Evening star. [volume] (Washington, D.C.) 1854-1972, 1890-01-20
THE LAST GREAT CHANGE.
The Hour at Which Death Most Usually
Occurs.

From the New York Medical Journal
A very general opinion is entertained by
medical practitioners and others engaged in
! caring for the sick that the greatest number of
| deaths occurring in individuals afflicted with
disease takes place during the hours immedi-
ately succeeding midnight and preceding the
dawn. This opinion most probably originates
in part from imperfect observation 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
ticulariy true in those suffering from chronic
exhausting diseases, and deductions have been
drawn from these impressions which have
served to regulate the administration of stimu-
lants in such cases, it being said .if six ounces
OF whisky be needed in twenty-four hours: four
should be administered from 2 to 6 a. m, for
then is vitality in the human being at its low
est and more deaths occur then than at any
other period"
Such expressions may be found scattered
through works on materia medica and ,thera-
peutlcs and in many of the text books on the
practice Of medicine. The idea finds express
sion also IN the lectures OF teachers in our col
1eges and usually leaves a ii-grounded i'm
preston on the mind of the medical student,
which is apt to remain a permanent one 1
accepted this teaching at college because had
neither the means nor the time to verify or dis
prove it to my own satisfaction. Yet ALWAYS
doubted the correctness Of the conclusions
drawn and, to settle the doubt in my mind
since entering on my duties at the hospital /
have collected the statistics given below which
find do not agree with this generally accepted
idea. Thinking that they may interest others,
and that the small mistakes in a subject are
sometimes and to certain people as important
as the greater, present them.
The statistics are taken from the records of
the charity hospital on the one hand and from
the books OF the New York board Of health on
the other. The former are mainly of deaths
occurring in those afflicted with chronic ex-
hausting diseases; the latter, in those dying
from the acute exanthemata. The former rep
resents all the deaths at the hospital for q
period OF nearly ten years, irrespective of sex,
age, disease or condition; the latter, all the
deaths occurring In the city and county of New
York from the acute contagious diseases. At
the hospital the records of death are kept with
great care, and 1 am sure can be taken as a fair
test. have no doubt that the health authori-
ties records are also accurate, bat they are the
result of individual reporters, so that they are
not so reliable as those OF the hospitals There
are many circumstances that should greatly
tend to increase the death rate at night in a
large public hospital, principal among which
Is the great vitiation of the atmosphere during
this period During the night all the patients
are confined to the ward and ventilation is apt
to be neglected. This must certainly have a
very depressing effect on those suffering with
pulmonary affection and on those in whom
disease has effected extensive alterations in the
physical and chemical characters of the blood.
his 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
happening at night. The contrary is, however,
the rule, the figures showing n cases fewer
from I'm. to am than for the correspond
twelve nf ha 6ay
Again, from to Pm. there we're no more
deaths than from to am. The total number
OF deaths In the list of acute diseases for twelve
hours from pm. to a. m. is 1863 less than for
the corresponding period during the day. The
hours from 2 to am. in this list show SO cases
more than for the corresponding period in the
afternoon; this in nearly 1000 cases is very
shght In the chronic cases the greatest num-
Der OF deaths at any one hour was at D. M,
with and pm. and am. close following;
the greatest in the acute list at a. M. with III
am. and pm. close following. The lowest
number in the acute list at IL IN. (midnight),
that hour so dreaded in the sick room by at
PENDANTS. and to which a good deal of
superstition attaches. 1t is noticeable that
the number for this hour is exceedingly
low-about half of the average number.
In the chronic diseases the lowest num-
Der appears at am. In the chronic cases the
number dying from 8 am. to IL m. (noon)
seems relatively low compared with the same
period In the acute list. | have used all the
figures available at the hospital and | only
stopped when the death books available were
exhausted l only sought the health boards
statistics for the purpose Of comparison and,
as the figures run up quickly, thought two
records would serve as well as longer period.
In making the collections noticed that the
figures did not vary essentially throughout.
There was always preponderance of deaths in
favor OF the hours of the day, while the indi-
vidual hours would vary by comparison at diff
ferent periods.
Deaths occurring at Charity hospital, Blackwels Is.
II Inv houra