The Democratic press. [volume] (Ravenna, O. [Ohio]) 1868-1901, 1890-07-16
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WHEN DEATH OCCURS,

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 Immediately sue
ceeding midnight and preceding the
dawn. says DR.. John Burns in the n. Y.
Medical Journal. This opinion most
probably originates in part from i'm
perfect 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 particularly true in those
diseases, and many deductions have
been made from these impressions
which have served to regulate the adj
ministratiOn of stimulants in such cases,
it being said If six ounces of whisky
be needed in twenty-four hours four
should be administered from 2 to a.
being at its lowest" and more deaths
occur at these hours than at any other
period" Such expressions NAV be
found scattered through works on
materia medica and therapeutics, and
practice of medicine. The idea finds
expression also in the lectures in our
colleges, and usually leaves we'll
grounded impression on the mind Of
the medical student, which is apt to
remain a permanent one. Iaccept this
teaching at college, because l had
neither the means nor the time to
verify or disprove it to my own salts
faction. 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 statistics,
which l find do not agree with this
generally accepted idea. There are
many circumstances that should greatly
tend to increase the death rate at night
in a large hospital, principal among
which is the great vitiation of the at
mosphere 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 very depressing effect on those
suffering with pulmonary affections,
and on those in whom disease has
effected extensive alterations in the
physical and chemical character 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 preponderance of deaths
happening at night.
The contrary is, however, the rule
the figures showing twenty-seven fewer
cases during the hours from p. m. to
a. m. than for the corresponding
twelve hours of the day. Again, from
to 6 p. N. there were sixty-six more
deaths than from to 6 a. M. The
total number of deaths in the list of
acute diseases for the twelve hours from
p. N. to a. m. is 169 less than for
the corresponding period during the
day. The hours from to 6 p. m. in
this list show fifty-three cases more
than for the corresponding period in
the afternoon; this in nearly 4, 900 cases
is very slight. In the chronic cases the
greatest number of deaths at any hour
was at i p. H., with 2 and p. m. and
a. NJ. closely following. The lowest
number in the acute lists was at y m.
(midnight), that hour so dreaded in the
sick-room by attendants. 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
cases the lowest number appears at 9
a. m.
From these 1900 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
number of eases taken and the time
covered. The only very positive con-
clusions I have formed from the figures
are: 1. That the idea that more deaths
take place in the early morning hours
is an erroneous one. 2. If stimulants
are to be pushed in disease during
these hours the practice must be justi-
fed upon some other ground than to
avert the possibility of danger sup
posed to be very probable at this period,
3. That the vitality of an individual
disease is not regulated by the same in
fuences 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 al.
| tered.