"I believe the reason for these conditions is plain. First of all it is due to Negroes leaving the country and crowding into the larger cities, especially in the North, where they live in a climate totally different from that with which they have been familiar. They occupy unsanitary homes; they are frequently compelled to labour with insufficient food and clothing and without proper rest. Of necessity they follow the hardest and most exposed occupations in order to make a livelihood. I regret to say that intemperance and immorality play a part in making these figures what they are. They easily fall victim to the unusual vices of the city. "Another reason for increased mortality is improper medical attention. Not only among the ignorant but among the intelligent we find too much trust put in patent medicines; the belief, latent it is true in many cases, but still existing among the ignorant, in the hoodoo militates against the close following of the doctor's orders. "What shall we do about it?" asks Dr. Furniss. "We must urge those around us to more personal cleanliness, insist on a pure home life, and less dissipation and intemperance: to have fewer picnics and save more money for a rainy day. Tell the young people in the South not to come to Northern cities, but to go to the smaller towns of the West, where they can have a fair chance. Unless something is done to change existing conditions, to stop this movement to our Northern cities, to provide proper habitations and surroundings for those who are already here, it will be only a question of time until the problem of the American Negro will reach a solution not at all desirable from our point of view." Of course a doctor always sees the pathological side of life and his view is likely to be pessimistic. I saw much of the tragedy of the slum Negroes in the cities of the North, and yet many Negroes have been able to survive, many have learned how to live in towns and are making a success of their lives--as I shall show more particularly in the next chapter. It must not be forgotten that Negro families in Boston and Philadelphia (mostly mulattoes, it is true) as well as in Charleston, Savannah, and New Orleans, have lived and thrived under city conditions for many generations. Not a few Negroes in Indianapolis whose homes I visited are housed better than the average of white families. _Sickness Among Northern Negroes_