We find that 9 have been in the habit of using coffee alone, 
that thirty have used tea alone ; 125 have used both coffee and 
tea, and there are but 8 instances in which neither one was 
used. As to their diet, nearly all subsist on mixed animal and 
vegetable food, and not more that two or three report them- 
selves as vegetarians. 
77 We would call attention to what seems to us an important 
item among the facts elicited by our inquiries, viz.: that these 
old men were early retirers to sleep, and early risers in the morn- 
ing; very few exceptions to this are found among them, and we 
state it as our firm belief that habits of early rising and retiring 
conduce greatly to the preservation of the freshness and strength 
of both body and mind. 
In regard to their present condition of bodily health, very 
nearly all these old gentlemen, who range, as we have before 
remarked, from 70 to 96, report themselves as able to take out- 
door exercise on foot, and some of the oldest are still able to 
chop wood and do “chores ’’ about the farm. 
The ages of 238 grandparents are given, showing an average 
of 74 4-12 years to each individual, and in the records of 
parents, their ages are given in 317 instances. The average age 
attained by the fathers is 71 2-12 years, and by the mothers 
72 4-12 years. The inferences to be drawn from the above 
averages are very plain. 
One interesting case of family longevity we notice. The re- 
spondent himself is now 92 years old, his father and mother died 
at ages of 86 and 94, respectively ; four brothers reached 77, 82, 
85 and 90; two sisters lived to be 85 and 92. This comprised 
the whole family, none having died in childhood, early or mid- 
dle life. 
Still another item of interest is that of a six-fingered family in 
which for several generations the respondent's ancestors were en- 
78 dowed with these extra digits ; he himself has them, and so also 
have all of his children. 
I am indebted to Dr. J. L. Sweet, of Newport, N. H., for 
some interesting vital statistics regarding that town. Some of 
the facts are not out of place in our report. During the past 
forty years, during which the Doctor has been an active practi- 
tioner in the above-named locality, he says there have been 1480 
deaths out ol an average population, during the period men- 
tioned, of 2100 individuals. Out of these 1480 cases, 197 
reached the age of 70 years ; 180 lived to upward of 80, and 35 
reached beyond 90, one of whom lived to about 100, and another 
to 101 1-2 years. He adds: “These two centenarians were 
soldiers in the war of our independence, and according to their 
statements, their deprivations and sufferings from hunger were 
almost incredible. ” 
About twenty per cent, of the 1480 died from consumption, 
of whom the ratio of females to males stood as about two to 
one. 
We shall notice one more interesting instance coming to our 
knowledge, while perusing these records, and then we are done. 
Many years ago a little book appeared, entitled Riley’s Narrative, 
giving an account of the shipwreck of a vessel on the north coast 
of Africa, and the capture and enslavement of the crew by the 
Arabs. 
It now transpires that one of our old men (77 years of age) 
was a cabin boy on that ship. He lived to escape from his 
79 captors, and subsequently spent 15 or 20 years in Mexico. Now 
after an eventful life he is residing quietly in New England. 
All of our data were gathered within the limits of the Union, 
coming mainly from the Eastern and Middle States. Some 
were from the West and none from any of the Southern States. 
Our thanks are due to the gentlemen who have so kindly de- 
voted their time and patience in securing the records for us, 
and to the officers of this Company who have aided us by all 
means that lay in their power. 
We trust the time we have given to this subject has not been 
spent in vain, but that some good may result, if in no other 
way, at least in stimulating our examiners to a more thorough 
appreciation of the value of family histories, and in rendering 
agents more charitable towards medical officers who find it 
necessary often to reject applicants, and especially young lives, 
with “tainted’’ records. 
With best wishes for the “Old United States, ” her trusty 
officers and valuable corps of hardworking agents, the above is 
respectfully submitted. 
A. HUNTINGTON, M. I). 
80 No. 
of 
Case. 
Present 
age of 
Resp’d’nt. 
Weight 
compared 
with 
Standard. 
M embers of 
fam. dead of 
Consumption 
and their ages. 
Which Parent 
the Resp’d’nt 
resembles. 
History of rest of 
family, Resp’d’nt 
being 30 years of 
Age. 
Subsequent 
developments 
in Family 
History. 
Respondents mode of life 
and surroundings. 
Ages attained 
by G. Parents. 
I 
79 
Below. 
Mother 37, 
three sisters 
ages not 
given. 
Mother. 
Father dead. 
Brother and three 
sisters living and 
healthy. 
One sister yet 
living (82). 
One sister died 
at 82. 
One sister died 
at 68. 
Has been merchant and 
banker ; used no liquors. 
Has had little or no ma- 
larial trouble ; general 
health been good. 
Grand parents 
reached ages 
29, 66, 87, 82. 
2 
71 
Above. 
( Mother 53. 
"( Brother 18. 
Father 
very markedly. 
Father living, in 
good health. 
Two brothers and 
a sister living, in 
good health. 
Father died at 
67. 
One brother still 
alive at 62 years. 
One brother and 
one sister died of 
consumption at 
31 and 32. 
Has followed the life of 
a farmer ; been an occa- 
sional moderate user of 
liquors. 
When a young man, had 
some spitting of blood, 
which physicians told him 
came from his lungs. He 
strained himself at wrest- 
ling about this time. 
Grand parents 
lived to be 75, 
67, 83, 72. 
3 
9° 
Above. 
Mother 36. 
Sister 18. 
Mother. 
Father and three 
brothers living, 
good health. 
Father died at 
73- 
Brothers at 69,78, 
84. 
Has been farmer and 
chairmaker ; a temperate 
user of liquors ; active, 
enjoyed generally good 
health. 
Were all old, 
ages not known. 
GROUP I. 
One Parent and one or more Brothers or Sisters Consumptive. No. 
of 
Case. 
Present 
Age of 
Resp’d’nt. 
Weight 
compared 
with 
Standard. 
Resembles 
which 
parent ? 
Which 
parent died 
with 
Consumption. 
Age. 
Flistory of rest of 
family at age of 30. 
Subsequent 
developments in 
Family History. 
Mode of life 
and surroundings. 
Ages attained 
by G. Parents. 
I 
74 
Above. 
Father. 
Father. 
59 
Mother living, fee- 
ble. A brother and 
four sisters living, 
in good health. 
Mother died at 75. 
Has two sisters yet 
living ; old people. 
Brother and two 
sisters died over 50 
years of age, one 
71 with cancer. 
Has been farmer and 
hotel keeper, used no 
liquors ; generally good 
health. 
Not stated. 
2 
74 
Average. 
Father. 
Mother. 
66 
Father, two bros. 
and a sister living, 
in good health. 
Father died at 84. 
Brothers and sisters 
all died at advanced 
ages. 
Has been a teaeher, 
stationer and farmer ; 
used no liquor ; was 
weak and puny, when 
quite young, grew stouter 
with age. 
G. Parents 
from 68 to 75. 
3 
72 
Average. 
Mother. 
Mother. 
55 
Father, brother and 
three sisters living, 
in good health. 
Father died at 71. 
Brother and sisters 
still living, good 
health, 65 to 77. 
Followed a farmer’s life 
and used liquors freely. 
G. Parents 
69, 89. 73. 8t. 
4 
7' 
Average. 
Father, 
Father. 
Not 
stated. 
Mother dead. One 
sister alive, in good 
health. 
Sister still alive, 
age 75- 
Was a cooper at 30, has 
followed farming since, 
always in good health. 
Has at times been an 
immoderate user of 
liquors. 
Not stated. 
GROUP II. 
One Parent Consumptive. No. 
of 
case. 
Present 
age of 
Resp’d’nt. 
Weight 
compared 
with 
Standard. 
Resembles 
which 
parent ? 
Which 
parent died 
with 
consumption. 
Age. 
History of rest of 
family at age of 30. 
Subsequent 
developments in 
Family History. 
Mode of life 
and surroundings. 
Ages attained 
by G. Parents. 
5 
7i 
Average. 
Mother. 
Father. 
59 
Mother, three bros. 
and nine sisters liv- 
ing and in good 
health. 
Mother died at 74. 
Three brothers yet 
alive, eldest 81. 
One sister living, 
age 83 ; two sisters 
died of cancer. 
Has followed mercantile 
life ; been in general 
good health, of good 
habits, etc. 
G. Parents 
(two G. fathers) 
88 and 77. 
6 
76 
Below. 
Not 
stated. 
Mother. 
Not 
stated. 
Father dead. 
No other record. 
No record of bros. 
or sisters, if ever 
had any. 
Has been a merchant. 
Had some severe illnesses, 
nature not stated. Always 
temperate in use of 
liquors. 
Not stated. 
7 
75 
Average. 
Both 
somewhat, 
Father 
most. 
Mother. 
6l 
Father, two brothers 
and three sisters 
living, one brother 
dead. 
Father died at 90, 
one bro. still living 
at 73, rest all dead, 
one reached 84. 
Has been a farmer. 
Nearly a total abstin- 
ance man. Had rheu- 
matism in early life; is 
now asthmatic. 
G. Parents 50. 
60, 75, 90. 
8 
75 
Below. 
Not 
stated. 
Father. 
49 
Mother and four 
sisters living, moth- 
er an invalid. 
Two brothers dead. 
Mother died at 64 
with pleurisy. One 
sister now living at 
70, rest all died in 
middle life. 
Has been a farmer ; used 
little liquor in early life, 
total abstinance since. 
Generally good health 
and habits. 
Not stated. 
GROUP I I —{Continued) 
One Parent Consumptive. No. 
of 
case. 
Present 
age of 
Resp’d’nt 
Weight 
compared 
with 
standard. 
Resembles 
which 
parent. 
Which 
parent died 
witn 
consumption. 
Age. 
History of rest of 
family at age of 30. 
Subsequent 
developments in 
family history. 
Mode of life 
and surroundings. 
Ages attained 
by G. Parents. 
9 
78 
Above. 
Mother. 
Father. 
28 
Mother, three brcs. 
and three sisters liv- 
ing, good health. 
Two bros. dead. 
Mother died at 91. 
One bro. yet alive 
82. Several bros. 
and sisters lived to be 
over 80. One sister 
died with cancer. 
Has been a sailor and 
farmer, used no liquor. 
Had some malarial trou- 
ble, but generally good 
health. 
One G.father 79. 
One G. mother 
93- 
IO 
70 
Average. 
Father. 
Father. 
46 
Mother, two bros. 
and three sisters liv- 
ing, good health. 
Mother died at 67, 
rest died in middle 
life, one brother at 
67 with consump- 
tion. 
Has been a mechanic of 
good habits and good 
health. 
Not stated. 
11 
70 
Above. 
Father. 
Father. 
5° 
Mother, three bros. 
and two sisters liv- 
ing in good health. 
Mother died at 90, 
a bro. and sister at 
40 with consump- 
tion, two other bros. 
died 45, 50, older 
sister 70. 
Has been a butcher, in 
early life used liquors 
moderately, later on be- 
came a total abstainer, 
was a great smoker al- 
ways. 
Stated simply, 
they were old. 
12 
73 
Below. 
Father. 
Father. 
Not 
stated. 
Mother, four bros. 
and a sister living, 
and in good health. 
Mother died at 77; 
brother all over 60 
one 84. 
Sister died at 90. 
Has led life of a farmer 
and lumberman, gener- 
ally healthy. 
Moderate use of liquors 
early in life ; later on, 
total abstinence. 
G. parents 75 
to 85, 
GROUP II ,—(Continued.) 
One Parent Consumptive. No. of 
Case. 
Present 
Age 
of 
Respondent. 
Weight 
compared 
with 
Standard. 
Brothers 
or 
Sisters 
Consumptive. 
Ages. 
History of rest 
of family at age 30. 
Subsequent developments 
in Family History. 
Occupation, Habits, 
&c., &c. 
I 
76 
Below. 
Brother, 
25 
Father, mother, two bro- 
Father died at 86, mother at 81. 
Farmer, always, a total ab- 
Sister. 
19 
thers, and five sisters liv- 
A brother and three sisters died 
stainer from alcohol. 
ing and in good health. 
of consumption in early life. 
Always good health. 
Some of G. parents old. 
2 
79 
Below. 
Three. 
20 
Father and mother living. 
Father and mother died at 76 
Tanner and farmer. Moderate 
21 
G. parents over 60 one 
and 52; former of bronchitis, 
user of alcohol till 30 ; after- 
Sisters. 
22 
side and over 80 on the 
latter of consumption. * 
wards total abstinence. 
other. 
3 
79 
Average. 
Brother. 
35 
Father, mother, brothers, 
Father, brother and two sisters 
Was a weaver at 30, afterward 
Sister. 
40 
and sisters living. G. 
died of consumption. 
became manufacturer and mer- 
parents were old. 
Mother died 71. 
chant. Habits good. Some 
bodily injuries. Good health. 
4 
87 
Above. 
Four Sisters 
l6 
Father and mother dead. 
Brothers (five), and sisters all 
Farmer, always healthy. Al- 
22 
Father with asthma at 58. 
lived to be old, all 70 and over. 
ways total abstainer from alco- 
24 
Five brothers and one 
hoi. Has suffered 20 years past 
31 
sister living ; all in good 
from Epithelioma of nose causing 
health. 
much deformity. 
81 
Below. 
Two 
18 
Parents dead ; father at 56 
A brother living aged 87, others 
Followed farming always. 
Sisters. 
26 
with congestion of lungs. 
all dead, some were over 80, all 
Health generally good. Was 
Five bros. and a sister in 
were old. 
always a total abstainer from 
good health. G. parents 
alcohol. 
were all old. 
GROUP III. 
More than One Brother or Sister Consumptive. No. of 
Case. 
Present 
Age of 
Respondent. 
Weight 
compared 
with 
Standard. 
Brother or 
Sister died of 
Consumption. 
Age 
at 
Death 
History of rest of 
Family at Age 30. • 
Subsequent Developments 
in Family History. 
Occupation, Habits, and 
Surroundings. 
' 
7° 
Below. 
Shter. 
*20 
. 
Father and mother living, 
also three brothers and 
four sisters. 
1‘ atl er died at 66, mother at 89. 
Brothers and sisters averaged 
well, one sister over 80. Two 
sisters died of pulmonary disease 
at 42 and 60 years. 
Followed farming, was tall and 
slim, always had good health. 
Habits good. 
2 
7fi 
Average. 
Sister. 
20 
Mother died at 48 of pa- 
ralysis. Father and three 
bros. living, good health. 
G. parents were old. 
Father lived to be 88, one bro. 
reached 70, others died under 
60. 
Has followed office business gen- 
erally, “ clerk,” &c. Had always 
a hoarse, weak voice. Generally 
healthy', though has had pneu- 
monia. Habits good. 
3 
82 
Average. 
Sister. 
40 
Father, mother, two bros. 
and three sisters living. 
G. parents lived to be 91, 
85, 81, 61. 
Father died 76, mother at 77, 
brothers and sisters all passed 
middle life, two sisters over 80. 
Has been a farmer all his life. 
Always had good health, though 
not strong before 30. Habits 
good. Total abstinence from 
liquor since 50. 
4 
88 
Average. 
Sister. 
40 
Father living, mother 
dead, Three brothers and 
three sisters living, good 
health. G. parents 70, 71, 
86, 86. 
Parents died at 80 and 63. Bros- 
all died over 70. One sister at 
40 of phthisis. Other two sisters 
over 60. 
Has been Minister of Gospel. 
Had several attacks of fever, 
otherwise had good health. Total 
abstainer from liquors since early 
manhood. 
GROUP IV. 
One Brother or Sister Dead with Consumption. No. of 
Case. 
Present 
Age of 
Respondent. 
Weight 
compared 
with 
Standard. 
Brother or 
Sister died 
of 
Consumption. 
Age 
at 
Death 
History of rest of 
Family at Age 30. 
Subsequent Developments 
in Family History. 
Occupation, Habits, and 
Surroundings. 
5 
78 
Average. 
Sister. 
20 
Both parents and eight 
brothers and sisters living, 
all in good health. 
Parents died 84, 88. One bro- 
ther died at 70, another at 79, a 
sister at 72, the others in middle 
life. 
Farmer all his life. Had typhus 
fever, otherwise good health. 
Good habits, moderate user of 
liquors always. 
6 
76 
Average. 
Sister. 
18 
Father and mother and a 
large family of bros. and 
sisters living. All good 
health. One, G. parent 
90 years; rest all died in 
middle life. 
Both parents died of cancer at 
75 and 80. A brother living at 
66, rest of family all dead. 
Has been a farmer always. 
Moderate user of liquors always. 
Has good health. 
7 
72 
Below. 
Sister. 
37 
Father, mother, six bros. 
and three sisters living, 
and in good health. 
Father died of cancer, 85. 
Mother died 56, accident. Two 
brothers and three sisters living, 
a sister died at 21, of consump- 
tion, rest in middle life, various 
causes. 
Has been a merchant. Was 
never very strong. A dyspeptic. 
A moderate user of alcohol. 
8 
80 
Average. 
Sister. 
27 
Father and mother living, 
also three bros. and four 
sisters. 
Father died at 86, mother at 71. 
Two sisters died of consumption, 
aged 35, 42. None lived to be 
older than 66. 
Has been a mason, used alcohol 
moderately in early life, none at 
all since 30. Generally good 
health. 
GROUP IV.—(Continued.) 
One Brother or Sister Dead with Consumption. ANNUAL REPORT 
OF THE 
MEDICAL DIRECTOR 
OF THE 
United States Life Insurance Co. 
For the Year Ending December 31st. 1877. 
To the Board of Directors of the United States Life 
Insurance Company. 
Gentlemen : 
During the year which has just come to an end, there have been 
reported 105 losses by death, involving $282,582. This shows an 
increase of $20,772 over the amount reported last year. At the 
89 same time the Company has carried a larger amount of insur- 
ance (on a greater number of lives) than during the previous 
year. 
For purposes of comparison, I submit herewith a table 
showing the number and causes of deaths, and,the average ex- 
posure, according to classes of disease, for the past eight years. 
From this tabular statement several interesting facts may be 
gleaned ; I shall call your attention, however, only to the fol- 
lowing : 
The average duration (exposure) of the policies ivhich become 
claims through death is steadily increasing. During the four years 
from 1870 to 1873 inclusive, the average exposure was 7.11 
years ; while during the last four, from 1874 to 1877 inclusive, 
it has been 10.13 years. The same is true of those policies 
which have become claims through death from consumption and 
chronic bronchitis ; the average duration (exposure) during the 
first four years (1870-1873) being 7. 37 years, while during the 
last four (1874-1877) it was 9.15 years. 
Respectfully submitted by 
ALBERT H. BUCK, M. D. 
New York, January, 1878. 
90  
1 
1870. 1871. 
1872. 
OO 
| 
1874. 
1875- 
1876. 
1877. 
Number of 
Cases. 
Average 
Exposure. 
I Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Number of 
Cases. 
Average 
Exposure. 
Zymotic Diseases, 
Such as Yellow Fever, Malarial and Typhoid j 
Fevers, Small-pox, Erysipelas, Carbun- >• 
5 
4 3 
oh 
13 
5/2 
16 
4'/2 
12 
7'A 
4 
7'+ 
11 
9 
13 
cle, Dysentery, Diphtheria, &c ) 
Constitutional Diseases, 
Such as Gout, Rheumatism, Diabetes, 1 
Leucocythasmia, General Debility, y 
1 
4# 1 
3/4 
4 
8 
2 
4 
2 
16% 
3 
20/4 
4 
13 4 
Scrofula, Old Age, &c ) 
Diseases of the Brain and Nervous 
System, 
Such as Softening, Insanity, Apoplexy, In-1 
flammation or Congestion, Epilepsy, 7 
11 
S'4 l3 
6% 
18 
16 
6)4 
19 
9 '4 
7 
IO 
17 
13% 
17 
11 >2 
Nervous Prostration, Suicide, &c J 
(Suicides) 
(3) 
(2t) (3) 
(4) 
(2) 
(«i) 
(3) 
(5-i) 
(1) 
(i) 
(3) 
(95> 
(1) 
(124) Diseases of the Heart and Blood Vessels. 
3 
9 
5 
6/ 
7 
6/ 
4 . 
8/ 
9 
123/ 
12 
8/ 
7 
'■'4 
21 
14/ 
• Diseases of the Lungs. 
27 
6/2 
6/ 
31 
• 7 
13 
8 
24 
8 
26 
7/ 
5H 
20 
8 '/2 
20 
1034 
23 
10/ 
Pneumonia, Pleurisy,Congestion of Lungs, &c. 
10 
IO 
7 U 
12 
8 
17 
6/ 
13 
!3 
9 U 
14 
12 / 
7 
7/4 
Diseases of the Abdominal Organs. 
Liver and Spleen 
I 
4 
5 
3 
4 
10/ 
3 
6/ 
10/ 
3 
12/ 
9/4 
4/ 
5 
7% 
n/ 
5 
II/ 
4 
10 
Kidneys 
2 
15X 
sH 
1 
14/ 
8/ 
14 k 
9U 
3 
7 
8 
4 
8-/ 
7 
S/ 
Inflammation of Bowels, Diarrhoea, Perito- ) 
nitis, Strangulated Hernia, &c j 
Gastritis and Ulcer of Stomach 
3 
6 
2 
8/ 
3 
6 
12 
6 
8/ 
3 
8/4 
4 
3 
6 
2 
7 
1 
6 
5 
81-4 
4 
10 
Diseases of Bladder and Urethra 
I 
' 2 
1 
H X 
2 
12 
3 
18 
1 
T9 
1 
9/4 
Puerperal Fever and Hemorrhage 
1 
I 
Cancer 
2 
7/2 
2 
10 
2 
S'A 
4 
9 
4 
17 
4 
11/ 
2 
8 
Abscess 
I 
1 
*9/4 
Diseases of Indeterminate Seat. 
Such as “Dropsy,” “Anasarca,” “As-) 
cites,” &c ) 
1 
14 
1 
6/2 
2 
8/ 
3 
4/ 
1 
2 
2 
24 
1 
13 
Injuries, Burns, Drowning 
5 
6/ 
13 
4/ 
5 
n 
6 
4/ 
9 
6 
6/ 
7 
4I2 
6 
9 
5 
8/ 
Intemperance 
2 
5 X 
4 
1 
0/ 
1 
3 
Totals 
72 
6.47 
85 
7.67 
92 
7-75 
io5 
6.57 
108 
8.42 
98 
9.96 
106 
Ti 41 
i°5 
10.75 ANNUAL REPORT' 
¥ 
OF THE 
MEDICAL DIRECTOR 
OF THE 
United States Life Insurance Co. 
For the year ending December 31st, 1878. 
To the Board of Directors of the United States Life Insur- 
ance Company. 
Gentlemen : 
The losses by death reported during the year which has just 
come to an end (1878) amount to $231,990, or $50,592 less than 
was reported for the year 1877, and $44,010 less than the ex- 
pected mortality. 
In the Annual Report which I made to your body in Janu- 
ary, 1877, I mentioned the fact that we were becoming more 
and more impressed with the necessity of testing the urine of 
applicants for life insurance. At that time, if I remember 
95 rightly, we assumed that affections of the kidneys were so rare 
before the age of 45 or 50 that we could safely limit our prac- 
tice of examining the urine to cases where the applicants had 
passed middle age ; accordingly, the urine was never tested in 
persons under 45 years of age, unless the appearance of the 
individual, or something in his past history, seemed to call for 
such an examination. The number of apparently healthy in- 
dividuals whose urine contained a recognizable amount of 
albumen was found during 1877 to be so large that, on the 1st 
of January, 1878, Mr. Buell authorized us to establish the rule 
that an examination of the urine must be made in every case, at 
least in this and other large towns and cities. The practical 
results of this experiment, which has now been tried with great 
faithfulness for an entire year, are the following : 
At the home office, in the City of New York, 211 individuals 
made application for policies on their lives. Their ages, divided 
into classes of five years, were : 
NO. OF 
AGES. 
INDIVIDUALS. 
20 25 
l3 
26 30 
29 
31—35 
32 
36—40 
37 
41—45 
41 
46—50 
25 
51—55 
11 
56—60 
15 
61—65 
6 
66—70 
2 
Total... 
211 
96 Of these 211 individuals, 29 (13%%) were found suffering 
from some disturbance of the genito-urinary system; in 19 
cases albumen was found (in only 2 of these cases with casts); 
in one case sugar alone was found ; in one case albumen and 
sugar were both found (death occurred within three or four 
months) ; finally, in 8 cases, evidences of inflammation of the 
bladder or urethra (stricture, in the majority) were found. 
These 29 individuals were all in fairly good health, and would, 
except, perhaps, in three or four cases, where the weight was 
excessive, have been accepted as insurable risks. Their ages, 
arranged in groups of five years, were as follows : 
AGES. 
NO. OF 
INDIVIDUALS. 
20 25 
2 
26 30 
3 
31—35 
4 
36—40 
4 
41—45 
5 
46—50 
2 
5i—55 
1 
56—60 
3 
61—65 
4 
66—70 
I 
T otal........ 
29 
The individual in whose urine sugar alone was found was 66 
years old ; the one in whose urine both albumen and sugar 
were found was 41 years old. 
From this it will be seen that albuminuria occurs almost as 
frequently before the 46th year as after it; that is, nearly 8 per 
97 cent, (u out of 152) of all the individuals under 46 years of 
age were found to have albuminuria, while after that age the 
proportion was 13 per cent. (8 out of 59). 
In the present state of medical knowledge, all these twenty* cases 
of albuminuria would be considered as manifesting at least the 
beginnings of disease of the kidneys, and could not, therefore, 
be recommended as fit subjects for life insurance. The full 
significance of the presence of albumen in the urine is, however, 
not yet understood. During the past two or three years doubts 
have been openly expressed in medical societies and the medical 
journals with regard to the value of albuminuria (i. e., un-com- 
plicated) as an evidence of kidney disease. The question is 
one of very great importance, and it seems to us that it can be 
more fully investigated and answered by the medical officers of 
life insurance companies than by general practitioners of medi- 
cine or by experimental physiologists. 
For this purpose careful records (name, address, date, age, 
occupation, &c.) should be kept of every apparently healthy (at 
least in all other respects) individual in whose urine albumen 
may be found, and then, from time to time, in subsequent 
years, the effort should be made to ascertain what has become 
of these individuals, whether alive or dead, in good or poor 
health, &c., &c. This is the course which the medical depart- 
ment of the company proposes to pursue, and we have reason to 
believe that the same plan will be carried out by more than one 
of the other companies. 
* The albumen in the remaining eight cases of bladder or urethral disease may have 
come from the blood vessels of these parts, and not from the kidneys. 
98 In conclusion I would state that all the examinations referred 
to above were made by my colleague, Dr. John Munn, who has 
exercised the greatest care to obtain absolutely accurate results, 
and who has, in the accompanying report, entered very fully 
into all the details. 
Respectfully submitted by 
ALBERT H. BUCK, M. D., 
Medical Director. 
January. 1879. 
99 ALBUMINURIA 
IN 
PERSONS APPARENTLY HEALTHY. 
For several years past it has been the custom of many Life 
Insurance Companies to require an examination of urine, only 
in cases where the amount of insurance applied for was large, or 
where, from the personal history or physical appearance, a 
kidney difficulty was suspected. Upon examination of the mor- 
tality records we have found that nearly io per cent, of all the 
deaths of policy-holders in the United States Life Insurance 
Company, occurred from Bright’s disease, so that it was con- 
sidered judicious to require an examination of urine in as many 
cases as possible, with the view of ascertaining in what percentage 
of applicants the urine was abnormal. This work was under- 
taken in the latter part of 1877. So many cases of albuminuria 
were discovered among those presenting themselves for insurance 
as to warrant the belief that an examination of urine is neces- 
sary and should be required in the case of each applicant, and 
accordingly such an order was issued by the executive. This 
101 furnished the opportunity to study the urine of persons appar- 
ently in perfect health, and it was determined to make careful 
records of each case, using the most delicate means possible to 
detect any variation from the normal condition. 
For our purposes, it was necessary to be able to discover 
albuminuria in its incipiency, and to do this special precautions 
were taken. It was found that after having boiled urine and 
added to it nitric acid, albumen, even when present in consid- 
erable quantity, might easily be overlooked if the test tube 
were not perfectly clean and bright, or it it were not held in light 
properly shaded. It is not sufficient to hold the tube before a 
dark background as is sometimes done, as the light from the 
window or burner dazzles the eye. It is necessary that the light 
enter the room through a comparatively small opening, and that 
it fall upon the test tube in such a manner as to allow the eye 
of the observer to rest upon a background entirely dark. 
The importance of this arrangement for the detection ot 
cloudiness in a fluid may be readily appreciated when we remem- 
ber how completely filled with floating particles the atmosphere 
appears when sunlight enters a dark room through a small 
aperture, while in the same room with open windows the air 
seems perfectly clear. 
After many experiments, the following method has been found 
to answer the purpose fully : I have placed immediately below 
the window glass, and extending up to it, a large square of black 
pasteboard. The dark window shade is drawn down to meet 
the upper margin of this pasteboard, and then carried out at the 
102 bottom to a distance of about one foot. Immediately under 
this the test tube is held. In this manner none but reflected 
light meets the eye. If any one will place in a perfectly clean 
test tube mine containing a considerable quantity of albumen, 
boil the upper portion, incline the tube to an angle of 45 
degrees, allow two or three drops of nitric acid to trickle down 
to the bottom, hold before an open window, or an unshaded 
burner, and afterwards place in light reflected as described 
above, he will lose his faith in tests for albumen as ordinarily 
undertaken. 
The acid should be carefully added, drop by drop, while the 
tube is in the reflected light, as in this manner the test is far 
more delicate. It has also appeared that albumen in a urine, 
alkaline, neutral, or even faintly acid, will not be readily de- 
tected ;—the urine must be distinctly acid, and when it is not, 
should be rendered so by the addition of acetic acid, and 
thoroughly well shaken before boiling. Unless this precaution 
is taken, albumen will be overlooked in many cases. 
It is also necessary that the urine be allowed to stand quietly 
in the test tube, at least five minutes after the nitric add is 
added, at the expiration of which time, if no cloudiness appears, 
it may safely be pronounced non-albuminous. 
The following table (see page 101) is made up of cases com- 
ing under my own observation. In each the heart and lungs 
were found to be normal, and nothing could be learned from 
the past history to lead to the suspicion that albuminuria existed ; 
furthermore, the physical appearance in ever)- case (with perhaps 
103 two exceptions) indicated a healthy condition. Each one con- 
sidered himself in perfect health and really appeared as if he were. 
They were all excluded solely on account of albuminuria, and 
formed eleven per cent, of those presenting themselves to me for 
examination. In nearly every case two or more specimens 
taken at different times were examined and albumen found in 
each. 
In a number of cases the applicant having been advised of 
the cause of rejection, returned to me saying that his family 
physician had examined a specimen of his urine and found it per- 
fectly normal. I have been able, however, in a few such instances 
(indeed, whenever a personal interview has been had), to con- 
vince the physician that the examination as made by him would 
not have detected any but a considerable quantity of albumen, 
and great surprise was expressed on demonstrating the ease with 
which it is possible to overlook albumen, unless proper care is 
taken in the analysis. Such experiences have strengthened the 
conviction that tests as ordinarily made are far from being relia- 
ble. I make this assertion boldly. 
While it is impossible to deduce definite conclusions from the 
limited number of cases here given, it is interesting to note 
that albuminuria was found as frequently in the young as in the 
old, half the number being under 45 years of age ; that in nearly 
half the number there was excessive weight; that the pulse was 
rapid in nearly all, though very little importance maybe attached 
to this; casts were found in but two cases. 
104 No. of 
Case. 
Occupation, 
Age. 
Weight. 
Height. 
Pulse. 
Albumen. 
I 
Bank Clerk 
23 
I25 
5-8 
76 
Well marked. 
2 
Com. Merchant.. .. 
23 
180 
5-6 
86 
Slight trace. 
3 
Lawyer 
23 
138 
5-7 
78 
Abundant. 
4 
Public Officer 
29 
245 
5-9 
108 
Abundant. 
5 
Com. Merchant .... 
32 
160 
5-9 
76 
Considerable. 
6 
Iron Merchant 
32 
175 
5-11 
80 
Mod. quantity. 
7 
Telegraphy 
33 
!52 
5-8 
84 
Well marked trace. 
8 
Physician 
40 
165 
5-8 
84 
Mod. quantity. 
9 
Printer 
40 
176 
5-6 
82 
Well marked. 
IO 
Haydealer 
41 
185 
5” 
74 
Abundant. 
* 11 
Bookkeeper in Brew- 
ery 
41 
210 
5-10 
85 
Mod. quan. also sug’r 
12 
Mfr. Woolens 
44 
175 
5-6 
84 
Abundant. 
13 
Liquors . 
45 
I40 
5-5 
Considerable. 
H 
None 
47 
167 
5-5 
92 
Abundant. 
15 
Ins. Agent 
5° 
181*4 
5-9/4 
92 
Trace. 
l6 
Safes 
52 
257 
4-8/4 
Albumen. 
17 
None 
53 
140 
5-9 
88-90 
Present. 
l8 
Mech. Engineer.... 
54 
180 
5-10 
108 
Considerable. 
19 
Velvets 
57 
160 
5-5 
76 
Considerable. 
20 
Lawyer. 
57 
195 
5-7 
84 
Well marked trace. 
21 
R. R. Pres’t 
61 
186 
5-9/4 
84 
Mod. quantity. 
22 
Clothing 
61 
160 
5-5 
84 
Mod. quantity. 
23 
Mer. Agent 
61 
161 
5-9 
78 
Well marked trace. 
24 
Publisher 
6l 
i65 
5-8/4 
66 
A trace. 
* Applied for insurance and was accepted in Dec., 1877, no examination of urine 
Applied again in three months, but was rejected, both sugar and albumen being found in 
urine. Died three months later. 
105 There is great difference of opinion as to what the clinical 
significance of albuminuria really is, but that it should exist in 
eleven per cent, of a large number of individuals considering 
themselves perfectly healthy, and with no discoverable cause for 
its presence, is a fact worthy of consideration. As no discom- 
fort is produced by it, our attention as physicians is not called to 
these cases, unless other manifestations of disease appear. Con- 
sequently such cases are very rarely observed. It is proposed to 
keep the cases here noted, together with such others as may 
come to my notice, under close observation ; to examine the 
urine from time to time, and note whatever changes occur in it, 
and in the general condition of the individual. By pursuing 
this plan for a number of years consecutively, we may hope to 
ascertain a little more definitely the real significance of albumi- 
nuria. 
From the investigations thus far made, the following con- 
clusions seem warranted : 
1. Albuminuria does exist in a far greater proportion of in- 
dividuals apparently in perfect health than is ordinarily supposed. 
2. The method of testing as commonly practised fails to de- 
tect any but a considerable quantity of albumen ; it is absolutely 
necessary to use light properly shaded. 
3. The urine, if not distinctly acid, must be rendered so 
before boiling. 
4. In an alkaline urine, unless properly acidulated before 
boiling, at least five minutes must elapse after adding the nitric 
acid before it is safe to pronounce it non-albuminous. 
106 5. The early morning specimen frequently contains no albu- 
men, while that voided later in the day does ; consequently a 
morning specimen, which physicians usually require for analysis, 
is not to be depended on in testing for albumen. 
6. Carelessness in procuring specimens (these often being re- 
ceived in an unclean vessel, or placed in a partially cleansed 
bottle), and the foul test tubes unfortunately used by many 
physicians, render the analysis untrustworthy. 
The vessel receiving and conveying the urine, and the test 
tubes used in testing it, must be absolutely clean. The reagents 
used must be chemically pure. 
Note.—An unclean urine receptacle favors the production of 
bacteria which appear in myriads after the vessel has stood a few 
hours in a warm temperature. The passing the fluid through 
many successive layers of filter paper will not remove these or- 
ganisms sufficiently, and there is no means at present known by 
which they can be eliminated, except by filtering the urine 
through porous clay. As this is not practicable, fresh specimens 
only should be used in testing for albumen. 
JOHN MUNN, M.D. 
107 ALBUMINURIA 
IN 
PERSONS APPARENTLY HEALTHY. 
(Second Paper.) 
In the last annual report of this company, we stated under the 
above heading that ten per cent, of the deaths among policy- 
holders occurred from Bright's disease, and that in view of this 
fact an examination of the urine had been required in the case 
of each applicant during the preceding year ; that in the carry- 
ing out of this requirement, it was found that eleven per cent, 
of those presenting themselves for examination had albuminuria 
attended with no discomfort or unpleasant symptom, and with 
no discoverable cause for its existence. The most delicate tests 
known had been used in the examination, and the greatest pos- 
sible care taken to discover any variation from the normal con- 
% x 
dition. An accurate record of the past family and personal his- 
tory had been made in each case, and a full statement given of 
the habits, occupation, and present condition. 
In the 24 cases reported at that time, we noted that albumi- 
nuria was found as frequently in the young as in the old ; that 
there was excessive weight in nearly half the number ; that the 
109 pulse was rapid in nearly all ; and that casts were found in 
two cases. It was also stated that inasmuch as no discomfort is 
produced by albuminuria, our attention as physicians is not 
called to these cases until other manifestations of disease appear. 
' Consequently, it is very rarely observed. In view of this fact, 
we proposed to keep the cases then examined, together with 
such others as came to our notice under close observation ; to 
examine the urine from time to time, and to note whatever 
changes occurred in it and in the general condition of the indi- 
vidual, and we expressed the hope that by pursuing this plan 
for a number of years consecutively, we might ascertain more 
definitely the real significance of the albuminuria. 
It is proposed in this paper to give briefly the present condi- 
tion of the individual and the urine in each of the 24 cases re- 
ported last year, and also to add to the number the new cases 
presented in the year just passed. 
For the purpose of comparison, the table showing the condi- 
tion one year ago has been reprinted on page hi, and on the 
adjoining page a second table, representing the present condi- 
tion, is given. 
Each case, with one exception, has been visited personally 
during the past month, and specimens of urine obtained from 
all but three. 
110 No. of 
Case. 
Occupation. 
Age 
Weight. 
Height. 
Pulse. 
Albumen. 
I 
Bank Clerk 
23 
125 
5-8 
76 
Well marked.... 
2 
Com. Merchant. 
23 
180 
5-6 
86 
Slight trace 
78 
4 
Public Officer... 
29 
245 
5-9 
108 
Abundant 
5 
Com. Merchant. 
32 
160 
5-9 
76 
Considerable.... 
6 
Iron Merchant.. 
32 
175 
5-i 1 
80 
Mod. quantity... 
7 
Telegraphy 
33 
152 
5-8 
84 
Well m’k’d trace. 
8 
Physician 
40 
165 
5-8 
84 
Mod. quantity... 
9 
Printer 
40 
176 
5-6 
82 
Well marked.... 
IO 
Haydealer 
41 
185 
5-i 1 
74 
Abundant 
*11 
Bookkeeper 
41 
210 
5-10 
85 
Md. q’n also sugr 
12 
M’fr Woolens... 
44 
175 
5-6 
84 
Abundant 
!3 
Liquors 
45 
I4O 
5-5 
Considerable.... 
. 
ti4 
None 
47 
167 
5-5 
92 
Abundant 
IS 
Ins. Agent 
5° 
181X 
5-9^ 
92 
Trace 
5-8*4 
i7 
None 
S3 
I40 
5-9 
88-90 
Present 
18 
Mec. Engineer.. 
54 
180 
5-10 
108 
Considerable.... 
i9 
Velvets 
57 
160 
6-5 
76 
Considerable.... 
20 
Lawyer 
57 
195 
5-7 
84 
Well m’k’d trace. 
21 
R. R. Pres’t 
6l 
186 
5-9 yi 
84 
Mod. quantity... 
22 
Clothing 
6l 
160 
5-5 
84 
Mod. quantity... 
23 
Mer Agent 
6l 
l6l 
5-9 
78 
Well m’k’d trace. 
24 
Publisher 
6l 
i'5 
5-8 y2 
66 
A trace 
* Applied for insurance and was accepted in Dec., 1877, no examination 
of urine. Applied again in three months,* but was rejected, both sugar and 
albumen being found in urine. Died three months later, 
f Hyaline casts found. 
111 I No. of | 
| Case. 
Occupation. 
Age 
Weight. 
Height. 
Pulse. 
Albumen. 
Casts. 
I 
Bank Clerk 
24 
128 
5-8 
80 
Mod. quantity. 
$2 
Com. Merchant.. 
24 
5-6 
5-7 
3 
24 
156 
Mod. quantity... 
4 
Public Officer... 
3° 
260 
5-9 
108 
Mod. quantity .. 
Hyaline. 
5 
Com. Merchant.. 
33 
I7l' 
190 
5-9 
56 
80 
6 
Iron Merchant.. 
33 
5-” 
Mod. quantity... 
(Epithelial and 
1 Hyaline. 
7 
Telegraphy 
34 
158 
5-8 
90 
Will m’k’d trace. 
8 
165 
180 
5-8 
■*+■ '+■ 
00 0 
9 
Printer 
41 
5-6 
Mod. quantity... 
Hyaline. 
io 
Hay dealer 
42 
197 
5-11 
67 
Abundant 
Small Hyaline. 
*11 
41 
45 
46 
85 
84 
12 
182 
13 
145 
88 
Mod. quantity... 
(Granular and 
) Hyaline. 
M 
None. !... 
48 
190 
5-5 
104 
Abundant 
1 Lpithelial, Hy- 
! aline and Gran- 
(ular. 
15 
16 
189 
5-9 >2 
5-8^ 
84 
270 
100 
(Epithelial, Hy- 
< alme and Gran- 
(ular. 
DD 
54 
55 
58 
18 
Mec. Engineer.. 
92 
80 
170 
Mod. quantity... 
20 
Lawyer 
58 
210 
5-7 
90 
Mod quantity... 
Hyaline. 
R. R. Pres’t ' 
5-9 >2 
5~ 5 
22 
Clothing 
62 
160 
84 
Mod. quantity... 
$23 
24 
78 
68 
62 
5-83*2 
Mod. quantity... 
* Deceased. 
f In feeble condition, and out of town for his health. 
| No specimen obtained. 
112 An examination of the preceding table furnishes the following 
results : 
One of the number has died. 
The weight was found unchanged in three cases. It has in- 
creased in sixteen, and markedly increased in nine of this 
number. 
The pulse was more rapid in ten cases, unchanged in five, 
and slower in four. 
Albumen was present in less quantity in three, unchanged in 
six, and increased in eight. It was not found in two cases. 
Casts were found in eight cases ; in seven for the first time by 
me ; hyaline alone in four cases, epithelial and hyaline in one, 
hyaline and granular in one, and epithelial, hyaline and granu- 
lar in two cases. They were not discovered in one of the cases 
which presented them last year. 
Each individual declared himself to be in good health, and 
said that his condition remained unchanged, though in after 
conversation it appeared that slight discomforts were manifested 
in some cases. 
No change in appearance*was noticeable, save in four cases. 
In these the puffy condition was more or less marked, though 
not distinctly so in any. 
In six of the eight cases in which casts were found, there was 
marked increase in weight. 
From the fact that albumen and casts may temporarily dis- 
appear from the urine and then reappear, we can neither say 
positively that casts have been developed during the past year, 
113 nor that the albuminuria has permanently ceased in the two 
cases in which it is not found at the present time. We can only 
state the facts as they exist, and patiently await further develop- 
ments in each of the cases under observation. 
The following table represents the cases presented during the 
year ending February ist, 1880. Each individual considered 
himself to be in perfect health, and there was nothing unusual 
in the appearance of any, save possibly three, to lead to any 
suspicion of the existence of albuminuria. There was nothing 
ound to account for its presence, though the excessive use of 
tobacco was noted as a possible cause in one case. It was found 
in over twelve per cent, of those presenting themselves to me for 
examination. 
114 No. of 
Case. 
Occupation. 
Age. 
Weight. Height 
Pulse. 
Albumen. 
25 
Actor 
25 
157 
5- 6J4 
78 
Well marked. 
26 
Clerk 
27 
155 
00 
1 
to 
70 
Mod. quantity. 
27 
Com. Traveler 
28 
153 
5- 4 
76 
Loaded. 
28 
Broker 
30 
153 
5- 7/2 
82 
Loaded. 
29 
Broker 
3° 
170 
5-“ 
84 
Faint trace. 
30 
Brick M’f’r 
33 
I24 
5- 8 
72 
Abundant. 
3i 
Telegraphy 
36 
195 
6 
88 
Trace. 
32 
Shirt IVBf’r 
39 
149 
4-n 
84 
Loaded. 
33 
Merchant 
44 
156 
5- 9 
76 
Well marked. 
34 
Grocer 
47 
15° 
5_ 6y2 
76 
Trace. 
35 
Broker 
48 
175 
5-8 
87 
Trace. 
36 
None 
49 
200 
5-"^ 
96 
Mod. quantity. 
37 
Hardware 
5° 
160 
5-6 
96 
Mod. quantity. 
38 
Broker 
52 
197 
5-ioj^ 
76 
Trace. 
39. 
Hatter 
53 
*95 
5- 9 
84 
Well marked. 
40 
Broker 
54 
I5° 
5- 6 
80 
Mod. quantity. 
41 
Dry Goods 
55 
180 
5- 9 
80 
Trace. 
42 
Jeweler 
56 
220 
5-i 1 
75 
Trace. 
43 
Banker 
63 
190 
5- 9lA 
72 
Trace. 
In the preceding table, we find as many cases among the 
young as among the old ; overweight in about half the number, 
but not quite so marked as in those reported last year; an ac- 
celerated pulse in half the number, and casts in two of the nine- 
teen cases. 
115 Again we must admit that there is still great uncertainty in 
our knowledge of what the clinical significance of albuminuria 
really is. All authorities are pretty well agreed in this, that it is 
always pathological, never physiological, and that, if it remains 
unchecked, serious results will follow. Some observers assert 
this positively. 
The percentage of cases may have been increased by reason 
of a previous knowledge of the existence of albuminuria, and by 
the consequent desire to obtain insurance. I think such in- 
stances very rare or entirely wanting; but as they may exist, we 
are not warranted in asserting that albuminaria exists in so large 
a percentage of individuals generally as we have found it among 
applicants for life insurance. 
From the fact that casts have bedn found in eleven of the 
forty-three cases observed by me, I feel justified in regarding the 
condition a grave one, and worthy of the most careful consider- 
ation. ' 
It is my purpose to continue the investigations until definite 
conclusions are reached, hoping to understand more fully not 
only what albuminuria really signifies, but also what conditions 
favor its development, its existence and its disappearance. 
JOHN MUNN, M, D. 
116 ALBUMINURIA 
IN 
PERSONS APPARENTLY HEALTHY. 
(Third Paper.) 
In last year’s report on albuminuria, we referred to this sub- 
ject in the following manner : 
“ In the last annual report of this Company, we stated under the 
above heading that ten per cent, of the deaths among policy- 
holders occurred from Bright’s disease, and that in view of this 
fact an examination of the urine had been required in the case 
of each applicant during the preceding year; that in the carry- 
ing out of this requirement, it was found that eleven per cent, 
of those presenting themselves for examination had albuminuria 
attended with no discomfort or unpleasant symptom, and with 
no discoverable cause for its existence. The most delicate tests 
known had been used in the examination, and the greatest pos- 
sible care taken to discover any variation from the normal con- 
dition. An accurate record of the past family and personal 
history had been made in each case, and a full statement given 
of the habits, occupation, and present condition. 
117 “ It was also stated that inasmuch as no djscomfort is pro- 
duced by albuminuria, our attention as physicians is not called 
to these cases until other manifestations of disease appear. 
Consequently, it is very rarely observed. In view of this fact, 
we proposed to keep the cases then examined, together with 
such others as came to our notice, under close observation ; to 
examine the urine from time to time, and to note whatever 
changes occurred in it and in the general condition of the indi- 
vidual, and we expressed the hope that by pursuing this plan 
for a number of years consecutively, we might ascertain more 
definitely the real significance of the albuminuria.” 
It is proposed in this paper to give briefly the present condi- 
tion of the individual, and the urine in each of the 43 cases 
reported last year, and also to add to the number the new cases 
presented in the year just passed. 
Our tables are somewhat imperfect, as specimens of urine 
could not be obtained from 18 of the number. 
118 Cases Observed First in 1878. 
o V 
6 pi 
25 
Occupation. 
Age 
Weight. 
Height. 
Pulse. 
Albumen. 
Casts. 
I 
Bank Clerk 
23 
125 
5-8 
76 
Well marked... 
2 
Com. Merchant. 
23 
180 
5-6 
86 
Slight trace..... 
3 
138 
78 
Hyaline. 
4 
Public Officer... 
29 
245 
5-9 
108 
Abundant. 
S 
Com. Merchant 
32 
160 
5-9 
76 
Considerable 
' 6 
Iron Merchant.. 
32 
175 
5-ri 
80 
Mod. quantity.. 
7 
Telegraphy 
33 
152 
5-8 
84 
Well m’k’d trace. 
8 
Physician 
40 
165 
5-8 
84 
Mod. quantity.. 
9 
Printer 
40 
176 
5-6 
82 
Well marked... 
10 
185 
kII 
Bookkeeper 
41 
210 
5-10 
85 
Md. q’n also sugr 
* 
12 
M’fr Woolens... 
44 
175 
5-6 
84 
Abundant 
Hyaline. 
15 
92 
5 81< 
l8 
Mec. Engineer.. 
54 
l8o 
v 
5-10 
108 
Considerable.... 
19 
Velvets 
57 
l6o 
5-5 
76 
Considerable.... 
20 
Lawyer 
57 
J95 
5-7 
84 
Well m’k’d trace: 
21 
R. R, Pres’t 
6l 
186 
5-9^ 
84 
Mod. quantity.. 
22 
Clothing 
6l 
160 
5-5 
84 
Mod. quantity.. 
23 
Mer. Agent 
6l 
l6l 
5-9 
78 
Well m’k’d trace. 
' . 
24 
Publisher 
6l 
165 
5-8^ 
66 
Trace 
* Applied for insurance and was accepted in Dec., 1877, no examination 
of urine. Applied again in three months, but was rejected, both sugar and 
albumen being found in urine. Died three months later. 
119 Condition in 1880. 
I No of 
| Case. 
Occupation. 
Age 
Weight. 
Height. 
Pulse. 
Albumen. 
Casts. 
130 
5-8 
88 
3 
Lawyer 
25 
151 
5-7 
90 
Mod. quantity.. 
Granular. 
u 
6 
Iron Merchant.. 
34 
190 
5-i 1 
94 
Abundant 
Hyaline. 
'57 
5-8 
96 
t8 
5- 8 
9 
Printer 
42 
172 
5-6 
84 
Well marked.... 
IO 
.... 
43 
208 
5-11 
60 
Mod. quantity.. 
*11 
Bookkeeper 
4: 
210 
5-10 
85 
Md. q’n alsosugr. 
12 
M’fr Woolens... 
46 
177 
5-6 
76 
Trace 
195 
88 
H) alme. 
ti7 
*18 
Mec. Engineer.. 
54 
180 
5-10 
108 
Considerable.... 
i9 
Velvets 
58 
170 
5-5 
80 
Mod. quantity.. 
Hyaline. 
22 
Clothing 
64 
160 
5-5 
76 
Mod. quantity.. 
24 
Publisher 
63 
165 
5-8 JS 
64 
Trace 
f No specimen obtained. 
* Died. 
120 Cases Observed First in 1879 
No. of 
Case. 
Occupation. 
<D 
bD 
< 
Weight. 
Height. 
Pulse. 
Albumen. 
25 
Actor 
25 
r57 
5- 6A 
78 
Well marked. 
26 
Clerk 
27 
155 
Ln 
1 
00 
70 
Mod. quantity. 
27 
Com. Traveler 
28 
153 
5- 4 
76 
Loaded. 
28 
Broker 
3° 
153 
5- 7J4 
82 
Loaded. 
29 
Broker 
3° 
170 
5-i 1 
84 
Faint trace. 
30 
Brick M’fr 
33 
124 
00 
1 
1-0 
72 
Abundant. 
31 
Telegraphy 
36 
195 
6 
88 
Trace. 
32 
Shirt M’f’r 
39 
149 
4-11 
84 
Loaded. 
33 
Merchant 
44 
156 
5- 9 
76 
Well marked. 
34 
Grocer 
47 
i5° 
5- 6/2 
76 
Trace. 
35 
Broker 
48 
i75 
Gri 
1 
00 
87 
Trace. 
36 
None 
49 
200 
5-H/4 
96 
Mod. quantity. 
37 
Hardware 
50 
160 
5- 6 
96 
Mod. quantity. 
33 
Broker 
52 
197 
0 
1 
lO 
76 
Trace. 
39 
Hatter 
53 
195 
5- 9 
84 
Well marked. 
40 
Broker 
54 
*5° 
5- 6 
80 
Mod. quantity. 
41 
Dry Goods 
55 
180 
5- 9 
80 
Trace. 
42 
[eweler 
56 
220 
5-u 
75 
Trace. 
45 
Banker.. 
63 
190 
5- 9/4 
72 
Trace. 
121 Condition in 1880. 
No. of 
Case. 
Occupation. 
Age. 
Weight. 
1 
Height. 
Pulse. 
Albumen. 
Casts. 
t25 
Actor 
26 
5- 
26 
Clerk 
28 
155 
5- 8% 
80 
Mod. quantity. 
127 
Com. Traveler.. 
29 
5- 4 
28 
Broker 
31 
166 
5- 7 V-f 
86 
Hyaline. 
29 
Broker 
3i 
176 
5-i 1 
90 
Faint trace ... 
t3o 
Brick M’fr 
34 
5- 8 
• 
t3i 
Telegraphy 
37 
6 
32 
Shirt M’fr 
40 
149 
4-11 
68 
Hyaline. 
33 
Merchant 
45 
155 
5- 9 
76 
Well marked.. 
34 
Grocer 
48 
*5° 
5- 6y2 
92 
t35 
Broker 
49 
5- 8 
36 
None 
5° 
220 
5-11V7 
96 
37 
Hardware 
5i 
177 
5- 6 
100 
Abundant .... 
Hyaline. 
t38 
Broker 
53 
5-1014 
t3Q 
Hatter 
54 
5- 9 
*40 
Broker 
54 
150 
5- 6 
80 
Mod. quantity. 
t4i 
Dry Goods 
56 
5~ 9 
42 
Jeweler 
57 
210 
5-n 
76 
43 
Banker 
64 
I90 
5- 9 
68 
Well marked.. 
Hyaline. 
tNo specimen obtained. 
* Died. 
122 An examination of the preceding tables furnishes the follow- 
ing results : 
Three of the number have died. 
The weight of the body was found unchanged in 7 cases. It 
was diminished in 2, and increased in 20 of the number. 
The pulse was unchanged in 7, diminished in 6, and 
increased in 19 cases. The change in this respect, however, 
has been so slight that little importance can be attached to this 
data. 
Albumen has disappeared in 3, diminished in 3, remained 
unchanged in 13, and increased in n cases. 
Casts were found in 8 cases : Hyaline in 7, and granular in 1. 
With two exceptions, each individual declared himself to be 
in good health, and said that his condition remained un- 
changed, though in after conversation it appeared that slight 
discomforts were manifested in some cases. 
No change in appearance was noticeable save in 3 cases. 
In those cases which presented casts, the weight remained 
unchanged in 2, and increased in 6, though not to any great 
extent. 
From the fact that albumen and casts may temporarily dis- 
appear from the urine, and then reappear, we can neither say 
positively that casts have been developed during the past year, 
nor that the albuminuria has permanently ceased in the three 
cases in which it is not found at the present time. We can 
123 simply state the facts as they exist, and patiently await further 
developments in each of the cases under observation. 
The following table represents the cases presented during the 
year 1880. Each person declared himself to be in perfect 
health, and nothing was found to account for the albuminuria. 
It was found in 10 per cent, of all the cases examined. 
124 O V 
c 
£0 
Occupation. 
Age 
Weight. 
Height, 
Pulse. 
Albumen. 
Casts. 
44 
22 
M3 
5- 9% 
72 
Mod. quantity.. 
45 
Bank Clerk 
23 
M3 
5-10 
72 
Mod. quantity.. 
46 
*47 
48 
07 
160 
5- 9 lA 
5- 6^ 
5- 8^ 
5~IOA 
80 
Lumber Dealer. 
29 
124 
86 
( Epithelial. 
! Hyaline. 
( Granular. 
'3° 
13 6IA 
49 
Ins. Broker 
33 
80 
Mod. quantity.. 
5° 
160 
5- 8 
IO4 
38 
5- 9^ 
Mod. quantity.. 
135 
72 
52 
53 
54 
38 
38 
39 
175 
170 
198^ 
96 
Bookbinder 
5" 9 
84 
Mod. quantity.. 
41 
*34 
84 
Mod. quantity.. 
DO 
56 
43 
194 
5- 8 
90 
57 
Liquors, etc 
44 
168 
5- 6 A 
76 
Mod. quantity.. 
58 
Saloon & Groc’y. 
47 
153 
5- 7 
84 
Loaded 
59 
48 
224 
6- 
Mod. quantity.. 
60 
240 
/2 
74 
Well marked 
6l 
R. R. Pres’t 
5° 
775 
5-i 1 
80 
Well marked.... 
5° 
55 
158 
190 
90 
76 
63 
5- 9^ 
Well marked,... 
64 
65 
66 
55 
56 
58 
60 
181^ 
165 
80 
86 
Mod. quantity.. 
Mod. quantity.. 
Mod. quantity.. 
Hyaline. 
{ Epithelial. 
< Hyaline. 
( Granular, 
5" 9 
5- 8 
84 
67 
l80 
68 
5- 9 
5- 8 
68 
72 
Trarp 
69 
67 
Hyaline. n 
* Died within three months. 
125 In the preceding table we find overweight in nearly half, and 
underweight in one-fourth the number. Casts were present in 
5 of the 26 cases. 
Even with the increased experience of the past year, we must 
admit, as we did in the last report, that there is still great 
uncertainty with regard to the clinical significance of albu- 
minuria. 
In view of the fact that 4 of the number have died, and that 
the general appearance of the majority of those who have been 
under observation for more than one year is gradually deteri- 
orating, I am led to believe that albuminuria should be 
regarded as of grave significance. In some cases, however, it 
may be of slight importance, and further research may pos- 
sibly enable us to discriminate between them. With this 
object in view I propose a continuation of this investigation 
-during the ensuing year. 
JOHN MUNN, M. D., 
Medical Examiner. 
126 SPECIAL REPORT 
ON THE 
Mortality of Rejected Risks. 
From the first of .January, 1871, to the first of January, 
1878, this Company refused insurance on 2,200 individuals. 
During the summer of 1879 an investigation was begun for 
the purpose of ascertaining how many of these individuals 
were at that time still alive, and w'hat was their condition of 
health. After considerable labor, involving a very extensive 
correspondence with physicians, postmasters, and others, on 
the part of the officers and clerks here at the home office, and 
a great deal of unremunerated work on the part of our agents 
and many of our medical examiners in different parts of the 
country, we ascertained that out of the 2,200 individuals 
rejected 172 had died,, and 1,773 were sti11 alive- tlie 
remaining 255 individuals we found it impossible to ascertain 
any information. In estimating, therefore, the mortality of 
our rejected risks we have been obliged to disregard wholly 
these 255 lives. If the unstable character of a large proportion 
127 of the population be taken into consideration, and if it be 
remembered that at least half of our letters of inquiry were 
directed to individuals who had not the slightest interest in our 
researches, I think we may justly congratulate ourselves on 
having been able to learn the subsequent life history of so 
many (88 per cent.) of our rejected risks. 
On examination I find that these 1,945 rejections maybe 
divided into two great classes : One containing 1,369 individuals 
who had been examined by physicians outside of the Home 
Office, and recommended for insurance; and a second con- 
taining 576 individuals who had been examined (partly 
by the medical officers at the Home Office, and partly 
by the Company’s Medical Examiners . outside of the City 
of New York) and not recommended for insurance. For 
the sake of convenience I will designate the first class 
or division by the term, “Home Office Rejections,” and 
the second by that of “Not Recommended Risks.” The 
results of our investigations into the mortality and present 
physicial condition of these two main divisions are set forth in 
the following tables, which have kindly been prepared for me 
by the Actuary of the Company. 
128 TABLE I. 
Division I. 
Home Office Rejections. 
Division II. 
Not Recommended Risks. 
1.369 
6,758-5 
576 
2,472 
Years of exposure 
Years of exposure 
Average exposure 
Number now living 
oh years 
1,261 
Average exposure 
Number now .living. ... 
4yV years 
512 
Expected deaths 
77-4 
Expected deaths 
27.9 
Actual deaths 
108 
Actual deaths 
64 
Total lives exposed 1,945 
Total years of exposure 9,230.5 
Average exposure 4T years. 
Number now living 1,773 
Expected deaths 105.3 
Actual deaths 172 
Ratio of actual deaths to expected—Home Office 1.3S 
“ “ “ Not Recommended Risks 2.30 
“ “ “ on both divisions combined 1.63 
Condition of Health of Those Now Living. 
Alive and well 1,229 
Health somewhat impaired 170 
In poor health 149 
State of health unknown 225 
129 Of the 172 deaths known to have occurred among these 
1,945 risks, 75, or 43*4 per cent, were due to consumption. 
In 36 instances (7. e., in nearly 21 per cent, of the entire 
number of deaths) we failed to ascertain the cause of death. 
Undoubtedly many of these deaths also were due to consump- 
tion. The statement may, therefore, be made that not far 
from half of the entire number of deaths experienced among 
our rejected risks were due to consumption. According to an 
investigation which I made in 1873, and which was based on 
1,000 deaths, the mortality from consumption, experienced by 
this Company, represented 27 per cent, of the entire mor- 
tality from all causes. As will be observed, this already exces- 
sive preponderance of deaths from consumption is far exceeded 
by that experienced among the deaths belonging to the class of 
rejected risks. 
With regard to the other causes of death, the following 
table may be consulted : 
130 TABLE IT. 
Causes of Death Classified. 
Class of Diseases. 
No. of Deaths. 
Zymotic diseases 
7 
Acute bronchial and pulmonary affections 
4 
Casual i ties 
4 
Consumption 
75 
Brain diseases, apoplexy, etc 
19 
Heart diseases 
Q 
Various other diseases (chiefly chronic), and intemperance 
18 
Unknown causes 
36 
Or if we compare this table with that based upon 1,000 con- 
secutive deaths experienced by the Company, we shall obtain 
the following percentages for each of the different classes of 
disease. 
131 TABLE III. 
Percentage of 
entire Mortality. 
Causes of Death. 
In 1,000 
Deaths of 
Insured 
Individuals 
In 172 
. Deaths of 
Rejected 
Risks. 
Zymotic diseases 
20% 
4% 
9% 
Brain diseases (apopl., paral., &c.) 
HX°o 
Heart diseases, aneurism, &c 
Consumption 
43^% 
Various other diseases, partly acute, partly chronic. 
i°/2% 
Casualties, assassination, &c 
Unknown causes 
20A% 
An examination of the causes of rejection in the class of risks 
we are now considering, shows that they are susceptible of being 
divided into six classes, as follows : 
132 I. —Personal predisposition to consumption. 
II. —Inherited predisposition to consumption. 
III. —Functional and organic affections of the organs of cir- 
culation of the blood. 
IV. —Plabits (excessive eating, drinking, or tobacco smok- 
ing), 
V. —Occupation (dangerous or unhealthy). 
VI. —Miscellaneous reasons (frequent attacks of illness, pre- 
disposition to inflammatory rheumatism, existing fistula in 
ano, marked disproportion between height and weight, thmors 
of a suspicious nature, enlarged liver, albuminuria, amount of 
insurance on applicant’s life excessive, etc.). 
Class I. 
Personal Predisposition to Consumption. 
This class may be subdivided into the following five sub-, 
ordinate classes : 
• i. “Subject to cough.” 
2. “ Subject to asthma/’ 
3. “ Previous attacks of bronchial or pulmonary disease.” 
4. “Spitting of blood” at some previous period. 
5. “Lungs not sound,” as ascertained by auscultation or 
percussion. 
133 TABLE IV. 
Home Office. 
Subdivision. 
Lives 
| Exposed. 
Now 
Living. 
Expected 
Deaths. 
Hi 
1 s 
i. Subject to cough 
10 
9 
■5°9 
1 
2. Subject to asthma 
32 
30 
CO 
CO 
2 
3. Previous pulmonary disease 
3i 
28 
1.638 
3 
4. Spitting of blood 
83 
73 
4.407 
10 
5. Lungs not Sound 
57 
48 
2.622 
9 
Totals ... 
213 
188 
hi 
25 
Subdivision. 
Lives 
Exposed". 
Now 
Living. 
Expected 
Deaths. 
Actual 
Deaths. 
i. Subject to cough 
J 
1 
.072 
2 
2. Subj’ect to asthma 
4 
2 
.105 
2 
3. Previous pulmonary disease 
I 
O 
.Ol6 
. 
I 
4. Spitting of blood 
23 
21 
.897 
2 
5. Lungs not sound 
185 
153 
7.300 
32 
Totals 
2l6 
177 
8.4 
39 
Not Recommended. 
134 CONTINUATION OF TABLE IV. 
Home Office. 
Not Recommended. 
Lives exposed 
213 
216 
Years of exposure . . 
1002.5 
Years of exposure 
S24.5 
Average exposure 
4io yrs- 
Average exposure 
310 yrs 
Number now living. .. 
188 
Number now living 
177 
Expected deaths 
1I.057 
8.390 
Actual deaths 
25 
39 
Total lives exposed 429 
Total years of exposure 1,827 
Average exposure 4,30 years. 
Number now living 365 
Expected deaths. 19.447 
Actual deaths .64 
Ratio of actual deaths to expected, II. O 2.25 
“ “ “ N. R 4.62 
“ “ “ on the whole class 3.27 
Present state of Health of those 
SUBDIVISON. 
Totals. 
Living. 
I. 
2. 
3- 
4- 
5- 
In good health 1 
7 
17 
i5 
70 
”5 
224 
Health somewhat impaired 
8 
6 
9 
26 
49 
In poor health 
2 
5 
2 
9 
14 
32 
State of health not ascertained 
2 
2 
5 
5 
46 
60 
135 The causes of death in the 64 deaths belonging to this class 
may be divided as follows : 
Consumption 41 
(64.6 per cent, of the total mortality of this class.) 
Pneumonia 2 
Heart disease, apoplexy, liver complaint, accidental 
injuries, each one • 4 
Causes not ascertained 17 
Total 64 
Sudivision 4 is made up of risks rejected on account 
of spitting blood. The ratio of Actual to Expected 
mortality in this subdivision is 2.26 
Ratio of Actual to Expected, as shown in an inves- 
tigation made among accepted risks in 1872 .... 1.79 
Class II. 
Inherited predisposition to Consumption. 
This class may be subdivided into ten subdivisions, in 
accordance with the degree of taint found in the family history. 
These subdivisions are the following : 
1. Both parents consumptive. 
2. Mother and two or more brothers or sisters consumptive. 
3. Father and two or more brothers or sisters consumptive. 
4. Mother and one brother or sister consumptive. 
5. Father and one brother or sister consumptive. 
6. Mother consumptive. 
7. Father consumptive. 
8. Two, or more brothers or sisters consumptive. 
9. One brother or sister consumptive. 
10. Family history doubtful. 
136 TABLE V. 
Total lives exposed 470 
Total years of exposure 2,324 
Average exposure 5 years. 
Number now living 451 
Expected deaths 22 89 
Actual deaths 19 
Ratio of actual deaths to expected , .83 
Ratio of actual to expected deaths, as shown in an 
investigation made among accepted risks in 1872. 82 
137 Present State of Health of those Living. 
Subdivision. 
i 
2 
3 
4. 
5 
6 
7 
8 
9 
IO 
T otals. 
In good health 
14 
11 
6 
37 
l6 
89 
59 
38 
27 
72 
349 
Health somewhat impaired 
3 
2 
3 
3 
*3 
8 
I 
3 
3 
39 
In poor health ... — 
I 
I 
5 
I 
5 
2 
‘2 
2 
7 
26 
State of health not ascer- 
tained 
2 
2 
2 
I 
14 
7 
2 
2 
5 
37 
The causes of death in these 19 deaths are the following : 
Consumption 12 
(63.16 per cent, of total mortality .of this class.) 
Diphtheria, cerebro-spinal meningitis, dropsy and 
paralysis, each one 4 
Accidental injuries 2 
Causes not ascertained 1 
Total 19 
In order to compare the results in this class with the results 
of the investigation of accepted risks made in 1872, we must 
make a new arrangement of subdivisions, as follows : 
1. Both parents consumptive. 
2. Father consumptive. 
3. Mother consumptive. 
4. Father and one or more brothers or sisters consumptive. 
5. Mother and one or more brothers or sisters consumptive. 
6. One or more brothers or sisters consumptive. 
138 TABLE VI. 
* Inquiry of 1872. 
Functional and 'organic affections of the organs of circulation of 
the blood. 
Class III 
This class is susceptible of being divided into two groups, 
one composed of individuals affected with organic disease of the 
heart (enlargement, valvular defects, or suspected fatty de- 
generation), 'and a second composed of those in whom the 
heart derangement seemed to be purely functional (attacks of 
palpitation, and rapid, intermittent, or unsteady action of the 
-organ). 
139 TABLE VII. 
Subdivision i.—(Organic Affections.) 
Lives 
Exposed. 
1 
Now Living. 
Expected 
Deaths. 
Actual Deaths. 
I 12 . 
IOO 
6-374 
12. 
Subdivision 2. 
(Functional Derangements). 
Lives 
1 
ON 
Exposed. 
4s- 
Ln 
Now 
Living. 
o 
PI 
o 
tO 
Expected 
*r] 
ON 
VO 
to 
Deaths. 
O 
PI 
Actual 
Deaths. 
t_n 
Lives 
Ln 
Exposed. 
o 
Now 
H 
Living. 
P3 
g 
2 
j K> 
. Expected 
1 O 
oo 
Deaths. 
X 
o 
PI 
« 
Actual 
Deaths. 
Total lives exposed 213 
Total years of exposure 996.5 
Average exposure years. 
Number now living ipp 
Expected deaths 12.046 
Actual deaths 14 
Ratio of actual deaths to expected —Subdivision 1 1.88 
“ “ “ Subdivision 2. 
H.O.. .37 
N. R.. .33 
Ratio of actual deaths to expected on the whole of Sub- 
division 2 25 
Ratio of actual deaths to expected on both Subdivisions .. i. 16 
140 Present State of Health of Those Living, 
Subdivision. 
i 
2 
Totals. 
In good health1 
68 
69 
137 
Health somewhat impaired 
6 
11 
17 
In poor health 
7 
9 
16 
State of health not ascertained... 
r9 
10 
29 
The causes of the 14 deaths that occurred in this class are as follows : 
Heart disease 4 (two in each 
subdivision). 
Paralysis 1 
Disease of bowels 1 
Consumption 2 
Dropsy I 
Unknown causes 5 
Total 14 
141 Class IV. 
HABITS; 
{Excessive Eating, Drinking or Tobacco Smoking.) 
TABLE VIII. 
Home Office 
Not Recommended. 
Lives 
Exposed. 
Now 
Living. 
Expected 
Deaths. 
Actual 
Deaths. 
Lives 
Exposed. 
Now 
Living. 
Expected 
Deaths. 
Actual 
Deaths. 
118 
102 
7.197 
16 
3° 
26 
1.790 
4 
Lives exposed 
Years of exposure....... 
Average exposure ' 
Number now living 
Expected deaths........ 
Actual deaths 
n8 
584.5 
5t'u years- 
102 
7.197 
16 
Lives exposed 
Years of exposure 
Average exposure 
Number now living. . .. 
Expected deaths 
Actual de aths 
30 
144 
4t8ct years. 
26 
1.790 
4 
Total lives exposed 148 
Total years of exposure 728.5 
Average exposure 5 years. 
Number now living 128 
Expected deaths 8.987 
Actual deaths 20 
Ratio of actual deaths to expected—H. O 2.22 
“ “ N. R 2.23 
■“ “ “ on the whole class 2.23 
142 Present State of Health of Those Living. 
In good health 7S 
Plealth somewhat impaired 8 
In poor health 22 
State of health not ascertained 20 
Of the 20 deaths that occurred in this class, the causes are as follows t 
Intemperance 3 
Consumption 2 
Apoplexy 1 
Suicide 1 
Congestion of lungs 1 
Pneumonia 1 
Dropsy of chest I 
Accidental injuries 1 
Unknown causes g 
Total 20- 
Class V. 
OCCUPATION. 
Total .ives exposed 80 
Total years of exposure 374.5 
Average exposure years- 
Number now living 76 
Expected deaths 3.930 
Actual deaths 4 
Ratio of actual deaths to expected 1.06 
TABLE IX,. 
143 Present State of Health of those Living. 
In good health 59 
Health somewhat impaired 4 
I11 poor health 4 
State of health not ascertained 9 
In this class there were four deaths, one from Bright’s 
disease, one from “fever,” one from diphtheria, and one from 
some cause not ascertained. 
Class VI. 
Miscellaneous Causes of Rejection. 
TABLE X. 
Home Office. 
Not Recommended. 
Lives 
Exposed. 
Now 
Living. 
Expected 
Deaths. 
Actual 
Deaths. 
Lives 
Exposed. 
> tn 
0 .£ 
Expected 
Deaths. 
Actual 
Deaths. 
47S 436 3io58 
42 
127 
118 
6.729 
9 
Lives exDOsed 
127 
Years of exposure 
2397-5 
Years of 
exposure. 
572.5 
Average exposure 
5 yrs- 
Average exposure. 
4x50yrs- 
Number now living 
436 
Number now living 
118 
Expected deaths 
3* •1 
Expected deaths. . 
6.7 
42 
9 
144 Total lives exposed 605 
Total years of exposure 2,970 
Average exposure years. 
Number now living 554 
Expected deaths 37.787 
Actual deaths 51 
Ratio of actual deaths to expected, H. 0 1.36 
“ “ “ N. R 1.35 
“ “ “ on the whole class.... 1.35 
Present State of IIealth of those Living. 
In good health 381 
Health somewhat impaired 53 
In poor health 49 
State of health not ascertained 71 
The 51 deaths occurring in this class were due to the follow- 
ing causes : 
Consumption 18 
Apoplexy, brain disease, &c 9 
Heart disease 4 
“ Dropsy ” 2 
“Fever” 2 
Miscellaneous causes 7 
Not ascertained 9 
Total 51 
145 The results of the preceding investigation may be briefly 
summarized as follows : 
In the first place, these rejected lives, taken as a whole, have 
turned out, after an exposure of less than five years, to be de- 
cidedly poor risks ; the mortality among them being 63 per cent, 
higher than that which the tables call for. But the poor 
quality of these risks is shown not merely by the excessive 
mortality thus far experienced, but also by the promise of a 
continued excessive death-rate in the future, as shown by the 
large number of individuals either in poor health (149), or in 
health which may be designated as “somewhat impaired ” (170). 
In the next place, if we compare the six different groups 
into which these rejected risks have been divided, we shall find 
that the heaviest mortality has been experienced among those 
who were believed to possess a personal or acquired predis- 
position to consumption; the mortality in this class being 
3i2oV hmes as great as that called for by the tables. 
The next largest mortality has been experienced among those 
individuals who were believed to be intemperate in their habits ; 
the rate being 212030 times greater than that of the tables. 
With regard to the remaining classes there are but two or 
three points to which I desire to call attention. In Class III., 
the heavy mortality experienced among those who were believed 
to be suffering from some organic affection of the heart, con- 
trasts strongly with the unusually small mortality experienced 
among those who manifested evidences of merely a functional 
146 disturbance of this organ. The contrast is almost as marked 
between Classes I. and II. (Personal and inherited predisposi- 
tion to consumption). Were it not for the small number of 
individuals comprised in Classes II. and III., I should feel as 
if we might safely attach less importance than we do to the 
value of “functional disturbances of the heart” and “family 
history,” in estimating the probable longevity of any individual 
risk. It is interesting to note in this connection that an inquiry 
made in 1872 (see annual report of 1873), for the purpose of 
determining the mortality experienced by the company among 
policy-holders who were believed to possess an inherited pre- 
disposition to consumption, also revealed a death-rate lower 
than that called for by the tables,-viz., about -j8020- of the same. 
, Respectfully submitted by 
ALBERT H. BUCK, M. D. 
147 I N D E X. 
Page 
Age, average, at death, in cases of heart disease. . . 9 
Albumen, tests for, ...... 102 
Albuminuria in persons apparently healthy, . 1 or, 109, 117 
Albuminuria, significance of, . . . . . 106 
Alcohol, influence of, upon longevity, ... 74 
Aneurism, deaths from, ...... 10 
Brain and nervous system, mortality from diseases of, 12, 13 
Brain diseases, average ages at death from, . . 14 
Brain diseases, hereditary predisposition to, . 15 
Brain diseases, mortality from, ..... 6 
Brain diseases, mortality from, in rheumatic risks, 43 
Brain diseases, relations of height to weight in cases of. . 15 
Circulatory organs, functional disturbances of, . . 139 
Coffee and tea, influence of, upon longevity, 77 
Consumption, hereditary character of, 22 
Consumption in the family history, . . . . 30 
Consumption, inherited predisposition to, 136 
Consumption, mortality from, . . . . 6, 18 
Consumption, mortality from, in different years, 19 
Consumption, personal predisposition to,-. . . 133 
149 Page 
Continuous fevers, mortality from, .... 17 
Delirium tremens, mortality from, . . . 12, 13 
Family history, importance of in selection of lives, . 23, .147 
Habits, influence of upon longevity, . . . . 142 
Heart diseases, mortality from, . . . . 7, 8 
Heart diseases, mortality from, in rheumatic risks, . 43 
Height to weight, relations of, ... 7 
Height to weight, relations of, in individuals who after- 
ward became consumptive, . . . . 25 
Heights and weights, American standard of, . . 49 
Hereditary predisposition to brain diseases . 15 
Longevity, study of, . . . . 65 
Lung diseases, mortality from, .... 6 
Lungs, acute diseases of, . . . . . 11 
Mortality among rejected risks, . . . . 127 
Nervous system, mortality from diseases of, . . 12, 13 
Occupation, influence of, upon longevity,. . . 143 
Old men, life history of, . . 65 
Overweights, . . . . . 51, 52 
Overweights, causes of death among, . . 57 
Overweights, consumption among, . . . . 58, 59 
Ratio of actual to expected mortality in persons having a 
consumptive family history, .... 35 
Rejected risks, mortality among, . . 127 
Rheumatic risks, mortality of, .... 39 
Rheumatism, relation of to consumption, . 26 
Rheumatism, relation of to heart disease, . 9 
150 Page 
Septuagenarians, . . . . . . . 65 
Septuagenarians, habits of, with regard to use of alcohol, 74 
Spitting of blood, ....... 27 
Spitting of blood risks, mortality of, .... 34 
Suicide, mortality from, . . . . 12, 13 
Suicides, ages of, at death, . . . . „ 16 
Suicides, classification of, .... 16 
Thermometer, employment of, in examinations for life 
insurance, ....... 64 
Typhoid fever, mortality from, . . . . . 17 
Underweights, . . . . . . 51, 54 
Underweights, causes of death among, . . . 57 
Underweights, consumption among, . . .58, 59 
Urine examinations in life insurance, .... 05 
Urine, proper manner of testing it chemically, . 102 
Yellow fever, mortality from, . . . . . 16 
Zymotic diseases, mortality from, . . . . 6, 16 
151 UWESr/fiw 
_ % 
-o I N *- 
' 
JNSUR^^ 
United States Life Insurance 
Company 
IN THE CITY OF NEW YORK.