The Republican. [volume] (Oakland, Md.) 1877-current, 1890-03-08
WHEN DEATH OCCURS,
The Night Hours Not Quite SO Fatal as
the Day.

Inc NIgnC Hours MOI quite SO tatal as
the Day.
A very general opinion is entertained
by medical practitioners and others en-
gagged in caring for the sick that the
greatest number of deaths occurring in
individuals afflicted with disease takes
place during the hours Immediately
succeeding midnight and preceding the
dawn. This opinion most probably origi-
mates in part from imperfect observa-
ton, and partly from misapplication
of the physiological law governing the
lowest period of vitality in the healthy
individual. The rule is said to be par
ticularly true in those suffering from
chronic exhausting diseases, and deduc-
| lions have been made from these i'm
pressions which have served to regulate
the administration of stimulants in such
cases, it being said, "if six ounces of
whisky be needed in twenty-four hours,
four should be administered from two to
six a. M, for then is vitality in the
human being at its lowest" and more
deaths occur at these hours than at any
other period" Such expressions may
be found scattered through works on
materia medica and therapeutics, and
in many of the textbooks, on the prac-
tice Of medicine. The idea finds ex-
preston also in the lectures of teachers
in our colleges, and usually leaves
well-gounded impression on the
mind of the medical student, which
is apt to remain permanent one.
l accepted this teaching at college,
because had neither the means nor the
time to verify or disprove it to my own
satisfaction. Yet always doubted the
correctness of the conclusions drawn,
and, to settle the doubts in my mind,
since entering on my duties at the hos
pital, have collected statistics, which
/ find do not agree with this generally
accepted idea. There are many circum-
stances that should greatly tend to in
crease the death rate at night in large
hospital, principal among which is the
vitiation of the atmosphere during this
period. During the night all the pa
tients are confined TO the ward, and
ventilation is apt to be neglected. This
must certainly have depressing effect
on those suffering with pulmonary af-
fections, and on those in whom disease
has effected extensive alterations in the
physical and chemical characters of the
blood. This alone should greatly tend
to increase the number of deaths at
night, and, if there was any truth in the
accepted notion, the records should show
quite a preponderance of deaths hap
pening at night.
The contrary u.s. however, the rule, the
figures showing twenty-seven fewer
cases during the hours from six p. m. to
six a. m. than for the corresponding
twelve hours of the day. Again, from
two to six p. m. there were siXty-six
more deaths than from two to six a. m.
The total number of deaths in the list
of acute diseases for the twelve hours
from six p. m. to six a. m. is 1859 less
than for the corresponding period during
the day. The hours from two to six
p. m. in this list show fifty-three cases
more than for the corresponding period
in the morning; this in nearly 1000
cases is very slight. In the chronic
cases the greatest number of deaths at
any one hour was at four p. M, with
two and five p. m. and six a. m. closely
following. The greatest in the acute
list was at three a. m, with eleven a. m.
and p. m. closely following. The lowest
number in the acute list was at twelve
m. (midnight), that hour so dreaded in
the sick room by attendants, and to
which a good deal of superstition at
taches 1t is noticeable that the num-
Der for this hour is exceedingly low
| Oh ho1f Of+ lo In
the chronic cases the lowest number APP
pears at nine a. m.
From these $4,000 cases extending
over period of twelve years, it would
appear that death occurs seemingly
without any particular prediction for
any certain hour, and that the number
of deaths for each hour is very evenly
proportioned, considering the large num-
Der of cases taken and the time covered.
The only very positive conclusion
have formed from the figures are:
l. That the idea that more deaths take
place in the early morning hours is an
erroneous one. 2. If stimulants are to
be pursued in disease during these
hours the practice must be justified
upon some other ground than to avert
the possibility of danger supposed to be
very probable at this period. 3. That
the vitality of an individual disease is
not regulated by the same influences or
subject to the same laws that govern
the vitality of healthy human being,
the normal equilibrium maintained in
health between the mental and physical
states being altered.-Dr. j. b. Burns,
in N. Y. Medical Journal.
PAY OF LEGISLATORS.