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March 3, 1956


Author Affiliations

New York

Chief Medical Director of the New York Life Insurance Company (Dr. Bolt) and Actuary and Statistician of the Metropolitan Life Insurance Company (Mr. Lew).

JAMA. 1956;160(9):736-741. doi:10.1001/jama.1956.02960440008003

• Fifteen years of experience by 27 insurance companies with more than half a million insured persons have yielded data on some 132 varieties of physical impairment. Some conclusions can be drawn as to what is or is not important in physical examination and history-taking.

Persons with apical systolic murmurs had a higher mortality than did standard risks, and those with records of rheumatic fever or streptococcic infection had a higher mortality than those without. In this group the adverse prognostic meaning of cardiac enlargement was distinctly seen, but it was also found that death rates have decreased materially over the past 25 years.

The unfavorable significance of phlebitis, of familial history of cardiovascular-renal disease, of renal stone or colic, of gallbladder disorders, of epilepsy, and of cesarean section was demonstrated. Within the group of 18,400 persons with peptic ulcer, a history of hemorrhage appeared to make the prognosis much worse.