GOTHA LIFE - Causes of Deaths during the 20 Years 1829-48, at different Ages.

GOTHA LIFE-Ratio of Deaths from each of 6 Causes to the whole Mort. during the

following Periods:

It will be remembered that there was a serious outbreak of Asiatic Cholera in Germany in 1831.

1857.-Mr. Neison, after an elaborate analysis of the mort. experience of this So., in Vital Statistics (3rd ed. p. 151, etc.), pointed out that it showed this remarkable and peculiar feature: "At the younger ages the mort. is much less than that indicated by any other of the Tables yet alluded to; but at the older ages the rate of mort. is very much greater." He adds:

At present it is difficult, if not impossible, to account for this peculiarity: whether it be due to the different circumstances and habits of life of our continental neighbours, or whether it arises from some mutation in the physical condition of the assuring classes in recent years, and is common to our own country, it is difficult to say; for we have no sufficient amount of data relating to the last 25 years, within which the facts of the Gotha Life Office are limited.

1862.-Dr. Fleming, in his Medical Statistics of Life Assu., pub. in Glasgow this year, gives various comparisons between the rate of mort. experienced by this So. and the Scottish Amicable So. (vide pp. 18-19), but there can be no useful object effected by reproducing these here.

1863.-Herr Hopf pub. in Gotha: Historical and Statistical Accounts of the Rise, Progress, and Present Condition of the German Life Assu. Co. of Gotha, with Tables of Mort. compiled from the Experience of the Co. during the 34 Years 1829-62.

1874. The Rep. of the So. for this year contained the following:

GOTHA LIFE.-T. showing the proportion which the actual Mort. of the Year 1874 bore

to the Expected Mort.

The average age at entry of those who died had been 40 years 4 months-the first ins. only being regarded where there was more than one on the same life-and at death 61 years 6 months. The average duration of these pol. was therefore 21 years. The distribution of deaths as regards sex was 860 males and 57 females; and as there were 43,673 males and 2236 females insured, the mort. of the former was 1'97 p.c., and of the latter 2.55 p.c. The mort. of the females was therefore, as usual, somewhat greater than that of the males, although their average age was nearly the same. The deaths by suicide were included in this T. The ages were taken at the dates the prem. fell due during the year. There is no reference to the experience of the year being other than ordinary.

An Appendix to the Rep. gave T. of the causes of death, occupations, months of the year when the deaths occurred, with amount and duration of pol.; the sexes being distinguished. [FEMALE LIFE.] [GERMANY.]

GOTHOFREDAS, J.-Pub. in Geneva, in 1637: De Imperio Maris de que Jure Naufragii Colligendi, ex Jure Romano. A work of great learning. [SEA, DOMINION OF THE.] GOTHLAND.-An island in the Baltic, whereon was situated the famous City of Wisby, the centre of the commerce of Northern Europe during the Middle Ages. The island was conquered by the Teutonic Knights in 1397-8; given up to the Danes in 1524; to Sweden in 1645; conquered by the Danes in 1677, and restored to Sweden in 1679. The earlier of these events probably left their impress upon the famous Code of Sea Laws. The Teutonic Knights played also a prominent part in the affairs of the HANSEATIC LEAGUE.

1868. This island has come again somewhat unexpectedly into prominence in consequence of an unofficial and unexpected visit to it this year by Mr. Gray, the Assistant Sec. of the Board of Trade, who was assured that there had for some time been an asso. of residents in Gothland, who, in case of a ship being wrecked or in danger, One member would affect to be would give assistance after a very profitable fashion.

agent for the shipowner, another for the owner of the cargo, another for the insurers, while another would represent himself as the consular agent, and yet another would become agent for the salvors. They could thus get the management of the case into their hands, and, living at various parts of the island, they formed a sort of network around it. In one case the sum demanded for salvage would be enormous; and an appeal to the Courts in Wisby is attended with vexatious delay. Another case, says Mr. Gray, would take this shape ::

A vessel got on shore; the weather was fine; and she was taken afloat the same day by a person who is reported to be a member of the Gottland organization, very little damaged, and lay in harbour for many days. She did not make more water in any one day than could be pumped out in ten minutes, or at the outside a quarter of an hour. After lying in harbour leaking steadily at this rate for some time, one day she suddenly leaked heavily. The ship was examined, and it was found that This was repaired, and the vessel did not leak some of the oakum had been driven out of the seams. much while the oakum remained in it, but it was pulled out again. The captain and mate were subsequently seen to go on board the vessel on two occasions. After one of their visits the vessel got deeper in the water, and after the other she went down altogether at her moorings. A survey was She was a new ship, and was sold for about held, and the vessel was condemned in due course. one-fifth of the sum for which she was insured. She was bought by a member of the organization, who was salvor, and the conditions of sale were strongly against any one else buying her. Shortly after the sale was effected, the leak was stopped and she was afloat in a few hours. Her bottom was

repaired by a few hands, and she took in cargo and sailed away. She was re-christened, and is st running. The agent of the underwriters, who is also reported to be a member of the organization, had a representative present at the sale in their behalf, and the underwriters dismissed him on account of this case, and declined to pay ins.

This was said to be not so bad a case as some. Excessive ins. tempts owners to contrive collusive losses, and a still more serious evil in Gottland is collusion between the master and salvors. The underwriters had employed as a special agent in some cases Lieutenant Falk, of the Gottland Militia, and he had done much to protect their interests, though subject to organized opposition and innumerable difficulties. There has been no British consular agent in Wisby for some time, and, owing to the urgent representations of Lloyd's and the representations also of the British Consul at Stockholm, the British Foreign Office in 1868 appointed Lieutenant Falk to that office; but the Swedish Government declined to grant him an exequatur. It is against their rules for an officer of the Swedish army to hold such an appointment, and there was a difference between Lieutenant Falk and the Governor of Gottland on some question of discipline, making it difficult or impossible for the two to work together.

1869.-In another report to the Board of Trade, Mr. Gray stated that among the 220 coasting passenger steamers of Sweden there has been a loss of only 3 ships in 10 years; while among 215 passenger coasting steamers of Gt. Britain, 17 had been totally lost under circumstances so grave as to require a formal and extensive inquiry by the Board of Trade. But then, it is added, the Swedish masters are paid partly by a share of the profits; self-interest is made to run hand in hand with duty. They get well paid if they do their best. If the ship is wrecked, they lose their per-centage, and find it difficult to get another ship. Mr. Gray submits that the facts he has stated afford ground for consideration and further inquiry. We believe matters have since improved. GOTLAND, SEA LAWS OF.-See WISBY, LAWS OF.

GOTTENBURG.—An ancient city in Sweden, of considerable mercantile importance. The police make inquiries into the causes of fire here. The inquiry is compulsory in all cases, whether suspicion arises or otherwise. The suspected person, if any, is imprisoned and tried; and the settlement of the claim, if in respect of property of the accused, is suspended while all this takes place.

GOTTINGEN.-An ancient city in Hanover, containing a University of European renown. From the various Professors of this University have proceeded from time to time many excellent treatises on Marine Ins. [GERMANY.] [MARINE INS., Hist. of.] GOTTSCHALK, F., Copenhagen.-He travelled for several years for the purpose of extending the agency connexions of the Northern, and in that period visited Mexico, the West Indies, and San Francisco.

GOUDARD, CHEVALIER AUGE, of Montpelier.-The reputed author of a work pub. in 1757, or earlier: Les Intérêts de la France mal Entendus, in which he opposed the practice of Marine Ins. [MARINE INS., HISt. of.]

GOURAUD, Mons. Charles.—“Docteur de la Faculté des Lettres de Paris,” published in Paris in 1848: Histoire du Calcul Probabilités depuis ses Origines jusqu'à nos Jours, wherein he traces the progress of the science from its origin up to the date at which he

wrote.

GOURLIE, MR.-Sec. in Belfast for the Scottish Widows since 1868. For some seven years previously, he had been Inspector of Agents for the same Co.

GOURMAND.—A greedy or ravenous eater; a glutton. Also a luxurious feeder, or one assumed to be learned in varieties of food, and its culinary processes.

GOUT (from the Latin, a drop).-A term derived, like Rheumatism, from the humoral pathology, and suggesting (in accordance with an old medical theory) the dropping of a morbid fluid into the joints. The disease presents two varieties:

1. Regular Gout. A specific form of articular inflammation, invariably accompanied with uric acid in the blood, and the deposition of nitrate of soda in the affected tissues. 2. Irregular Gout. The same specific inflammation of non-articular tissues, or disturbance of the functions of various organs, accompanied with the same abnormal state of the blood. There are also local varieties of each of these forms.

Definition. A good popular definition of Gout appears to be: A constitutional disease, occurring by paroxysms. It consists in an inflammation of fibrous and ligamentous parts of the joints, and almost always attacks first the great toe, next the smaller joints, after which it may attack the greater articulations. It is attended with various sympathetic phenomena, particularly in the digestive organs. It may also attack internal organs, as the stomach, the intestines, etc.— -Dunglison.

Gout is a common disease among the higher classes of society, especially among those who indulge in the luxuries of the table, or inherit a disposition to attack. Females are much less subject to it than males.. The first symptoms of its attack are those of dyspepsia and irregularity of the bowels, low spirits, and some fever and restlessness; but these often pass unobserved, till the patient is roused in the night by violent pain in some part of the leg, generally in the vicinity of the great toe, and of one foot only; there is much throbbing and uneasiness, with more or less swelling and inflammation, and the least motion commonly produces great increase of suffering. After some hours the pain and fever abate, perspiration comes on; the patient falls asleep, and awakes comparatively

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easy. These fits or paroxysms are apt to return at intervals, and often every evening; but they decrease in violence and at length go off, frequently with some decided increase of perspiration or other evacuation.-Brande.

We have given the preceding popular account of this malady, because persons sometimes suffer from these symptoms without at first knowing their true significance.

This has in all ages been a disease of the rich, and one from which the poor are almost wholly exempt. Martial, addressing a slave, and showing how much better his condition is than his master's, continues in a strain which has been rendered as follows: If you still dread the horrid cat-your master has the gout;

And could he say farewell to that-would gladly bear the knout.

The early dramatists turned the victims of gout to very good account frequently. Gay, in his "Fables," has the following:

Next Gout appears, with limping pace,
Which often shifts from place to place:
From head to foot how swift he flies,
And ev'ry joint and sinew plies;

Still working, when he seems supprest,

A most tenacious, stubborn guest.

Dr. Hennen, in his Medical Topography of the Mediterranean, on finding a single case of gout among the military hospital returns, calls it a rare, though not a unique instance. We have to deal with the disease in a more practical aspect, in view of pointing out -1. How it may be most readily discovered in its incipient stages. 2. What its effect upon the duration of life is.

1629.-The causes of death in the Metropolis began to be returned to the Co. of Parish Clerks this year, but they were not pub. in the Ann. Bills. A special Bill was pub. after 1656, which, however, gave the results for the years 1629-36, and also for the years 1647-56, making 18 years in all (with a break of 10 years in the centre). By this Bill the deaths from gout are shown to vary from a minimum of 2 in 1629, to a maximum of 12 in 1649-the average number being about 7 p.a.-See 1729.

1661.-Graunt, in his Observations on the Bills of Mort. pub. this year, says: "The gout stands much at a stay, that is, it answers the general proportion of burials: there dies not above I in 1000 of the gout, although I believe that more die gouty. The reason is, because those that have the gout are said to be long livers; and therefore when such die, they are returned as aged.'

1729.-The deaths from gout returned in the B. of Mort. for the Metropolis this year gave the total of 43.

1800-19.-In the mort. experience of the Equitable So. for the 20 years embraced in this period, out of 1930 deaths occurring during 151,754 years of insured life, only 26 were attributed to gout. Of these I occurred between the ages 30 and 40; 4 between 40 and 50; 4 between 50 and 60; 11 between 60 and 70; and 6 between 70 and 80. 1826. The Atlas Assu. Co., in its instructions to agents, pub. this year, had the following:

Gout. If it be declared that the party has had the gout, the Sol. is to ascertain and report-1. When the gouty symptoms first appeared. 2. What part of the body was affected. 3. How often the attacks of gout have occurred during the last 3 years.

1857.-Ward, in his Medical Estimate of Life for Life Assu., pub. this year, says: Special inquiry is to be made as to whether the party has had certain diseases which affect more immediately the value of life.

Gout. The having suffered from an occasional attack of this disease does not materially affect the value of any life; although the dangers of retrocedent gout, and the fact that the disease goes on increasing in force, and frequency of manifestation, and so ultimately affects the constitution, would seem to indicate some additional risk. . . . . It must be remembered, however, that deaths from retrocedent or suppressed gout would be represented under different titles, and that consequently the statistics in question [those of the Equitable So.] do not fairly represent the risk. When an individual is a great victim to gout, and has had severe attacks in the stomach, or suspicious head or chest symptoms, it will be better to decline the risk. In a gouty person, who is a free liver, and of sedentary habits, the risk is of course increased.

1859.-Dr. Garrod, M.D., pub.: The Nature and Treatment of Gout, which, from his repute in regard to this disease, attracted much attention. He confirmed the results arrived at by Sir C. Scudamore's analysis of 522 cases, showing the hereditary influence to prevail in more than one-half.

1860.—The deaths from gout in E. and W. this year were, males 212; females 56. Dr. Farr says hereon (23rd Rep. R. G. p. 337), "Gout is not always the consequence of over-feeding; but the excesses in eating and drinking of men at public dinners and elsewhere sufficiently account for this excess of mort. by gout, representing a still greater excess of suffering from the same malady."-See also 1865, 1869, and 1871.

The mort. experience of the North British Ins. Co. for the 37 years 1823-60 gives 6 deaths as arising from gout. Of these the average duration after acceptance was 8 years and I month. The average expec. had been 19.11. The per-centage on total mort. was '46. 1865.-The deaths from gout this year in E. and W. were 361; and said Dr. Farr, Ten years previously (1856) they "The deaths from this cause increase every year.' were 260. He adds (28th Rep. p. 177):

It is quite certain that few of its victims belonged to the selected classes-to the magni reges, dynasta exercituum, classiumque duces, philosophi, aliique his similes. Yet gout has infected some

of the ablest men in England, and there is perhaps some connexion between the phosphorus abounding in the brain and the excess of phosphoric acid in the blood of the gouty before a paroxysm. There is this peculiarity in gout: it is five times as common in men as in women, and it is very rarely fatal in either men or women under 35 years of age. The greatest number of deaths (of 96 men, of 19 women by gout) occurs at the ages of 65-75.

Dr. Mann's Contributions to the Medical Statistics of Life Assu., pub. this year, contains the following (p. 119):

The influence of Gout upon the duration of life cannot be rightly estimated by looking at the reports of deaths, either in the lists of the Reg.-Gen. or in the lists of our Life Assu. Offices. . It is in its influence in indirectly producing fatal results, which appear in our lists of mort. under the names of Apoplexy, Paralysis, Diseased Heart, Diseased Kidney, and Asthma, that we should form a more correct estimate of the fatal tendencies of Gout.

Nor do we arrive at a complete view until we also reckon the influence of gouty dyspepsia, and of the calculous forms of disease-especially those consisting of uric acid formations-in lessening the general powers of the body to resist disease, and to recover from its attacks. Whatever be the form of disease, medical or surgical, the gouty diathesis serves to increase its intensity, and to prolong its duration.

He proceeds to say that sometimes gouty persons reach old age. He could recollect patients who had passed 80 years of age. These were generally persons of temperate, regular habits, and who suffered from crippled joints of the fingers especially, and from the deposits called chalk-stones. He proceeds:

I remember an aged couple who had, each of them, a pill-box filled with these, which had exuded from their own joints. It does not, however, always happen that these deposits are harmless. I have known of instances in which suppuration has arisen from their presence more than once in the anklejoint, and once in the knee-joint.

Nor does it happen that the children of gouty parents who have been long-lived inherit the longevity as well as the gout. More frequently I believe the case is the reverse.

He asks then how, practically, medical examiners are to deal with cases in which gout— "a disease in which the data seem so variable and inconstant"-occurs in the personal history; and he answers his own inquiry in this form :

It hardly seems practicable to lay down any invariable general rule. Probably the most correct course will be to study each case in itself, and in its family connexions, as if it were a case sui generis. In looking at the individual we should consider the age at which the disease first began to show itself; the frequency of the attacks, their severity, and their continuance; and especially the presence or absence of any of those indirect results of gouty action on those organs which are essential to the functions of life: i.e. the stomach (especially also its auxiliary the colon), the lungs, the heart, the kidneys, and the brain, which involve danger to life. In looking at the family hist., we should notice whether the correlatives of gout, such as asthma, apoplexy, paralysis, and calculus, have often been fatal. To the study of the physique we must add that of the morale. Upon the latter, the dangerous development of the former will generally depend. Prob. the key to the exceedingly variable results of gout in different individuals of apparently similar constitution, and similar circumstances, will be found in the study of the moral, rather than of the purely physical and material relations of the cases

under consideration.

The powerful influence of hereditary predisposition is strongly marked in the history of gout. I have rarely met with instances of gout in private practice which were not distinctly traceable to this

source.

This is prob. the most able summary, from a practical point of view, of the bearing of gout upon Life Ins. which has yet appeared. The British Empire Mut., for which Dr. Mann was chief medical adviser, had no death from gout in the first 10 years of its experience.

1868. Dr. James Begbie, M.D., F.R.S. E., pub. a Rep. On the Causes of Death in the Scottish Widows Fund, etc., wherein he shows (T. III.) the causes of death of the members of that So. from 1815 to 1866. This T. gives 20 deaths from gout, viz. 2 between ages 30 and 40; 1 between 40 and 50; 8 between 50 and 60; 5 between 60 and 70; 3 between 70 and 80; and I above 80. In a previous report (1860, p. 22) Dr. Begbie had said, "The habits of the intemperate favour the development of gout and other blood-poisons, engendering diseases both of the vascular and nervous systems, and in this way bear a part in loading the cols. of our Mort. T." There is a later Rep. pub. in 1874, which however contains nothing requiring special comment.

We may here remark that the Scottish offices generally-that is, such of them as have pub. their mort. experience-appear to have a very small number of deaths attributed to gout. Has the national beverage, whisky, any bearing upon this circumstance? 1869.-Dr. Farr, in the 32nd Rep. of Reg.-Gen., commenting on the deaths of this year, says:

Gout is, like syphilis, becoming more fatal; the deaths regis. to its account are rapidly increasing, and loudly proclaim the necessity of beginning at least some reform in the dinners of the wealthier classes, if they would avoid not only the pangs of this dreadful disease, but its disorganizing ravages on their vital organs.

Some of his following remarks have already been quoted under title GLUTTONY; he adds: "Women have hitherto and we may hope will still continue to set men good examples; for the deaths of 352 men, and of but 96 women, are referred to gout."

Dr. J. Adams Allen, in his Medical Examinations for Life Ins. 5th ed. pub. this year (1869), says:

Gout of chronic character, and particularly if in any degree hereditary, disqualifies. But it does not follow that all sore toes are gouty. Analysis of individual cases is indispensable. The habits of life and surroundings will attract the attention of the examiner. The dyspepsia and general malaise discoverable by examination are of more significance to the cautious medical agent [examiner] of the Co.