Richmond dispatch. [volume] (Richmond, Va.) 1884-1903, 1890-01-18
WHEN DEATH oFTeNEsT OCCURS.
The Night Hours Not So Fatal rs the Day
IDr. John Francis Burns. IN tho yev York hedi-
cal Journal

III "N1H - ~ thD @soF
cal Journal
A very general opinion ia entertained
by medical practitioners and others en-.
gagged in caring for the sick that
the greatest number of deaths occur
ring IN individuals afflicted with dis
ease takes place during the hours
Immediately succeeding midnight and
preceding the dawn. This opinion most
probably originates IN part from imperfect
observation and partly from misapplica-
ton Of the physiological law governing
the lowest period of vitality in the healthy
individual. The rule is said to be
particularly true in those suffering from
chronic exhausting diseases. and deduc-
tiops have been made from these impress
sioDs which have served To regulate the adj
ministration of stimulants in such cases,
il being said, IF six ounces of whiskey De
needed in twenty-four hours. four should
be administered from to A. NJ, for then
is vitality in the human being 81 us
lowest" and more deaths occur at these
hours than at any other period" Such ex-
pressions may be found scattered through
works on inateria meGica and therapeutics,
and in many of the textbooks on the
practice of medicine. The idea find!
expression also in the lectures or
teachers in our colleges, and usually
leaves well-grounded impression on
the minds of the medical student, which
is apt TO remain permanent one. &C
cepted this teaching at college because
had neither the means nor the time 70 veri-
fy or disproye it to my own satisfaction.
Yeti always doubted the CORRECTNESS OF me
conclusions drawn, and. 20 settle the
doubt in my mind, since entering on my
duties nj the hospital have collected STA
tistics. which | find do not agree with TIPS
generally-accepted idea. There are many
Circumstances that should greatly tend to
increase the death-rate at night in large
hospital. principal among which Is the
rreat yitiatiOn OF the atmosphere during
this period. During the night all the pa
tents are confined 30 the ward, and ven
tilation IS apt 10 be neglected. This must
certainly have very depressing effect
on those suffering with pulmonary alice
tions. and on those in whom disease has
effected extensive alterations IN tue physi-
cal and chemical characters of the blood.
This alone should greatly tend TO increase
the number OF deaths at night, and II
there was any truth in the accepted notion
the records should show quite prepon-
derance of deaths happening al night.
The contrary is, however, the rule, the
figures showing twenty-Seyen fewer cases
during the hours from =. NJ. to A. NJ.
than for the corresponding twelve hours OF
the dav. Again, from 2 TO L. NJ. there
were sixtv-six more deaths than from 70
GA. u. The total number of deaths IN the
list of acute diseases for the twelve hours
from Z. VI. to A. NJ. is 1863 less than for
the corresponding period during the day.
The hours from 10 A. NJ. IN tins llsb
show hfty-three cases more than Tor the
corresponding period in the afternoon
this in nearly 1900 cases Is very slight.
In the chronic cases tho greatest nuinoer
of deaths at any one hour was ut I. NJ,
II nI ! A. 81 Isf fgl
lowing Tho greatest in the acute list was
AZ 3 A. NJ. with IL A. VI. and p NJ. closely
following. The lowest number in the acute
list was at ~ NJ. (midnightl. that hour SO
dreaded in the sick-roOm by attendants,
and TO which GOOD deal Of superstition
attaches. 1t il noticeable that the number
for this hour is exceeding lOw-abOut half
of the average number. In the chronic
cases the lowest number appears at A. NJ.
From these 1900 cases, extending over
period of twelve years. 1t 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 cases
taken and time covered. The only very
positive conclusions | have formed
from the figures are: /. That the idea
that more deaths take place IN the
early morning hours Is an crrOneou5
one ?. If the stimulants are 10 be pushed
IN disease during these hours the practice
must be justified upon some other ground
than to avert the possibility of danger
supposed - be very probable at this pc
rod. 3. That the vitality Of an individual
in disease is not regulated 10y the Same
Influences or subject TO the same laws that
govern the vitality Of healthy human be-
ing. the normal equilibrium maintained IN
health between the mental and physical
states being altered.