■ PHYSICAL ECONOMICS. 
 
 [Comprising a mathematical formula for the normal 
 earning ability of the body by which, with the requisite 
 data a person may be either rated, or his economic value 
 may be ascertained, and thereby damages to his body from 
 injury or disease, with an indemnity to be allowed therefor, 
 may be determined in a manner equitable to all concerned.] 
 
 ERASTUS EUGENE HOLT, A.M., M.D., LL.D. 
 
 PORTLAND, MAINE. 
 
 M L ^ ' 
 
 < . . T' . ' fc > I I -—7— ■ 
 
 JlTlVI 1, " I 1 ' 1 1 t I » 
 
 - (.i j. j. / I, ;■ ^ ’ 
 
 Reprinted from The Journal of the American Medical Association, 
 July 21, 1906, Vol. xlvii, pp. 19i-204. 
 
 CHICAGO : 
 
 PUESS OP THE AMERICAN MEDICAL ASSOCIATION, 
 ONE HUNDRED AND THREE DEARBORN AVENUE, 
 
 1906. 
 

(^omrnrrco. 2vl0C>*t Ta\|Io'*' ,?.S 
 
 ■RA 
 
 y 
 
 — i. 
 
 )o 64 
 ° H ip^f\ 
 
 a PHYSICAL ECONOMICS.* 
 
 Vy 
 
 [Comprising a mathematical formula for the normal 
 ^ earning ability of the body by which, with the requisite 
 
 data a person may be either rated, or his economic value 
 may be ascertained, and thereby damages to his body from 
 injury or disease, with an indemnity to be allowed therefor, 
 may be determined in a manner equitable to ail concerned. J 
 
 ERASTUS EUGENE HOLT, A.M., M.D., LL.D. 
 
 PORTLAND, MAINE. 
 
 An oculist, when called on to ascertain damages to 
 the. eyes from an injury, frequently meets with other 
 disabilities of the body which occurred at the same time. 
 If he works in connection with other physicians and 
 surgeons who are to determine damages to other parts 
 of the body, it is highly important that there should be 
 standard methods of procedure which can be applied to 
 every system and organ of the body so that each may 
 understand the other and work together to obtain results 
 on a scientific basis. The object of this paper is to pro- 
 mulgate methods by which this may be accomplished in 
 a manner equitable to all concerned. 
 
 The problem is a mixed one, inasmuch as w^e must 
 have a method for ascertaining the economic value of a 
 person both before and after he has been damaged from 
 injury or disease. All recognize the importance of 
 scientific methods for 'solving this problem, but no one 
 has had the temerity to attempt to overcome the diffi- 
 culties surrounding it. It occurred to me, liowever, 
 while I was disabled from an injury, received in 1903, 
 that if, when the eyes were damaged, the remaining 
 earning ability could be determined by a mathematical 
 formula, based on the principles employed in the natural! 
 sciences in measuring any power, as had been done bv 
 Magnus^ of Germany, the principle might be utilized' 
 
 ♦ Read in the Section on Ophthalmology of the American' 
 Medical Association, at the Fifty-seventh Annual Session, June, 1906. 
 
 1. “Visual Economics,” by Dr. PI. Magnus of Breslau, Germany, 
 translated with additions by Dr. H. V. Wiirdemann, Milwaukee,. 
 
 Wis. 
 
 p A. (b ^ 
 
2 
 
 for the whole body. I, therefore, spent many of the 
 long weary hours of my disability in thinking how this 
 could be accomplished. After I had adapted the princi- 
 ple to the whole body, it seemed so simple that I won- 
 dered if some one had not solved the problem in a simi- 
 lar way. On making inquiries in connection with the 
 reprints of my papers among many persons I have 
 failed to find any one who had solved the problem in 
 this manner. 
 
 Professor Seaver, formerly director of the gymnasium 
 of Yale University, replied: 
 
 I wish to thank you for a reprint on “Physical Economics” 
 
 . . . which strikes me as a very valuable contribution on 
 
 a subject to which I have given considerable thought without 
 being able to arrive at definite conclusions, and so I have 
 never published anything. You have hit on a practical method 
 of rating a man’s physical utility so far as the physical side 
 of him is concerned, as mental rating is given by intellectual 
 tests, so that we may have a fairly accurate mathematical 
 statement of his probable worth to society. 
 
 Professor Bowditch, of the Harvard Medical School, 
 with several others, referred me to ^‘^Vital Statistics: a 
 Memorial Volume of Selections from the Eeports and 
 Writings of William Farr, M.D., D.C.L., C.B., F.K.S., 
 edited by Noel A. Humphreys.^^ Dr. Farr spent his life 
 in the Eegistrar-GeneraPs office of England, where by 
 his writings on vital statistics and allied subjects he 
 rendered one of the greatest services to his country that 
 ever fell to the lot of man, and which made him an 
 authority on these subjects throughout the whole civil- 
 ized world. 
 
 In this work, under the head of ^^Cost and the Pres- 
 ent and Future Economic Value of Man,” we find: 
 “The characteristics of life property in wages and in 
 income from professions, commerce, trades and manu- 
 factures is that it is inherent in man and is the value of 
 his services — of the direct product of his skill and indus- 
 try. In slaves it is vendible and transferable; in free- 
 men it is inalienable ; but is not the less on that account 
 property which in the early states of society is assessed 
 and taxed in the form of personal services. It is com- 
 bined with stock in all production; and the proportion 
 of the elements varies in every kind of product. The 
 labor of the parents and the expenses of attendance, 
 nurture, clothing, lodging, education, apprenticeship, 
 practice, are investments of capital, at risk extending 
 
3 
 
 over many years ; and the return appears in the form of 
 the wages, salaries or income, of the survivors, com- 
 mencing at various ages, 12, 15, 21, 24, 30, 33, 36, 39, 
 and ages still greater; for the incomes in the higher 
 professions increase probably up to the age of 50 or 
 55. The outgo increases from infancy up to a certain 
 age; the earnings then commence, and ere long equal 
 the outgo; they are subsequently in excess throughout 
 manhood, and at advanced age decrease, until they are 
 extinguished amidst the feebleness and infirmities of old 
 age. The present value of the personas probable future 
 earnings, minus the necessary outgo in realizing these 
 earnings, is the present value of that personas services. 
 Like capital invested in the soil, in the vintage, or in a 
 commercial adventure, the capital invested in the life 
 of man returns, in happy natures, profit of a hundred- 
 fold; in other cases fifty, twenty, tenfold; in others it 
 is barely returned; in some it is entirely lost, either by 
 death, sickness, vice, idleness, or misfortune.'’^ 
 
 On the ^^Economic Effect of Death by Different Dis- 
 eases,” he says: ^^Life has a pecuniary value. In its 
 production and education a certain amount of capital 
 is sunk for a longer or shorter time, and that capital, 
 with its interest, as a general rule, reappears in wages 
 of the laborer, the pay of the officer, and the income of 
 the professional man. At first it is all expenditure, 
 and a certain necessary expenditure goes on to the end 
 to keep life in being even when its economic results are 
 ' negative. 
 
 ^^The value of any class of lives is determined by 
 valuing first at birth, or at any age, the cost of future 
 maintenance, and then the value of the future earnings. 
 Thus proceeding, I found the value of a Norfolk agri- 
 cultural laborer to be £246 at the age of 25; the child 
 is by this method worth only £5 at birth, £56 at the age 
 of 5 ; £117 at the age of 10; the youth £192 at the age 
 of 15 ; the young man £234 at the age of 20 ; the man 
 £246 at the age of 25, and £241 at the age of 30, when 
 the value goes on declining to £138 at the age of 55, 
 and only £1 at the age of 70; the cost of maintenance 
 afterward exceeding the earnings, the value becomes 
 negative; at 80 the value of the cost of maintenance 
 exceeds the value of the earnings by £41. These values 
 .may be compared with the former cost of slaves in 
 Eome, in the United States, and in the West Indies. 
 
4 
 
 ‘‘The amount of capital sunk in the education of pro- 
 fessional men is not only greater, but it is probably at 
 greater risk, and it has to remain longer under in\e8t- 
 ment before it is returned. The maximum value of 
 such a man is attained later in life, probably 40; and 
 in the highest orders of the church, law, and politics, 
 where experience and great weight of character are 
 requisite, the life still increases in value at higher ages.” 
 
 This method employed by Dr. Farr, and other high 
 authorities, for ascertaining the present value of a per- 
 son, at any age, must be accepted as the correct one for 
 determining the economic value of a human being. It 
 necessarily involves a knowledge of the bodily functions, 
 for on the physical condition of a person depends his 
 prospective earning ability; therefore, an examination 
 of the body must be made to decide whether it is in a 
 condition to meet the exppctations of a working life at 
 that age. If the examination revealed conditions which 
 are known to lessen tin- ‘Expectation of life, then this 
 fact must be taken into consideration in the calculation 
 and materially modifies the results. 
 
 The present value of the net yearly earnings (‘f a 
 person for a prospective working life is the sum of tli^Ese 
 net earnings when discounted at the rate of interest, 
 used in the computation, compounded for each of the 
 series of years before they will be realized. This makes 
 the interest account of very great economic importance 
 in the problem, because the present value of any sum, 
 due any number of years hence, depends on the rate of 
 interest per annum and the number of years before it 
 becomes due. The present value is very much less when 
 a high rate of interest is used than when a low rate of 
 interest is used in the computation, for it is the reverse 
 of a sum to be realized at compound interest in the 
 future. 
 
 In the computation carried out in the work of Magnus 
 already referred to, the gross earnings are taken and 
 multiplied by the years of the prospective working life 
 as a base on which to determine the damages. It is 
 manifestly wrong to take the gross earnings of a person 
 for a base on which to determine damages to his body, 
 for if a man was totally disabled he should, according 
 to this method, receive an indemnity equal to his gross 
 earnings. We must keep constantly in view that the 
 solution of this problem is based entirely on the present 
 
5 
 
 economic value of a person, and that this economic 
 value must be determined from his age and his net 
 annual earning ability for a prospective working life at 
 a rate of interest to be realized on a long time, as we 
 have shown by a quotation from the writings of Dr. 
 Farr, whose authority is recognized throughout the civ- 
 ilized world. There might be fixed a value for a person 
 whose earnings only equalled or were less than his ex- 
 penses in realizing those earnings, but it would have to 
 be estimated on a philanthropic and not on an economic 
 basis. 
 
 The method employed by Dr. Farr for determining 
 the present value of a person from the net yearly income 
 of his normal earning ability has much in common with 
 the principle employed in life insurance, and, therefore, 
 is just as accurate and reliable in its results, especially 
 when obtained with the same care as to all the details. 
 The economic value of a person at the time of the acci- 
 dent is the base on which to compute his economic loss. 
 After we have ascertained his remaining earning ability 
 in the form of a fraction of the normal, the economic 
 loss may be obtained in dollars and cents. 
 
 For the purpose of determining the remaining earn- 
 ing ability of a person damaged from injury or disease, 
 we need a mathematical formula for the normal earning 
 ability of the body. 
 
 In the analysis of a person to determine the elements 
 which are indispensable for his normal earning ability 
 and which m_ay be used as factors to express them in a 
 mathematical formula, we find that the functions of the 
 body in a fairly normal condition are of first impor- 
 tance. This constitutes the functional ability of the 
 person and the factor of first importance in the formula. 
 
 A person would be of very little use, economically, in 
 the world without having had that training of the mind 
 and body which would fit him to follow some occupation 
 successfully. This constitutes the technical ability of a 
 person and the second factor in the' formula. With the 
 functional and technical ability of the first order, there 
 is another element of a person of considerable impor- 
 tance, namely, his ability to secure and perform the 
 duties of an occupation successfully. It makes no dif- 
 ference whether his services are rendered direct to the 
 general public or through some employer; his success 
 depends on his ability to obtain work and to serve those 
 
6 
 
 who employ him. This constitutes the competing abil- 
 ity of a person and the last factor in the formula. 
 Therefore, the three elements of a person which are 
 absolutely indispensable to his normal earning ability 
 are, first, the functional ability; second, the technical 
 ability, and, third, the competing ability. This analysis 
 of a person includes everything needed in the perform- 
 ance of the duties of any occupation. It may, therefore, 
 be considered complete, and, moreover, it is in accord- 
 ance with the principles employed in the analysis of any 
 physical force by which its efficiency is determined. The 
 acceptance of this analysis of a person is of prime im- 
 portance to an understanding of the mathematical 
 formula for the normal earning ability of the body, be- 
 cause its object is to determine the essential elements 
 which may be used as factors in the formula. 
 
 In a similar way that much-used substance called 
 electricity has been analyzed; the unit of the electro- 
 motive force being designated as a volt, which is a cur- 
 rent of one ampere, with a‘ resistance of one ohm. The 
 amount of electricity is obtained by multiplying these 
 three elements together, producing a composite quantity 
 called watts, 746 of which make a horse-power. By 
 using the first letter of each word this process is repre- 
 sented in the formula W == V A 0. When, however, 
 electricity is obtained by this standard of resistance, its 
 efficiency is determined by multiplying volts by amperes, 
 and the formula thus simplified is W = V A. 
 
 In a similar manner if we use the first letter of the 
 prominent word in the analysis of a person, F = the 
 functional ; T = the technical ; C = the competing, and 
 E = the earning ability of a person; hence E = 
 FTC, the mathematical formula for the normal earn- 
 ing ability of the body: 
 
 These three factors are not of equal value, although 
 the efficiency of each is interdependent on the other, F 
 being first in importance; T second in importance; 
 whereas C is least important, because it depends on the 
 other two and the conditions of the labor market. The 
 competing ability is composed of the same elements as 
 F and is modified to a similar but less extent when F is 
 impaired. It is also modified by T and the way em- 
 ployers and the public consider the person, especially 
 when he has been damaged by injury or disease. There- 
 fore, to meet all these conditions, C must be placed 
 
7 
 
 under a radical in the formula, the index of which may 
 be designated by an X to indicate that it is to be de- 
 termined in each instance, and the formula thus modi- 
 fied is E = F T v/'(X 
 
 To amplify the formula,^ F must be resolved into its 
 component parts by selecting and grouping into the 
 form of units such systems and organs as are so inter- 
 dependent that each is needed to insure the functions 
 of the other in its particular unit, and these systems and 
 organs taken together form a unit that is absolutely 
 indispensable to the functions of the body. These 
 units are to be regarded as factors of F, which when 
 multiplied together, and by the other two factors of the 
 formula, produce the composite quantity E. As much 
 as possible, systems and organs have been selected and 
 grouped together as units in accordance with their de- 
 velopment and associated functions, it being found nec- 
 essary to have four such units for the whole body, which 
 when designated by the first four letters of the alphabet 
 are as follows : 
 
 , the bones, 
 
 , the joints, 
 
 , the muscles. 
 
 , the heart, 
 
 , the vessels, 
 
 , the lungs and their accessory 
 organs. 
 
 :, the alimentary canal, 
 
 , its accessory organs, 
 
 1 , the kidneys with the genital 
 ^ organs. 
 
 f n, the brain, its membranes, and its' 
 r Cerebro-spi- 1 nerves, 
 
 I nal systems, | o, the spinal cord, its membranes, its 
 d =-{ nerves and -{ anterior motor, and its poster- 
 
 I ganglia, con- I ior sensory nerves, 
 
 ' Insisting of p, nerves and organs of special 
 1. sense. 
 
 Each of these units fulfills the requirements of our 
 definition: it is composed of systems and organs so in- 
 terdependent that each is needed to insure the functions 
 of the other, and these taken together form a unit that 
 is absolutely indispensable to the functions of the body. 
 This being true, the value of the function of each unit 
 may be obtained by a formula similar to that employed 
 in determining the value of any physical force. In 
 amplifying F, by resolving it into its component parts, 
 as factors, a, b, c, d, each of these was resolved into its 
 
 I the sympa- 
 f-tlietic nerves 
 I and ganglia. 
 
 b = 
 
 5 Osseous, articular, and 
 1 muscular systems, consisting of 
 
 5 Circulatory and respiratory 
 1 systems, consisting of 
 
 5 Digestive and genito-urinary 
 ( systems, consisting of 
 
 
 2. The remainder of this discussion of the formula is from my 
 article in the second and enlarged edition of the Encyclopedia 
 Americana. 
 
8 
 
 component parts, as factors, and a = efg;b = hij: 
 c = k 1 m ; and d= nop. 
 
 In any computation, if one of the factors becomes 0, 
 the product is 0. In diseases of the bones, like osteo- 
 malacia, producing an inability to support the body, e 
 would become 0, then a = 0 ; in inflammation of the 
 joints, like chronic articular rheumatism, causing a 
 large number of stiff joints, f would become 0, and 
 a = 0; in diseases and injuries producing paralysis of 
 the muscles, g would become 0, then a = 0, and finally, 
 in diseases and injuries by which a large portion of the 
 extremities were lost, a certainty would become 0, and 
 if a = 0 then F = 0. In serious valvular and organic 
 diseases of the heart, or vessels, h or i would become 0, 
 then b = 0 ; in serious diseases of the lungs and their 
 accessory organs, j would become 0, then b = 0, and if 
 b = 0, then F = 0. Iff the various serious diseases of 
 the alimentary canal, its accessory organs, the kidneys 
 with the genital organs, each of k, 1, m, might become 
 0, then c = 0, and F = 0 ; and in the various serious 
 diseases of the brain, spinal cord, and organs of special 
 sense, each of n, o, p, might become 0, then d = 0, and 
 F = 0, and finally, if F — 0, then E = 0. Therefore, 
 the parts of each unit, as factors, bear the same relation 
 to the unit, as the units, as factors, do to the whole body. 
 Each part, as factor, is indispensable to the other, and 
 each unit as factor is indispensable to the body. The 
 units are always to be regarded as factors of F, and 
 multiplied together and by the other two factors of the 
 formula, if we are to conceive of the earning ability of 
 the body as a whole which can be given a mathematical 
 expression. Our formula represents, mathematically, 
 the complete earning ability of the body in a healthy 
 normal person, which is a composite quantity, resulting 
 
 As ha s already been show n, when F is resolved into 
 from the multiplication of factors; the same as was 
 \ done in obtai ning the efficiency of electricity. 
 its component parts, as factors, it is represented by 
 
 X X 
 
 (abed) andv'c, becomes ^/{a b c d), because C is 
 composed of the same elements as F; hence the com- 
 plete formula for the normal earning ability is E = 
 
 X 
 
 (abed) T >/(a b c d). Now in this formula the 
 units, or factors, are not of equal value, and, hence, 
 when damage to them has been ascertained by scientific 
 
standards of measurement they may be placed in the 
 formula under a radical, the index of which will de- 
 pend on how much less it is desired the damaged units 
 shall affect the formula than that given to them by 
 scientific standards of measurement. The unit, d, rep- 
 resenting the cerebrospinal systems, nerves, and ganglia, 
 would under almost all circumstances be placed in the 
 formula at its full value, as determined by scientific 
 standards of measurement, as any damage to it pro- 
 duces in the person thus affected proportional disability 
 for all gainful occupations. 
 
 To ascertain the remaining value of a unit in a given 
 case of damage, it must be compared with some scien- 
 tific standard of measurement, and the remaining value 
 given in the form of a fraction of the whole unit. This 
 method, which permits of the mathematical determina- 
 tion of each unit of the bodily function, as a fraction of 
 the normal unit must be considered complete, as it is 
 in accordance with the principles laid down by the 
 natural sciences in measuring the power of any ph 5 ^sical 
 force, one of which, that of electricity, has been given. 
 
 “The four units of F, or their remaining value, after 
 being damaged, must always be regarded as factors and 
 multiplied. Their product is a composite quantity — the 
 earning ability of the body. They must never be regarded 
 as quantities to be added, for wrong practical deductions 
 would be obtained^ as the following will clearly show : 
 
 X ^ 
 
 In the formula, E = (a b c d) T ^ (a b c d), let us 
 suppose that from an injury a person was rendered 
 blind and deaf, and that, therefore, the unit, d, becomes 
 0. It is self-evident that a person in this condition 
 would have no earning ability, and yet, if we add the 
 remaining units, a, b, and c, which might be normal, 
 we would obtain three-fourths of the earning abil- 
 ity of the body, which results in a reductio ad absur- 
 dum. With a, b, c, d, of oUr formula regarded as fac- 
 tors, to be multiplied, however, when d, or any other 
 factor, becomes 0, the product is 0, also, and no ab- 
 surdity results, because in any computation, if one of 
 the factors is 0, the product will always be 0. If a 
 person has no technical ability, T would be 0, and, 
 therefore, E = 0. This would be true in actual prac- 
 tice. Finally, if we decide that a person has no com- 
 peting ability x = 0, and E = 0, and this would be 
 true in the labor markets, notwithstanding the bodily 
 
10 
 
 functions might be normal and the technical ability 
 might be of the highest order, yet if the personas serv- 
 ices were not needed and he could not dispose of them 
 at any price, his earning ability would be 0. There- 
 fore, in our mathematical formula for the normal earn- 
 ing ability of the body, if any one of the units as fac- 
 tors becomes 0, then E = 0, and no absurdity results. 
 We have, at some length, dwelt on F, of our formula, 
 because it is the most important factor in it. We now 
 pass on to T, the next in importance. 
 
 The technical ability of a person is usually gained 
 during adolescence, and is generally attained by the 
 time the growth of the body is completed. The formula 
 may be used as a guide during the years of growth and 
 development and serve to rate the youth, taking into 
 •consideration the condition of the functional ability on 
 which the mental and technical ability so much depend, 
 but which has been heretofore practically ignored. As 
 important as T is to the normal earning ability, and in 
 rating a person, when that person’s vocation becomes 
 fixed, T may be considered as equal to one in estimating 
 damages. The technical ability is not injured, but lim- 
 ited only in proportion to the damages to F, impair- 
 ment of which will include these damages; therefore, T 
 may be omitted, and the formula thus modified for de- 
 termining damages to the earning ability of the body is 
 
 E == (a b c d) -s/(a b c d) 
 
 We now come to C, the third and last factor of our 
 formula. The ability to compete is a condition which is 
 affected by a variety of circumstances; first, by the per- 
 son’s functional ability ; second, by his technical ability ; 
 and, third, by the way employers consider these condi- 
 tions, together with the supply and demand for labor. 
 Therefore, when a person becomes disabled, the damage 
 to his body acts immediately in two ways : first, by its 
 direct impairment of the functional ability, according 
 to the nature and extent of the damage by reason of 
 which he will not be able to perform so much, and per- 
 haps not so good work, as he did before; and, second, 
 by the way employers consider these conditions. The 
 damage to the body might be of such a nature as to ef- 
 fect the appearance of the person without interfering 
 materially with his earning ability; such as in the unit 
 a, loss of the auricles, or nose ; in the unit d, a large 
 scar of the cornea, or an injury to a blind eye causing it 
 
11 
 
 to become crossed. Disfigurements like these, although 
 not interfering with a personas ability to work as well as 
 he did before the damage was done, would seriously in- 
 terfere with his chances to obtain employment, and 
 should, therefore, be considered a serious obstacle to his 
 competing ability. In case of damages, a person has a 
 right to secure compensation, not only for the loss to 
 his functional ability but also to his appearance, when it 
 seriously interferes with his ability to obtain employ- 
 ment in the grade of work and command the wages to 
 which he is entitled. The part of his ability to com- 
 pete not represented in the person himself, but in the 
 way employers consider the damages we render in the 
 number selected for the index of the radical of the com- 
 peting ability. In general, if a person has no compet- 
 ing ability we would select 0 ; if it is seriously affected 
 we would select 2 or 3 ; if only moderately affected 5 or 
 7 ; and if but slightly affected 10, for the index of the 
 radical of the competing ability. By leaving this to the 
 physicians who have ascertained the damages to F, and 
 who are the most competent to judge what it shall be, 
 disabilities of the body, and an indemnity to be allowed 
 therefor, may be determined in a* manner equitable to all 
 concerned. 
 
 The higher mathematics involved in the extraction of 
 the roots of the radicals are avoided by the construction 
 of a chart by Prof. Hart of the University of Maine, by 
 which geometric curves represent the different roots ; the 
 value of the abscissa being given at the top and bottom, 
 and that of the ordinate on either side. By taking the 
 remaining decimal value of the unit of the body, as ab- 
 scissa, and tracing the line to the geometric curve repre- 
 senting the root sought, and from this point following 
 the ordinate to its end on either side, the value of the 
 root will be found. Inserting this value in the formula, 
 the process of finding the remaining earning ability and 
 thereby the damages to the body is one of simple compu-. 
 tation, involving no more mathematics than an example 
 in interest or partial payments. 
 
 Although it is true that scientific standards of meas- 
 urement of all the parts of the units of the body have not 
 been determined and agreed on, nevertheless it is a 
 self-evident fact that anything that is used must have a 
 value placed upon it, and when this value has been meas- 
 ured, tested, compared, and estimated in a scientific man- 
 
13 
 
 uer, in a large number of normal healthy persons, and 
 an average value ascertained, this average value becomes 
 a scientific standard of measurement for that particular 
 part of the unit of the body. It is in this way that all 
 the scientific standards of measurement, now employed, 
 have been determined and agreed on, and it is in this 
 way that all the remaining ones must be established. 
 Until this work is consummated we shall have to employ 
 such standards as have been agreed on, and by the same 
 methods by which these have been obtained determine 
 values for all the remaining systems and organs of the 
 units of the body which will eventually be accepted as 
 scientific standards of measurement. 
 
 In ascertaining damages to the body, a physician 
 must first determine what the impairment of the func- 
 tion of the unit is, and then, by comparing this with the 
 case record and the scientific standard of measurement 
 for it, give the remaining value in the form of a fraction 
 of the whole unit in the formula. The principles and 
 process then are the same as those employed in deter- 
 mining the efficiency of any physical force. It will be 
 seen that it is the daniaged functions that the physician 
 first seeks, and not necessarily the pathology of the dam- 
 aged unit. To illustrate this, a physician might in ex- 
 amining the eyes find the sight seriously impaired, the 
 fields markedly contracted, and the muscular move- 
 ments badly deranged. He could determine the exact 
 functional disability of each of these units of the eyes by 
 the scientific standards of measurement for them, and 
 give the remaining value of each unit in the form of a 
 fraction for the Magnus formula, and thereby ascertain 
 the remaining earning ability of the eyes without know- 
 ing the pathology of the disabilities. The exact nature 
 of the disabilities could not be determined without insti- 
 tuting an examination which would reveal their path- 
 ology, and therefore the physician could not state whether 
 the disabilities were temporary or permanent without 
 such an examination. The pathology of a disability is 
 necessary only to determine its character, whether trans- 
 itory or permanent, serious or not, as the case may be. 
 and should not be made the basis to determine the re- 
 maining earning ability of the body. The earning abil- 
 ity is a composite quantity made up of the physiologic 
 functions of the systems and organs of the units of the 
 
13 
 
 body, each of which is interdependent on the other in 
 making man the most wonderful product of nature. 
 
 In youth and the beginning of manhood, we can only 
 rate a person according to his functional and his tech- 
 nical ability, but when that person has a fixed occupation 
 we can, thereby, determine, by our formula, his earning 
 ability and his economic power in the world as accurately 
 as we can that of any physical force. We can determine 
 his mental ability only so far as it is manifested in his 
 vocation and the importance placed on it as evidenced in 
 the remuneration he receives for it. We can not figure 
 on possible prospects of advancement, nor change of 
 occupation. We can only figure on the actual conditions 
 of life as they exist, and when accidents occur, causing 
 damage, on the supposition that these conditions would 
 continue for a length of time thereafter according to 
 the basis on which the American experience table of 
 mortality has been constructed and on which has been 
 established life insurance — the first business of the 
 world. 
 
 The value of the functions of the body cannot be deter- 
 mined, for health, like character, is priceless. Even the 
 possession of health much below any economic value is 
 priceless, and is clung to under all conditions of priva- 
 tion and suffering. This does not affect the purpose of 
 our formula, which represents mathematically the nor- 
 mal earning ability of the body. This has solely to do 
 with the individuaTs ability to perform certain services 
 and to receive a specific compensation therefor for the 
 remainder of a prospective working life. Ho life insur- 
 ance company would consider a risk on a man^s life for 
 an amount his business or wealth did not warrant. A 
 man who has no income whatever and could offer no 
 collateral would be refused a loan of money from any 
 person, or bank, and he could not obtain money except 
 by reasons which are foreign to the rules of business. 
 A person with good habits and a steady occupation with 
 a specified income would be able to hire money on that 
 alone, in proportion to his income, other things being 
 equal. The time is coming when the earning ability of 
 man will be rated and will be just as valuable in the labor 
 market as in the rating of his financial ability to-day in 
 the business marts of the world. 
 
 We will now proceed to illustrate the use of the for- 
 mula in the case of a young man whose eyes were severely 
 
14 
 
 damaged and the right hand badly burned by a current 
 of electricity sufficient to kill two men instantly. 
 
 W. O’B. * aged 20, mill employ^, June 22, 1900, while stand- 
 ing on an iron platform and handling a portable electric light, 
 received a current of electricity sufficient to throw him down 
 instantly. Two of his fellow-workmen who saw him fall 
 quickly went to his aid and, in attempting to pull him away 
 from the platform and the wire of the lamp, which was burn- 
 ing his hand, both were killed instantly. The electric current 
 was shut off as soon as possible and Mr. O’B. was extricated 
 from his perilous position. Dr. G. F. Webber of Fairfield, 
 Maine, was called to attend him and stated that the fiexor 
 tendons of the thumb and forefinger were burned off and the 
 flesh of the other fingers was burned severely. The hair and 
 scalp to the size of a silver dollar were burned off where the 
 back of the head rested on the iron platform. He was uncon- 
 scious for seven or eight hours after the accident. 
 
 There was evidence that the wires, of the electric light com- 
 pany, outside the mill became crossed in the mill yard, the 
 primary wire carrying a current of 2,200 volts. 
 
 When the wound healed the thumb became adherent to the 
 forefinger so he was unable to grasp anything between the 
 forefinger and the thumb. His sight was seriously affected, 
 and he came under the care of Dr. J. F. Hill of Waterville, 
 Maine. He also consulted Hon. Charles F. Johnson of Water- 
 ville to ascertain how he might recover damages for his 
 injuries. 
 
 On Sept. 13, 1901, I made an examination of Mr. O’B. with 
 the following results: Vision right eye 0.1, no improvement 
 with lenses. Vision left eye 0.4, no improvement with lenses. 
 Corneal astigmatism right eye, 1 D. at 90°; left eye, 0.8 D. at 
 90°; abduction, 4°; adduction, 14°; esophoria, 5%°; sursum- 
 duction right eye, 3°; left eye, 3°. Deciphers type No. 10 
 (3l^ mm. in height). The right field of vision was contracted 
 30° on the temporal side and 20° above, below and on the nasal 
 side. The left field of vision was contracted about 10° in all 
 directions. No limitations of the muscular movements were 
 recorded. 
 
 Examination of the interior of the eyes showed the media 
 fairly clear, so that the retina and optic nerve of each eye 
 could be seen readily. It was evident from the ophthalmo- 
 scopic appearance that both the nerve and retina of each eye, 
 especially of the right eye, had suffered from inflammation, 
 but, of course, there was nothing in the slight changes to indi- 
 cate the cause of it or when it may have occurred. 
 
 He was examined again on Dec. 27, 1901, and his condition 
 was found to be about the same as here recorded. 
 
 The suit was brought for $5,000, and the trial took place at 
 Skowhegan, Maine, in December, 1901, Hon. A. S. Littlefield 
 of Rockland being the attorney for the pulp mill company. 
 
15 
 
 Mr. Littlefield consulted me about testifying for the defense. 
 After I stated to him I was engaged, and the substance of my 
 testimony, he did not engage any one to testify as to the 
 condition of the eyes, but engaged Dr. W. P. Giddings of 
 Gardiner, Maine, to testify as to the physical condition of 
 Mr. O’B. After a trial of several days the jury rendered a 
 verdict for Mt. O’B. of $3,271. This verdict was set aside 
 afterward, because of the erroneous ruling of the judge who 
 held the pulp mill company liable for negligence of the elec- 
 tric light company which supplied the electricity. 
 
 As to the verdict and a new trial Mr. Johnson writes me: 
 “1 am, of course, very much disappointed that the verdict 
 should be lost on what really had nothing to do with the de- 
 cision of the case, for if the jury had been correctly instructed 
 by the court, I feel very certain that the result would not 
 have been changed, but as attorneys, we have to learn to take 
 the bitter with the sweet. I intended to try the case the 
 second time, but the young man’s brother-in-law, who was 
 able to furnish him some financial assistance^ died, and in the 
 meantime the young man’s hand was operated on in the hos- 
 pital at Augusta, where I got him a free bed. After the 
 operation he was able to use it more than before and found 
 employment in the woolen mills at Fairfield at the same 
 price per day which he had received in the pulp mill. He 
 never will, however, have a good hand, and the work about 
 which he is employed in the woolen mill does not call for 
 very much use of his hand. Certainly through the remainder 
 of his life he will not have more than one-half the use of 
 that hand. The last time I saw him in 1905 his eyesight was 
 no better. When he undertook to read or look at an object 
 steadily, or for any length of time, his eyes manifested very 
 marked signs of weakness. For the work about which he is 
 now employed it is not necessary that he use his eyes very 
 much. I think otherwise he has been in good health and has 
 continued to work in the woolen mill. 
 
 ‘‘The insurance company® made an offer of $1,000, which 
 could not be considered in any light adequate compensation 
 for his injuries. However, he had no money to continue liti- 
 gation, and he was able to work some, and there were trou- 
 blesome questions of law about the liability of the defendant 
 company, as well as the question about collecting an execu- 
 tion from the pulp mill, I thought it best to accept the offer. 
 
 “Since I heard your lecture on physical economics at Water- 
 ville I have been very much interested in the subject. The 
 question of what are adequate damages for personal injuries is 
 always a very troublesome one for the courts, and the juries 
 
 3. The Insurance company was one that Insured the pulp mill 
 company against liabilities for injuries to Its employes and against 
 the cost of defending suits to the amount of $5,000 in any indi- 
 vidual case. 
 
IG 
 
 liave no certain guide to go by. It seems to me that you have 
 developed a practical method for rating a person and for de- 
 termining damages to the body from injuries or disease, and I 
 sliall hope to see it in daily use in the near future.” 
 
 The position I took at the trial was that, inasmuch as 
 Mr. O’B’s eyes had never been examined and there was 
 no record of the condition of the eyes before the acci- 
 dent, 1 could only state the condition I found them in, 
 and the probable effect this would have on his future 
 earning ability. In answer to a question as to the prob- 
 able effect of a current of electricity of high voltage on 
 the brain and organs of special sense, I replied that it 
 could not be definitely determined without a carefully 
 made record of the condition of a person before it passed 
 through these organs, but in this case, inasmuch as two 
 of Mr. O’B’s comrades were killed, instantly, by the cur- 
 rent which must have passed through his body to them, 
 and there was no history of weak eyes to offset the claim 
 that his eyes were good and strong before the accident, 
 it was fair and equitable in my opinion, to assume that 
 they were good before the accident. This testimony was 
 acceptable to both parties to the suit. 
 
 In determining the damages to Mr. O’B. in conse- 
 quence of the partial loss of the functions of the eyes, it 
 was necessary to consider the loss of central and peri- 
 pheral vision. Central vision was reduced to 0.1 normal 
 in the right eye, and 0.4 normal in the left eye. As nor- 
 mal vision according to the standard of measurement is 
 not essential to mill employes, that is, a large number of 
 them earn and receive full wages when vision is very 
 much below this scientific standard of measurement for 
 normal vision, it could not be assumed that the fractional 
 part of the loss of vision lessens the earning ability of the 
 eyes to that same amount. At the time of the accident 
 the American edition of Magnus’ work had not appeared. 
 I find, however, that my estimation of the effects of the 
 loss of vision on the earning ability of Mr. O’B. at that 
 time, correspond very nearly to the results obtained by 
 the standard adopted by Magnus, as I assumed then 
 from an examination of a large number of laborers of 
 different vocations that one-half of the scientific stand- 
 ard of measurement for normal vision was sufficient for 
 full earning ability, provided the fields of vision of each 
 eye were nearly normal. 
 
 The loss in the field of vision in this case, especially 
 of the right eye of 30 degrees on the temporal side, I re- 
 
17 
 
 garded seriously as it is the same in amount as when one 
 eye is entirely lost, and no matter in what direction Mr. 
 O^B. looked there would be just so much narrowing of 
 the field of vision, and a corresponding detriment in his 
 ability to work in any vocation and protect himself from 
 dangers without that are constantly menacing persons 
 with such a disability. Considering the damages on this 
 basis, I determined the economic loss to Mr. O’B’s eyes 
 3/8 of the whole, and, therefore, the remaining earn- 
 ing ability 5/8. This corresponds closely to the results 
 obtained by Mangus’ method by which I figured it after 
 the American edition of that work appeared. 
 
 As much as we all admire the work of Magnus, and 
 the additions made to it by the translator and editor of 
 the American edition. Dr. Wilrdemann, it is not satis- 
 factory to determine damages to the eyes by one method, 
 and damages to another part of the body, which were 
 caused by the same injury, by an entirely different 
 method, therefore I saw the necessity of adapting the 
 principle employed by Magnus in his formula for the 
 normal earning ability of the eyes to the whole body, 
 and developed the mathematical formula for the nor- 
 mal earning ability of the body, the application of which 
 to solving problems in cases of damages to the body 
 from injury, or disease, with an indemnity to be allowed 
 therefor, is the object for which this paper has been pre- 
 pared. 
 
 In determining the remaining earning ability of Mr. 
 O’B. by the mathematical formula for the normal earn- 
 ing ability of the body, we will ascertain the remaining 
 earning ability of the eyes, first, which are a part of one 
 of the factors in unit d. 
 
 The eyes, as Magnus has clearly demonstrated, have 
 three factors which are absolutely indispensable to their 
 normal earning ability, namely the central acuity of vis- 
 ion, the field of vision, and the muscular movements. 
 Although these factors are not of equal value, and for 
 that reason are placed under a radical in the Magnus 
 formula, nevertheless if either one of the two lesser ones 
 in value be totally destroyed the earning ability of the 
 eyes likewise will be destroyed. 
 
 Mr. O’B^s best eye, the left, which determines his cen- 
 tral acuity of vision, was 0.4 normal scientific standard 
 of measurement. Assuming that 0.5 normal scientific 
 standard of measurement is sufficient for full earning 
 
18 
 
 ability, which is the standard adopted by Magnus for 
 mill employes, he had lost 1/5 of the sight actually 
 needed in this vocation, and therefore had 4/5 left, 
 
 .OJ .lO .ts .*0 -SS .50 ZS .40 45’ SO .S S .6 0 ZS .To .7S AO As' '.SO 9S 1.00 
 
 which is one of the factors of the coefficient of the unit d. 
 The vision of the right eye was 0.1 of the normal scien- 
 tific standard of measurement, and the loss in the field of 
 vision on the temporal side was 30° of the normal scien- 
 
i 
 
 19 
 
 tific standard of measurement. If the binocular field is 
 divided into three zones^ as suggested by Schroeter, and 
 ^ practiced by Magnus, there will be six zones of 30° each, 
 
 and as the outer zone of 30° was gone, there was 5/6 left, 
 which in consideration of the serious loss of vision of 
 this eye, should be placed in the formula at its full value 
 as the other factor of the coefficient of the unit d. 
 
 The defect in the muscular balance of the eyes (eso- 
 phoria) and the weakened accommodation were not 
 thought sufficient to be taken into account in the calcula- 
 tion. 
 
 The objective damages to the body are included in the 
 unit a. The damage to the scalp could be concealed by 
 the hair and the real damage from this particular part 
 was to unit d, which has already been determined. 
 
 The damage to the right hand was severe. In look- 
 ing for a standard of measurement by which the loss of 
 the function of the hand could be compared and its re- 
 maining economic value be determined, I feel sure that 
 all who saw the case would agree that the disability was 
 equal to, or greater, than ankylosis of the wrist, and his 
 competing ability would be less than a person suffering 
 from ankylosis of the wrist, because in ankylosis of the 
 wrist, there would be no scar, or deformity, only the loss 
 of motion, whereas Mr. O^B. had loss of motion and a 
 bad looking scar of the hand. If this disability of the 
 hand is considered equal to that of ankylosis of the 
 wrist, for which the standard of the Bureau of Pensions 
 of the United States is one-ninth of total disability and 
 which I have shown in a paper read before the National 
 Association of United States Pension Examining Sur- 
 geons, at Atlantic City, published in their transactions 
 for 1904, is equivalent to 10 per cent, of total disability 
 when placed in the mathematical formula for the normal 
 earning ability of the body and the competing ability 
 considered, we have 9/10 of the unit a left, which is its 
 coefficient. Discarding all undamaged units of the form- 
 
 • ula, we have as an expression of the remaining earning 
 ability of the body of Mr. O’B. when placed in the form- 
 ula the following: 
 
 * E = 9/lOa (4/5 x 5/6 )d 1 / 9/lOa (4/5 x 5/6d = 
 0.60 V 0.60. 
 
 It is necessary now to ascertain Mr. O’B’s competing 
 ability. His right hand was a bad looking one, and 
 
20 
 
 moreover its functions were not one-half what a normal 
 hand should be, which would prevent him from obtain- 
 ing emploj^ment in many occupations. Taking the ob^ 
 jective disability of the right hand, and the subjective 
 disability of his eyes, we choose 5, as fair and equitable 
 for the index of the radical of his competing ability on a 
 scale of 2 being used when the competing ability is the 
 most seriously affected, and 10 when it is but slightly 
 
 affected. We then have E = 0.60 v/ o.60 = 0.60 x 0.905 
 = 0.543 : E = 54.3 per cent. Therefore, Mr. 
 O’B.^s remaining earning ability is 54.3 per cent, of hi? 
 normal earning ability, and, hence, his economic loss 
 is 45.7 per cent. The loss in wages and other necessari 
 
 expenses connected with the injury are as follows : 
 
 Two and one-fourth years’ wages at $375 $843.75 
 
 Less $80 earned canvassing during this time.... 80.00 
 
 $763.75 
 
 Physician’s bill for services 208.00 
 
 Druggist’s bill for medicine 30.00 
 
 Care and nursing, estimated 42.00 
 
 Cost of treatment at hospital estimated 58.00 
 
 Making a total of $1,101.75 
 
 This should be added to the loss of the earning ability. 
 
 We will now proceed to determine the present value of 
 Mr. O^B. at the time of the accident from his age and the 
 wages he was earning. He was 20 years old and was 
 earning $1.25 per day. Assuming he would work, on an 
 average of 300 days in the year, his income would be 
 $375. This would allow thirteen days each common and 
 fourteen days on leap year for sickness or vacation. It is 
 a close approximation to what ought to be actually rea- 
 lized. 
 
 The cost of maintenance, as Dr. Earr says, is an esti- 
 mate, but it must be remembered that any transaction 
 of man must have a value placed on it and when this 
 value has been measured, tested, compared and esti- 
 mated in a scientific manner, in a large number of in- 
 stances and an average value ascertained, this average 
 value becomes a scientific standard of measurement for 
 the value of that particular transaction. 
 
 We need a standard of measurement for the economic 
 value of man^ in two vocations, the average laborer, and 
 
 4. The Bureau of Pensions of the United States has established 
 $864 for total disability, for a soldier or sailor. As total disa- 
 bility requires the regular aid and attendance of another person It 
 may be inferred that this amount represents the gross earnings of 
 two persons, and, therefore, the earnings of one would be one-half 
 of it or $432 a year, $36 a month, and $1.44 a day. 
 
21 
 
 the average professional man. The first should be ob^ 
 tained from the wages of a laborer of average minimum 
 capacity, based on his age, his physical condition and his 
 income. The present value of the net income must be 
 computed at a rate of interest that has been accepted as 
 a standard for such computations, which we have as- 
 sumed to be 3.5 per cent., as nearly all insurance values 
 are figured at this rate. 
 
 As this has not been done in this country on an eco- 
 nomic basis, we will accept Dr. Farris standard for a 
 Norfolk agricultural laborer, who at the age of 20, earned 
 £23 a year, at the age of 25, £29 a year, and at the age 
 of 30, £31 a year, and thereafter until the age of 60, £31 
 a year. Taking an average of £29 a year and reducing it 
 to dollars and cents, we have $140.94. Dividing $375 
 by $140.94 and we obtain 2.66 as the ratio between a 
 Norfolk agricultural laborer and the wages Mr. O’B. was 
 earning. Multiplying the standard for the present eco- 
 nomic value of a Norfolk agricultural laborer as deter- 
 mined by Dr. Farr on a basis of 5 per cent, per annum 
 by 2.66, and we have a standard for an American lab- 
 orer, on the same basis. 
 
 In another table Dr. Farr determines the present eco- 
 nomic value of a Norfolk agricultural laborer on a basis 
 of 3 per cent. With this and the 5 per cent, table, we ob- 
 tain one on a 4 per cent, basis and with the 4 per cent, 
 and 3 per cent, we obtain the present economic value on 
 a 3.5 per cent, basis, which are as follows, from birth to 
 70 years of age. 
 
 Age 
 
 Total 
 
 Died 
 
 English 
 
 American 
 
 3%f?ibasis 
 
 3%basis 
 
 Birth 
 
 
 
 5%basis 
 
 5 basis 
 
 
 
 
 513 
 
 
 $26.10 
 
 $69.43 
 
 $119.54 
 
 $146.64 
 
 5 
 
 372 
 
 141 
 
 271.87 
 
 723.17 
 
 1,245.16 
 
 1,518.03 
 
 10 
 
 355 
 
 17 
 
 568.04 
 
 1,510.99 
 
 2,601.62 
 
 4,169.66 
 
 15 
 
 346 
 
 9 
 
 930.93 
 
 2,476.27 
 
 4,263.66 
 
 5,194.59 
 
 20 
 
 335 
 
 11 
 
 1,135.25 
 
 3,019.77 
 
 5,451.75 
 
 6,295.74 
 
 25 
 
 321 
 
 14 
 
 1,197.26 
 
 3,184.71 
 
 5,488.03 
 
 6,686.29 
 
 30 
 
 307 
 
 14 
 
 1,172.06 
 
 3,117.03 
 
 5,368.03 
 
 6,540.09 
 
 35 
 
 291 
 
 16 
 
 1,109.15 
 
 2,950.34 
 
 5,079.91 
 
 6,189.06 
 
 40 
 
 275 
 
 16 
 
 1,030.42 
 
 2,740.92 
 
 4,719.32 
 
 5,749.73 
 
 45 
 
 257 
 
 18 
 
 936.81 
 
 2,491.91 
 
 4,290.59 
 
 5,227.40 
 
 50 
 
 237 
 
 20 
 
 818.28 
 
 1,910.02 
 
 3,742.71 
 
 4,566.00 
 
 55 
 
 215 
 
 22 
 
 669.80 
 
 1,781.67 
 
 3,067.68 
 
 3,737.48 
 
 60 
 
 189 
 
 26 
 
 472.49 
 
 1,256.82 
 
 2,163.90 
 
 2,636.49 
 
 65 
 
 156 
 
 33 
 
 223.56 
 
 594.67 
 
 1,023.90 
 
 1,247.46 
 
 70 
 
 118 
 
 38 
 
 3.74 
 
 9.95 
 
 17.13 
 
 20.87 
 
 75 
 
 79 
 
 39 
 
 —119.31 
 
 317.37 
 
 —546.44 
 
 —565.75 
 
 80 
 
 44 
 
 35 
 
 —199.31 
 
 530.16 
 
 —872.74 
 
 —1,112.15 
 
 Multiplying the present economic value for the age of 
 20, as here obtained by the percentage of the remaining 
 earning ability of Mr. O’B., and we have the amount of 
 his remaining earning ability. Subtracting this re- 
 
22 
 
 maining earning ability from his present economic value 
 and we have his economic loss, then adding his loss in 
 wages and his expenses after the injury, and we have his 
 total economic loss as follows : 
 
 $3,019.77 X .543 = $1,639.74 ; $3,019.77 — $1,639.74 = $1,380.03; 
 
 $1,380.3 $1,101.75 = $2,481.78, 5 per cent, basis. 
 
 $5,451.75 X .543 = $2,960.30 ; $5,451.75 — $2,960.30 = $2,491.45 ; 
 
 $2,491.45 + $1,101.75 = $3,593.20,3% per cent, basis. 
 $6,295.74 X .543 = $3,418.58 ; $6,295.74 — $3,418.59 = $2,877.16 ; 
 
 $2,877.16 + $1,101.75 = $3,978.91, 3 per cent, basis. 
 
 Thus we see that the total economic loss to Mr. O’B. 
 varies according to the rate per cent, used in computing 
 his present value at the time of the accident. To which- 
 ever amount that may be accepted as equitable, should 
 be added such a sum for the suffering in mind and body, 
 as may be warranted on philanthropic grounds. 
 
 When these methods are accepted as a means of ad- 
 justing damages to the body from injury or disease, it 
 will be necessary only to determine who was responsible 
 for the accident that caused them, then the settlement 
 may be made in a manner equitable to all concerned. 
 
 The amount for which suit was brought, ($5,000) in 
 view of the serious damage to Mr. O’B., was not an un- 
 reasonable sum for such damages, as shown by his eco- 
 nomic value at the time of the accident and from his 
 remaining earning ability, as determined by scientific 
 and economic standards of measurement, and the math- 
 ematical formula for the normal earning ability of the 
 body. When the present value of Mr. O’B. is determined 
 at the rate of 5 per cent, discount, the amount that 
 should be paid him is $789.22 less than the amount of 
 the verdict rendered by the jury; when determined at 3.5 
 per cent, it is $322.20 more than that rendered by the 
 jury; while at 3 per cent, it is $707.91 more than that 
 rendered by the jury. 
 
 We believe that if the jury, in this case, could have 
 had these methods, as here worked out, demonstrated to 
 •them, their duty would have been easier to perform and 
 the results would have been more satisfactory to them- 
 selves. However, we have no criticism to make on the 
 verdict rendered, considering the standpoint from which 
 it was ascertained. 
 
 In determining a standard of measurement for the 
 present value of a man in the United States, we believe 
 that the wages earned by Mr. O’B. at the time of the ac- 
 cident, $1.25 per day, are an average minimum for this 
 •^country and that the rate of interest of 3.5 per cent, per 
 
23 
 
 annum, may be accepted as a standard for computation. 
 
 Dr. Farr determines the present value of persons in 
 professions on moderate incomes, earning £288 a year, 
 or $1,399.78, practically $1,400, or $4.50 per day, inter- 
 est 3 per cent., as follows : 
 
 1. Age 25, economic value $25,898.94 
 
 2. Age 30, economic value 27,702.00 
 
 3. Age 35, economic value 28,921.86 
 
 4. Age 40, economic value 29,344.68 
 
 5. Age 45, economic value 28,829.52 
 
 6. Age 50, economic value 27,138.24 
 
 7. Age 55, economic value 23,974.38 
 
 8. Age 60, economic value 19,337.94 
 
 9. Age 65, economic value 13.209.48 
 
 10. Age 70, economic value 2,988.00 
 
 It will be seen by reviewing the methods by which the 
 damages to Mr. O’B. have been determined, that every 
 step in the process has been taken with a well-defined ob- 
 ject in view, and that it has been accomplished by the 
 use of a mathematical formula for the normal earning 
 ability of the body, based on the principles employed in 
 the natural sciences in ascertaining the value of any 
 physical power, and therefore is scientifically correct. 
 The two values to be determined in the case were first, 
 his remaining earning ability, in the form of a fraction - 
 of the normal earning ability, and second, his economic 
 value at the time of the accident. We determined the 
 first by comparing the conditions found in the eyes with 
 such economic standards of measurement of the eyes as 
 have been found by the examination of a large number 
 of cases by different observers to be sufficient for a mill 
 employe to perform the work required of him success- 
 fully, and give the remainder in the form of a fraction 
 for each of the factors of the eyes thus involved. These 
 remaining values of the factors of the eyes were multi- 
 plied together for the coefficient of the unit d to which 
 they belong. 
 
 We obtained the remaining value of the hand by com- 
 paring the disability with the standard of measurement 
 established by the Bureau of Pensions of the Dnited 
 States for all minor disabilities, namely, ankylosis of 
 the wrist, by which millions are paid to soldiers and 
 sailors annually. We then had the remaining value of 
 the damaged units a and d, as their coefficients, and dis- 
 carding h and c because not considered injured, and 
 therefore equal to one e^ch, we have the formula com- 
 plete for working, except the index of the radical of the 
 competing ability. • The number for the index of the 
 radical of the competing ability is determined by a moth- 
 
24 
 
 od based on principles as well defined as those employed 
 in rating a person at school or college. With this chosen, 
 we proceed to work the formula according to the prin- 
 ciples upon which it is constructed, and obtained the re- 
 maining earning ability of Mr. O^’B. in the form of a 
 fraction of the normal earning ability as 54.3 per cent. 
 
 Thus every step of the process to determine the eco- 
 nomic value of the damage to Mr. O’B. in consequence 
 of the injury he received June 22, 1900, has been taken 
 with a well-defined method of procedure, as that of 
 weighing or measuring of any commodity and then mul- 
 tiplying the quantity by the price per unit of the stand- 
 ard of measurement for that commodity, in order to ob- 
 tain its value. The final result then can not be ques- 
 tioned on the ground of the want of care in obtaining it, 
 it can only be questioned on the ground as to whether 
 the principles on which the methods are based are correct 
 and give results that* are right and equitable to all con- 
 cerned. 
 
 On both of these points we have the highest authority, 
 for my formula for the normal earning ability of the 
 body is based upon the principles employed in the 
 sciences in determining the value or efficiency of any 
 natural power. It was employed by Magnus in his 
 mathematical formula for the normal earning ability of 
 the eyes. My work has been to adapt these principles to 
 the entire body by selecting and arranging the different 
 systems and organs according to their development and 
 associated functions, that all the essential parts of the 
 body may be grouped under four units, which may be 
 used as factors of the functional ability in a practical 
 formula as readily as though the principles were applied 
 to but one organ at a time. 
 
 For the success and approval of this work, . I have 
 quoted from one of the many letters which I have re- 
 ceived, because Dr. Seaver, as he writes, has spent a large 
 part of his life in studying the body, to develop, measure, 
 and utilize it to the best advantage. He has written one 
 of the best works on anthropometry and physical exam- 
 inations in the English language, and therefore his opin- 
 ion is an authority on this subject. 
 
 As to the method of determining the present economic- 
 value of a person, I have quoted from the highest Eng- 
 ii>ii <iuiiioi u\, and rheretore, of the world, because the 
 
25 
 
 science of vital statistics owes its existence largely to 
 English writers, the greatest of whom was Dr. Farr. 
 
 After admitting the principles of the methods and 
 every step of the process taken in the solution of this 
 problem are correct, it might be argued that the final re- 
 sult is not equitable because Mr. O^B. has obtained work 
 in a woolen mill for the same wages he received at the 
 time of the accident. 
 
 This argument would be too fallacious to need refuta- 
 tion when the history of the case and the conditions 
 under which Mr. O’B. now works are taken into con- 
 sideration. He must at the best, always take an inferior 
 position. The current of electricity which passed through 
 his body was sufficient to kill two men, and the bad ef- 
 fects may gradually develop, thus farther disabling him. 
 This is no small consideration in the problem, but it is 
 not taken into account in the result obtained. We have 
 endeavored to be conservative in every step of the pro- 
 cess, and believe the result is obtained in a manner equit- 
 able to all concerned. 
 
 One important datum is lacking in the absence of a 
 record of an examination of the eyes before the accident, 
 and, therefore, we are unable to assert positively that the 
 conditions of his eyes, as found after the accident, was 
 due to the injury, but we are confident that the position 
 taken is fully justified by the history of the case, and the 
 nature of the injury. 
 
 We have gone into the details of this case at consider- 
 able length, because it illustrates how well the formula 
 is adapted to working out the remaining earning ability 
 of a person when one or more of the units of the body 
 has been damaged by injury or disease, and, therefore, 
 it is a type of all such cases. 
 
 If Mr. O^B. had had a record of an examination of 
 his eyes showing that they were normal prior to the acci- 
 dent, all doubt on this point would have been removed. 
 This again shows the necessity of every person having a 
 case record of his physical condition, for no one knows 
 when he may meet with an accident and need it to deter- 
 mine just what the amount of the damage is from a given 
 injury. If the history and examination revealed a sus- 
 picion that a part of a disability existed prior to the acci- 
 dent for which damages are claimed, and this should be, 
 by further evidence in the case, established beyond a 
 reasonable doubt, then the fact must be taken into con- 
 
26 
 
 sideration in determining the amount of the damages 
 due to the accident. To avoid disputes and litigations 
 every person should have a carefully made record from 
 repeated examinations of his body. 
 
 This would be of great value to a person, not only in 
 case of injury, but also in the treatment of any disease. 
 
 The progress of medicine is towards preventing, rather 
 than curing diseases, and in order to make this practice 
 more complete, the time is coming when physicians will 
 be largely occupied in making these examinations and 
 case records, and thereby preventing rather than curing 
 diseases. There is nothing of more importance to be in- 
 stituted in the science and practice of medicine for its 
 welfare and advancement than the carefully made rec- 
 ords of the physical and laboratory examinations of 
 every person. To make them more effective they should 
 be instituted when the child enters school, and be re- 
 peated at stated times during the whole period of school 
 life. This would necessitate establishing a new officer, 
 the school physician, not an inspector of the schools, but 
 one who would take a child, analyze him, detect all ab- 
 normalties and in conjunction with the parents and other 
 physicians correct them during school life, and thus have 
 the body improve'd with the mind, that each may help the 
 other to the fullest development. From these records 
 data could be obtained which, when applied to the math- 
 ematical formula for the normal earning ability of the 
 body, and worked out according to the principles on 
 which it is constructed, would give the rating of a child, 
 taking into consideration his functional ability on which 
 his technical ability so largely depends, but which has 
 been heretofore almost entirely neglected in rating him. 
 With this work carried out during school life, it would 
 soon demonstrate its own importance, by making these 
 records of the highest value in the training of the mind 
 and the body, the advancement of the race, for the pro- 
 motion of health and the prevention of disease, and in 
 furnishing data to determine damages to the body from 
 injury or disease by the mathematical formula for the 
 normal earning ability of the body, in a manner equit- 
 able to all concerned. 
 
 DISCUSSION. 
 
 Dr. H. V. WuRDEMANN, Milwaukee, said that one could talk 
 for hours and still not convince some people that mathematics 
 can be applied to this question. Some definite standard is 
 
27 
 
 needed in court. To say that a person has lost one-half his 
 visual activity means nothing; it is a matter of dollars and 
 cents and one should be able to state that a man has lost a 
 certain per cent, of his earning ability, a certain amount in 
 dollars and cents. Such studies as those of Farr and Magnus 
 have demonstrated that mathematics may be applied to deter- 
 mining the function ability of man to compete with his fel- 
 low. It has been demonstrated, mainly through the German 
 observers, that there are definite visual factors which may be 
 damaged, and which damage may have a definite infiuence on 
 the earning ability. In court two questions arise : a question of 
 fact and a question of opinion. If an opinion be generally ac- 
 cepted by any profession it has almost as much weight in 
 court as a fact. We will not for many years reach a position 
 in which these formulje will be received as the general opinion 
 of the profession, yet even now they have some weight. There 
 is a remarkable similarity of results obtained by the method 
 of Magnus and Wiirdemann to damages given in several hun- 
 dred suits that he has studied; a remarkable similarity in the 
 amount given empirically to that found by mathematical 
 standards. Dr. Holt’s paper goes very far into the future. It 
 will be a long time before such an opinion will be favorably 
 received by the general profession and accepted by courts and 
 juries. He thought that the citation of the case of Mr. O’B. 
 was rather unfortunate, inasmuch as he was able to earn 
 practically the same amount after the accident as before. What 
 we need now is statistics and each one can contribute to the 
 literature one or more cases showing the amount of earning 
 capacity after a certain accident. It is only by such evidence 
 that we will be able ultimately to determine exactly the per- 
 centage of loss of earning ability following a given accident. 
 At the Ophthalmological Congress at Lucerne three men were 
 called on, one to represent France, one Germany and one the 
 American and English, to get what evidence they could and 
 endeavor to establish some standard whereby to determine the 
 resulting loss from injury to an eye. In Great Britain the 
 loss is placed at 50 per cent, for one eye. A man earning 28 
 shillings 4 pence a week got his 50 per cent, relief and in addi- 
 tion 38.3 per cent, from a fraternal society, so that it paid him 
 to be sick. The Germans allow 33 1/3 per cent, insurance for 
 loss of an eye. He did not think he could go as far as Dr. 
 Holt until we have accumulated a great number of statistics 
 on the subject. It is only by an accumulation of such statis- 
 tics, where individuals suffering certain accidents have been 
 damaged in a definite pecuniary way, that we can arrive at an 
 opinion in the matter that will be received by the courts as a 
 statement of fact. 
 
 Dr. L. Webster Fox, Philadelphia, said that these questions 
 are of very great importance to ophthalmic surgeons located in 
 manufacturing centers. Some system is needed by which an 
 
28 
 
 opinion can be formed as to the value of an injured eye, arm 
 or leg. Unfortunately for statistics in America, accident cases 
 are taken up by unscrupulous attorneys and fought on a con- 
 tingent-fee basis, and many of these cases are settled out of the 
 courts. In Philadelphia are very large manufacturing inter- 
 ests, and it is important to the ophthalmic surgeon that some 
 set of tables be prepared in a manner in which he can use them 
 for reference of value. At the Baldwin locomotive works 17- 
 000 men are employed; the Medico-Chirurgical Hospital re- 
 ceives a large number of the accident eases; but by a system 
 of their own they prevent the cases from getting into the 
 courts. There are many other cases in which it is a difficult 
 problem to settle the damages. Recently he saw a case in 
 which both eyes were destroyed and the plaintiff received the 
 sum of $10,000 from a sympathetic jury; the accident in this 
 case was partly due to the man’s own negligence. Now when an 
 opinion is asked, the physician can at least give the courts an 
 idea of the value of the earning ability of such an individual 
 by referring to Holt’s system of valuation, thereby giving a 
 pro rata share of his loss. Each occupation, of course, is a 
 law unto itself and differs in degree; some men receive $20 
 or $30 a week, others $10 or $15. He believes that the move- 
 ment is a practical one and should be taken up by the -asso- 
 ciation, for it lessens the power of a jury to determine the 
 value of a lost eye in such cases. 
 
 Dr. Edward Jackson, Denver, said that a mathematical 
 formula is simply a method of stating some fact. An enormous 
 number of facts that Ave do not think of as having anything 
 to do with mathematics can be stated in rigid mathematical 
 formulae. To study these facts in any way is to render them 
 clearer in our own minds, and on this account he thinks we 
 ought not to leave these formulae to Dr. Holt or Dr. Wiirde- 
 mann, or any feAV men especially interested in the subject. 
 The formulae are not complete, and that is a reason for bring- 
 ing them before this section. In order to complete them we 
 must have observations made by a large number of the profes- 
 sion. These analyses of Dr. Holt have largely to do Avith 
 functional ability. If Ave can get definite reports from actual 
 cases, in which the earning ability before and after the acci- 
 dent has been ascertained, our estimate of the real impairment 
 of economic ability will be better. Functional ability may 
 contribute to various things, as the comfort and pleasure of 
 the indiAudual, etc., but in this connection it is Avith reference 
 to productiA’^e work, and the actual facts can only be settled 
 by the combined experience of the profession. Functional 
 ability is the foundation of the AA’hole subject and must be 
 settled by our united statistics. Some day it aauII be settled 
 in that AA’ay, and if the members of this section Avill consider 
 the cases that come to their notice in the next year, or the 
 next fi\’e years, Avith reference to this point, there aauII result 
 
29 
 
 a basis of observed facts wbich will make these formulae of the 
 greatest value. 
 
 Dr. E. E. Holt, Portland, Me., agreed with Dr. Jackson that 
 the functional .ability is the most important element in the 
 problem, but he said further that, as he had shown in the dis- 
 cussion of the formula for the normal earning ability of the 
 body, the functional ability of the, body, however perfect, would 
 be of no economic value without the technical and competing 
 ability of the person to go with it and make it useful. It 
 should be demonstrated that the economic value of man can be 
 ascertained as readily as any of the values on which insurance, 
 the first business of the world, is based. With these methods 
 the economic value of a person at any age can be demonstrated 
 to all interested parties, and then a standard has been estab- 
 lished for a base on which to compute that person’s economic 
 loss when damaged from injury or disease. In a number of 
 cases he had been consulted privately and has figured the 
 problem out according to the methods here presented with so 
 much satisfaction that the cases have been settled out of court. 
 With standard methods of procedure to ascertain the economic 
 value of a person at any age, according to his functional and 
 his net earning ability, that person’s present economic value 
 can be readily determined ; and, with the mathematical formula 
 for the normal earning ability of the body, with the requisite 
 data, that person’s economic loss can be determined when he 
 has been damaged, in a manner equitable to all concerned. 
 Thus, in a given case, what is right and equitable can be ascer- 
 tained; this is of very much more importance than collecting 
 statistics of what is being done under present empirical 
 methods.