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October 19, 1895


JAMA. 1895;XXV(16):678-679. doi:10.1001/jama.1895.02430420034005

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Some years ago, a prominent medical writer published an account of an ideal "City of Health," an assumedly impossible municipality in which all preventable causes of disease were avoided, and the death rate lowered to two or three in the thousand by faultless construction and organization and absolutely perfect sanitation. The article was widely quoted in the lay and medical press, and everywhere with approval, until a mathematician or an actuary ventured to figure on the possibilities and demonstrated that with such a death rate without a corresponding reduction in births, there would not, in a relatively very few years,be standing room for the population in such a community.

Man is a very prolific animal and the procreative instinct is one of the strongest in our nature; certainly this is so with what has been called in continental Europe, the proletariat, a class that includes mainly the improvident poor, and

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