Physically the Jews appear to be inferior to the Anglo-Saxons in the United States. They are about five feet five inches in height on the average, which is more than the Jews in eastern Europe measure. There, it was found that the average stature of the Jews was about five feet three to five feet four inches. It appears that the immigrant Jews, like immigrants of other races, are taller than the average of the stock from which they come. This is best explained by the fact that it is mostly the taller and perhaps also the stronger physically who venture on a long journey to a distant land. In general it can be stated that this shortness of stature of the Jews is primarily due to race influence. It seems that the ancient Jews were also not tall. They are said to have been, compared with the Amorites, sons of Anak, as "grasshoppers in their own sight." It has also been shown that the races and peoples among whom the eastern European Jews have lived for centuries, are mostly of a short stature, as for instance, the Slavonians in Russia, Galicia, and Roumania. Added to this, their abject poverty, the underfeeding, the insanitary conditions of the European Ghettos, have conspired to reduce the physique of the Jew. It is a striking fact that wherever they have been given a chance to recuperate, they have gained one or two inches of stature.¹ Thus the native Jews in New York city, the children of the immigrants, are much taller than their parents, and Joseph Jacobs has found that in London also the West End Jews are taller than their poorer coreligionists in the East End.²

Another characteristic of the Jews is their narrow chest. It is known that in the majority of healthy individuals the girth of the chest exceeds one-half of their stature. In the case of the Jews it is found that the girth equals or is less than half their height. This, with their poorly developed muscular system and frequency of anemia, gives them the appearance of sickly people. But considering the fact that for the last two thousand years they have mostly been town dwellers, and in the towns they have mostly inhabited the poorest districts in insanitary conditions, crowded in small, badly ventilated dwellings, as we learn from the histories of the various European Ghettos, it would be surprising if all these adverse conditions had not reduced the physique of the Jews.

Paradoxical though it may seem, the East Side Jews of New York City, notwithstanding their apparent physical inferiority externally are not inferior pathologically--they do not swell the mortality returns of the city; in fact they enjoy an unprecedented longevity, far above most other non-Jewish races of the city. "The Jew, particularly amid large Jewries of the East," says Leroy Beaulieu, "is often small and puny--he looks wretched, sickly, shrunken and pale. But all this should not deceive us; under the frail exterior is concealed an intense vitality. The Jew may be likened to those lean actresses, the Rachels and Sarahs, who spit blood and seem to have but a spark of life left, and yet who, when they have stepped upon the stage, put forth indomitable strength and energy. Life with them has hidden springs."³ On his arrival at New York, the Russian Jew is confronted by sanitary conditions which are as foreign to him as the language of the country. It is of course quite difficult for him to adapt himself to his new surroundings; but my observations, which have been very extensive among the foreign population of New York, have convinced me that the Jew adapts himself to his new environment far more easily and more speedily than his neighbors, the Italians, the Bohemians, the Poles, the Scandinavians, and others.

In New York the immigrant Jew is principally a dweller in the tenement house. Although scattered all over the city a large proportion of Russian Jews live on the East Side, south of Fourteenth Street and east of the Bowery; principally in the Seventh, Tenth, Eleventh and Thirteenth Wards. These wards enjoy the evil distinction of being the most densely populated spots in the United States, and probably on the earth. The Tenth Ward has over 700 persons to the acre, the Thirteenth about 600. They are overcrowded with tenement houses which are known as "double-deckers," "dumb-bell" tenements, a type of abode for human beings which New York has the unenviable reputation of having invented. No other city in the United States has any such houses. Their characteristics, according to the report of the Tenement House Commission, are: (1) Insufficiency of air, light, and ventilation due to narrow courts or air-shafts; undue height, owing to the occupation by the building and adjacent buildings of too great a proportion of land area; (2) overcrowding; ( 3) danger in case of fire; (4) lack of separate water closets and washing facilities; (5) foul cellars and courts.

A "double-decker " is usually a building six to seven stories high, about twenty-five feet wide, and built upon a lot of the same width and about 100 feet deep. Each floor is usually divided into four sets of apartments, there being seven rooms on each side. The front apartments generally consist of four rooms each, and the rear of three rooms each, making altogether fourteen rooms upon each floor, only four of which receive direct light and air from the street or from the small yard at the back of the building. Of these four rooms only two are large enough to deserve the name of rooms. The front one is generally about 10 feet 6 inches wide by 11 feet 3 inches long; this is used as a parlor. The next room is a kitchen, generally of the same size as the parlor, which receives its air and light from a window opening into the narrow "air-shaft" or such a supply which may come to it through the door opening into the front room. This room contains a range, a sink, and one or two glass-door closets for dishes. Behind these two rooms are two bed-rooms in the four-room apartments, or only one in the three-room apartments. The name of bed-room is applied to these holes by the landlords who charge rent for them, but in reality they are hardly more than closets, being each about 7 feet wide and 8 feet 6 inches long. When a fair-sized bed is in position, there is hardly left sufficient space for one to pass through the room. These rooms get no air or light whatever save such as comes from the window opening into the air-shaft, and with the exception of the highest stories are generally almost totally dark. Water-closets are provided in the hallway, one for two apartments or for two families. The vast majority of these "dumb-bells" contain no bath-rooms, though some of the latest models do contain a bath-tub in each apartment or one for the entire building--for about twenty-five families.

The ventilation in these houses is obtained through the so-called air-shafts, which have been called by some witness before the Tenement House Commission "foul air shafts," "culture tubes on a gigantic scale." Owing to its narrowness and its height, evidently the air-shaft cannot afford light to the rooms, particularly the bed-rooms, but only semi-darkness. The air that it does supply is foul, because it contains the air coming from the windows of the other apartments (there are as many as sixty windows opening in some of these air-shafts). Moreover, the airshaft is used by some as a convenient receptacle for garbage and all sorts of refuse and indescribable filth thrown out of the windows, and this filth is often allowed to remain rotting at the bottom of the shaft for weeks without being cleaned out. In many houses this air-shaft is also used for the clothes lines, and on washing days the air and light are obstructed by the linens hung on these lines to dry.

It will be observed that the ventilation of the houses in these tenements is reduced to a minimum. But there is an older kind of tenement house in the Jewish quarter of our city which is even inferior to the one just described. These houses have no air-shaft--and consequently no windows at all in the kitchens and bed-rooms--one sink for the supply of water in the hallway on each floor for four apartments, only one water-closet in the yard for all the sixteen to twenty-five families of the building, and have no gas fixtures, and the light at night is obtained from kerosene lamps. These inferior old tenements are inhabited chiefly by the very poor Jews, and almost invariably by the non-Jewish part of the Ghetto population. It is, in fact, remarkable how rarely the Irish, German, Bohemian, Italian and other Gentiles inhabit the new tenements in this district, which are therefore left almost exclusively to the Jews. As we shall see hereafter, this is because the Russian Jew's home is comparatively cleaner than that of his non-Jewish neighbors of the same social and financial status, and he therefore prefers to live in a house having a handy water supply, a water-closet, wash-tubs, a modern range, and the like.

The number of persons to an apartment depends on the size of the family inhabiting it, on the financial and social condition of its members and on their personal habits. The better class live in three or four rooms. Considering that a family of the Ghetto consists on an average of six persons the better class require three or four rooms for every six persons. But the large majority of the East Side Jews are very poor, and cannot afford to pay ten to eighteen dollars rent per month; they therefore resort to lodgers to obtain part of their rent. In the four-room apartments, one bedroom is usually sublet to one or more, frequently to two men or women, and in many houses the front room is also sublet to two or more lodgers for sleeping purposes. The writer on many occasions while calling professionally at night at some of these houses, beheld a condition of affairs like this: A family consisting of husband, wife, and six to eight children whose ages range from less than one to twenty-five years each. The parents occupy the small bedroom, together with two, three or even four of the younger children. In the kitchen, on cots and on the floor, are the older children; in the front room two or more (in rare cases as many as five) lodgers sleep on the lounge, on the floor and on cots, and in the fourth bed-room two lodgers who do not care for the price charged, but who desire to have a "separate room" to themselves.

When we bear in mind that the Ghetto population is the poorest in the city and that the rents charged are the highest, we are not surprised at the condition of affairs just described. It is only surprising that, in spite of such overcrowding, the Jews manage to be the healthiest and longest lived class of the population of New York City.

Of the homes of the poor population of the city, the Jewish home is the cleanest. In the small three-room or four-room apartments, which a poor family inhabits, we find, as a rule, the largest, called the "front room," covered with some oil cloth and rugs; sometimes, perhaps, with carpets; in the very poor houses the bare wooden floor is usually kept clean. The front room in tidy homes is kept closed, and the children are kept out of it the greater part of the day. Such a clean, tidy room for the reception of friends and guests, and for social purposes, is not seen in most of the homes of the other slum population. The second room, as we have seen above, is the kitchen, which is also used as a dining-room at meal time, and as a sitting-room for the father, mother and children. The entrance to the house is through this kitchen, and outside visitors, beholding the entire family around the stove or table, and some of the children playing on the floor, gain the impression that the home of the Russian Jew is untidy and even filthy. But careful inspection of the contents of the room will show the contrary: The range is sparkling--the Russian Jewish woman takes great pride in the condition of the range. Where the landlord does not provide one, a Jewish woman will spend as much as $20 for a good range "with much nickel," and give hours of hard labor in cleaning and polishing it daily. I have actually seen houses with a pitiful scarcity of furniture, but with ranges worth from $15 to $20. The sink, which in modern houses is also found in this room, is in the majority of cases kept as clean as in any home of the American family, and much cleaner than by people of other nationalities (for instance, Poles, Bohemians, Italians, etc.) of the same social status. The third, and in four-room apartments also the fourth room, is the bed-room--the contents are, as a rule, a large double-bed, and, if there are small children, a baby carriage or a small children's bed. The cleanliness of this room depends usually on the readiness of the housekeeper to work and clean it of the vermin that are apt to be found in such dark, unventilated places.

The personal cleanliness of the Russian Jew is far above that of the average slum population. The Russian baths are very numerous in the Jewish quarters, and very much frequented. "I cannot get along without a ‘sweat’ (Russian bath) at least once a week," many a Jew will tell you. On the days when these Russian baths admit only women, they are also crowded with women and children. During the summer, the public baths on the East River are crowded with Jewish people from daybreak till late in the evening. It is to be regretted that the city does not provide more of these baths. It must also be borne in mind that the religious Jew cuts the nails of his fingers and toes at least once a week, because, according to the rabbinical teaching, dirt under the nails contains "devils" or "evil spirits." Before each meal he must wash his hands, and repeat this operation immediately after meals, and must then also rinse his month; and he must not walk four steps from his bed in the morning without careful ablution of his face and hands. A Jewish woman must visit a bath at least once a month; the nails of her fingers and toes must be cut off. These religious rites and customs are carefully observed by the older generation who are generally pious; the younger people, though they do not observe these rites religiously, follow some of them. These religious rites are, in the opinion of modern sanitarians, highly conducive to the health and cleanliness of the Jews, and, as a matter of fact, the sanitary condition of the Jew's person and home is not inferior to that of any other race living under similar conditions of poverty, want and overcrowding.

One reason for the impression of uncleanliness that the casual observer may obtain is the filthy streets in the New York Ghetto. This is due in great measure to the negligence of the city officials; they permit in the Jewish streets nuisances which would not be tolerated in any other quarter of the city; the street cleaning department clears the Ghetto only after it has cleaned the other streets. The residents have enough to care for the houses, which are overcrowded, and leave the streets to the city. But after all this, I can state, and I am convinced that I will be sustained by all who are justly entitled to an opinion, that even the streets in the New York Jewish quarter are as clean as those inhabited by the poor Italians, Bohemians and other immigrant populations. These other nationalities do very little marketing on the streets. They procure their groceries, dry goods, crockery, etc., in stores or markets. The Jews generally buy most of their goods on the streets from push carts, stands, and the like. The reason for this is, probably, that the habit is very prevalent in Russia and Galicia, and they have brought it over from their old home; besides, the Jew has somewhat of a mercantile nature--when he cannot satisfy this instinct on account of his poverty by opening a store, he will at least sell from a push cart or do some peddling. Streets used as markets cannot be kept very clean.
The food of the Russian Jews is considered to be above reproach. The meat consumed, as is well known, has, before being placed on sale, undergone a thorough inspection as to the health of the animal killed. The meat is therefore more wholesome and more fit for human consumption than that in the average non-Jewish butcher shop. As we shall see hereafter, this has some influence on the liability of the Jew to tuberculosis. Moreover, the meat consumed by the Jew is fresh. Meat more than three days old is not kosher (ritually clean), and in order that it may be made kosher it must be carefully rinsed in clean water. Religious butchers for this reason do not keep meat for more than a day or two. The same applies to fowls, such as chickens, turkeys, etc. Those sold in Jewish shops are fresh, and come from healthy animals.

Fish is one of the most important articles in the diet of the Jew. Those who do not consume much of it must at least have fish for Friday night and for Saturday, and when fish is scarce a Jewess will pay a high price for at least one or two pounds of it for Sabbath. I am informed that the Jews consume proportionally more fish than any other race in New York.

A very important article in the Jewish diet is herring. In very poor Jewish families, when other food cannot be procured, they can live for days on bread, herring, and tea alone. Potatoes, too, are much in vogue. With the exception of horse-radish, carrots, cabbage, beets, and a few others, the Jews consume very few vegetables, although fruits of all varieties are very freely used.

Another important fact is that the Jews do not eat much--a pound of meat per diem is sufficient for a poor family of a husband, wife and a few children. While this may be partly due to the expense--kosher meat is very expensive--still it is a fact that the well-to-do eat comparatively less than non-Jews. Gluttony is considered a sin among the Russian Jews. This trait has also been retained from Russia, where the multitude of the Jews are very poor, and food, particularly meat, is expensive, because of the special tax levied on kosher meat (takse). Jewish women generally differ from the men in this respect. You will quite often meet a woman who likes to eat much and well. This, added to the fact that the Jewish women usually do nothing but housework after marriage, is probably the reason why obesity is more frequently met with among them than among non-Jewish women.

It is well known that alcoholism is very rare among Jews, particularly those from Russia. It is even thought by many that Jews are total abstainers. Though this may be so with a small proportion, many Jews partake more or less of alcohol in its various forms, and those who do not ordinarily drink, usually do so at least on Saturday and holidays for religious purposes (kiddush) and on various other occasions. One thing must be conceded--Jews only rarely drink to intoxication; living in the Jewish quarters of New York for ten years, I have seen a Jewish "drunk" only rarely, although in my practice as a physician, I have repeatedly met with Jewish patients suffering from the effects of chronic alcoholism as cirrhosis of the liver, alcoholic gastritis, etc. One of the reasons why Jews are not seen in an intoxicated condition on the streets is because the Jew generally knows when to stop drinking, and when he is somewhat intoxicated, those near him will at once remove him to his home and will not permit him to behave boisterously on the streets. An officer of the Society Chesed Shel Emeth, which has as one of its objects to give poor people Jewish burial, informed me that among the unclaimed Jewish dead in the New York morgue he has during more than one year's service met with only one case in which alcoholism was stated to be the cause of death, and this among an average of five to six corpses weekly (including children). When we recall the fact that the unclaimed bodies in the morgue almost invariably come from the lowest classes of society, and that at least seventy-five per cent. of the Gentile unclaimed dead in the morgue are directly or indirectly caused by alcoholism, we are the more surprised at the infrequency of alcoholism among the Jews in New York. But still it can positively be stated that the vice is growing in frequency among the Jews in New York City. We occasionally meet a Jewish patient in the alcoholic ward of Bellevue Hospital. In their old home in Russia, the Jews abhor a drunkard; they name him with converts and outcasts. To have a drunkard in the family means difficulty in contracting suitable marriages for the children. The Jew knows that it does not pay to be drunk. Having lived for centuries under the ceaseless ban of abuse and persecution in the European Ghettos, he has found it advantageous to his well-being always to be sober. But here, alcoholism is increasing, particularly among the young generation, who are adapting the habits and customs of life of their gentile neighbors--their virtues as well as their vices.

The Russian Jews are generally inveterate smokers of cigarettes; only few, those who are more or less "Americanized," smoke cigars. The Russian Jews prefer cigarettes with mouth-pieces, such as they were wont to smoke in their old home. Others smoke cigarettes which they roll very dexterously with their fingers from tobacco in
cigarette paper. Pipes are not very common. Another habit of the older people is snuffing pulverized tobacco. Chewing tobacco is unknown among Russian Jews.

Tea is probably consumed by Russian Jews far more than by any other nationality living in New York. We frequently see one who drinks more than a dozen glasses of this beverage daily. In the cafes of the Ghetto one may always observe people sitting for hours and drinking tea. This habit has been acquired in Russia, where excessive tea drinking is common. One advantage of the tea drunk by the Russian Jews over that consumed by the Americans is the fact that the Russians never drink tea that has been boiled; they make of the tea an infusion with boiling water; the amount of tannin retained is thereby reduced to a minimum, and it is consequently less liable to cause indigestion, and only the volatile oil which gives the aroma is extracted.

Considering the fact that the Jews are the most nervous of people, as we shall see hereafter, it is not surprising that they consume much tea. Having their nervous system often fatigued and exhausted from worry, care and anxiety, they require some agreeable stimulant which will remove, at least temporarily, the sense of fatigue, and give a feeling of well-being. Other nations use alcohol for such purposes, but the Jews prefer tea, which in the long run, of course, overstimulates their nervous system, and a depression is the result, which requires larger doses of tea to overcome it. A vicious circle is thereby established, which by no means contributes to the health and well-being of the Russian Jew.
Coffee is used by the Jews in Russia only rarely. Here in the United States it is more frequently consumed, but not so freely as tea. Drug habits, such as the use of opium, chloral, cocaine, etc., are almost unknown among the Russian Jews.

While speaking of the evils of the New York tenement houses, the various Tenement House Commissions were always wont to point out that the mortality in the tenements is considerably higher than that of the private dwellings. They succeeded in obtaining from the vital statistics of the city figures showing that the mortality in some wards was between two and five times higher than that in the wards without, or with few, tenement houses. But on careful analysis it was discovered that the wards which enjoy the lowest mortality of the other wards in New York are most
densely populated spots in the city, overcrowded with tenements, each of which affords a dwelling place for between 200 and 400 human beings.

The wards showing the lowest mortality in Greater New York are those inhabited by the Russian Jews. The wards showing the highest death rates are inhabited chiefly by Italians, Irish, Bohemians, etc., and with none or only few Jews. "In certain blocks in the Italian quarter of the city there is a very high death rate," says the Report of the Tenement House Commission of 1900,⁴ "while in certain other blocks only half a mile away, in the Jewish quarter, the death rate is only one-half as great as the average death rate of the city; yet in the latter district there was a greater population, the tenement houses were taller, and the general sanitary conditions were worse."

In fact, when we observe the comparative death rates of the Seventh, Tenth, Eleventh and Thirteenth Wards, which are chiefly inhabited by Jews,⁵ we find that during 1899 the death rate per 1,000 population was: In the Seventh Ward 18.16; in the Tenth, 14.23; in the Eleventh, 16.78, and in the Thirteenth, 14.52; for New York City the death rate was, in the same year, 18.53 per 1,000. It will be observed that the Seventh Ward had the highest death rate of the Jewish districts, 18.16, nearly approaching that of the city. But considering that in this ward the non-Jewish, particularly the Irish population, makes up at least 35 per cent. of the total, we must conclude that the mortality of the Jews in this district is also lower than the average of the city.

When we recall that the death rate in New York City was in 1880, 26.40 per 1,000 of population, and that ever since it has been with slight fluctuations, steadily declining, we may find that, possibly, there may be some correspondence between this reduction of mortality in the city and the steady influx of Jewish immigrants. While the activity of the Board of Health towards the lowering of the death rates of the city is evident, still the thousands of Jews with their low mortality may also have contributed somewhat to this effect.

The low mortality of the immigrant Jewish population in New York City was noticed in the report compiled by Dr. John S. Billings, for the Eleventh Census of the United States.⁶ According to these statistics the Russian and Polish Jews showed the lowest rates of mortality in New York during the five years ending May 31st, 1890. The highest mortality rate--43.57, was found to be among the Bohemians; the Italians are next, with 35.29; the Irish, with 32.51, etc., while those whose mothers were born in Russia and Poland enjoyed the lowest mortality rates--only 14.85. The mortality of children was also the lowest among the Russian Jews--only 28.67 per 1,000 population, as against 82.57 among the Bohemians, 76.41 among the Italians, and so on. W. Z. Ripley,⁷ in speaking of the longevity of the Jews, aptly illustrates it by the following example:" Suppose two groups of one hundred infants each, one Jewish, one of the average American parentage (Massachusetts), to be born on the same day. In spite of all the disparity of social conditions in favor of the latter, the chances, determined by statistical means, are that one-half of the American will die within forty-seven years; while the first half of the Jews will not succumb to disease or accident before the expiration of seventy-one years. The death rate is but little over one-half of the average American population. This holds good in infancy and in middle age."

The longevity of the Jews has always appeared paradoxical to those who have investigated the question. As we have seen above, the Jew is by external appearances the least physically developed of the European nations; in stature he is the shortest, the girth of his chest is the narrowest, he is paler and poorer in blood than most of the non-Jewish nations among whom he lives. But his longevity and resistance to disease surpasses those of his apparently stronger neighbor. The cause of this paradox is plain when we consider the Jew's history. The Jewish race has, for the last two thousand years, spread widely over the face of the earth. During all his migrations from continent to continent and from country to country, the Jew was always exposed physically and mentally to the most diversified conditions. The variety of climate, the repeated changes of habits and attempts at acclimatization have wrought great changes in his physical organization. His struggles against adverse circumstances, endeavoring to readjust his organism in adaptation to new conditions, defending himself against his mediaeval persecutors who mercilessly gloated over his agonies, torturing him with a fiendish glee of hate and intolerance, have left him a physical wreck as far as external appearance is concerned. But on the other hand, these inimical conditions have also had other effects on the Jew's organization. Partly by weeding out, either by death or baptism, all those of the Jews who, by reason of physical, mental and intellectual inferiority, could not withstand the ban of poverty, abuse, and persecution, and partly by keenly sharpening the senses, and by developing the functional activity of the brains of those who were sufficiently brave, stubborn enough to remain Jews in the face of that brutal persecution, natural selection has left behind a race which is at present fully equipped with means to resist poverty, misfortune, and even death more easily than other races who have had no such struggle for their existence. Only those most resistant to the effects of disease, the healthiest who could easily adapt and acclimatize themselves to new external conditions on short notice,--in brief, only the fittest have survived. At one period of their history they had to withstand the effects of contagious diseases, all those predisposed, the weak, sickly and infirm, succumbed, and those left behind were more or less immune. This immunity was transmitted to future generations. At another period of their history, intelligence and intellect were the best weapons for the preservation of the race in the struggle against persecution, and only those who possessed the most intelligence and knowledge and the toughest, the shrewdest, who were best fitted to cope with the adverse circumstances, survived; the weakest, the most stupid and the most ignorant, went to the wall. These qualities were inherited by the succeeding generations. The final result is that the Jews at present are a picked race which can resist pain, misfortune, grief, worry, starvation, disease, and even death better than other civilized races. Those who were shiftless, immoral, lazy, incorrigible, drunkards, could not remain Jews under the medieval persecutions. Only those who were strong, healthy, and energetic could venture to remain Jews--hence their longevity.

Of the diseases to which Jews are most liable those of the nervous system stand out most prominently. Neurasthenia and hysteria are more frequent among them than among any other race. Some physicians have even gone so far as to state that the vast majority of the Jews are neurasthenics, and that nearly all the women are hysterical. The observations of the physicians who practice among the Russian Jews in New York sustain these contentions. Hysteria is very frequent among women, and among men is far more often met with in Jews than among any other people.
Insanity is very frequent among the Jews. It appears that it was very frequent among the ancient Hebrews. At present we find, wherever statistics on the subject are available, that the Jews suffer proportionately from two to five times more frequently from mental alienation than non-Jews. Here in New York City we meet with similar conditions. Recent statistics show that the Jews in this city supply a greater number of insane to the asylums than any other race living here.⁸ The same can be observed in the asylums for idiotic and feeble-minded children of our city. It is stated on good authority that more than fifty per cent. of the inmates are of Jewish origin. Remembering that the Jews constitute less than twenty per cent. of the total population of Greater New York, we can appreciate the fearful proportion of insanity and idiocy among the Jews.

A disease of which the Jews suffer more than any other nationality is diabetes. Dr. Heinrich Stern⁹ examined carefully the mortality from diabetes in New York City during 1899, and found that out of a total of 202 deaths due to this cause, fifty-four, i. e., twenty-five per cent., occurred among the Jews. And as the Jewish population of New York City is scarcely twenty per cent. of the total population, it follows that the Jews suffer about three times more often than others from diabetes.¹⁰ Varicose veins, hemorrhoids, ruptures and some form of diseases of the nervous system are also more frequent among Jews than non-Jews.

The greater liability of the Jews to nervous diseases, particularly neurasthenia, hysteria, and diabetes is to be considered as the outcome of a long series of events in the Jews' history for the last two thousand years. It is a result of the anxiety, prolonged worry, grief, and cerebral overwork of the Jews under the ban of mediaeval persecution. These diseases, as we all know, are diseases of great urban centres, and they signify that the organism of their possessor has entered on a race of competition for which it is not adequately equipped. The Jew has been for centuries an urban resident. According to Jacobs, four-fifths of the Jewish population live in large towns.¹¹ The diseases of the city population are therefore accentuated in the body and mind of the Jew. Of non-Jews only one-third of the population are town-dwellers; and the case is consequently different with them. It has been shown by Mr. Cantlie, in his book, "Degeneration Amongst Londoners," that the London poor do not survive beyond three, or at most, four generations; the same has been proved to be the fate of the poor inhabitants of Paris. It is, indeed, rare to find among the poor in modern large cities families which could trace their ancestors back for five or six generations as city dwellers. The population of the cities is kept up by the constant influx of good, pure, fresh blood from the country, which counteracts the deteriorating influences of the busy, enervating city life. Dr. Otto Ammon has conclusively shown that the large majority of the town-dwellers in Baden, Germany, are either themselves immigrants from the country or else the children of immigrants. The same has been shown to be true of nearly all the other cities in Germany--nearly one-half their population is of direct country descent. One-third of the population in London is of country birth; the same is true of Paris. For thirty of the principal cities of Europe, according to Ripley, it has been calculated that only about one-half of their increase is from the loins of their own people, the overwhelming majority being of country birth. The Jews have not had this advantage of draining the pure, fresh, healthy country blood for the rejuvenation of their own, which is deteriorated by town-dwelling, and as a result we find that the evil effects of the strained, nerve-shattering city life have been deeply rooted in their bodies and minds, and this in turn has been transmitted to their offspring. With each new generation the nervous vitality of the Jewish race lessened, and as a final result, we find that most of the diseases that increase with the advance of civilization, particularly the neuroses and psychoses and also diabetes, are relatively more frequent among the Jews than among the non-Jews. " The Jew," says Leroy Beaulieu,¹² " is the most nervous and in so far the most modern of men. He is, by the very nature of his diseases, the forerunner of his contemporaries, preceding them on that perilous path upon which society is urged by the excesses of its intellectual and emotional life, and by the increasing spur of competition. The noisy army of psychopathics and neuropathics is gaining so many recruits among us that it will not take the Christians long to catch up with the Jews in this respect."

Consanguineous marriages, which are very frequent among the Jews, have been assigned as a most potent cause of their nervousness and also of the frequency of diabetes among them. I do not believe that this is a satisfactory explanation. Modern medical science teaches that consanguineous marriages between healthy people, per se, do not cause any disease or infirmity in the offspring--excepting those, of course, which are contracted between diseased people.

A very important factor in the production of the nervousness of the Jews is that they are essentially a commercial people--many prefer speculation in business pursuits to manual labor. This can be observed in New York City, where a number of Jewish laborers, after having succeeded in saving a few dollars, begin business on a small scale; they peddle or sell from push-carts, stands and small stores.

Business, particularly that done with lack of funds, involves prolonged morbid emotional excitement, such as worry, vexation, grief, and anxiety; and the importance of these as factors in brain exhaustion cannot be overestimated. The Russian Jew, again, as we have seen, is under-fed, emaciated and anemic. The disproportion between his mental activity on the one hand, and his lack of physical development on the other, are added to the fact that he comes into this world already handicapped; the nervous vitality of his parents has also been more or less affected by the same causes and an additional very potent cause of nervous exhaustion, persecution, which has strained and shattered them physically and emotionally. All these factors taken together give us more than sufficient reason to expect nervousness among the Russian Jews.

The education of the Russian Jews in their old homes is acquired in the so-called cheder, at an early age. At four or five years a Jewish child attends school, and studies ardently the Hebrew language. Between seven and ten years he studies the Bible, and in instances the Talmud. The Jewish schools in Russia, the chedarim, are anything but conducive to the healthy functional development of the young children's nervous system and bodily activity.
If we bear in mind further that systematic exercises, such as billiards, golf, tennis, hunting, gymnastics are not in vogue at all among immigrant Jews, we have the picture complete--the restless, overworked and exhausted nervous system gets no recreation, and breaks down under the slightest provocation.

Suicide has been observed to be infrequent among the Jews in Eastern Europe, but in New York City it appears to be growing among them. We have no exact statistics as to its proportion, but the fact is, we hear of Jewish suicides quite often. Here again we see the effects of modern civilization on the Jew.¹³

By immunity is understood the resistance of the tissues of the system to the development of infectious diseases. It has only a relative meaning, because there is no absolute immunity. When we say that a race is immune to a certain disease, as the negro is, for instance, to yellow fever, we do not mean to convey the idea that the negro never suffers from that disease, but that he is affected less frequently than the white races are, or only rarely. Using the term immunity in this sense, I can positively state that the Jews in New York are relatively immune to most of the infectious diseases. I make this statement with the full knowledge that most of those who have not made a special study of the mortality from contagious diseases in New York have always entertained a decidedly contrary opinion. But I think that a careful analysis of the statistics given below, will convince all skeptics as to the truth of the assertion.

As we have seen above, there are four wards in New York City which are chiefly inhabited by Jews--namely the Seventh, Tenth, Eleventh and Thirteenth. At least 75 per cent. of the people living in these wards are Jews. By computing the mortality from infectious diseases in these wards as they are recorded in the annual reports of the Board of Health, we can easily see if the Jews have a lower mortality from these diseases. An analysis of these figures shows that diphtheria and croup killed in New York during 1897, 1898 and 1899, 64.20 per 100,000 population, and of Jews in the four wards referred to only 59.55. Scarlet fever and measles appear to have been the exceptions, the former being for the city only 24.17 and for the Jews 34.14 per 100,000, the latter showing 21.69 and 21.15 respectively. In Dr. Billings' report on Vital Statistics of New York City and Brooklyn, published by the Eleventh Census of the United States, there is given the mortality from certain diseases of the various races and nationalities confirming these figures. I have assumed the figures in this report which refer to Russians as applying to Russian Jews, as these are the greater part classified under the nationality in these cities.

Diarrheal diseases are also less fatal among the Jews. Every year we hear that when philanthropists are clamoring about the great mortality of children from diarrheal diseases during the summer months, they point to the congested tenement districts inhabited by the Jews as being the stronghold of the scourge. If they had studied the question more closely, they would have ascertained that the Jews in the Seventh, Tenth, Eleventh and Thirteenth Wards have a lower mortality from this disease than any other nationality - the average annual mortality in New York City during 1897, 1898 and 1899 was 125.54 per 100,000 population. Among the Jews in the four wards mentioned only 106.79. For the six years ending May 31st, 1890, the mortality for New York from diarrheal diseases was 316.85; among the Bohemians, 766.73; Italians, 425.58; United States, white, 398.34, and among the Russian and Polish Jews only 195.55. The same is true of typhoid fever. It is proportionately less frequent in the East than in the West Side of the city.

The mortality from diseases of the nervous system among the Russian Jews of New York during six years ending May 31st, 1890, as given in the Eleventh Census was 117.68, as against 336.76 among the Bohemians, 293.48 white Americans, 242.44 Irish, and so on.¹⁴ This is contrary to the opinion of many demographers who consider the Jews the greatest sufferers from nervous diseases. But if we bear in mind the fact brought out by the author while speaking of the nervousness of the Jews that " only the functional nervous diseases, as hysteria and neurasthenia, are more prevalent among the Jews, while the organic degenerative nervous diseases are even less frequently met with among them," we are not surprised at the low mortality from this cause among the Jews of Russia and Poland in New York.

Of the venereal diseases, such as syphilis, the Jews appear to suffer less frequently than other races. Many writers in Russia have recorded statistics to that effect. We have no exact statistics about the prevalence of syphilis and gonorrhea among the Jews in New York, but the testimony of physicians practicing among them shows that while among the Jews syphilis is often met with, it is not so frequently encountered as among non-Jews. Gonorrhea seems at present to be very much on the increase among the Jews in the East Side of New York, which again shows the effects of their sojourn in our metropolis.

The most important disease to which the Jews show a relative immunity is tuberculosis, or, as it is commonly known, consumption. The author of this article has shown this to be a fact among the immigrant Jewish population in New York City in his paper on the " Relative Infrequency of Tuberculosis Among Jews," to which the reader is referred for details.¹⁵ One fact we desire to emphasize here, namely that consumption is very much on the increase among our population on the East Side, particularly among the poorer classes of the Jews living in New York City. Dr. Lee K. Frankel, manager of the United Hebrew Charities, has shown that, while in 1895 the ratio of consumptive applicants for relief was 2 per cent., in 1899 it reached 3 per cent; i.e., that is, an increase of 50 per cent. in four years, which is appalling. Dr. Frankel also shows that consumption as it exists among the Jews in New York is almost wholly confined to the lower classes, the poorer element of the Jewish population, and that the foreigners who suffer from this disease have contracted it after their arrival in the United States. He bases his deduction on an examination of 10,000 death certificates in the New York City Board of Health, beginning with January 1st, 1900. In 888 of these the cause of death was stated to be tuberculosis; 72 of these were Jews. If we recall the fact that the Jewish population of New York City is estimated to be at least 15 per cent. of the total population, we may from Dr. Frankel's figures, also find that if consumption was as prevalent among the Jews as among the general population, the number of deaths due to this cause should have been 133. As it is, only 72 were recorded, a little over one-half that of the population of the city. We also find from Dr. Frankel's figures that of the 72 Jews who died of consumption, 39 died in tenement houses, 23 in institutions and only 1 in a private house. This tends to show that those Jews who are socially and economically on a higher plane, are even less liable to consumption than the unfortunate poor who are huddled together in congested tenements, in poverty and in want, exposed to infection to the highest degree. It can be positively stated that in case the conditions of over-crowding and misery among the immigrant Jewish population on the East Side shall keep on as they are at present, the Jews living here will in the near future show a yet greater mortality from the "white plague" than the Irish and Italians do at present.

The low mortality of the New York Jews from the contagious diseases is the more remarkable when we bear in mind that everything that is conducive to the spread of infection is at hand in the East Side--poverty, overwork, ill-ventilated sweat-shops, overcrowding in the tenements, lack of fresh air and sunshine--in fact, the New York Ghetto is considered the most densely populated spot on earth. When we remember that, in spite of all these adverse conditions, the Jews show a lower mortality from contagious diseases, we are forced to conclude that they do possess some relative immunity or a greater power of resistance to the noxious effects of contagious diseases.

The causes of this relative immunity of the Jews are to be sought in their past history, their religious customs and habits of life; to their devotion as husbands, as wives, as parents and as children. Although the nervous system of the Jews is more or less shattered as a result of the ceaseless persecution, abuse and oppression they have undergone for centuries, still the organic nervous diseases are infrequent among them--the reason for this is plainly evident--and alcohol and syphilis are also infrequent. We know that any poison that depresses the vitality of the system, as alcoholism and syphilis, predisposes infection by pathogenic micro-organism. Pneumonia, consumption and many other fatal diseases have alcoholism as a remote cause of their origin. The Jews, not being addicted to alcoholism, are consequently less frequently affected by these diseases. Another important point is the fact that the prognosis of most of the infectious diseases depends on the patients' antecedents. A mild attack of disease in an alcoholic is more liable to kill than a severe case in a temperate man. The vitality of the offspring also depends very much on the presence or absence of alcoholism and syphilis in the parents. Children begotten of parents suffering from these virulent poisons are easy prey to the infectious diseases. The Jewish children show a lower mortality, because their parents bestow on them a vitality untainted by alcoholism and syphilis, and they can therefore more easily resist the effects of contagious diseases. Jewish parents are also more devoted to their children than others, their anxiety in case of slight illness is greater than that of poor people of other races, and they seek medical assistance far more frequently. Added to this fact, that Jewish women do not after marriage work in factories as frequently as poor women of other nationalities and have more time to attend to their children, and we have all the factors that reduce the mortality, particularly of infants.
The lesser mortality of the Jews from consumption is explained by the above factors, and an additional very important religious rite--the inspection of carcasses in the slaughter-house as to the health of the cattle. The Jew is prohibited from consuming meat coming from diseased cattle, particularly such which have suffered from diseases of the lungs and pleura. We know that a great proportion of the tuberculosis has its origin in the consumption of meat coming from tubercular cattle. In the case of the Jews the chances of infection from this source are reduced to a minimum.
To the cleanliness of the Jewish home from the moral and sanitary point of view we must ascribe most of the health, longevity, and immunities of the Jews. When the Jew assimilates with his non-Jewish neighbors, adopting their modes of life and habits, he gradually loses his immunity and his longevity, and in time does not differ as to health and sanitation from the people among whom he happens to live.

It is agreed that the immigration of sober, healthy, and industrious people to the United States is desirable, and in view of all the facts we have collected the Russian Jew is as desirable as any other clan of foreigners and better than many. We all know that notwithstanding the fact that the Russian Jew comes from a country where typhus and smallpox are endemic and cholera quite often rages epidemically, he has never brought these diseases with him; even during 1891-1894, when cholera was raging in Russia, the numerous Jewish immigrants did not import the disease to the United States.

The fact that they are not addicted to alcoholism is also one of the most important qualities that make the Russian Jew a desirable immigrant. Those few insanitary habits which he acquired in Russia the Jew does his best to forget after living a longer time in the United States. And as his children attend public school almost invariably, we are convinced that the generation which will succeed the Russian Jews of to-day will prove to be good Americana morally, physically, and intellectually.
 

¹ For details about the stature of the Jews in the United States, and how it is influenced by heredity and environment, see M. Fisbberg, "Materials for the Physical Anthropology of the Eastern European Jews;” Annals of the New York Academy of Sciences, 1905.
² Studies in Jewish Statistics, p. 80.
³ Israel Among the Nations, p. 150.
⁴ De Forest & Veiller, The Tenement House Problem, Vol. 1, p. 55.
⁵ It is estimated that over 76 per cent of the population in these wards are Jews -the Tenth and the Thirteenth almost exclusively, the Eleventh with at least 80 per cent., and the Seventh 65 per cent.
⁶ Vital Statistics of New York City and Brooklyn, p. 15.
⁷The Races of Ewroft, p. 383.
⁸See articles "Idiocy” and "Insanity," by the author, Jewish Encyclopedia, Vol. VI.
⁹ Medical Record, November 17, 1900.
¹⁰ For a more thorough discussion of the subject, see article "Diabetes," by the author, Jewish Encyclopedia, Vol. V.
¹¹ Anthropology," Jewish Encyclopedia, Vol. I.
¹² Israel Among the Nations, p. 169.
¹³ It is worthy of notice that the same phenomenon has been observed among the Jews in Western Europe: About fifty years ago it was very rare to meet a Jewish suicide. At present the number of Jews who commit suicide has increased to an alarming extent Thus the latest statistics for Prussia show that self destruction is more frequent among the Jews than among the
Chris tians; from 1898 to 1897 there occurred among the Christians 81.17 male and 8.02 female suicides per 100,000 population. Among the Jews the proportion was 86.50 male and 11.89 females per 100,000. (Arthur Rupin, Die Socialen Verhaeltnisse der Juden in Pruessen und Deutschland. Berlin, 1902).
¹⁴ Billings, Vital Statistics of New York City and Brooklyn, p. 41.
¹⁵ American Medicine, November 2, 1901. See, also, article "Consumption;' Jewish Encyclopedia, Vol. IV.