It is well known that while in England, and in most other old countries, there is an excess of females in the adult population, at birth there is an excess of males nearly everywhere. 1 There are more boys than 1 There is considerable reason to conclude that the same holds true of at all events a large number of the lower animals; see, for example, Darwin, Descent of 'Man, Part II., chap. viii.
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girls born among the Germans, French, English, and the other most civilised European races; there are equally more boys than girls born among the Ved- dahs of Ceylon, one of the lowest of human races. 1 According to a Report, prepared for the Italian Government in 1884, the proportion of male births to 100 female births is in various countries as follows: — Russian Poland IOI Sweden.
England and Ireland Denmark France.
European Russia.
Scotland.
Vermont.
Prussia.
Rhode Island.
Bavaria.
Italy Saxony.
Ireland.
Thuringia Austria.
Wurtemberg.
Croatia.
Baden Norway.
German Empire Servia Alsace-Lorraine Massachusetts Hungary.
Spain Switzerland Connecticut.
no Belgium.
Roumania in Holland.
Greece.
The great excess of male births in Greece is notable, and it may be added that Greece is perhaps the only European country in which males are in marked excess among the adult population; at the last census, in 1889, there were 107.6 males to 100 females. But even in Greece, after the age of 85, an excess of females in the population becomes more and more marked. Among Russian Jews it appears that no fewer than 129 boys are born to every 100 girls. 2 Among Jews everywhere the male birth-rate is higher than among Christians. It is also note- worthy that the proportion of male births in England is decreasing; while, about forty years ago, it was 105.3 males for every 100 females, it is now 103.9. On 1 Deschamps, " Les Veddas," V Anthropologic, 1 891, No. 3. 1 Leinenberg, Int. Klin. Rundschau, 15th Sept. 1889.
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the whole the variations from year to year are not very great, as the following table, which presents the number of boys in iooo children at birth in various countries, clearly shows: — * Italy.
Scotland.
Ireland.
Saxony.
Rhode Island.
5" 5" 5" 5M It is unnecessary to accumulate figures, but it may be added that in most countries there is some differ- ence in this respect between legitimate and illegitimate births, the preponderance of boys being less among the illegitimate births than among the legitimate by 1 or 2 per cent, notwithstanding the fact that, accord- ing to Bertillon, a woman's first children are more likely to be boys than girls. 2 In England and Wales, according to the Report of the Registrar-General for 1891, if we take the births for thirty years as a basis, the proportion of male infants to 1000 female infants varies from 1032 to 1033 in some counties to 1055, 1056, and 1058 in others. He adds some suggestions as to the possibility of the variations being due to racial difference. "It may be noticed that the registration counties with the highest proportions are Cumberland, Cornwall, and North Wales, while South Wales, though it has not the next highest proportion, comes only a little way down in the list, its proportions being 1046, and considerably above the average for the whole country...The Celtic character of the areas mentioned above as having the highest proportions of male infants suggests the idea that not impossibly race has some influence in the matter; a surmise which is not inconsistent with the fact that the pro- portions are invariably much higher both in Ireland and in Scotland than in England. 11 I question if this suggestion will bear examination.
1 Bertillon, Art. " Natality," Diet. ency. des Sci. M/d.
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If we turn to the adult population, we find usually that, in very varying degrees, there is a marked excess of women. It exists independently of emigration; and while it may be said to be excessive in most European countries (and especially in Great Britain and Sweden), in new countries it usually does not exist at all.
How are we to explain this discrepancy between the sexual proportions at birth and at adult age?
It was formerly supposed that war and the ex- posure of men in dangerous occupations were alone sufficient to account for the greater mortality of men. That they are the chief factors seems to admit of little doubt; an exact analysis does not now permit us to conclude that they are the sole factors.
War and occupation can only come in as working factors during youth and adult life; and the same may be said, on the whole, even of men's tendency to indulge in excesses, 1 which is sometimes brought in as a factor, though it is probably to a large extent a factor of organic rather than of merely accidental social character. It is during the very earliest period of life and at the latest that the greater mor- tality of males is most clearly marked. 2 Bertillon showed, many years ago, that while the proportion of living children born is ioo girls to 105 boys, the proportion of all births, living and dead, is 100 girls to 106.6 boys; the proportion of still-born children in Belgium during 1860-65 was 100 females to not less than 136 males; so that still-born children are much more frequently males than are living children. 8 Girls, 1 I do not attach much importance to this, as against it must be set the depressing influences, lack of air and nourishment, etc., under which women s lives are Frequently passed.
a The greater mortality of new-born males is found in all countries where precise statistics exist. In some countries, in Sweden, for instance, but not in England, the male mortality is greater than the female at every age. (Bertillon, Art. " Mortality," p. 762, Diet. ency. des Sei. Mid.
8 Bertillon, Art. " Mort-ne\" Diet. ency. des Sei. Mid.
Google NATALITY AND MORTALITY. 377 owing to their smaller size, possess at the outset a better chance of slipping safely into the world. For some little time after birth the same factor is operative. Collins, of the Rotunda Lying-in Hospital, Dublin, 1 showed that within half-an-hour after birth only 1 female died to 16 males; within the first hour only 2 females to 19 males, and within the first six hours only 7 females to 29 males.
The larger size of the male head can, however, only be a factor at birth, and for a short time afterwards, but there is still a greater male mortality; male children under one year of age are very liable to die, and this, as Sir G. Humphry remarks in his study of Old Age> is alone enough to suggest, though by no means to prove, that the superiority of females in this respect is not due to their comparative freedom from exposures and to their greater temperance. Dr. Longstaff also considers that the great mortality of males during the first year of life " must depend on some constitutional difference." During the first dentition male children are much more apt to die of diseases of the nervous system than female children. From the third until towards the thirty-fifth year there does not appear to be great sexual difference in mortality; this is no doubt due to the great mortality of males at the beginning of life; only the more robust out of a large number being left to compete with the smaller but apparently more vigorous females; after the development of puberty in women, from the fifteenth to the twentieth years, the female mortality is usually greater than the male; this is the period of special danger for women. After the thirtieth or thirty-fifth years there is a difference in favour of women which steadily increases. It is this superior tenacity of life which to a large extent accounts for the excess of women in this country, 1 As quoted by Braxton Hicks, " Croonian Lectures on the Differ- ences between the Sexes in regard to the Aspect and Treatment of Disease," Brit, Med. Journal, 1877.
Google 378 MAN AND WOMAN.
four-fifths of that excess consisting of widows. 1 The farther we proceed towards the extreme limit of life, and the more we are able to eliminate all but the inherent constitutional factors of vitality, the more marked is the preponderance of women. Sir G. Humphry, in his Old Age, found opportunities for the detailed study of 36 female centenarians as against only 16 males. The Registrar-General's Reports show that of those persons who at death are supposed to have died over the age of 100, only a small propor- tion are males. In England in 1891, at the age of 85 and upwards, 8291 women died to only 5320 men; between 75 and 85, it is worth noting, the excess of women is by no means so great (24,506 men to 28,785 women). According to the last census, 104 women were centenarians to 42 men. In France, from 1866 to 1885, the yearly average of deaths of cen- tenarians has been 27 men to 46 women. 8 Among the more primitive human races it is not so easy to obtain definite statistics, but it is probable that the same relation holds good as in civilisation; thus among the Nicobarese Islanders, according to Man, of those who survive the sixtieth year fully two-thirds are women. 8 It may be added that, if we take a broader zoological view, the same truth holds good; it is certainly well marked in crustaceans, rotifers, etc, among whom the female is often much longer lived than the male.
If we turn to consider the bearing on this point of the mortality from definite diseases, the impression given by a glance at the birth-rate and death-rate as a whole is confirmed. If, for instance, we take the zymotic group of infectious diseases which chiefly 1 Longstaff, Studies in Statistics, p. 8. The accompanying diagram, reproduced from the Studies by Dr. Longstaff 's permission, shows in a graphic form the sexual differences in mortality from all causes in England and Wales during the years 1 871 -8a 2 Turquan, " Statistique des Centenaires," Revue Scientifique* ist * Journal Anth. Institute, May 1889, p. 385.
Google Google 380 MAN AND WOMAN.
affect young children, we find nearly always that the advantage is on the side of the female. Whooping- cough and diphtheria only are more fatal in the female, a result which has been attributed to the smaller larynx of girls, and to their customs of frequent kissing, sharing sweets, etc Even when we take statistics which show on the whole a greater liability to in- fection in women, the mortality is not equally great Thus if we take the figures of the Metropolitan Asylums Board Hospitals during the years 1 871 -91, as given by Dr. Whitelegge, we find: — * Case Gases.
Deaths.
Mortality.
Scarlet Fever Males...»
So that even in diphtheria, if we take into account the number of individuals attacked, the mortality of females is not greater than that of males. This small fatality with considerable susceptibility is what we see in brain disease also in a marked manner; nervous disease of a slight and non-fatal character is extremely prevalent among women; nervous disease of a grave character is comparatively rare. This is probably another aspect of the affectability of women.
An analysis of the phenomena of one of the most important of the zymotic diseases, scarlet fever, brings out the characteristic sexual differences. From the Registrar-General's Reports for 1859-85 it appears that the highest mortality from scarlet fever occurs in both sexes in the third year of life, and diminishes with each successive year-period. Up to the end of 1 Whitelegge, " Milroy Lectures on Changes of Type in Epidemic Disease," Brit. Med. Journal \ March l8th, 1893.
Google NATALITY AND MORTALITY. 38 1 the tenth year of life the mortality among males con- siderably exceeds that among females, but in all sub- sequent periods the reverse is the case — i.e. % women remain nearer to children than men. On the whole, the liability of males to a fatal result is consider- ably greater than that of females. But though the attacks in males are more likely to end fatally, the female sex throughout life, with the possible exception of the first year, is more liable to be attacked by scarlet fever than the male sex. 1 Small-pox is more fatal to males than to females throughout nearly the whole of life, except during the years from ten to fifteen. Cholera attacks women more often than men, but less often fatally; during the epidemic of 1854 the mortality for males was 8.02, for females 7.78. Influenza, according to most observers, attacks women more frequently than men, but the mortality among men is much greater than among women, being as 1 to 2; children are more rarely affected, and suffer but slightly. It would be easy to show by the examination of other groups of disease that while women are frequently, as in the zymotic group, more susceptible, men usually suffer more severely.
It is an interesting fact, as pointed out by Dr. LongstafF, that recent improvements in the death- rate have on the whole benefited women more than men. In childhood and youth girls suffer more than boys from phthisis, whooping-cough, diphtheria, and heart disease, which are all diminishing in fatality. On the other hand, boys suffer more than girls from violence, kidney disease, brain disease, "all other causes," lung disease, and to a less degree from diarrhceal diseases, small-pox, measles, and scarlatina. Of these, lung and kidney disease are increasing in fatality, the rest declining; the net result being that girls gain more than boys in the proportion of 7 1 For a summary of the statistics of this disease, see Sanitary Record, 16th January 1888.
Google 382 MAN AND WOMAN to 6. During adult life it is only from cancer that women suffer more than men — the loss here being more than double — but the rate of increase in cancer is greater in males than in females. The net results show that females gain more than males in the pro- portion of 7 to 3. So in old age; the mortality of both old men and old women is increasing, but the death-rate of old men three times as fast as that of old women. "It is quite plain," Dr. Longstaff concludes, "that the recent fall in the death-rate favours the accumulation of surplus women, if one may be allowed such an expression, and should the change of mortality go on in the same direction the rate of accumulation will be increased." 1 The greater tenacity of life in women and their great constitutional youthfulness are shown also in the less frequency with which they exhibit the char- acteristic signs of old age. Baldness is rare in women; it is equally rare among the less civilised races; for example, among the Nicobarese Islanders, with whom baldness in men is not uncommon. Degenerative disease of the arteries is less common in old women than in old men. Sir G. Humphry found among his centenarians that the elasticity of the thorax, as evinced by the condition of the costal cartilages and its capacity for dilatation during inspir- ation, is better preserved in women than in mea He also found (as may, indeed, be stated to be the rule) that the arcus senilis in the eye, a very characteristic indication of old age in men, is less marked in old women. The specific gravity of the blood, also, as Lloyd Jones has found, is higher in old women than in old men. The mental derangements of old age, again, are commoner in men than in women; thus Wille finds 10 per cent, males to only 6 per cent. females. 2 There is also some reason to believe that 1 G. B. Longstaff, Studies in Statistics, pp. 248-251.
2 Ludwig Wille, Art. "Old Age and its Psychoses," Diet, of Psych. Med.
Google NATALITY AND MORTALITY. 383 old age produces relatively less loss of brain tissue in women than in men.
One other fact may be brought forward in proof of the greater tendency of men to die. The majority of sudden deaths from internal or pathological causes are in men. French statistics show a very consider- able difference in the frequency of sudden death from the sexual point of view. Devergie gives 39 cases in men to only 5 in women, a proportion of males equal to 88.7 per cent Tourdes, among 88 cases, found 59 men — i.e. t 67.3 per cent. Lacassagne, consulting the archives of the Lyons Morgue, found that from 1854 to 1880, out of 459 cases of sudden death 365 were men — i.e. f yg.6 per cent Out of 62 cases under the observation of Lacassagne, Coutagne, and P. Bernard, there were 41 men — *>., 66.1 percent We may con- clude that about three-fourths are men. It is rare among children, and commonest between the ages of 50 and 60. 1 It should be added that a greater liability to sudden death may to a considerable extent be regarded as the manifestation of a greater liability to degenerative disease of the arteries.
All the evidence brought together or referred to in this chapter points, with varying degrees of certainty, to the same conclusion — the greater physical frailty of men, the greater tenacity of life in women. 2 Although this conclusion may not be altogether in harmony with the popular notion, it is in harmony with many other groups of facts, some of which are elsewhere dealt with in this book. It is in harmony also with the impression that we obtain on glancing across the zoological field. The female is the mother of the new generation, and has a closer and more permanent connection with the care of the young; 1 Paul Bernard, Arch. delAnth. Crim., 15th March 1890.
8 An independent collection of data on the same subject will be found in Dr. H. Campbell's Nervous Organisation of Man and Woman, pp. 121-128. He concludes that women possess "a greater innate recuperative power."
Google 384 MAN AND WOMAN.
she is thus of greater importance than the male from Nature's point of view. We therefore find that the female — notwithstanding her greater affectability by minor stimuli — is more resistant to adverse influences, and longer lived than the male.
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CONCLUSION.
THE KNOWLEDGE WE HAVE GAINED DOES NOT ENABLE US DEFINITELY TO SETTLE SPECIAL PROBLEMS — WHAT IT DOES ENABLE US TO DO — WOMEN ARE NEARER TO CHILDREN THAN ARE MEN — BUT WOMAN IS NOT UNDEVELOPED MAN — THE CHILD REPRESENTS A HIGHER DEGREE OF EVOLUTION THAN THE ADULT — THE PROGRESS OF THE RACE HAS BEEN A PROGRESS IN YOUTHFULNESS — IN SOME RESPECTS IT HAS BEEN A PROGRESS IN FEMINISATION — ABSURDITY OF SPEAK- ING OF THE SUPERIORITY OF ONE SEX OVER ANOTHER — THE SEXES PERFECTLY POISED— BUT SOCIAL RE- ADJUSTMENTS MAY STILL BE NECESSARY — WE MAY FACE ALL SUCH READJUSTMENTS WITH EQUANIMITY, We have examined Man and Woman, as precisely as may be, from various points of view. It is time to pause, as we do so bringing together a few general observations suggested by the multifarious facts we have encountered It is abundantly evident that we have not reached the end proposed at the outset We have not suc- ceeded in determining the radical and essential characters of men and women uninfluenced by external modifying conditions. Sometimes a suffi- ciently wide induction of facts (as in the question of the alleged sexual differences in respiration) suffices to show us what is artificial and what is real; at 25 Google i 386 MAN AND WOMAN.
other times (as in the question of differences in tactile sensibility) the wider our induction of facts the more complex and mobile become our results. We have to recognise that our present knowledge of men and women cannot tell us what they might be or what they ought to be, but what they actually are, under the conditions of civilisatioa By showing us that under varying conditions men and women are, within certain limits, indefinitely modifiable, a precise knowledge of the actual facts of the life of men and women forbids us to dogmatise rigidly concerning the respective spheres of men and women. It is a matter which experience alone can demonstrate in detail If this is not exactly the result which we set out to attain, it is still a result of very considerable import- ance. TM^g *h* aY * at thfillQQt Qf m ftPY pseudn- sci entific superstitio ns. It clears the ground of much tffTFfecessary verbiage and fruitless discussion, and enables us to see more clearly the really essential points at issued The small group of women who 'wish to prove the absolute inferiority of the male sex, the larger group of men who wish to circumscribe rigidly the sphere of women, must alike be ruled out >f court Nor may we listen to those would-be ^scientific dogmatists who on a priori grounds, on the strength of some single and often doubtful anatomical fact, lay down social laws for mankind at large. The ludicrous errors of arrogant and over-hasty brain anatomists in the past should alone suffice to teach us this caution. The facts are far too complex to enable us to rush hastily to a conclusion as to their significance. The facts, moreover, are so numerous that even when we have ascertained the precise signi- ficance of some one fact, we cannot be sure that it is not contradicted by other facts. And so many of the facts are modifiable under a changing environment that in the absence of experience we cannot pro- nounce definitely regarding the behaviour of either the male or female organism under different condi- Google CONCLUSION. 387 tions. There is but one tribunal whose sentence is final and without appeal. Only Nature can pronounce concerning the legitimacy of social modifications. The sentence may be sterility or death, but no other tribunal, no appeal to common-sense, will serve instead. Yet there are certain general conclusions which have again and again presented themselves, even when we have been occupied in considering very diverse aspects of the physical and psychic pheno- mena of human life. One of these is the g cekte r v ariabil ity of the male; this is true for almost the whole of the field we* have covered, and it has social and practical consequences of the widest significance. The whole of our human civilisation would have been a different thing if in early zoological epochs the male had not acquired a greater variational tendency than the female. Another general con- clusion of an equally far-reaching character is the precocity of women, involving greater rapidity of growth and its earlier arrest than in men. The result of this pr^cpcity is that wqgien, taken altogether, present the characters of shQjrt men, and to some extent of children. The whole organism of the average woman, physical and psychic, is fundament- ally unlike that of the average man, on account of this fact alone. The differences may often be of a slight or subtle character, but they are none the less real, and they extend to the smallest details of organic constitution. We have found over and over again that when women differ from men, it is the latter who have diverged, leaving women nearer to the child-type. The earlier arrest of development in women is thus connected with the variational tendency of men. And all these sexual differences probably have their origin in the more intimate c onnection of y nmpfj wif hoffspring. "Further evidence regarding the i nfantile diathesis. ^ of women, as we may call it, is found in pathological statistics. It is difficult to find diseases that are Google 388 MAN AND WOMAN.
common in children and men and rare in women, and still more difficult to find diseases that are rare in children and men and common in womea On the other hand, it is very easy to find diseases which are common in children and women and rare in men, and diseases which are rare in children and women and common in men.
Asthma is a well-ascertained example of a disease which is common in children and men and rare in women; Salter gives the proportion as two men to one woman in England, and See agrees with Naumann that in France and Germany it is as much as six times more common in men than in women. The case of asthma does not, however, possess much signifi- cance, as it is a symptom rather than a disease. Typhlitis (or appendicitis) is also common in children and in men but rarer in women, while chyluria seems to be a disorder that is rare in childhood but commoner in females than in males.
There are a large number of important and fully-studied pathological conditions which reveal children and women in association for good or for ill As an example of those in which they are associated for good may be mentioned angina pectoris, which is extremely rare in women, while very few cases in children are recorded Diabetes, again, is essentially a disease of adult life, occurring chiefly between the ages of 40 and 50, but in women somewhat earlier, between 30 and 4a It is much more frequent in men than in women; in England from 1850 to 1870 there were nearly twice as many deaths of men as of women from diabetes; Oppolzer, at Vienna, found the propor- tion to be four cases in men to one in women; while in France, Le*corche\ uniting various statistics, found 117 women to 310 men. Diabetes, it may be added, is a disease of towns rather than ot the country, and is therefore increasing, though well known to both Greeks and R onia ns at the commencement of the Christian era; among the hig56teducated and nonjjflesh-eaiing inhabitants of India it is very prevalent, as well as among the Jews, but the yelTow and black races are almost entirely free ^ ffoTh it (R. SauricTby, Lecturefon Diabetes, 1891). DupuytrSrs contraction of the fingers is an interesting example of a patho- logical condition to which there is undoubtedly strong hereditary predisposition, but which is almost unknown in childhood; in 800 children no trace of the disease was to be found, and among 203,000 soldiers between the ages of seventeen and thirty-five only three cases came under treatment; it is not until late .middle life that an appreciable percentage of cases can be found, and of these only half are women, or, according to one Google CONCLUSION. 389 authority, only a fifth (W. Anderson, "Lectures on Contrac- tions of the Fingers and Toes," Lancet, July 4, 1891). Bright's disease is a disease of middle life, rare in childhood, and it affects about twice as many males as females. Sciatica, again, is an affection of mature life which is much commoner in men; thus Gibson, at Buxton, in 1000 consecutive cases found 88.4 per cent, in men, 11.6 per cent, in women. Hay-fever rarely attacks children, and among adults it affects about three men to one woman; it is a disease of the town rather than the country, and is chiefly found among the refined and educated. Aneurism is much commoner in men than in women, and is very rare in children, but carotid aneurism is about equally common in men and in women, and appears to be found at a somewhat earlier age than other forms of aneurism. Some of the diseases that are common in men and rare in women and children, it can easily be seen, owe their discrepancy in sexual incidence merely to the greater exposure of men to excesses and strains of various kinds. The predominantly masculine diseases are thus often associated with high mental or physical development; they are also very often diseases that are on the increase, and that are favoured by town life and by civilisation. If we turn to the group of diseases which tend to affect both children and women, we find that scarlet fever, as Sanne* con- cludes (Art. " Scarlatine," Diet ency. des Set. Mid.\ is about equally common in both sexes up to' about twenty years of age, while after that women are more liable to it Subungual exostosis is common in early life, and more frequent in girls. Scleroderma (or hide-bound disease) is much commoner in women than in men (at least three women to one man), and while it attacks all ages, is very frequently found among the young. Herpes zoster is as common in children above the age of two as in adults, and is much more frequent in females than in males. Aphtha of the mouth, which is chiefly found in infants, is, among adults, more often found in wom gn than in mea There are two important pathological conditions of the heart, one affecting the mitral valve, the other the aortic valve. Mitral disease is comparatively common in children; aortic disease is very rare in children. But among adults it is universally agreed that mitral disease is much commoner in women, and aortic disease in men; Bamberger found aortic insufficiency three times as frequent in men as in women, and mitral stenosis, according to various authorities, is found to be from two to four times more frequent in women than in men. It is scarcely necessary to add that not all these sexual differ-