ARMY MEDICAL LIBRARY FOUNDED 1636 WASHINGTON, D.C. DUE TWO WEEKS FROM LAST DATE HAR191956 UN !TED STATES <> i'1 m i<: xi r o It All A M -\ ■■■ /.V/./l.V/>.V nFATOSinKDAIL I1IEIP©M SICKNESS AND MORTALITY IN THE ajrwe ©ef fni wsrn^nE) s^p^'H'ibso COMPILED FROM THE RECORDS OF THE SURGEON GENERAL'S AND ADJUTANT GENERAL'S OFFICES—EMBRACING A PERIOD OF TWENTY YEARS, FROM JANUARY, 1819, TO JANUARY, 1839. PREPARED UNDER THE DIRECTION OF THOMAS LAWSON, M. D SURGEON GENERAL. Published for the use of the Medical Officers of the Army of the United States. WASHINGTON: PRINTED BY JACOB GIDEON, JR, \ l/MLf// »bRAR' % IQ4o V.. | THE MATTER CONTAINED IN THE FOLLOWING PAGES WAS COLLATED AND CONDENSED BY SAMUEL FORRY, M. D. LATE OF THE UNITED STATES ARMY. } INTRODUCTION. The following pages are devoted to the investigation of the comparative in- fluence of various systems of climate upon the organization of man—a subject which enga^"1 *u° -"ention of the father of physic himself, in his treatise on 44 Air, Water, anu situation." The medical literature of almost every coun- try abounds with medico-topographical descriptions of particular localities ; but the mere accumulation of facts of this kind, unless systematically arranged can avail but little in determining the operation of physical causes upon the human constitution. In observing the phenomena of nature, the view of the individual practitioner is here restricted to narrow boundaries ; and as these various and complicated facts have been but partially generalized, the laws of / nature in regard to these external'influences upon the healthy and diseased condition of man are often sadly misinterpreted. For the period of twenty years, quarterly reports of diseases among the regular troops have been uninterruptedly made to the Medical Bureau of the United States Army ; thus affording the means, in connexion with the returna in the Adjutant General's Office, not only to investigate morbid action by the numerical method, but to show its relation with climate. As these diversified facts admit of classification according to certain geographical limits, the results, ' it is hoped, will furnish some general laws towards the basis of a system of medical geography. This report consists of a collection of facts in relation to the medical topo- graphy of the military posts, and the vital statistics of the troops extending over a period of twenty years. The general conclusions have been arrived at through a process of statistical investigation, and the accompanying remarks are the result of the experience and observation of individuals whose officia duty it was to study the local features of certain regions, to investigate the causes of their diseases, and to analyze and describe them. The diseases incident to armies present an extensive field for observation. , The advantages offered in the Revolutionary war, and in our second struggle with Great Britain, were but slightly improved. Excepting the " Medical Sketches " of Surgeon Mann, and a few remarks interspersed in the works of Dr. Rush, we are almost entirely ignorant of the medical history of these two eventful periods. Military hygiene—the knowledge of maintaining the health IV. of soldiers, and of promoting their efficiency—is another subject which should not only be carefully studied by medical and all other officers, but receive the special attention of Government. In the arrangement of these statistical materials, the subject has been divid- ed into two parts, each embracing the period of ten years. In the former, the numerical mode of investigation, in default of the requisite data in regard to the mean strength of each post, prior to 1829, is carried out only in part; but in the latter period, all the advantages afforded by this method of analysis has been realized. The extent of labor in preparing these papers may be in- ferred from the single fact that it was necessary to examine about 4,000 quar- terly sick-reports, (a majority of which have been condensed into abstracts,) and to obtain from the Adjutant General's Office the mean strength for corres- ponding periods, compiled from the post and regimental returns. In the brief topographical descriptions of the posts, due allowance will be made by those having the personal knowledge derived from a residence at a station, for the difficulty attending a compilation from statements made by different individuals and at different periods. As this report exhibits a con- densed view of the labors of the majority of the medical officers belonging to the army for a period of twenty years, it is impracticable to acknowledge the collator's obligation to each one individually. He, therefore, avails himself of this opportunity of expressing to them generally his indebtedness for the val- uable data afforded by their quarterly reports. To the late Surgeon General, much credit pertains for having organized a system of returns, rendering it feasible to condense the results of so long a period into the form now pre- sented. Surgeon General's Office, April, 1840. PART I. In entering upon the annual details, it may be necessary to re- mark, that in this part it is intended to give merely an outline 1819. of the medical history of each year, descending in no instance to the considerarion of specific cases unless warranted by unusual circumstances. The object aimed at is, to exhibit more especially the peculiar character of the diseases which prevail in wrild and newly cultivated countries, and to bring under notice several affections, which, with the exception of the army, are little met with in our country, such as scurvy and the poisonous effects of lead. Military hygiene, or the art of preserving the health of soldiers and of promoting their efficiency under all circumstances, will receive attention. As no attempt will be made to enter deeply into the pathology of disease, censoriousness may possibly be disarmed by stating that no medical officer in making an official report, supposed that it would ever be applied to its present use. To the army Surgeon at least, it is believed that the facts embodied will prove of some value. Nearly all conclusions derived from statistical results have been reserved for the second part. During the first five years embraced in this report, the features of morbid action in general were characterized by unusual severity. Inde- pendently of ordinary observation, this fact, so far as the data extend, is established by numerical results. The aggregate of cases and deaths presented in the reports of the first quarter of this }rear, is comparatively small, no disease being suffi- ciently prevalent to require comment. At Forts McHenryand Severn, (Baltimore and Annapolis,) however, " a violent bilious colic," remarks the Surgeon General, " attended with frequent attacks of inflammation of the brain, terminating in delirium, apoplexy, and death, has prevailed for the last year." At Fort Severn no satisfactory cause could be assigned, independently of the local peculiarities of position ; whilst at Fort McHenry, the men are represented as excessively addicted to the vice of intemperance. Dr. Stewart, who had resided many years at Baltimore, regarded it as a new modification of disease. It was looked upon as one of those inscrutable results, which, by the fortuitous con- currence of circumstances, are developed from time to time; and,which, in the infinite series of such contingencies, may never again occur. It will be seen, howrever, that this disease, which continued to harass these tw7o garrisons for several years, final!} received a rational explanation. 6 In the southern division of ihe army, the usual diseases of our troops, intermittents, diarrhoea, and dvscntery, prevailed ; but the cases reported were generally of a mild character, and controllable by ordinary reme- dies. The reports for the quarter ending the 30th June, exhibit nothing peculiar. Pulmonary consumption and intemperance are as usual the active causes of death among (he troops. The deaths from these two causes, as in our bills of mortality, it will be seen, constantly present a heavy item. In this quarter, out* of twenty-three deaths, nine are traced directly to an excessive use of ardent spirits, whilst others doubtless were owing indirectly to the same cause. The Surgeon General em- braced this occasion to impress upon the Secretary of War the import- ance of striking the whiskey altogether from the ration, and substituting an equivalent in vegetables or sugar and coffee ; but it was not until the administration of Mr. Cass, in 1830, although its necessity was frequently urged, that an order was promulgated directing that " the commissaries shall cease to issue ardent spirits as a part of the daily ration of the soldier." The total of cases and deaths reported for the quarter ending the 30th September, was unusually large. The principal diseases were fevers of the synochal, intermittent, and remittent type, and diarrhoea and dysen- tery. Under the first form of fever is included, the typhus which pre- vailed at the north; and under the last, the bilious remittent or yellow fever, which appeared in many of our cities, on the sea-board, and even as far west as the Missouri. In the southern division, intermittents and remittents, in their common form, were unusually prevalent; and at most places, more especially along the borders of Florida, attended with much hepatic derangement. Dysentery was also presented in a char- acter of more than ordinary severity and fatality. The sick reports of all the military stations from the Atlantic to the Mississippi, showed in general a high ratio of disease, the symptoms were for the most part severe, and the average of fatal cases proportionally high. Some facts of an interesting and valuable character, in relation to yellow fever, are interspersed through the quarterly reports. It may be regarded as a singular concurrence of opinion, coming, as it does, from individuals so remotely situated and viewing the subject under such various circumstances, that the belief in its contagious nature, has been in no instance avowed. The doctrine that intermittent, remittent, and yellow fever, assume, according to circumstances, more or less the t)me of one another, seems to be extensively entertained. Believing them to arise from similar causes, variously modified, to assail the system through the same avenues, and to require the same general treatment, these fevers are regarded by this class of reasoners as essentially the same, modified by the intensity of the cause, and peculiarity of consti- tution. This position is strongly confirmed by the oft observed fact, that the natives of our southern cities, in which yellow fever is endemi- cal, possess, in a great measure, an exemption from this malady ; for, whilst intermittents and mild remittents prevail among the old inhabi- tants, yellow fever often manifests itself -so exclusively among those 7 lately arrived from northern latitudes, that it has received the name of " Strangers' Fever." We are certainly not justified, however, in the present state of our knowledge, to assert that the same miasm, which produces remittent fever, excites, in its more virulent state, )rellow fever, or, indeed, that the latter is of paludal origin. The opinion of the origin of yellow fever, from miasmatic effluvia, seems to be strongly corroborated by the following facts: 1. Yellow fever always appears simultaneously with bilious remittents ; 2. a high range of atmospheric temperature is essential to the generation of its cause; 3. its first appearance is ahvays in the lowest and most filthy parts of towns, and in localities favorable to the production of miasmata; and, 4. the supervention of storms, heavy rains, or cold weather, puts an immediate check to its progress. These view's are sustained by the most experienced writers on the subject. It is remarked by Dr. Rush, in relation to the yellow fever of Philadelphia, in 1802, that " intermit- tents, the mild remittent, the inflammatory, bilious, and the malignant yellow fever, have, in many instances, all run into each other." Speak- ing of the yellow fever of the same city in 1803, Dr. Caldwell observes, " as the fever receded from the lowr ground, and malignant atmosphere -of Water street, it became more and more mild and manageable, till its evanescent shades in Second street were, in many instances, much lighter than the common remittent of the counuy." In the yellow fever of Charleston in 1S04, Dr. Ramsay says," neglected intermittents frequently terminated in yellow fever." In regard to Baltimore, Dr. Davidge states that " the bilious or remitting fever, in its ordinary form, prevailed in that town, and continued until it was gradually lost in the severer form of yellow fever as the season advanced." That the disease was in none of these epidemics, imparted or communicated by conta- gion, all these writers unanimously agree. At New Orleans, the experience of almost every year exemplifies the same fact. Situated on a mighty river's bank, formed of the alluvion of its own current, this emporium may be regarded as a healthy locality during nine months of the year. As the summer temperature increases, yellow fever appears almost with the certainty of the varying seasons, and disappears as regularly when the scale of the thermometer indicates its decrease. Although steamers laden with fugitives from malarious pestilence, ascend the stream by hundreds at this period; yet the disease, notwithstanding the fatal black vomit appears on the decks as they pass along, is never manifested among fellow-passengers from uninfected regions ; nor is it, under like circumstances, communicated to the inha- bitants of the district to which they may fly. It is, therefore, purely a disease of season and locality. Although we are not quite certain that fevers which have, or are supposed to have, their source in vegetable miasms, or in effluvia from marshes, never subsequently spread by contagion ; yet yellow fever, as developed in our northern cities, even when engendered in the holds of ships navigating in hot climates, is known not to have been communicated. A cause of this kind would no doubt fall harmless upon the inhabitants of a salubrious country locality. To develope this ma- 8- lignant fever, seems to require (he conjoint operation of both local and general causes, constituting an endemico-epidemic ; and in the summer atmosphere of a crowded city, there appears to exist some peculiar agency favoring this result. In these cases, there is generally found an '' infected district," which slowly and regularly extends its boundaries, rendering all who come within its limits, subject to this form of fever. In our northern cities, this has been repeatedly observed. That yellow fever requires for its development a high atmospheric temperature, is illustrated in the island of Jamaica, which has almost every variety of climate. As you ascend its lofty range of mountains, the vegetation of the tropics gives place to that of temperate regions. Whilst the scourge of yellow fever cuts off its thousands annually along the coast of this island, a complete immunity is enjoyed from its effects in these elevated regions. It has never been known, as determined by. the researches of Humboldt, to extend, in any climate, beyond the height of 2,500 feet. The pallid and sickly aspect of those residing in the low districts, forms a striking contrast to the ruddy glow of health which characterizes the dwellers in the mountain region. The question of the contagiousness of yellow fever, w7as, at this pe- riod, (1819) a theme of interminable discussion and acrimonious con- troversy. Although considerable discrepency of opinion continued to obtain, the mass of the profession finally received as established doc- trines, that yellow fever is, strictly speaking, endemico-epidemic, that its origin may always be traced to a combination of atmospheric and local causes, and that it is unsusceptible of propagation by specific con- tagion. The experience of several centuries teaches us that the cause of this fever is perennially present in our southern cities. Indissolubly connected with our soil and climate, it maintains the same relation towards the animal system as the malaria of our southern low lands. Appertaining to geographical position, this dreadful malady, in different grades of intensity, is liable to be developed at any time by the com- bined operation of heat and other agents. As yellow fever, as is stated in the Surgeon General's quarterly report, made its appearance, this season, simultaneously at many points remote from one another, at some of which, importation may be regarded as impracticable, its domestic or miasmatic origin would seem beyond the possibility of a doubt. In the summer of this year, the waters of the Missouri and Mississippi were remarkably low, and all those circum- stances obtained which favor the evolution of miasmatic emanations. Consequently, a bilious remittant fever of a malignant tendency became epidemic both in Missouri territory and the State of Illinois. Although it generally assumed a milder form than on the seaboard, owTing to the circumstance that the morbific agents were less concentrated than in the filthy streets and wharves of populous cities; yet, many of the cases reported had the characteristic features of typhus icterodes so decidedly marked, that the Surgeon General entertained no doubt of the identity of the disease. Its present appearance on the banks of the Missouri and Mississippi confirms the report of its existence, in former years, on the Ohio in 9 localities peculiarly favorable to the production of malaria. The cele- brated Volney, who had seen the disease in our sea-ports, found, during his travels through the interior, the yellow fever in many places. Dr. Miller, of New York, in his excellent essay on yellow fever, refers to the journal of a voyage down the Ohio in 1T96, by Mr. A. Ellicott. This judicious observer was a witness, at Gallipolis, inhabited by some miserable French families, to the disease, which raged violently, the fatal cases being generally attended with the symptom of black vomit. " The fever could not," he says, " have been taken there from the At- lantic States, as my boat was the first that descended the river after the fall of the water in the spring. Neither could it have been taken from New Orleans, as there is no communication up the river at that season of the year. [This was .prior to the era of steam-boats.] Moreover, the distance is so great, that a boat would not have time to ascend the river, after the disorder appeared that year in New Orleans, before the winter would set in." In 1797, the disease appeared at New Design, 15 miles from the Mississippi and 20 from St. Louis, and carried off more than one-fourth of the inhabitants, although no person, during the preceding twelve months, had come to this village from any place at which the malady prevailed. As these facts are attested by Dr. Watkins, who had seen the disease in Philadelphia, and as an identity of disease supposes an identity of cause, it is shown indisputably that fevers with the pathognomonic features of typhus icterodes, do occur in positions which forbid the assumption of importation. In the last quarter of the year, diseases were of a mild character. In the northern division, the total of deaths reported in the medical returns was 42, one-half of which occurred in a detachment of the 5th Infantry, stationed at the mouth of the St. Peter's. The prevailing diseases were catarrhal and intermittent fever, diarrhoea and dysentery, and dropsical and scorbutic affections. The causes seem to have been of a local and fortuitous character ; such as, exposure to very inclement weather, both on the march to St. Peter's, and during the time employed in establish- ing quarters; the want of the usual supplies of the lighter articles of food, and the deteriorated quality of the rations that were issued; the difficulty of attending to those details of police duty upon which the health of a garrison materially depends; and, lastly, the absence of all permanent accommodations for the sick. In the southern division of the army, no peculiarity of morbid action is presented. Two-thirds of the fatal cases occurred in the 8th Infantry, employed in cutting a military road, and in the 6th Infantry and Rifle regiment on the Missouri. It is a fact confirmed by multiplied experi- ence, that the diseases of troops in permanent stations are comparatively few and mild; whilst those of a detachment on fatigue, removed from the usual station, exhibit not only an increased ratio, but an augmented average of mortality. The reports for this quarter from the detachments thus employed, " are" says the Surgeon General, " nearly as large in proportion as they were from most of the frontier posts during the war." Although the summer of this year was remarkable for the general prevalence of fevers characterized by a malignant tendency, yet the ratio 2 10 of mortality for the whole yea'r is about the same as the average of AJ years. The fatal character of fever may also be learned from the med- ical journals of the day, in which we find detailed accounts of its rava- ges in Boston, New York, Philadelphia, Baltimore, Charleston, Savan- nah, Mobile, New Orleans, and Natchez. At New Orleans, it was esti- mated that upwards of 3000 died of yellow fever; and it was not until after the first of December that it was deemed prudent to return either to this city or Natchez. The interior of the country, more especially in the southern States, seemed to suffer in a corresponding ratio. In the West Indies, the fever exhibited perhaps still greater mortality. At Ha- vana, in default of attention to police regulations, the disease, favored by uninterrupted high temperature, continued to prevail until late in January. This year is remarkable far the prevalence of several diseases, characterized by phenomena of an unusual character. A pecu- 1820. liar constitution of the atmosphere, at this time, pervaded our whole extent of territory, predisposing to those diseases which were called into action, at various points, by local exciting causes. The ratio of mortality is twice as great as that of the pre- ceding year; a result ascribable to the dreadful ravages of a scorbutic affection. In the northern division, in the first quarter, more than one-half of the deaths occurred at Fort Mifflin and St. Peter's. At the former, then a recruiting station, much disease prevailed, owing, in a great measure, to the necessity of crowding the men during the winter season in bar- racks not calculated to accommodate more than one-third the number. " In many cases," says Post Surgeon S. B. Smith, " there was a total exhaustion of nervous power, and three expired in the act of conversing with their friends, unconscious of danger." The effects of this endemic were manifested in different forms, but the deaths were chiefly among the cases of typhus fever. At St. Peter's, the prevailing disease was scorbutus. The reports from the southern division, with the exception of a pestilence to be described, presented nothing demanding comment. The aggregate of deaths was 188, of which 157 occurred at Council Bluffs from scurvy, leaving but 31 from all other diseases in the whole division. The number of men reported at Camp Missouri on the first of Janu- ary was 788, and at St. Peter's 228, making an aggregate of 1,016. The total of cases reported for the quarter at these two points was 895; of these, 503 were of a scorbutic character, and the number of deaths from this cause was 168. With scurvy in its more aggravated forms, we are fortunately, in the United States, but little acquainted. Our troops, within the present century have, with the exception of two periods, been nearly wholly exempt from its ravages. The following table, exhibiting the number of cases of scurvy, and 11 the consequent deaths in the army, during a period of twenty years, shows the comparative infrequency of the disease : Years OS 00 © 00 GO 00 C<5 00 <* 00 a* ao CD 00 00 00 00 OS 00 o CO 00 CO 00 CO 00 CO CO 00 CO 00 CO 00 CO 00 co 00 00 CO 00 Cases 7 734 86 4 29 - 8 4 2 8 1 6 16 3 7 5 15 9 17 59 159 Deaths - - 190 5 3 1 1 The cases reported in the last three years occurred, nearly all, either in Florida, or amongst troops that had served in those campaigns. The ratio of mortality is very low. The relation of cause and effect is here very apparent; for, it can be readily perceived that a diet, consisting mainly of salt provisions, in a constitution deteriorated by repeated at- tacks of intermittent and remittent fever, and diarrhoea and dysentery, will develope scorbutic and cachectic affections. The ration of our sol- dier, regarded in all its component parts, no doubt disposes the system to scurvy in warm countries; and in these campaigns, whenever it proved deficient in any respect, it was always found to be so in refer- ence to the vegetable portion. It appears, from the official reports, that the troops at St. Peter's and Council Bluffs were exposed to many of the causes, both predisposing and exciting, of scurvy. During their progress from St. Louis up the Missouri, and from Green Bay up the Mississippi, they were not unfre- quently obliged to labor in the water beneath the rays of an ardent sun. Sleeping in their wet clothes, and exposed to a damp atmosphere im- pregnated with malaria, they became reduced by disease ; and in this state of predisposition to scurvy, they began, late in the season, the es- tablishment of their winter quarters. The position at Council Bluffs is stated to be " flat, low, marshy, and clayey;" and the weather, during the winter, was exceedingly cold ; the mean temperature for January at Council Bluffs being 8 deg. 62 min., and at St. Peter's 0 deg. 17 min. They were destitute of groceries and vegetable food, except flour and corn, which were more or less damaged from having been wet; and their animal food, which was principally salted, they were obliged to eat during a portion of the winter in a putrescent state. This condition of the meats, however, was as far as practicable corrected by washing and boiling with charcoal. As this disease is one of pre-eminent importance to the army and navy surgeon, a detailed history of its progress at Council Bluffs will prove no less profitable than interesting. As the reports of the two medical officers, Surgeon T. G. Mower, of the 6th Infantry, and Surgeon John Gale, of the Rifle Regiment, indicate the exercise of sound judgment combined with professional skill, their observations aie entitled to more than ordinary consideration. From a medico-topographical report, made the preceding quarter by Surgeon Gale, the following extracts are made :— 12 " Cantonment Missouri is situated on the south bank of the river, in lat. 41 deg. 31 min. N., and agreeably to Major Long's estimate, seven hundred and eighty miles above the confluence of the Missouri and Mississippi. " The range of hills, which, at unequal distances, every where bounds the Missouri, runs in upon the river about two miles below the canton- ment, and breaks off perpendicularly at the water's brink. This point, denominated by Lewis and Clark "Council Bluffs," was recommended by them as an eligible position for a permanent military work. It affords very sublime and picturesque views ; and as a healthy situation, it is certainly unequalled by any other in the vicinity. " The climate is less healthy, and the face of the country less plea- sant, on the upper than on the lower Missouri. The alluvial tract, which in general bounds the river, is narrower; the soil is less deep; and the timber is smaller and less abundant. The winter commences earlier, and continues later. The frost this year killed the vegetables as early as the 25th September, and the severity of winter began the 22d December. The wTeather is more fluctuating and subject to ex- tremes of temperature. The heat and cold, during the months of Oc- tober, November, and December, have varied from 88 deg. to 10 deg. below zero of Fahrenheit. The prevailing winds have been from the S. E. and N. W. " Intermittent and simple continued fevers, rheumatism, dysentery, and catarrh, have been the reigning diseases during this quarter. The predisposing cause may be found in the extreme exposure to which the peculiar mode of navigating the Missouri had necessarily subjected our men." To illustrate more fully the peculiar character of this endemic mala- dy, several paragraphs from the report of Surgeon Gale, and the entire report of Surgeon Mower, are subjoined. " The second battalion of Riflemen," says Surgeon Gale, in his spe- cial report dated Camp Council Bluffs, October 1st, 1820, " left Belle Fontaine and proceeded up the Missouri on the 15th June, 1819 ; joined the first battalion at Cow Island, on the 30th of August, and arrived at Council Bluffs, a distance of 780 miles, on the 2d of October. " It will not surprise you to learn that the fatigue endured in trans- porting loaded boats such a distance in the peculiarly laborious manner of navigating the Missouri, and exposure to the meridian sun, the dews of evening, and the chill air of night, were productive of disease. Nearly every man had suffered severely from sickness, and many expe- rienced relapses, before arriving at our point of destination ; nor did we then cease to suffer from dysentery, catarrh, and rheumatism." " With every exertion, our buildings were not completed until the first of January. At this period, from accumulated suffering, a disposi- tion to despondency was manifest. Nearly all seemed to be reduced by protracted sickness and long continued labor. The sutler's supplies were exhausted, the fresh provisions were nearly all issued, and the Hospital stores were inadequate to an emergency. In this situation 13 when the most nutritive diet was requisite to restore our exhausted ener- gies, the men were compelled to subsist on salted or smoke-dried meats, without vegetables or groceries of any description. To add to our list of sufferings, the weather in January became excessively severe; the mercury, at different periods, for several days in succession, did not rise above zero, and once fell 22 deg. below that point. Under these cir- cumstances, about the 20th January, the scurvy made its appearance, to which all other diseases soon yielded precedence ; but it proved fatal in few cases until Februaiy, wThen nearly the whole regiment sank be- neath its influence. " The disease continued unabated until the 7th of April, when wild vegetables appeared. After this period, no new cases occurred, and those already affected began to recover. Of the riflemen, eighty fell victims to the malady, sixty at this place and twenty between this point and Fort Osage. None died after the arrival of the sick at the latter place. " That debility, induced by long continued sickness, was favorable to its development, is manifest from the fact, that those who were most debilitated from previous indisposition, were first seized and numbered among its earliest victims. It may also be reasonably inferred that ex- cessive labor and fatigue, and the severity of the weather, had an agency in the production of the disease; for the officers and non-commissioned officers, who experienced less of the former, and were less exposed to the latter, were exempt from its effects. One officer, who had been long confined by indisposition, formed an exception. This wras the only case in which there was the least degree of convalescence observable prior to the appearance of vegetables; and this was probably effected by our being enabled to subsist him on eggs, chickens, milk, &c.—pre- sumptive evidence that a nutritive diet will produce a cure. "Among the causes producing the disease, may also be enumerated the residence of the men in green damp rooms in conjunction with a faulty diet; for the riflemen, who are more expert in hunting than the Infantry, procured more wild meat and suffered far less. Our hunters detailed especially for that purpose, who resided in the wroods and sub- sisted on game, were in no instance unhealthy. An officer with a de- tachment, who wintered in a half-faced camp, some distance below this place, and subsisted his men entirely on fresh provisions from the woods, experienced no sickness of any description." The following is the special report of Surgeon Mower:— " Camp Council Bluffs, October 1st, 1820. " Sir: I have been honored with your letter of the 13th May, requiring me to ' transmit with my next quarterly report, a detailed account of all the causes, both immediate and remote, which have probably produced the unusual mortality among the troops on the Missouri; stating the situation and circumstances of the men, both in relation to the nature of the country and of the duties required of them; the quantity and quality of their supplies of all kinds, &c.' 14 " It may be proper to premise that the general character of the report required supposes me possessed of information, which in no wise ap- pertains to my department, and for which I have never been clothed with authority to ask, much less to demand. With the exception that the issues of provisions fell under«*ny inspection, it is obvious that my knowledge of the supplies, belonging to the Quartermaster's and Com- missary's Department, is for the most part casual and unofficial. To remedy this embarrassment, I addressed a note to the commanding offi- cer of the regiment, requesting him to afford me information upon seve- ral subjects, with which I am imperfectly acquainted. To this note I have received no answer. " It may be worthy of remark that some circumstances, perhaps im- portant to this report, may have transpired during my unavoidable absence from the main body of the regiment, for more than four months. Having embarked at Belle Fontaine on board the steamboat ' Johnson,' she was arrested in her progress about 300 miles above the mouth of the river. This occurrence necessarily delayed my arrival at the Council Bluffs till the 10th of November. " As few cases of mortality are recorded in the regiment since its ar- rival on this river, in which the scorbutic taint was not predominant, our inquiries are consequently confined to the probable causes which produced this particular disease. It is foreign to my purpose to attempt a theoretical discussion of the nature of the disease in question, or its proximate causes. The circumstances which preceded, and which are supposed to have contributed to the production of that distressing mala- dy, form the subjects of consideration. " The prevalence of scurvy in the 6th Regiment of Infantry, during the last winter, may be attributed to the following causes, viz: excessive and long continued fatigue—cold and dampness—faulty diet. The 6th Regiment of Infantry, previously to taking up its march for the Missouri, had been cantoned at Plattsburgh for nearly three years, where it had experienced much of the " gay delight" of a military life with few of its hardships or privations. During this period, many for- eigners had entered its ranks, who, from education and habits, were better fitted for the ordinary duties of a garrison than to undergo the laborious toils which awaited them. " The corps left Plattsburgh on the 20th of March, and arrived at Pittsburgh the 1st of May. At this place it halted one week, when it was embarked on board transports for St. Louis. The confinement on board the boats during our passage down the Ohio, together with the use of the river water, which was extremely turbid, added considerably to the sick list. " On our arrival at Belle Fontaine, (June 8,) the men appeared some- what enfeebled; nor was the weather, which proved excessively warm, calculated to restore them to strength and activity. On the contrary, they seemed to experience the same languor, which is felt by the north- ern man on passing into tropical climates. "u°nihe evenino of tne 4th July, the regiment was again embarked on board of three steamboats and four barges, destined for the Council 15 Bluffs. Without the experience of watermen, the troops had now to contend with a tonent, which, in point of rapidity and natural obstruc- tions, is perhaps without a parallel. " The narrow channel of the Missouri at low stages of water, com- bined with its frequent and sudden bends, precludes in a great measure the use of sails. In propelling the barges, thecordelle and setting poles form the. principal dependence. This mode of ascending the river re- quires of the navigator the most active and incessant exertions; while the severity of his labors is not a little aggravated by being frequently compelled to plunge into the water. After the most persevering exer- tions, the several companies composing the regiment reached the place of destination between the 3d of October and the 14th of November. To the failure of the steamboats this dispersed state of the regiment is to be attributed. " It now remained for the troops to shelter themselves from the in- clemency of the season, and to secure themselves against hostile aggres- sions. An alluvial bottom on the right bank of the river, about two miles above the Council Bluffs, was designated as the site for the can- tonment of the infantry and rifle regiments. This bottom is skirted by a range of high bluffs, which alternately approach and recede from the river. These bluffs are intersected by several deep ravines and small water-courses, which break through from the high-lands. The bottom composed principally of clay, is low and flat, and consequently produc- tive of a humid atmosphere. This region is in its primitive state. With the exception of the bottom just described, and the borders of streams generally, which are covered with a thin forest, consisting principally of poplars, walnut, elm, and some oak, the adjacent country presents a boundless prairie. The extremes of heat and cold inseparable from an inland region, are here increased by the prevalence of high winds, which are favored by the openness of the country. " The site for the cantonment, as subsequent experience has proven, had little to recommend it, excepting the facility of procuring timber. A small lake of about three miles circumference, during the low stages of the Missouri, approaches within 600 yards of the cantonment. At the late unusual and perhaps unprecedented rise of the river, its waters communicated with those of the lake, and inundated the adjaeent bottoms, including the ground on which the cantonment had been erected. " The agency of this lake in producing those diseases, which afflicted our troops while stationed in its vicinity, has been a subject of specula- tion. It is true, experience has taught us to guard against the exhala- tions arising from stagnant bodies of water, more especially if any por- tion of the soil recently submerged is exposed to the direct rays of the sun. When various circumstances combine, calculated to produce any particular effect, it is often difficult to assign to each its peculiar agency. In the present instance, the character of the diseases which prevailed, and the period at which they commenced, seem to lessen very much the probability that any unsalutary effects resulted from our proximity to the lake. 16 "Early in October, the ground having been surveyed and laid off, the regiment commenced the erection of its barracks. At this period, only five companies out of eight had arrived. The position selected for our cantonment was surrounded by, a thick grove of poplars—a species of timber known in this country by the name of cotton-wood. The principal part of the logs and plank used in the construction of the bar- racks, was procured in the immediate vicinity. The covering (clap- boards) for one-half the rooms, the stone for fire-places, and the lime, were transported by water the distance of ten or twelve miles. The remaining rooms, including the store-houses, were covered with shingles or boards procured near the cantonment. Fifty eighteen-feet rooms were erected for the accommodation of the regiment, exclusive of store- houses, workshops, &c. The barracks were constructed with single roofs, having a perpendicular height of 9 feet in front and 18 in rear. " It is difficult to say at what period the quarters were completed, or when they were first occupied. Some of the officers went in between the 20th and 30th of November; whilst others remained in tents for more than four weeks after. The men moved into their barracks at different periods during the month of December, although many of the rooms were still deficient in floors, bunks, doors, &c. The regimental hospital was prepared for the reception of the sick about the 20th of the same month. " The latter part of December and the whole of January proved ex- cessively cold, the mean of the latter month being 8 deg. 62 min.; and the barracks, hastily thrown up from green materials, opposed but a feeble barrier to the inclemency of the season. Notwithstanding the severity of the weather, the regiment was still constantly employed in procuring materials for the completion of the barracks, fire-wood, &c. Owing to the small number of working cattle and the feeble state of the men, it required the whole strength of the corps to accomplish these ob- jects. It is here proper to remark that no objection can rest against the supply of clothing furnished during the last winter. " The timber (cotton wood) which composed the greater part of the barracks, although convenient and sufficiently abundant, was particu- larly objectionable on account of its humidity; the quantity of water contained in this wTood is almost incredible. The advanced state of the season, however, compelled the men to take shelter under their rude covers, green, damp, and unfinished as they were. " The state of our subsistence stores had long been reviewed with concern. Fresh beef, which had been issued to the troops since their arrival, in the usual proportion, was in the latter part of January re- stricted to the use of a few hospital patients. The country not abound- ing in game, and the regiment having no expert hunters, little advantage was derived from the chase. The important articles of beans, peas, and vinegar, contemplated to have formed component parts of the ration, failed altogether. Salted pork and beef, bacon, flour, and Indian corn, constituted the substantial part of the ration. By far the greater part of the meat was decidedly in a putrescent state, and absolutely unfit for issue ; the smell and taste both rejected it with disgust. The flour, 17 although less exceptionable than the meats, and originally of a fine quality, had become musty previously to its issue. The corn, which was furnished in the proportion of two pints to every six rations, was soon thrown aside as a drug. Deprived of vegetables and the usual condiments of the table, the repast of the soldier was, at the same time, deficient in nutriment, unpalatable, and unwholesome. " The medical supplies of the regiment, although sufficient in quan- tity for ordinary seasons, were of a very inferior quality, and by no means calculated to meet the present exigency. " Previously to the appearance of scurvy, the men had been much enfeebled by dysentery and pulmonic inflammations ; and were conse- quently rendered more susceptible of other ailments. The former dis- ease commenced its attack soon after their arrival, and raged with vio- lence till the close of the year. It was then succeeded by inflammatory affections of the lungs, which prevailed with little abatement till the latter part of January. " Early in this month (January) a scorbutic taint was perceptible in some of our patients, who were laboring under other diseases. At first the cases were mild, and appeared to yield, in some measure, to treat- ment. During the whole of this month, it was noticed that the recovery of our patients was peculiarly slow and precarious; in many cases, after the acuteness of disease had been subdued, the sufferer continued to languish and decline. Early in February the progress of scurvy had become alarming;'its baneful influence was rapidly extending to every form of disease. The situation of the command had assumed a serious aspect. Most of the exciting causes still existed, while the means of relief were beyond our reach. The commandant of the post having been apprized, from time to time, of the nature and extent of the pre- vailing malady, arid of the means best calculated to arrest its progress, organized parties under the direction of officers, and despatched them up the river in pursuit of buffalo and other game. Unfortunately the success attending these exertions was very inconsiderable. " We regret to acknowledge that the firmness of the American soldier should have been for a moment shaken by any concurrence of circum- stances. We cannot conceal the fact, however, that during the preva- lence of that loathsome malady which afflicted our garrison, gloomy forebodings were depicted on many a countenance ; nor were the best directed efforts to counteract this despondency, by introducing diverting games, music, &c, attended with much success.* On the 23d of Feb- * Surgeon Mower having several times witnessed small-pox and epidemic cholera in their most malignant forms, avers that neither is as dreadful at the endemic described in his report. It is not the sight of pale forms, encircled by bloody bandages, that blanches the soldier's cheek, for he knows that such is the chance of battle. Even when the surgeon tells his wounded patient that he must look for help beyond the grave, the transition from time to eternity is borne with calmness and resignation, soothed by the consciousness of having fallen in the discharge of his duty and in his country's cause. But when the wards of an" hospital become crowded with ghastly and attenuated frames, victims to a baneful 3 IS ruary, the commandant, feelingly alive to the interests of the soldier, summoned together a board of war to deliberate on measures tor the relief of the command. Of the result of these deliberations, I am at present ignorant. In compliance with the wishes of this board, I sub- mitted to them a report relative to the health of the regiment, and the means best calculated to counteract the influence of the disease then unhappily existing. On the 25th of the following month, 70 scorbutic patients belonging to the 6th Regiment were embarked on board of keel boats, under the charge of Surgeon's mate Nicoll, destined for Fort Osage. At this place it was believed that they would more speedily obtain a regimen adapted to their condition. " On the removal of these men, we had nearly 100 patients left, suf- fering under the influence of the same disorder. During the first week in April, the weather proving favorable, we removed a large proportion of our sick from the Cantonment, and located them on a small stream under tents, about three miles distant. Fortunately, at this period, wild vegetables began to shoot up. These powerful remedies, combined with mild weather, pure air, and change of scenery, soon banished the demon, Scurvy, and. restored its victims to strength and activity. So potent was the influence of this new state of things, that patients re- covered under the most unpromising aspects. Not a single death oc- curred at " Camp Recovery," although several persons were removed thither in a seeming moribund state. In some of them, every tooth had dropped from its socket, and even large portions of the lips had sloughed off. Among the vegetable products first discovered, and most esteemed for its remedial virtues, was the wild onion, a very diminutive bulbous root, not larger than a nutmeg. " When we reflect on the long and arduous march performed by the 6th regiment of Infantry,—the unavoidable fatigues which awaited these troops on their arrival at the place of destination,—the vicissitudes of heat, cold, and dampness, to* which they were exposed,—the wretch- ed quality of provisions on which they subsisted,—we cease to wonder that sickness and mortality have prevailed. Had the corps maintained its health, we might be warranted in believing that the age of miracles had returned. I have the honor to be, very respectfully, Your obedient servant, T. G. MOWER, Surgeon 6th Infantry." Joseph Lotell, Esq. Surgeon General U. S- Army. climate, or a loathsome pestilence, living skeletons, debilitated and slowly sinking, doomed— —---" to feel The icy worm around them steal, Without the power to scare away The cold consumers of their clay," how appalling to the living is the spectacle of the dead and the dying! When those, who but several days previously bore their comrades to the grave, are in turn stretched upon the same bier, then it is that the bravest heart quails! 19 During the second quarter of the year, there was no prevailing com- plaint. In the northern division there were but 16 deaths, of which six arose from pulmonary consumption. In the southern division, the deaths numbered 61 ; of these, however, 21 occurred early in the quar- ter, being the effects of the scurvy which had prevailed, during the win- ter, on the Missouri. So far as regards the effects of climate, it will be seen that the mortality of this division must be still further reduced. At Fort Scott, Ga., the average strength of the command was 410, and the number of deaths 8. Of these fatal cases, one arose from apoplexy and another from hoematemesis; and in regard to the six others, it is re- marked by Surgeon Thomas Lawson, that " life Was nearly exhausted on their arrival at the post from Fort Gadsden, and that 5 or 6 had died on the passage, in consequence of being pent up for more than twenty days in a small vessel, and deprived the greater part of the time of medi- cal aid." At Fort Gadsden, seven recruits died very soon after their ar- rival from the north. The sending of recruits to the south at unpropi- tious seasons has happened too often in our military history to be recon- ciled on the ground of necessity ; and as a specimen of the moral and physical constitution of the subjects exposed to this trial, it is remarked by Post Surgeon Walmsey, that—" among 70 recruits from Philadel- phia, several are old men, three are idiots, and nearly all intemperate." The scorbutic patiente of the 6th Infantry and Rifle regiment, as al- ready stated, were removed to Fort Osage. The number of cases not embraced in the previous report was 119, of which 7 proved fatal. The numerical strength of the command was 117, and the sick report, at the close of the quarter, exhibited but 27 cases. The 6th Infantry, numbering from 200 to 250 men, had 92 cases, chiefly scorbutic, on the sick list at the previous quarterly report; of these, 13 died before the 15th of April, after which period no death occurred. The Rifle regi- ment, numbering about 350, became remarkably healthy; although the sick report presented 77 cases, principally scurvy, at the beginning of the quarter, but one death took place. Fernandina, Montpelier, the Bay of St. Louis, and Petite Coquille, were extraordinarily salubrious. At Ba- ton Rouge, there were 9 deaths out of 383 cases; and at New Orleans, 8 deaths in 36 cases. During the third quarter, the diseases of the northern division pre- sented their ordinaiy aspect. The aggregate of deaths was only 28; of which 6 were from typhus fever, 4 from phthisis pulmonalis, and 3 from intemperance, the causes of 7 being undesignated. In die southern division, the mortality was unusually great; the ma- jority of the deaths, however, occurred at a few posts. The aggregate was 116 ; 25 at Fort Gadsden, 12 at Apalachicola Bay, 16 at Montpe- lier, 10 at the Bay of St. Louis, 8 at New Orleans, and 30 at Baton Rouge. The chief complaints at these posts, (the causes ef death at Baton Rouge not being stated,) were diarrhoea and dysentery, and inter- mittent, remittent, and tvphus fever. Of the deaths reported at the other stations, 6 arose from typhus fever, 30 from dysentery, and 28 from bil- ious remittent or yellow fever. The unhealthiiiess of (lie summer season in the souUi may be traced 20 to the following causes : 1st. Excessively high and long continued at- mospheric temperature, the mean temperature at 2 P. M. for the quar- ter being, at Fort Scott a fraction less than 86, at Montpelier and IN ew Orleans 85, and at Baton Rouge 83. 2d. The insalubrious locality of some posts, especially Forts Scott and Gadsden. 3d. The impractica- bility of preventing decomposition in some portions of the ration. 4th. The destructive effects of a southern climate, in an unhealthy season, upon northern constitutions already debilitated by indulgence in vicious habits. To these causes may be added others comparatively of minor importance ; such as errors in diet and police, and a want of due atten- tion in selecting the time and limiting the duration of fatigue duty, dur- ing the prevalence of summer heats. To illustrate this subject more fully, several extracts from the re- ports of medical officers are appended. " Yellow Fever," says Dr. Bell, " has prevailed in most of the south- ern sea-ports, particularly at Savannah, during this quarter. It made its appearance at New Orleans about the 10th of July, exhibiting a character somewrhat new; its malignity was uncommonly great, most cases eventuating in death. On its decline, about the 18th of October, the disease assumed a typhoid form in its sequel. It prevailed also at the bay of St. Louis, the usual summer resort of the citizens of New Orleans, with such dreadful malignity as to prove fatal, after a few days illness, to several natives of the place. At this post (Petite Coquille) it appeared about the 10th of August." At the bay of St. Louis, Mi., the average strength of the command for the quarter was 446; the number of cases treated 486, and the deaths 10. Diarrhoea and dysentery were very rife; the latter, although characterized by considerable severity and a fever of the remittent type, did not prove fatal. In July intermittent fever was most common, but in August and September nearly all cases assumed the remittent form. " A small detachment," says Dr. Merrill, Surgeon's Mate of the 8th Infantry, " arrived here on the 20th August, commanded by Lieutenant Blaney. These men, in descending the Mississippi, had been greatly exposed and suffered much fatigue, and at New Orleans they were de- tained sometime after the sickly season had begun, and attacks of yel- low fever had become frequent. One man, who had been attacked with yellow fever on the route from New Orleans to this place, died with the black vomit 12 hours after their arrival. This produced con- siderable consternation; and within 24 hours five more were seized in the same manner, two of whom died on the third day. The first symp- toms were violent pains in the head and back, nausea, and a great dis- position to vomit on receiving food; the pulse was preternaturally slow and depressed, the skin dry, the eyes suffused with blood, and the tongue furred and parched. These symptoms were succeeded by list- lessness and stupor, great irritability of the stomach, and a frequent vomiting of viscid mucus, mixed with particles or flakes of black mat- ter resembling coagulated blood. If the vomiting continued, this subtance increased in quantity,and became more attenuated; and in the stage 21 immediately preceding death, it assumed precisely the appearance of old coffee-grounds. " The first three cases proved fatal, and in these the treatment waa nearly the same as in bilious remittent of the usual type. In the succeeding cases, a more energetic plan was pursued. Venesection was performed ad deliquium; to produce this effect, 30 and 36 ounces were in some instances taken. From 15 to 20 grains of calomel with an equal quantity of jalap, were then administered, with cooling muci- laginous and acidulated drinks. This was immediately followed by calomel, every hour, in doses of 2 or 3 grains, combined with a suffi- cient quantity of opium to prevent a cathartic effect. At the same time, mercurial friction was employed without reference to quantity. Nausea and vomiting were generally relieved by the aqua carb: am- nion : in doses of from 30 to 40 drops. As the patient invariably com- plained of a burning acid taste in the matter vomited, I was led to the use of alkalies, instead of acids, in the latter stages of the complaint. To alleviate this symptom, the ol: terebin: was in some cases used, but with less beneficial effects. " After this treatment was adopted, not a single case proved fatal. In four or five days, a profuse salivation was commonly induced, which always rendered the patient safe. As soon as was practicable after the arrival of this detachment, sixteen ounces of blood were taken from the arm of each man, and a large dose of calomel and jalap administered. The desired effect being produced, none were violently seized after- wards. "It may not be amiss to observe that the practice of sending northern recruits to this section of the country, during the hot and sickly season, is a dangerous one, particularly when transported by way of the rivers. Change of climate is not the most important consideration. Crowded into open and uncomfortable boats, they are constantly exposed during the day to the powerful rays of the sun, and during the night to the noxious miasma of extensive marshes. As the change of climate is great, and the morbific agents potent, a corresponding mortality is always exhibited." As many of the diseases of our southern latitudes frequently assume a malignant character, demanding a treatment corresponding to these peculiar phases, the importance of correct knowledge in regard to their pathology and remedial management is very obvious. And as every circumstance tending to elucidate this subject is fraught with great value, the following remarks from the pen of Surgeon Thomas Lawson, (now Surgeon General,) in relation to the several modifications of disease at Fort Scott, near the confluence of the Flint with the Chattahoochee river, will be found not wholly without interest: " Fort Scott, Ga., October 1, 1820. " Sir : The current summer has proven unusually sickly. An insa- lubrious atmosphere has pervaded the country, and disease and death 22 have been everywhere present. That the troops have suffered in the utmost severity, the record of mortality affords melancholy evidence. " About the 15th July, the simple inflammatory fevers began to yield to remittents; dysentery and diarrhoea also gave ground ; but intermit- tents maintained their position in the foremost rank. On the 1st Au- gust, remittents became more rife, and exhibited in a short time temble phenomena. In September, they still gained ground, and eventually became so formidable as to prostrate every thing against which their force was directed. " Bilious remitting fever, although not the most prevalent disease of our cantonment, claims, on account of its malignant character, our first and special consideration. " This disease, many cases of which present the characteristic features of yellow fever, exhibits in its invasion, progress, and termination, very diversified phenomena. Although inflammatory symptoms most com- monly mark its attack, it frequently assumes, even at the onset, a ty- phoid character. Its course is very irregular, manifesting various and opposite symptoms in different, and frequently in the same subject; and its termination, if not immediately in death or restoration to health, generally eventuates in an intermittent, a diarrhoea, or dysentery, or in visceral obstructions. Its fatal close is sometimes sudden, but oftener gradual. The patient, in some instances, sinks directly under the Weight of the primary disease; in other cases, after withstanding the first assault, and even that of two or three successive maladies, he willingly resigns his life, worn down by continued suffering. Whilst some expire in convulsions, others pass awray without a groan or a struggle. " The precursory symptoms, in every modification of the disease, are, mental anxiety, listlessness, languor, and lassitude on the least muscular exertion. But the disease is presented under several prominent modifi- cations. The symptoms of the first or milder grade of the regular form, are nausea, pains in the back and extremities, vertigo, acute pain in the head, and vehement pyrexia. The febrile-exacerbation is com- monly ushered in with a chill, although frequently without it. During the stage of reaction, the pulse is frequent, full, and tense; an intoler- able heat is diffused over the superficies of the body, with a similar sen- sation in the internal organs; the skin is dry and parched ; the tongue is slightly moist, and covered with a white or greenish fur; great deter- mination to the head and high delirium usually exist. "In the second grade of the regular form, the disease is manifested by vertigo, imperfect vision, obtuse pain in the head, pain and anxiety in the region of the chest, difficulty of respiration, a tendency to coma, vomiting sometimes attended with purging, great prostration of strength, and loss of the power of locomotion. In this modification, the reaction is less frequently preceded by a chill; the pulse is small and frequent; the skin is dry and contracted; the tongue is parched and constricted, with a glossy appearance ; the thirst is intolerable ; a horrible sensation of burning heat is felt throughout the intestines; and slupor prevails in every stage of the disease. 23 '' In the third variety, or first irregular form, the patient is suddenly affected with syncope, he falls down and remains in a state of insensi- bility for fifteen or thirty minutes, and on being resuscitated, a cold sweat appears; his respiration is laborious, with great anxiety about the prce- cordia; the stomach rejects its contents, and the bowels are often vio- lently evacuated; and lastly, he is seized with general paralysis. In this condition, the pulse is small, quick, and frequently intermitting; the skin is very cold and shrivelled; the tongue maintains its natural appearance; little or no delirium prevails; but the tendency to syncope is so great, that the patient faints upon the least change of position, more especially when placed in an erect posture. " In the fourth modification, or second irregular form, the victim seems affected with vertigo and total loss of vision ; he totters, reels, and sinks exanimate to the ground. " Vertigo is a universal symptom, and frequently continues through the whole course of the disease. Symptomatic phrenitis is generally present in the first form, and stupor prevails in almost every case of the second grade. Unquenchable thirst, a very distressing sensation of in- ternal heat, and difficulty in respiration, are phenomena present in all its modifications. Constipation of the bowels is a constant attendant, and dysuria, ischuria, gastrodynia, and various anomalous symptoms often supervene during the progress of the malady. " In a number of cases, the skin becomes yellow. This, although a highly unfavorable symptom, is not absolutely indicative of a fatal result. Towards the fatal termination, the skin assumes a saffron hue, a cadaverous smell exhales from the body, haemorrhage takes place from the mouth, nose, and ears, whilst the stomach constantly ejects a very dark green or black colored matter. " In the first form, a remission of fever is scarcely perceptible for forty- eight or sixty hours, after which period there are daily exacerbations and remissions. In the second form, it assumes at first the type of a quoti- dian or rather double tertian, for every other paroxysm is decidedly the more severe. In its third modification, the disease assumes no definite characters. In some instances, every organ quickly resumes its proper functions, the enemy seeming to have expended his whole force in the first assault. In other cases, the patient lies prostrate for twenty-four or thirty-six hours, when symptoms of resuscitation appear, and his system gradually, but not without many struggles, regains its wonted energies. There are other cases, again, in which the powers of life are prostrated beyond recovery. Under these circumstances, the person remains in a state of prostration,but quite rational and calm, until the third, fourth, or fifth day, when nature, seeming to rally all her powers, makes a violent effort to free the system from oppression, but failing in the attempt, the patient expires in the struggle. In the fourth form, the victim is at once cut off. " The predisposing and exciting causes of the disease under conside- ration, are so various and complex, that it were no easy matter to assign to each its proper influence. On the one hand, we have exhalations from surrounding marshes, and the effluvia arising from putrid animal 24 and vegetable matter; and on the other hand, fatigue, drunkenness, in- solation, and exposure to cold and damp night air, all acting in con- junction with the effects of unwholesome provisions and a disaffected state of the general mind. " Our police, although far from commendable, is perhaps as well maintained as is practicable among recruits. Despite the efforts of offi- cers, drunkenness wall prevail. Whiskey is smuggled into camp; moreover, as a few of the men dispose of their whiskey ration, others are enabled to get daily a pint or a quart of ardent spirits. The fatigue endured by our men in transporting provisions, &c.,from Fort Gadsden to this point, and in building and repairing barracks, &c, cannot be re- garded as excessive to men of ordinary physical strength and accustomed to labor; but to the refuse of mankind, gathered from the purlieus of our cities, the burdens imposed may have been beyond the measure of their abilities. Our provisions have been in a state of such impurity, that were other supplies within reach, it is very probable that the greater part would be condemned. As the men have lately changed their mode of life, have come to an unfriendly clime, and are ignorant of their new profession, they have experienced just enough of military life to hate the service. " In prescribing for this bilious remitting fever, the therapeutic means have been as various as its different forms, and the several grades of each modification. As each grade is characterized by peculiar patho- logical conditions, the treatment was based upon the principle to com- bat the symptoms as they arise. "In the inflammatory form of the disease, it is absolutely necessary to abstract from twelve to twenty ounces of blood, an operation which it is sometimes required to repeat once or twice. As a general rule, I usually administer on the first day an emetic, and on the second a cathartic; and thenceforth adopt means to procure daily evacuations, a result not easily effected in consequence of the extreme torpor of the intestinal canal. With the view to restore the healthy functions of the skin, and to maintain the bowels in a soluble state, I give, every three or four hours, a powder composed of nit. potassse, ant. tart., and sub- murhydrg. Cooling acidulated drinks, and the application of cold water by effusion, have proven very useful remedies; whilst the application of blisters is frequently required during the progress of the malady. " In the second modification, I usually, on the first day, if the state of the stomach allows, administer a dose of ipecacuanha; and should it not excite purgation as well as emesis, some aperient medicine is soon after given. Frequently, by the next morning, the reaction has become so violent as to demand depletion. I accordingly abstract blood and administer a cathartic, and at night prescribe an anodyne diaphoretic draught. The subsequent remediate management depends on the character of the morbid manifestations. If it become a disease of high febrile action, I resort to such means as tend directly to reduce arterial excitement, and as soon as a long and distinct remission or a perfect in- termission is established, I administer some of the milder tonics. Should a low form of fever, on the contrary, supervene, I prescribe 25 during the exacerbation, the spiritus nit. dulcis every three or four hours; and when a distinct remission or complete apyrexia occurs, wine, bark, and other tonics, are administered. The application of cold water or vinegar and water, by ablution or aspersion, has been tested; and its good° effects, in cases pertaining to both these modifications, have been abundantly established. " In the event of the stomach's being so irritable as to reject eveiy thing, I administer copious draughts of warm water or chamomile tea, and afterwards a cordial anodyne. The irritability being thus allayed, 15 or 20 grains of calomel can be given on the following day with ad- vantage. The subsequent treatment will depend upon circumstances. " In the third modification, the principal indications are, to allay the irritability of the stomach and to support the sinking powers of the sys- tem. To fulfil these views, the application of hot bricks to the feet and flannel wrung out of boiling water to the abdomen, and the inter- nal administration of aether and laudanum, are prompt and certain in their effects. If retained by the stomach, the draught is repeated accord- ing to the urgency of the symptoms; but if rejected, 40 or 50 drops of laudanum are united to a saline draught, and given in the act of effer- vesence—to be repeated at intervals of several hours, pro re nata. In cases of this kind, large and active sinapisms, or blisters to the region of the stomach, have been found very servicable; anodyne en em at a fre- quently repeated have proven decidedly beneficial, and the application by friction to the abdomen of a linament composed of ol: olivar: aq. amnion: and tr: opii, has also been attended with marked advantage. After the vital actions have been re-established, the patient will require but little medicine, as each organ will naturally resume its appropriate function. It not unfrequently happens, however, that fever of a typhoid character supervenes, impeding and sometimes arresting the progress of convalescence. " With those w ho have fallen by this disease in its fourth modification I had very little to do, for disease and death at one and the same mo- ment grappled the victim, and instantly plunged him into eternity. " As the history of this destructive malady supersedes the necessity of a detailed account of the other diseases of our camp, I shall exhibit simply the outlines of their character. " The diseases under consideration are verycomplex, may "perplex, and often come in ' such a questionable shape ' as to defy all nosological systems. The constitution of the atmosphere has been so peculiarly favourable to the production of bilious remitting fever, that all other diseases have been taught to acknowledge its supremacy. Upon a general survey of the peculiarities of each disease, the fact is ciearly established that the character of all is modified by the prevailing epidemic. Nearly all the cases of dysentery are accompanied writh some grade of fever of the remitting type, and would have been, perhaps, bilious remit- tents, had not a predisposition to intestinal derangement been induced in the subjects by their having been drenched in rain, having slept in wet clothes, or having laid out in the night air. The cases of diarrhoea also are nothing more than irregular forms of the reigning disease, the predis- 26 position having been induced by eating very course and impure corn- meal, or by the excessive use of spirituous liquors. It seems as though the enemy, perceiving a breach in the fortress, changed his mode of at- tack and brought his whole force to bear upon the point most vulnerable. " Nor are intermittents less under the control of the prevailing type; for most of them are of the quotidian form, which readily runs into the remittent, and then into the continued type, assuming sometimes a ma- lignant character." " With sentiments of high consideration and respect, I have the honor to be, Your obedient servant, THOMAS LAWSON, Surgeon, 1th Infantry." "Joseph Loyxl!, M. D. Surgeon General United States Army. In the last quarter of the year, the number of deaths in the northern division was 26, and in the southern 122. At Fort Scott and Baton Rouge, those two most deadly positions, the mortality was extraordina- rily great. In the consolidated 7th regiment of Infantry, consisting of 760 men, there wTere 769 cases of indisposition, a majority of them ma- lignant diseases, and 32 deaths. At Baton Rouge, in a command of about 375, the cases of disease were 553, and deaths 38. The chief causes of the mortality at these two posts have been referred to already; but as the diseases of the former post assumed unusual characters, some extracts from the report of Surgeon Lawson, dated 1st of January, 1821, are presented, in elucidation of their peculiarities. " In opposition to our confident expectations, the troops at this place continued extraordinarily sickly until the 20th of November, and up to this period cases of malignant bilious fever daily occurred. "As the season advanced, our perplexities augmented. Diseases commonly the most simple became complex; the more difficult grew malignant, and all assumed such an aggravated character as to be scarcely definable. To determine the causes of all these anomalies, I have not been wanting in proper exertions; nevertheless, the conclusions to which I have arrived, are not altogether satisfactory. Independently of the various specific sources of disease among us, so many other causes tending to the destruction of the 7th Infantry have existed, (the ele- ments themselves being against us,) that I cannot otherwise account for the misfortunes that have befallen us, than by ascribing them to a dis- pensation of Providence. " About the 15th of September, as the sick-list increased daily in numbers, and the diseases in malignancy, it was deemed advisable that a portion of our invalids should be removed beyond the influence of the cantonment's atmosphere. "Accordingly on the 18th, such as were capable of enduring the un- avoidable fatigue, and whose complaints were likely to be benefitted by a change of air, in number about 70, were removed under the charge pf one of the Assistant Surgeons to a high pine ridge to the southeast 27 of, and three miles distant from this place and the river. But scarcely were the tents pitched before a heavy rain came on, which, continuing five or six days, occasioned the immediate dissolution of several, and produced irreparable injury to all the sick. Many of those affected with intermitting fever, were also attacked with dysentery or diarrhoea, and vice versa. Nay, the diseases generally became blended the one with the other. " As the weather soon grew mild, this little colony began to revive, one or two dropping off occasionally, until the 22d of October, when the sudden fall of the thermometer laid all prostrate, some of them never more to rise. This was the most fatal period. Every convalescent re- Lapsed into his old, or contracted some new disease; and this state of things continued, with but little melioration, until the 23d November, when the establishment was broken up, and the surviving sick brought back to the cantonment. Thus did, in consequence of adventitious cir- cumstances, the most disastrous results follow our best directed efforts. " Nor was death much less busy at this place. As soon as cold weather commenced, which came on a month earlier than usual, all diseases ex- hibited new complications and more fatal results. In some cases, eveiy symptom of disease having been removed, the convalescent indulged the hope that his sufferings were at an end ; but an ill-omened change, with- out any evident cause, would unexpectedly appear; and so little power of resisting the influence of external agents remained, that even a sud- den reduction in the temperature of the atmosphere was sufficient to de- stroy vitality. In other instances, the patient seemed overwhelmed with several diseases. Between the 22d October and the 1st December, al- most every case of intermittent fever was complicated with diarrhoea or dysentery. Remitting fever and scurvy were also frequently combined. Nor were the instances few in which four distinct characters of disease were developed in the same individual. For days, for weeks, nay longer, would one of these poor creatures stagger under the burden of intermit- tent fever, dropsy, and scurvy combined, when the diarrhoea also com- ing on him, he necessarily sank under the accumulated weight of dis- ease." In the northern division, during the first quarter, diseases pre- sented their usual characters. Towards the end of January, 1821. scurvy made its appearance at Fort Crawford, Prairie du Chien. There were 16 cases, two of which terminated fatally. It was ascribed to the influence of a damp atmosphere in conjunction with the want of fresh vegetables, upon constitutions reduced by previous sickness. The two fatal cases occurred in individuals who had labored, during the summer, under intermittent fever complicated with hepatic lesions. They sank under a scorbutic dysenteiy. Surgeon's mate Men- denhall reports that, having used the " nitrous vinegar " with little suc- cess, he resorted to the employment of raw potatoes and vinegar. " To be satisfied of the virtue of this remedy," he says, " I selected four or five of the worst cases, which had received no alleviation from the use of the nitre and vinegar, and directed each one to eat per day a common soup-plate full of the potatoe sliced down in a sufficient quantity of vin- 28 egar. It had an immediate effect on the stomach, which recovered its natural vigor; the bowels became regular, the pains abated, the stricture of the tendons was overcome, the ulcers put on a healthy aspect, and in a few days the patient found himself in a happy state of convalescence. The southern division was unusually healthy, the total of deaths be- ing but 42; of which eight occurred at Baton Rouge in a command of 372 men, with 347 sick ; 11 at Fort Gadsden, on the Appalachicola river, in a battalion of 250 Artillery, with 296 sick ; and seven at Fort Scott, in the 7th Infantry, 750 men strong, with 541 cases of indisposi- tion. At Fort Scott the mortality was, for several quarters, mostly con- fined to northern recruits, who are represented by the medical officers to have been unfit for military service in any clime or season. In reference to Baton Rouge, the Surgeon General, in his quarterly report, speaks thus: " The causes of death are not mentioned. The chief complaints were di- arrhoea, dysentery, and pleurisy. The troops, more especially the recruits, had been very sickly during the previous quarter, and many of the fatal cases were probably of long standing. The reports of last year, [ending 31st March,] showr more sickness and mortality at Baton Rouge than at any other post. The total number of deaths in the army was 403,,of which 91 occurred at this place, [the annual mean strength being 372,] being nearly a fourth of the whole. The only material cause assigned by Surgeon Harney is the exposure of the recruits to too much fatigue, during the warmest season of the year, in a climate to which they are unaccustomed." At Fernandina, a decided improvement in the healthfulness of the troops was manifested. This happy result is attributed by Assistant Surgeon Weightman to the attention given to cooking and the establish- ment of regular messes, and the commutation of the ration of whiskey, (which was voluntarily relinquished,) for tea, coffee, and sugar. Many of the fatal diseases usually imputed to climate and locality arise, in a great measure, from defects in police and in the internal economy of the camp. Cleanliness is the life of an army. The Jewish code, enjoining ablutions and purifications as religious rites, has been quoted as a system adapted to a camp. The general police of the camp, no less than the observance of personal cleanliness, should, at all times, be rigidly en- forced. Attention in the selection of recruits is likewise all-important, and equally so is the mode of employing them during the first year of service. The mere labor performed by the recruit is generally but a minor part of the inconvenience arising from his new mode of life; for the fatigue and exposure that may be very well borne by a soldier after twelve months' service, will often prove destructive to him who has not yet learned to take care of himself when relieved from duty. The reports of the second quarter present nothing worthy of com- ment, save the remarkable healthfulness of the season. To this gene- ral remark, an exception is found at Baton Rouge and Fort Gadsden. The total of deaths for this quarter was 41, of which 16 occurred at the former and seven at the latter post. At Fort Scott, the other most sickly position then occupied by troops, there was fortunately no death. 29 The third quarter presents a different aspect, the mortality being more than twice as great. The aggregate of deaths was 104, of which 67 occurred at three posts, viz: at Baton Rouge 35, Fort Scott and neighboring encampments 18, and Fort Gadsden 14, leaving but 37 for all the other stations. At the eastern posts, from Fort Sullivan to Fort Severn, including West Point and the arsenals of Watervliet and Pitts- burgh, diseases presented a mild type and the ordinary variety, there being but one death. From Fort Washington to Fernandina, the re- ports exhibit but little sickness. At the post at Norfolk, there were two fatal cases of yellow fever. At Fort Scott, there were still in operation, the same causes of disease,—intemperance and irregularity of every description. The police was exceedingly defective; and the recruits, brought from the north, resembled the paupers which, in more recent years, have been transported to our shores from Europe. During this quarter, there wrere twelve cases of scurvy; and nearly every fatal case of disease might be traced to the abuse of spirituous liquors. " For the last two years." says Surgeon Lawson, " our cantonment has never been encircled by a chain of sentinels ; nay, the resemblance scarcely of guard duty has been maintained within our command." The men thus unrestrained gave loose to their inclinations, and wan- dered through the country by day and by night to the manifest preju- dice of their health, and in violation of every rule of military service. Moral as well as physical causes then, may be considered as having had an agency in producing the prostration of the 7th Infantry. Pros- trate indeed it is, for it is crippled beyond recovery, and lies a wreck sub- ject to the influence of every blast. At the Barancas there were 24 cases of scurvy, attributed to the influ- ence of local causes, and the want of vegetable diet; the deaths were 4, one of wThich arose from scurvy. At St. Marks, there were 7 deaths. The prevailing diseases were remittent and intermittent fever, diarrhoea, and dysentery. The following extract from the report of Assistant Sur- \ geon B. King, renders the prevalence of disease no ways extraordinary :— i "My hospital is very bad,and more or less wet at every rain; on the 16th September, the tide rose uncommonly high, which nearly inunda- ted this place and the adjacent country ; the water was a foot deep in the hospital; in fact, I visited my sick and went through it in a canoe. The bunks were sufficiently high to keep the sick out of the water; but this occurrence, as well as the dampness from the rains, had a very injurious effect on my patients, more particularly those laboring under dysentery and diarrhoea." The civil practitioner has little idea of the disadvantages which attend the professional career of his military brother. Among civilians, the comforts of life, and the solicitude of friends, rob disease of half its terrors. The army surgeon, on the other hand, is not unfrequently placed in positions which preclude the practicability of affording pro- tection to his sick from the inclemency of the weather, or he may find himself, despite his own exertions, deficient in medicines and hospital stores. As one day's action may bring under his care a greater number of violent injuries than the best employed civil practitioner could wit- 30 ness in a life time; so operations become indispensable, which might be deferred, or perhaps wholly avoided, in private life. Even the naval surgeon is placed in far more favorable circumstances than his army brother. The sailor fights at home, the hospital, medical supplies, pro- visions, and many little comforts, all within reach. Not so with the soldier, who often lies on the field of battle, wounded, destitute of food, bedding, or shelter; or torn from his comrades, is conveyed to distant hospitals in carts or litters, over broken-up roads or intricate mountain passes. At Fort St. Philip, intermittent fever was the prevalent complaint; and at the Bay of St. Louis, diarrhoea and dysentery. At Baton Rouge, the total of deaths was 35, in a mean strength of 287, being one-third of the aggregate of the whole army. Surgeon Harney reports, " the most of the diseases, and particularly those of a severe type, are almost solely the consequence of severe labor and exposure. * * * The men employed in getting timber in the swamps of the Mississippi, some 10 or 15 miles above this place, have been very subject to diseases which have proven of the most severe and fatal character." The 1st regi- ment of Infantry had in truth become " hewers of wood and drawers of water," much better qualified to shoulder a hod than a musket. All esprit du corps being lost, the officer, instead of drilling his men in war- like exercises, expended his military spirit in superintending fatigue parties, operating in dismal swamps. Baton Rouge, or more properly speaking, the swamps of the Mississippi, proved literally the grave of the regiment. The reports from the western posts, including Plattsburg and Sackett'a Harbor, exhibit nothing requiring special comment. The principal dis- ease was intermittent fever, and the total of deaths was only seven. During the last quarter of this year, the chief diseases were intermit- tent fever, diarrhoea, and dysentery, which have, at all periods, proven the scourge of camps. The total of deaths reported was 126, being nearly equal to that of the corresponding quarter in the previous year, when the numerical strength of the army was nearly twice as great. At Baton Rouge the number of important cases was nearly 300, and the mortality, compared with the previous quarter, seems to have suffer- ed no diminution, 29 in a mean strength of 340 men having fallen un- der the influence of disease. By this time Fort Gadsden had been abandoned, and the 7th Infan- try having been withdrawn from the swamps of the Flint and Chatta- hoochee rivers and the ponds around was en route towards the frontiers of Louisiana and Arkansas. At St. Augustine, yellow fever prevailed. From the report of Post Surgeon McMahon, the following extracts are made: " The streets are very narrow and filthy. The houses, originally crowded and badly constructed, are for the most part in a state of dilap- idation. Cleanliness has never been accounted a cardinal virtue by the Spaniards. Hence, the filth and dirt of a century have been suffered to accumulate in every street, lot, or other enclosure. 31 " The disease first made its appearance aboard the Schooner Alexan- der, which arrived at this port from the Havanna some time in the month of August. Whilst she was riding quarantine, the captain and crew died. Hence an opinion was prevalent that the disease was imported by that vessel; but by adverting to the period when the malady mani- fested itself in the city, and taking into view the fact that the schooner was not permitted to hold any intercourse, direct or indirect, with the land, either before or after the death of the captain and crew, it will be evident that this opinion is not founded in truth." In'the third week of September, several cases of " malignant fever" occurred; but the disease was not recognised as an epidemic until the close of the month. From this period the progress of the malady con- tinued unarrested until the recurrence of frost in the latter part of De- cember. " Its ravages," continues Dr. McMahon, " were entirely confined to strangers. By this tenn, I would be understood to designate all persons not inured to the atmosphere of the city by nativity or a residence of a long series of years. Spaniards or natives, resident in the country, who had the temerity to venture into the city during its prevalence, were liable to its attack, though in a milder degree than the emigrants." Examinations post mortem revealed the following appearances: The strongest marks of disorganization were observable in the alimentary ca- nal. The stomach was reduced in size, incipient mortification was manifest, and it contained the peculiar black matter resembling coffee- grounds. Its pyloric portion and the duodenum were effused with black blood. The remainder of the primae viae, as well as the lungs, kidneys, spleen, liver, and biliary ducts, presented no organic lesions. Post Surgeon McCoskry having fallen a victim to the epidemic, he was succeeded by the author of the above extracts, by whom 14 cases were treated, of which four proved fatal. Among the citizens attacked, who were principally Europeans, the mortality was much greater. In September, according to the reports of the Surgeons, the 7th regiment of Infantry took up the line of inarch from Fort Scott—a po- sition which had always been rife with disease, the character of which was rendered more fatal by the enfeebled constitutions of the men and their irregular habits. The sick list numbered 154 cases, mostly dysen- tery, whilst the whole command was much enfeebled by previous dis- ease. Having descended the Appalachicola, and being encamped near its mouth, the troops were much exposed to violent storms of wind and rain, which caused a great augmentation of the sick list. Transporta- tion having at length arrived, the troops embarked for New Orleans in seven sloops and schooners—the sick being stowed away with the other men and the baggage of their companies respectively; and until their anival at the bayou St. John they were, by this arrangement in most of the vessels, deprived of medical aid. Here the men suffered exceed- ingly from the quality of the water, which had been put into casks con- taining the impure lees of wine. The cases of dysentery were conse- quently much increased in number, and rendered more fatal. At 32 New Orleans, the sick were put into a house, in which they were ex- posed to the inclemencv of the weather, and suffered equally from con- fined rooms and the want of fuel. These circumstances, although re- peatedly reported by the several medical officers to the commandant, failed to receive the attention so imperiously demanded. The result is calcu- lated to illustrate an important principle in military affairs, viz. that the comfort and transportation of the sick should, on the ground both of humanity and public interest, always engage the anxious solicitude of the commanding officer. Whilst encamped at this place, the troops suffered again from a storm of four days' continuance, by which the tents were prostrated and the grounds inundated. Divided into two battalions of five companies each, they embarked on the 6th November for their respective destinations. The sick of the detachment for Fort Selden, near Natchitoches, suffered much from exposure to rain ; and so enfeebled wrere the vital energies of these men, that several perished during those nights when the thermome- ter indicated a sudden decrease of temperature. On the Red river, the boiler of one of the boats exploded, killing three men and injuring several others seriously. Arrived at Alexandria, the lowness of the water pre- vented the further progress of the boats ; but having transferred the bag- gage to barges, and dragged them over the rocks, the rapids were soon cleared; and on the 17th December the command reached its des- tination, having been two and a half months on the route. In this debilitated condition, the troops were set to work in repairing the bar- racks and building an hospital. The detachment destined for Fort. Smith, Arkansas, was also much exposed on the decks of a steamer on the Mississippi, and in open boats on the Arkansas river, and suffered much from the inclemency of the weather. During the protracted movement of this ill-fated corps, it lost many of its members by disease and casualties; but, as the companies were frequently separated, and no regular reports were made on the march of the number or the manner of the deaths, the aggregate that perished is not accurately known. The medical history of the 1st and 7th Infantry affords matter for the serious consideration of every military man, and teaches a lesson of ex- perience which ought not to be forgotten by the Executive officers of the Government. Recruits should not be brought from our northern States and cities to the south in the summer season, and then be put immediately to work building barracks in which to shelter themselves. It is improper, except for some immediate or temporary object, to concentrate a large body of men in the immediate vicinity of swamps, lakes, and lagoons, and equally wrong to hold them there after the experience of a season es- tablishes incontestibly the unhealthfulness of the position. If troops must occupy unfavorable localities in a southern latitude, they should be divided into small commands; we know from experi- ence that one hundred men may remain comparatively healthy at points where five hundred or one thousand will contract disease; and it is 33 manifestly against reason to put a body of men in motion for a long journey with one third actually sick, and the remainder just convalescing from disease. Had the troops left Fort Scott in March, instead of the last of September, 1821, the heavy loss by death and the invaliding of the men would have been saved to the country. The movement of masses of men in a crippled condition will invariably be attended with an aggravation of disease and corresponding loss of life. Numerous widows and orphans to this day mourn the untimely fate of relations and friends who sank under disease during the disastrous movement of the army from Terre aux Bosuf to the highlands of the Mississippi. In this year, an epidemic bilious fever prevailed in every sec- tion of the United States. 1822. The reports of the first quarter exhibit a remarkable degree of healthfulness at the military posts generally. The aggregate of deaths was but 54, Baton Rouge even being exempt from its usual degree of mortality. The total of deaths in the second quarter was 41, of which 28 occurred at Baton Rouge, and 22 of these in the month of June. There were, therefore, but 13 fatal cases at all other posts. The continued prevalence of sickness at Baton Rouge was attributed by the Surgeon to the unceasing and laborious occupations of the men, acting in conjunction with the influence of a long-continued drought and the effects of habitual intemperance. The numerical strength of the command was about 300, and the total cases of disease 421. The prevailing diseases, more especially at the southern and western posts, were intermittent and remittent fever, diarrhoea, and dysentery. At Baton Rouge, there Avere 81 cases of the two latter, and 122 cases of the two former complaints. In the third quarter there were 75 deaths. Of the cases under treat- ment, nearly one-half was intermittent and remittent fever, which pre- vailed to a great and fatal extent in many parts of the country. Of these cases, 540 occurred at Council Bluffs, in a command of nearly 500 men. The causes of this unusual sickness are referred by Surgeon Gale to the annual inundation of the low grounds selected for cultiva- tion. Only one case, however, terminated fatally. The prevalence of intermittent and remittent fever, in newly settled countries, is a very general occurrence. That a half-cultivated region is more sickly than a wilderness, or a country in the highest state of agri- cultural improvement, is a fact often remarked by the close observer of nature. In treating of the " Diseases of the early settlers of Ohio," Dr. Hildreth says, " They were sometimes attacked with malignant re- mittents in the summer, and pneumonias and pleurisies in the winter, but no serious epidemics appeared until partial openings had been made in the primeval forests, and the wet low grounds exposed to the action of a summer sun. Accordingly, we find that a partially cultivated region is more sickly than one which is either totally covered with forests, or in a state of complete redemption." This opinion accords entirely witk the general experience of our army surgeons. The hun'er, and the w ild 34 borderer, who are the pioneers of the actual settler, suffer less from dis- ease than the latter class. As the hunter and the borderer live like the savages around them, depending for subsistence nearly altogether upon fishing and the chase, their diseases are generally of a simple inflamma- tory character, arising from the combined influence of hunger, fatigue, and exposure to variable and extreme weather. In this unreclaimed state, .the baneful exhalations which arise from the decayed vegetable matter covering the soil, seldom ascend beyond the higher foliage of the trees; but as soon as the permanent settler begins to fell the forest, leav- ing the branches to undergo decomposition in the heats of summer, and to turn up to the action of the sun the marshy ground, consisting of the accumulated vegetable deposition of years, deleterious agents are ex- haled, giving rise to the most malignant epidemics. In the recent Flo- rida campaigns, it is a common observation, that encampments near jungles seldom prove insalubrious, unless the soil is cultivated, or the * trees and shrubbery are cut down, thus exposing the boggy surface to the influence of solar action. Dr. Hildreth also notices the epidemics of 1821-'2-'3, as being of the most fatal character throughout the valley of the Ohio. The epidemic of 1823-'4, varying in its attacks from the mildest intermittents to the most malignant remittents, extended east of the Alleganies through Pennsylvania. The epidemic of 1823, says Dr. Cartwright of Natchez, was probably the most terrible that ever prevailed in the United States. Dr. Heustis, formerly of the United States army, in some medico-to- pographical remarks on Alabama, observes, " For the first three years after my arrival in this State, in 1821-'2-'3, the country was dreadfully sickly, and the mortality great and appalling, more especially near the rivers. The whole country was then new, and the warmth and humid- ity of the seasons caused a great and rapid decomposition in the recently exposed and turned up vegetable matters. Many flourishing towns upon the rivers, which had risen up, as it were, by the hand of enchant- ment, received a sudden check, and became suddenly almost totally abandoned from death and desertion. Strangers from every part of the United States, invited by the fertility of the soil, the beauty of the country, and the serenity of the climate, brought together by fortuitous association, with foreign and unseasoned constitutions, were suddenly swept off by thousands. In many families there were not well persons sufficient to attend upon the sick and dying. Never have I known a time of such general calamity." At Fort McHemy, in a garrison of 108 men, there were 62 cases and 2 deaths. Several circumstances are reported which throw some light on the nature of the " bilious cholic," which had prevailed there, for several years, in a very severe form. There were 56 recruits, all of whom were employed on police duty, whilst the old soldiers performed the necessary guard duties. The diet of both was the same. Both were exposed to the high temperature of the day; but the latter, were subjected to the additional influence of the damp atmosphere of the night, laden with marsh effluvia. The extent of sickness in these two 9 classes of men, was perhaps equal; but the cases of " bilious cholic" occurred only among the old soldiers, whilst the detachment of recruits 35 suffered much from intermittent fever. It wrould seem, then, that the poison, in a certain quantum, produced intermittent fever; and when conjoined with the effects of exposure to night air, the result was " bil- ious cholic." Between the skin and the liver there exists an intimate and powerful sympathy. In proportion as high atmospheric tempera- ture excites these organs into inordinate functional action, are they ren- dered susceptible to the impressions of cold and dampness. Assuming, therefore, that both the recruits and old soldiers were equally exposed to the causes of intermittent fever, we are led to the inference that the con- joined influence of exposure to the night air produced a sudden torpor or inactivity of these two important enunctories, causing that group of violent abnormal manifestations, designated " bilious cholic." This view of the subject accords with the appearance of similar affections at other points, and accounts for its unusual prevalence two years previ- ously, when the men were employed in boats. Improper diet and irregu- lar habits were the causes then assigned. Bilious remittent or yellow fever appeared at Pensacola on the 7th August, and soon extended over the whole city. Between the 13th and 20th of the month, 20 deaths occurred; and on the 26th, the troops abandoned the town and encamped on a dry and elevated position in the vicinity. As some men were necessarily left behind to guard the public property, most of the cases occurred among them. The total number of cases was 52, of which 11 proved fatal—a relative mortality much lower than that among the civil population. The three medical officers, Drs. Elliott, McMahon, and Merrill, were seriously attacked, the first of whom fell a victim to the disease. The following report is from Assistant Surgeon McMahon, whose opinions derive additional impor- tance from the fact that he had witnessed the disease, the previous year, at St. Augustine:— " Pensacola is situated on the bay of that name, in latitude 30 deg. 29 min. N., and longitude 10 deg. W. It is bounded on the south and east by the bay, on the north by bayou Tacha, and on the west, by the little bayou and an extensive pine barren. A chain of heights, whose maximum elevation does not exceed 60 feet, extends along the rear of the town, and is the source of a never-failing spring, which supplies the inhabitants with water. " From an attentive examination of its natural position, I am induced to believe that this city holds out a fine prospect for salubrity. Exposed in front to the sea, and sufficiently remote, on every other side, from swamps or large bodies of fresh water, it possesses so much elevation as to have a constant and free ventilation, whilst the soil of the city, as well as of the vicinity, is one unvaried bed of sand, mingled sparsely with a rich vegetable mould. " The streets are wide and spacious, intersecting each other at right: angles. Deprived of pavements and the protecting shade of trees, the sand, by which they are covered to the depth of seven or eight inches, acquires, during four or five months of the year, such an intense degree* of heat as to render all attempts at walking abroad, during the day,, manifesdy dangerous. 36 " The houses, generally built of wood, are, many of diem,, in a state of decay. The lots and yards containing the accumulated filth of years, are extremely offensive. The privies being very much neglected, are abominably fetid. The soil of the gardens being in a great measure artificial, vegetation is very productive; and as the leaves and offals are suffered to remain on the surface, decomposition, favored by heat and moisture, rapidly ensues. " To these prolific sources of miasmata may be added, a total neglect of cleanliness in the personal habits and domestic economy of the in- habitants. " An unusual degree of heat and moisture during the summer, has tended effectually to bring those exciting causes of disease into operation. It cannot, therefore, be doubted that they were amply sufficient to pro- duce malignant fever in a climate where, during the summer months, an intense degree of heat prevails, and wdiere the average annual quan- tity of rain that falls is rarely below fifty or sixty inches. " The first five months of the year were remarkably healthy. The month of June was ushered in by the prevalence of a fatal distemper among brute animals. Its operation was particularly marked upon dogs, foxes, and panthers. The mortality among the two last was, indeed, immense; numbers being found every where dead in the woods. It is somewhat singular that four, five, and six bodies were generally discov- ered collected about the same spot. During the same period, a general state of mal-aise prevailed amongst the inhabitants, manifesting itself in depression of spirits, loss of appetite, and apathy to every species of exercise and amusement; but no case of fever wearing a bilious or ma- lignant type had as yet occurred. Towards the close of the month, however, a number of cases of bilious remittent fever were observed; but inasmuch as they were found to prevail only amongst the poor and laboring classes and those of dissolute habits, they excited no suspicion of the approaching catastrophe. " About the first of July, a brig having a cargo of cod-fish, most of them in an unsound or putrid state, arrived from the Havanna. As the captain and crew were in apparent good health, the boarding officer, at the quarantine grounds, permitted her to pass. She lay eight or ten days at anchor before the town, when a remonstrance was made to the board of health by a number of the inhabitants residing on Bay street, representing her as a nuisance of the most noxious character. This served to awaken them, for a moment, to some sense of their duty. An order was issued directing the brig to depart the harbor forthwith; but it was now too late, as the evils against which it intended to guard, had been already committed. The fish, for the most part, had been landed and sold, as the captain phrased it, " for a mere song." Thus a new source of pestilential effluvia was introduced, tending to rouse into action the dormant enemy within the bosom of this ill-fated city. " July was rendered remarkable by the immense quantity of rain that fell, and by a storm of some days' duration, which prevailed from the southwest, and caused considerable injury to the town and the shipping 37 along the coast. It may, on the whole, be pronounced a healthy month, as the cases of disease w7ere few and of a mild character. " The month of August was ushered in by very hot calm weather. On the 7th, a young lady, who had recently arrived from New Orleans, died with the black vomit. Her attending physicians, Drs. Elliott and Bronaugh, had no suspicion of the real character of the disease, until this last fatal harbinger of death made its appearance. About the same time, two other cases of malignant fever occurred in a quarter of the town which had been considered the most healthy. As the symptoms in these cases were very mild in appearance, and as the subject of one was a Spanish lady,long a resident in the climate, the physicians labored under the same delusion as in the first case : both patients died on the 12th with black vomit. On the 13th, the board of health publicly announced the existence of the disease, and warned all the inhabitants able to remove, to retire to the country. At the same time, they ordered the putrid cod-fish to be seized wherever found, and buried without the limits of the city. This order wTas very imperfectly obeyed ; and as the fish had been purchased by persons residing in every quarter of the town, the effluvia hence arising, during the warm still mornings of this month, were intolerable. In addition to this evil, the board caused fires to be kept continually burning in every direction, by which the heat of the atmosphere, already excessive, was redoubled. The pestilence, however, became more rife, and the disease acquired new malignity. " Between the 13th and 20th, upwards of 20 deaths took place. The disease now spread rapidly, and with a degree of malignity rarely equalled in the annals of this destructive malady. Out of a population of 1,000 souls, upwards of 200 have already become its victims. Neither age, sex, complexion, occupation, or residence, has afforded any exemption from its fatal ravages. The old and the young, the na- tive and the emigrant, the white and the black, have been alike subject to its baleful influence. " On the 26th the troops evacuated the town. Up to this period, their health remained unusually good. A knowledge of this fact pre vented many citizens from retiring, and thus many valuable lives were sacrificed. Believing that this singular exemption of the soldiery was due to their peculiar habits and mode of living, whiskey and salt pork were now considered as prophylactics—and, as might have been anticipa- ted, all those who had recourse to the supposed preventives, fell speedy victims to the disease. "A scarcity of tents and the want of buildings for the reception of the sick and the public property, rendered it necessary that attendents and a guard should remain in town, to watch over them until conve- nient sheds were erected for their protection. As soon as this measure was effected, they were removed to the camp ; but few, if any, escaped the infection. And here I would offer a tribute of praise to the salubri- ty of our present encampment, and to the humane and benevolent con- duct of the officers, who have invariably promoted every measure, tend- ing to the comfort of the troops and the preservation of their health. In no instance has a case of fever, originating here, fallen under my 38 notice, and from every other disease, incidental to the season and cli- mate, we are equally exempt. , , q(< " It will be seen, on reference to the quarterly report, that out o db cases of malignant fever contracted by the troops, only ten have died. This mortality, compared with that in town, presents a very low ratio. Among its first victims was Dr. Elliott, an officer whose loss cannot be too much regretted ; his amenity of manners and correctness of conduct entitle him to the lasting esteem of all who knew him. " The general symptoms of this disease are marked by a near resem- blance to those observed last year at St. Augustine; such as, weariness, restlessness, loss of appetite, excruciating pains in the head and back, turgescence of the vessels of the eye, -and in some cases a watery suffu- sion and a wild stare painful to the beholder, obstinate costiveness, tongue covered with a dark fur with its edges very red and swollen, the thirst excessive, and the skin hot, dry, and constricted. In most instan- ces, violent arterial action, indicating the use of active depleting meas ures, attends. " These symptoms constitute the first stage of the disease, and, if not speedily removed, are followed by others of a most alarming character. The pulse sinks rapidly; the skin becomes cold ; the patient experi- ences an indescribable sense of weight and oppression about the proecor- dia ; violent gastric irritability supervenes ; and tremors of the limbs and fainting fits occur, whenever the patient attempts to rise or go to stool. Delirium succeeds, and if not speedily arrested, the patient complains of a sense of heaviness in his head, as if it were about to fall from his shoul- ders by its own weight. A burning sensation is next experienced in the thoracic and abdominal regions ; the tongue becomes covered with a yellowish black sordes ; the stools are liquid and dark green, mixed with floculi of a deep brown color; and the urine is small in quantity and passed with great difficulty. The patient now becomes alarmed ; he catches hold and endeavors to detain every person that approaches his bed-side ; the weight of clothes, even that of a sheet, becomes intolera- ble ; the stools are involuntary, and assume a dark grumous appearance. The patient complains of a sense of choking, or constriction in the su- perior region of the larynx, to which point he refers the whole of his disease. Cold, clammy sweats next ensue ; the pulse becomes imper- ceptible at the wrist; then follow subsultus tendinum, singultus, con- vulsions, and hoemonhage from the mouth, nose, eyes, and ears, and in some cases from the extremities of the toes and fingers—the immediate precursors of death ; and finally, black vomit, that ever fatal symptom, puts a period to the patient's sufferings. " Only one case of recovery, after the secondary train of symptoms had set in, has fallen uuder my notice. The first twelve hours are in gen- eral decisive of the patient's fate. If prominent symptoms are not then relieved by active depleting measures, all hopes of recovery may be abandoned. Gastric irritability, continual watchfulness, dread of ap- proaching dissolution, and sinking of the powers of life, succeed one another with such rapidity that the patient soon succumbs under their accumulated weight." 39 At the Barrancas there were 9 deaths, of which 7 arose from bilious remittent fever. The report from Baton Rouge presents the usual mor- tality ; the average strength of the command was 245, the total number of cases 281, and the deaths 29. Of intermittent fever there were 101 cases, and of remittent 45. The post at St. Marks was very healthy from the beginning of the year until August, when bilious fever of the remittent type made its appearance. The total of cases was 68, and the deaths but 5. The local or exciting causes were not dissimilar from those in operation at Pensacola. The causes enumerated by Assistant Surgeon Stevenson, are as follows : the unusual low tides, by which a large quantity of putrid vegetable and animal matter was exposed to the action of the sun ; the prevalence of east winds, coming over an exten- sive marshy country ; and the general failure of summer vegetables, which are very essential to the maintenance of health in warm climates. To these exciting causes must be added the more important and essen- tial one, viz. the peculiar general constitution of the atmosphere, (con- stitute a'eris,) indicated by the simultaneous prevalence of remittent and bilious fevers in every district of the United States. As these local causes are found in other places and in other seasons to a much greater extent without producing similar effects, it is obvious that some peculiar meteorological condition of the atmosphere is essential to give potency to these morbific agents. A fact in regard to the brute creation, observed in the black death of the 14th century, and in many other epidemics, has been noticed in the report of Dr. McMahon. Like the Grecian plague before Troy, " On mules and dogs th' infection first began, And last the vengeful arrows fixed on man." As animal decomposition is regarded by many as innoxious, the agency ascribed by the same medical officer to the putrid fish at Pensa- cola, as " a new source of pestilential effluvia," will be doubted by this class of reasoners. There seems to be, however, pretty strong evidence in favor of the affirmative. Yellow fever was clearly traced to the very same source, as an exciting cause, in Newburyport in 1796, and in New London in 1798. That putrid oysters in the shell, and hides in a state of putrifaction, exert the same agency, has been often strenuously maintained. The north-wrestem posts, and those along the eastern coast, generally require but little comment. At Prairie du Chien, the diseases arising from the general epidemic constitution of the atmosphere, assumed chief- ly a dysenteric form, followed by intermittent fever. At the Sault St. Marie, diarrhoea was the only disease of any consequence: and at Sa- guina Bay, intermittents and remittents prevailed. The aggregate of deaths, reported this quarter, was but 65—a mortal- ity which, when we consider the extent and fatal character of diseases in general during the summer, was very low ; and which, at the same time, afforded a practical comment on the efficiency of the medical corps of the army. The following case of ileus, which occurred in the hospital at St. Marks, under the care of Assistant Surgeon Stevenson, is replete with interest: 40 On the 11th July, a private soldier of the 4th regiment of A^{e^ was reported sick with the usual symptoms of spasmodic cholic. i ne or- dinary remedies were employed, but the stomach rejected every ming , whilst the bowels continued, for three days, obstinately constipated, un the evening of the 12th, the patient had stercoraceous discharges Horn the stomach, attended with cold sweats and a small weak pulse. V ene- section, blisters, and enemata, were used without any abatement of the alarming symptoms, until the evening of the 15th, when he had a copi- ous and fetid alvine evacuation. On the morning of the 16th, he dis- charged per anum a portion of the small intestine, 6| inches in length. As the calibre, thickness, and texture of this organized substance pre- cluded the possibility of mistake, the inference is obvious, that the inva- ginated portion had become gangrenous and sloughed off. The patient recovered his health slowly, and on the 23d of July returned to quar- ters. On the 14th August he was attacked by the prevailing epidemic, and on the 18th he died. It is a matter of serious regret that the state of the medical officer's health was such as to render him unable to make an autopsic examination. During the fourth quarter, the total mortality of the army was 42. Of these, 15 occurred at Baton Rouge, the strength of the command be- ing 238, and the number of cases 276. The prevailing disorders were diarrhoea, dysentery, and fever of the intennittent and remittent type. At Fort San Carlos de Barrancas, 12 died of malignant fever out of 24 cases. The strength of the command varied from 90 to 300 men, and the total of cases under treatment was 66. " The cases which proved fatal," says Dr. Bell, " generally terminated on the third, fourth, or fifth day, the patient having sunk into a typhoid state, accompanied by a vomiting of black matter resembling coffee-grounds." At Pensacola, there was one death from the same disease. The following report of Dr. McMahon is a continuation of his remarks given in the preceding quarter: " Since the first part of this report was transmitted, the malignant fe- ver continued, but with diminished violence, until the 27th of Novem- ber, when the occurrence of a severe frost put a final stop to its ravages. " From the observations made during the past and present season up- on this disease, I conceive it impracticable to lay down or pursue any regular mode of treatment. At St. Augustine, for instance, the employ- ment of the lancet or mercurial preparations was invariably accompanied by fatal results; whereas at Pensacola the reverse took place. It has frequently happened that similar remedial means, employed under ap- parently similar circumstances, have often produced, at the two places, various and opposite effects. Carefully to watch its approach and pro- gress, and to combat and obviate symptoms, was the ' unica et ultima regula,\ which I observed in the management of this insidious malady." Before and after the 9th of October, the disease presented a character diametrically opposite. Prior to the above period, there was an excess of arterial action requiring a free and liberal use of the lancet; but sub- sequently, the vital powers manifested such a loss of energy that the strongest stimulants were imperiously demanded. The disease, at this 41 period, ran its course in 18 or 24 hours, and if stimuli were not exhibited on the first indication of an attack, the patient's fate was irrecoverably sealed. The aggregate of deaths from all the other military posts, during this quarter, was but 11. At Council Bluffs there were 428 cases, but none proved fatal. At Fort McHenry, cases of " bilious cholic " were still reported; and at Fort Severn, also, it continued to prevail. No case, however, resulted fatally. In the first quarter, the mortality of the army, according to the medical returns, amounted to 35. Of these deaths, 13 occurred 1823. at Baton Rouge, at which point dysentery and intermittent fever were as rife as usual. During the second quarter, the aggregate mortality was 50, Baton Rouge having furnished 29 fatal cases. In the corresponding quarter of the prior year, the total of deaths was 41, of which 28 were reported at Baton Rouge. The garrison now consisted of about 400 men, of whom three-fourths were recruits. The continued prevalence of disease is ascribed by the Surgeon, as in former reports, to the operation of the following causes: 1. Intemperance; 2. Severe fatigue duty ; and, 3. The consequent exposure, especially among the recruits who were unacclimated. These causes, in conjunction with the change of diet, and other habits to which a recruit is necessarily subjected, are regarded* by Surgeon Harney as adequate to the explanation of the extent and fa- tality of diseases. In the third quarter, the deaths numbered 53. Of these, 24 occur- red at Fort Smith, (Arkansas Territory,) 6 at Council Bluffs, (Missou- ri,) and 3 at Saguina Bay, (Michigan,) leaving the small mortality of 20 at. all other posts. It may be worthy of remark that Baton Rouge, during the summer, was occupied by very few men. At most of the southern and western stations, intermittent and remittent fevers wTere the prevailing maladies. At Fort Smith, the endemic assumed all the man- ifestations of a high grade of yellow fever; but, fortunately, its fatality was limited to a very short period. The strength of the command was 200, and the total of cases, during the quarter, was 277. The subjoin- ed report is from Assistant Surgeon (now Surgeon) C. A. Finley. " Fort Smith, October 15, 1823. " Sir : From the accompanying report of the quarter ending the 30th September, you will observe that the mortality of this post has been un- usually and alarmingly great. Prior to the 5th of September, our dis- eases did not assume a character calculated to excite any anxiety, but were such as we anticipated in this season and climate. About the pe- riod just named, the fever became more rife, and manifested a violent grade of action. When first attacked, the patient complained of slight chilliness, which was soon succeeded by fever, general pains, most se- vere in the head and loins, and excessive irritability of the stomach, at- tended with continued vomiting and excrutiating pain in the same re- gion. Although the application of a blister invariably relieved the pain, it had not the effect of arresting the vomiting, which only ceased with death. The matter discharged from the stomach was black, and had 6 42 the appearance of clotted blood. The pulse was quick and soft, and the eyes were red and painful. After the first 12 or 18 hours, deiinum ensued ; the tongue became black, rough, and dry; the thirst, owing to the irritability of the stomach, was unquenchable ; and finally, comes and convulsions announced the approach of death. " In the treatment, I adopted, after giving an emetic and brisk purga- tive, the mercurial plan; but this was not attended with much success, until, after some experience, I premised the cold shower bath. The disease now yielded, nor did I lose a case in which the bath was used within the first twelve hours." During the last quarter, intermittent fever, diarrhoea, and bronchial affections, were the maladies most rife. The aggregate mortality was 56, of which 13 were reported at Baton Rouge. It is to be regretted that we have not more detailed accounts in reference to the medical to- pography of this station. In the quarterly report, we are informed merely that " the post has been garrisoned by four companies, and about 40 prisoners; the latter are generally very sickly, and almost without pay or clothing." At Tybee Island, near Savannah, the whole command, including women and children, were attacked with " au- tumnal fever." The number of men present was 41, of whom nine 'died, and eight or ten were rendered nearly unfit for service. In the first quarter, the aggregate mortality was but 23. No 1824. disease exhibited any peculiarities demanding comment. At Baton Rouge, five recruits from the north died. The second quarter presents a total of 30 deaths. At Baton Rouge there were eight fatal cases, but the causes from which they arose are not specified. At Petite Coquille, the cases of bilious fever were pretty numerous, of which one only proved fatal. The medical officer reports that " the weather during this quarter has been unusually hot, no rain having fallen' for the last six weeks. The marshes which environ u? on every side are no longer covered with water; and the exhalations from them at night are intolerably fetid. To these causes, in conjunc- tion with the unfitness of the buildings occupied as barracks, may be attributed the occurrence of so many violent cases of bilious inflamma- tory and remittent fever." Amongst the causes of disease enumerated by surgeons stationed at southern posts, reference is frequently made to the circumstance of troops from the north being sent to that climate al improper seasons. During the third quarter, the mortality was unusually low, the ag- gregate of deaths being but 35. The garrison of Fort Mifflin, as in the summer months of former years, suffered severely from febrile affections of an intermittent and remittent type; but no case terminated fatally. There are 35 cases of opthalmia reported, some of which were mark- ed by a very high grade of inflammatory action. The unusual preva- lence of this disease was generally ascribed to the peculiar form of the forage-cap worn by the soldiers. At Fort Moultrie, Charleston Harbor, 12 cases of yellow fever ap- peared. The strength of the command was 70; and although the mor- tality was very great in the city and its vicinity, no fatal case occurred 43 among the soldiery. This immunity from the epidemic must, in a great measure, be attributed to the timely precaution of Assistant Sur- geon Richard Randall, by whose advice the troops were removed to the sand-beach on the opposite end of the island. The day after the re- moval, there were brought to the hospital two new cases, which proved to be the last. " The disease has been treated," says Dr. R., " in my practice by pretty free depletion, mild mercurials, and active cathartics ; and my greater success warrants me in believing that it is a better plan of treatment than the exclusively mercurial one, which is generally pur- sued by the physicians of Carolina." At Pensacola, there were two deaths from yellow fever reported. The diseases at all other posts were so entirely free from peculiarity as to require no comment. The stations on our northwestern frontier, the northern chain of lakes, and the At- lantic sea-board north of Philadelphia, have as yet, indeed, called for little notice. Among the diseases of the last quarter of the year, the principal were intermittent fever, diarrhoea, dysentery, and the usual inflammatory af- fections of the season. In Charleston harbor, in a command of 90 men, 15 cases of yellow fever occurred, two of which terminatedrfatally. Op- thalmic affections still continued to prevail, 35 cases having been report- ed for the quarter; and, during the year, several men were discharged the service in consequence of loss of vision. A special report on this subject having been made to the War Department by the Surgeon Gen- eral, certain alterations in the shape of the forage cap were directed; and as there were but three cases of opthalmia reported in the succeeding quarter, the presumed cause was inferred to be the legitimate one. As these affections, however, became year after year more rife, it affords another evidence of the difficulty and uncertainty of medical causation. Our knowledge of cause and effect in regard to a succession of events, is founded entirely on the observation of a uniform sequence in the phe- nomena; and to assign to these successive events the relation of uniform sequence, is often a step of the utmost perplexity in eveiy department of science. In the prosecution'of medical investigations, this is more es- pecially apparent in our efforts to determine the effects of external agents as causes of morbid action, the effects of external agents as therapeutic means, and the connexion of certain functional and organic lesions of internal organs with certain external expressions or signs of disease. The aggregate mortality of the quarter wTas 34. At Baton Rouge the mean strength was 137, and out of 117 cases there were nine deaths ; but in regard to the character of the prevailing diseases, or the causes of their continuance, the report furnishes no information. As a general conclusion from the reports of the whole year, it appears that the mortality was owing chiefly to diseases arising from the influence of causes, with the exception of ardent spirits, beyond the control of man; whilst those diseases which depend more particularly upon police and discipline, as typhus fever, diarrhoea, and dysentery, have been neither numerous nor fatal. The fact that but seven deaths occurred from the latter complaints during the year, affords presumptive evidence that these important points of duty were rigidly enforced. 41 The annual aggregate mortality was 122. Among the causes of death the abuse of spirituous liquors holds a prominent rank. To this pest ot the army forty deaths may be traced, under the different forms ot liver disease, dropsy, apoplexy, &c. To suppress this growing evil, Dr._Lov- ell, with laudable zeal, ceased not to urge upon the Secretary of War the necessity of abolishing the use of whiskey among the troops, or of supplying a less deleterious substitute. He maintained that it was the cause, not only of many of the irregularities of service, but of vast ex- pense to the public treasury by the increase of the sick-list, and by pre- mature deaths and discharges. In consequence of incurable diseases proceeding mainly from this cause, 108 were discharged, during the pre- vious year, from the hospitals alone. As the post at Baton Rouge has demanded comment in every quar- terly report, an abstract of the last six years may afford interesting results. The mortality of the 1st regiment of Infantry at this post is, doubtless, higher than that of any other regiment since the organization of our Gov- ernment. To ascertain the exact ratio it was necessary, as the condensed records kept in the Adjutant General's Office at that period could not furnish all the essential data, to collect the information from musty regi- mental returns. Although some of these files are now imperfect, yet I had the good fortune to find, with one exception, all the monthly returns of the 1st regiment of Infantry at Baton Rouge complete. ABSTRACT showing the annual ratio of mortality, per centum, of the 1st regiment of Infantry at Baton Rouge, from 1819 to 1824 inclusive. , 1819 1820 1821 1822 1823 1824 MONTHS. bo ■Ja e c/i i a i i a J i a to 9 p 9 eS £ 4) annual ratio of Deaths per tent. 227 12.8 342 22.2 352 23.0 329 25.8 297 18.5 139 17.3 Six companies are reported at Camp Clark near St. Louis, but of the position of the other four companies there is no record. 45 ABSTRACT exhibiting tlie deaths, and the number of cases under treatment, during the same period. YEARS. Mean strength per Adjutant Cases treated per Medical Deaths per Adjutant Gen-eral's returns. Ratio per 1000 mean strength. turns. returns. Treated. Died. 1819 1820 1821 1822 1823 1824 227 342 352 329 297 139 _ * 1878 2041 1420 1090 514 29 76 81 85 55 24 5.492 5.798 4.322 3.670 3.698 128 222 230 258 185 173 Total - 1686 6943 350 | - Average 281 1389 58 4.596 208 * No report. It appears, then, that the ratio of mortality, on an average of six years, is nearly 21 per cent., a result unprecedented in our military annals. In 1822, the most fatal year, the mean was nearly 26 per cent. As there were, among every 1,000 men, 4596 cases under treatment in the course of the year, it follows that every man, on an average, must have been on the sick list once in every two months and nineteen days. It is deemed unnecessary to extend these remarks, as the medical his- tory of the regiment has been developed at every step of our progress. The question, why the post was not abandoned or a new system of in- ternal economy adopted, is doubtless suggested to every mind. It were useless, at this late day, to inquire into the motives that influenced our public councils. Suffice it to say, that the late Surgeon Ggjjejal, in a report to the Secretary of War, as early as November, 1821, uses the fol- lowing language: " The duties required of the soldiery at this post, since the commencement of the public works, have not only been labo- rious and severe in the extreme, but inhuman and unjust. The num- ber of cases treated, the deaths, and desertions, will, I think, conclusively prove how impolitic have been the measures pursued. It also appears that, whilst the mortality amongst the troops has been so great, the citizens in the vicinity are quite healthy." The first quarter of this year was remarkably healthy. The 1825. aggregate mortality was 31, of which seven arose directly from intemperance, and the same number from phthisis pulmonalis, leaving but 17 from all other diseases. In the second quarter, the aggregate of deaths was still lower, being but 24. Notwithstanding the change in the forage cap, alluded to in the previous year, 67 cases of opthalmia are reported this quarter, and 58 in the succeeding one. In the third quarter there were 46 deaths. The stations along our northern Atlantic coast were healthy, with the exception of Fort Con- stitution at Portsmouth. Nearly the whole garrison was attacked with 46 cholic and cholera morbus, but no case terminated fatally. At Fort Delaware, nearly every man suffered from diarrhoea and intermittent and bilious remittent fever. In connexion with the heat and dryness of the season, Assistant Surgeon S. B. Smith mentions, among the accidental causes, the intemperance of the soldiery, who were employed all sum- mer in enlarging the fosse surrounding the fort; and as the bottom con- sisted of soft alluvial matter, he ascribes the prevalence of the febrile affections, in a great measure, to its agencyr. The company stationed at Fort McHenry, in consequence of the in- salubrity of the position during the summer months, encamped, as had been found necessary for several years previously, about two miles from Baltimore; and in this position the troops enjoyed good health. At Fortress Monroe, fevers of the intermittent and remittent type, as well as typhus, prevailed extensively ; but two cases, however, proved fatal, the result of the last named disease. At Fort Moultrie, the ratio of sickness was also very high; for, among 90 men present, there were reported 46 cases of cholic, dysenteiy, and bilious fever; but one case, however, terminated fatally. At Bellona Arsenal, near Richmond, intermittent and remittent fever prevailed, as usual, to a great extent. Although the fatal cases were few in number, nearly all were attacked, and recovery was exceeding-. ly slow in consequence of relapses. The locality being regarded very insalubrious, it was recommended that the troops form an encampment, a few miles from the post, during the summer months. The good effects experienced from this measure at Fort McHenry, and the partial advantage at the arsenal near Augusta, Ga., were urged in its favour. At Savannah, the troops, since their removal from Tybee island, were more healthy. The diseases to which they were now exposed, are attributed to the rice fields in the immediate vicinity of the barracks. At Augusta, all the garrison suffered from the " country fever," except two men ; and even on the 31st December, very few were fit for duty. The only advantage derived from encamping on the " sand hills," dur- ing the summer months, was, that fewer cases proved fatal and relapses were less frequent. The liability to disease seems not to have been diminished; for, as it was necessary to keep a guard at the arsenal, (then situated on the Savannah,) the men were in turn exposed to this miasmatic atmosphere ; and nearly every case of a severe character oc- curred among those relieved from this duty. " So long as a company," says the Surgeon General, " is kept at this place, no means, it is believ- ed, can be adopted to prevent an annual visitation of fatal disease, and the number of cases seems only to be limited by the number of men present." On the 15th July, yellow fever appeared at New Orleans. Among the troops stationed there, three cases occurred, all of which terminated favourably. On the 1st of August the whole detachment moved to Baton Rouge, in which position it continued, in general good health, until the subsidence of the disease at New Orleans. In a mean strength of 265 at cantonment Gibson, there were in September 111 on the sick-list. The prevailing maladies were dysen- 47 tery and intermittent fever. There was one death from epilepsy, and among 9 cases of typhus fever, 8 terminated fatally. Typhus, properly so called, it may be well to remark, is a comparatively rare disease in our abundant country. Remittent fever, assuming in its progress a typhoid type, is doubtless often reported under the name of typhus fever. On the Missouri, Upper Mississippi, and the Lakes, although many of the troops suffered from enteritic affections and intermittent fever, there were but six deaths. At Detroit, although the position is salubri- ous, most of the soldiers were sick during the present quarter. This arose from the circumstance of their being employed in cutting a road near the River Rouge, a result usually attending such details. The strength was 77, the total of cases 76, and of deaths 4. The aggregate of cases during the summer was unusually great; but the ratio of mortality, with the exception of that of cantonment Gibson, was comparatively low. " This fact affords," says the Surgeon General, " presumptive evidence that the officers of the medical staff continue to merit their well-earned reputation for professional skill and attention to duty." In the last quarter there were 53 deaths. No reports were received from Savannah and Petite Coquille, private physicians having been em- ployed at those posts. At cantonment Gibson, nine deaths occurred— four from dysentery, two of apoplexy, and three of typhus fever. The strength was 249, and there were for some time upwards of 100 on the sick list. At Augusta, the whole command still suffered severely from bilious remittent fever; the average strength was 27, the total of cases 31, and of deaths 7. At New Orleans, there were 51 cases of varioloid, of which six proved fatal. In the southern and western States, this disease prevailed to a considerable extent, and with more than its usual fatality. The detachment of the 1st regiment of Infantry, stationed in the Creek Nation, was also much afflicted. All the other posts were happily exempt from more than ordinaiy sickness. The following remarks are extracted from a special report made by the late Surgeon General to the Hon. James Barbour, Secretary of War, on the subject of a contemplated exchange of posts between the 1st and 4th regiments of Artillery. It may not be amiss to say, that the experi- ence of later years, when it has not been unusual to transport troops, at all seasons, from the Canada frontier to our southern borders, and vice versa, does not warrant to their full extent the apprehensions entertain- ed. It is, however, observed by Dr. Lovell, " that the change, it is be- lieved, will not materially affect the health of the troops, unless the sea- son should prove a sickly one." The remarks are as follows : " From the reports of surgeons station- ed from Charleston to Baton Rouge, it appears that whenever detach- ments have arrived from the eastern or middle States, nearly every man has been attacked, during the first summer, with the diseases peculiar to the country; and that two-thirds of the cases of severe sickness occur- red among those unaccustomed to the climate. Even at St. Augustine, which is one of the healthiest posts, disease prevails on the arrival of a new detachment, and is for the most part confined to it. This effect is AS more especially to be expected at the arsenal near Augusta, at Savan- nah, and Fort St. Philip. During the last year, which was by no means a sickly one, every man, with the exception of two, stationed at the first named place, was severely attacked with the autumnal fever. There were seven deaths, including the Surgeon and Quartermaster; and at the close of the year, very few of those that escaped were fit for duty. The same complaint prevails annually at Fort St. Philip to a great ex- tent, but it is seldom as fatal as at Augusta. " From these facts, in connexion with the well-known effects of a southern climate on northern constitutions, it is to be presumed that the exchange between the 2d and 4th regiments of Artillery will be follow- ed by a considerable increase of sickness during the first year, and espe- cially at the three posts above mentioned; and from the concurrent tes- timony of all who have attended to the subject, there can be no doubt that the period at which the movement is made is of essential impor- tance. That it should be as late as possible in the fall of the year, is evident from the fact, that even natives of those parts of our southern country subject to autumnal fevers, find it necessary, after an absence of a year or two, to return at this period. If the exchange be made in the spring, it would bring the northern regiment to their posts precisely at the time when they would be most exposed to the debilitating effects of the climate. With systems under the influence of the elastic and bra- cing air of a long and pretty severe winter, they would arrive at their stations just about the time when the more variable and less oppressive heat of the spring is yielding to the settled and high temperature of summer. They must, therefore, become eminently disqualified, during the months of June and July, to resist the fatal endemics of August and September. Were the 4th regiment, however, to leave their posts in the fall, and relieve the 2d, so as to bring them to their stations about October and November, tliey would be in a measure prepared-to with- stand the diseases of the succeeding year. This subject has been fre- quently mentioned in former reports, in consequence of the representa- tions of surgeons, showing the bad effects of sending recruits, at an im- proper season, to the southern stations." The Florida war, as will be shown hereafter, has had no material ef- fect upon the annual ratio of mortality. The mean mortality of the whole army for 1836-'7-'8, ascertained from monthly regimental re- turns, is but a fraction higher than the average of 10 years, (from 1829 to 1838 inclusive,) the former being 4.8 and the latter 4.4per centum; and is lower than the respective ratios of 1832-'4-'5. Here, then, is a fair exhibition of the consequences of successive Indian campaigns con- joined with the effects resulting from change of climate. In concluding the observations of this year, I shall present several tabular abstracts, compiled from a report showing the number of deaths find desertions in the army for three years, made to Congress by Adju- tant General Roger Jones in the winter of 1825-'6. The following table exhibits the annual strength and the number of deaths in each regiment, for the three years terminating respectively on the 30th September, 1823-'4-'5 : r&o'* "—;;>> rfV>\v 1823 1824 1825 Total, Y if CO CO »f if if -4 00 00 CO O © Strength. CO > a to to tO ►- © Deaths. If o to if if f © 00 «l 00 en OJ Strength. to > CO tO tO if © Deaths. vf if CO Cn if if if 00 ■»! ^J © to os Strength. co a OS CO to to to H- -CS h- Deaths. CO © if if f >f OS CO if -3 to Strength. > a 00 to to to tO if w Deaths. >f 00 f if Ol oo to © -3 GO tO Strength. 05 If CO if CJi 00 ~I © Deaths. to C7I if if © oo to -JOi-■ t0 © » © Deaths. CO to to i^ if if touoi to to 00 Strength. 5-3* ■f l-MW CO © ►- Deaths. 6* 50 TABLE showing the annual ratio of mortality in each Regiment, ceding abstract. Regiments. Strength. Deaths. Ratio of deaths per 1000 of mean strength. 1st Artillery, 2d do 3d do 4th do 1st Infantry, 2d do 3d do 4th do 5th do 6th do 7th do Total -Average 1439 1409 1435 1350 1487 1519 1280 1171 1334 1304 1392 29 32 69 78 141 26 28 42 26 42 54 20 23 48 58 95 17 22 36 19 32 39 15120 667 - - - 37.5 TABLE showing the relative annual ratio of mortality between the North and the South, taking the latitude of Washington as the line of division. Years. Nobth. South. Strength. 00 C3 0 TO . rS <«-, £ ss O ho 13° 0) 3 6 1 4 4 9 Wounds and Injuries 6 4 3 1 7 6 6 6 o a. 9 48 4 4 4 2 3 8 3 5 10 4 47 1 1 2 3 7 . . . m 1 ?, 1 ?, 6 All other diseases - 3 7 7 3 14 3 7 4 3 51 1 2 4 6 8 5 4 5 4 4 43 Total - 17 44 27 18 42 39 60 27 - 32 306 11 36 18 23 29 39 44 44 57 26 327 72 Under the class of diseases of the respiratory organs are comprised, 248 catarrh and influenza, 33 pneumonia, 6 pleuritis, and 7 phthisis pulmonalis; under the head of digestive organs, 119 diarrhoea and dy- sentery, 39 cholic and cholera, and 1 hepatitis; under the class of brain and nervous system, 7 epilepsy, 2 mania a potu, and 5 nyctalopia; and under that of venereal affections, 40 gonorrhoea and 48 syphilis. As the total of deaths, according to the Adjutant General's returns, is 11, and the aggregate mean strength is 984, the annual ratio of mortal- ity is l^ per cent. Of the deaths, six are reported in the medical re- turns, viz: one typhus fever, one phthisis pulmonalis, one cholera mor- bus, occurring in a patient exhausted by chronic diarrhoea and secondary syphilis, and three from causes not designated, exhibiting a mortality of £$ per cent. This discrepancy arises from the circumstance that medi- cal officers generally report the deaths on the sick-list only, omitting those that occur suddenly, from accidental causes, or on detachments. This post may justly be regarded as one of the most salubrious sta- tions in the United States. The annual ratio of febrile cases of mala- rial origin is low, that of intermitting fever being four per cent., and that of remitting fever only three, per thousand of the mean strength. Mor- bid action generally assumes an inflammatory character; and, with the exception of the typhus, which prevailed in the winter of 1837-'8, there has been no disease of a malignant tendency. In regard to this en- demic, Assistant Surgeon (now Surgeon) McDougall reported as fol- lows : " Shortly after my arrival at Fort Brady, in October, 1837, scor- butic symptoms were manifested in nearly every case of disease which occurred, such as spongy gums with hcemorrhage, unusual debility, coldness of the surface, and the sensation of sinking in the epigastrium. The whole command being put on a strictly antiscorbutic regimen, these symptoms soon disappeared without any recurrence. At this pe- riod, the first case of typhus was reported; hut as I soon became a sub- ject of the disease myself, I lost the only opportunity I have had of ob- serving and treating this formidable disease. " Symptoms.—Lassitude, loss of muscular power, tinitus aurium, disposition to syncope, pains in the head, back, and extremities, difficult respiration, rigors, pulse irregular, small, quick, and sometimes hard, tongue clean and red, and bowels constipated. In most cases, within 60 hours from the attack reaction was fully established; then the tongue became dark and dry with hoemorrhagic fissures, the teeth covered with black tough sordes, the eyes red and watery, and the temperature of the skin increased, giving that peculiar tingling sensation to the fingers char- acteristic of the malady. If the disease continues, petechial blotches appear, followed by subsultus tendinum, delirium, extreme prostration, and death. A favorable prognosis is indicated by a gradual subsidence of the symptoms detailed—abatement of thirst and heat, moisture of the skin, disappearance of petechice, black discharges from the bowels, hcemorrhage from the nose, deafness, and a turbid secretion from the kidneys. The duration of the disease was from one to two naonths. " The treatment consisted in ventilation of the wards, strict police, and personal cleanliness, tepid bathing, calomel and opium to correct 73 the secretions, diffusible stimulants, particularly carb, ammonise, rubefa- cients, blisters, and occasionally cups applied to the epigastrium. Some of the cases were undoubtedly typhus syncopalis; but the general char- acter of the disease was that of typhus gravior and mitior. The first case originated within the pickets, which are near 20 feet in height; the next occurred among the hospital attendants, then among the convales- cents from other diseases, until finally all in hospital, excepting the steward, were affected. The only case that proved fatal in hospital was a private under treatment for gonorrhoea. From the garrison, the dis- ease extended to the village, and thence to the Canadian shore. " The probable causes of the fever were, the long continued preva- lence of N. E. winds with rain, which, in this climate, is remarkably depressing to the powers of life—great accumulation of vegetable mat- ter in a putrid state beneath the buildings of the fort, and in its immedi- ate vicinity—confined air from the high stockade, and deficiency of acetic vegetables." During the 10 years, there are 15 cases of typhus fever reported, of which eight occurred at the period to which reference has just been made. In the last two quarters of 1835, pneumonia was prevalent, and although severe, no case terminated fatally. In regard to pulmonary lesions no comments are required, inasmuch as this subject has been fully elucidated in a special report. The relative influence of the sea- sons is manifested in relation to intermittent fever; but this question will be more fully illustrated in the general results of this class of posts. As regards disease in general, there is little diversity presented in the different seasons. The first and fourth quarters exhibit the lowest ratio of sickness, as shown in the following table : TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 10 first quarters -10 second " -9 third " . 10 fourth " -Annual ratio - 1,011 947 885 1,004 302 340 306 327 299 359 347 326 * 962 1,275 1,325* It thus appears that among 1,000 troops, there are 1,325 cases of dis- ease reported in the course of the year, and that consequently every man, on an average, has been under treatment once in every nine months. • As this average does not quadrate with the total of the four quarters, it may be neces- »ary to say that it is the result of the annua] ratios, the mean strength being 962, and the total of cases 1,275. This remark will be found of frequent application. 74 As the forms of tabular arrangement adopted in reference to this post, are equally applicable to all subsequent ones, a few explanatory re- marks are required. Under the head of synochal fever are condensed the cases reported as synocha, synochus, common continued, epheme- ral, and inflammatory; but the majority of cases are reported under the last name. As the term typhus is subject to vague and arbitrary em- ployment, diseases of a very diverse character are doubtless often regis- tered under this head. The cases of typhus reported at our southern and southwestern stations, it may be presumed, generally owe their ori- gin to the same miasm which produces intermittent and remittent fever. That it is often generated by the ordinary causes of fevers, is an opin- ion advanced by Armstrong—a doctrine which seems to have found but few advocates. When these morbific agents act on a system depressed and debilitated from any cause, a low or typhoid state of fever will be developed; but the phenomena of these fevers do not accord with those which characterize genuine contagious typhus, as described by Surgeon McDougall. Under the class of diseases of the respiratory organs, are included the following specific diseases: pneumonia, pleuritis, phthisis pulmonalis, hoemoptysis, catarrhus, asthma, dyspnoea, laryngitis, pertus- sis, etc. Under the class of diseases of the digestive organs, the fol- lowing : tonsillitis, gastritis, hcematemesis, enteritis, peritonitis, dyspep- sia, colica, cholera, constipatio, diarrhoea, dysenteria, hepatitis, icterus, etc. Under the class of brain and nervous system, the following: men- ingitis, apoplexia, paralysis, epilepsia, cephalalgia, ictus solis, mania, delirium tremens, nyctalopia, etc. In regard to the other classes, it is deemed unnecessary to state the specific diseases. FORT MACKINAC. LATITUDE 45° 51' N. LONGITUDE 85° 05' W. General Description.—Based upon limestone, wTith a very superficial covering of soil, the island of Mackinac rises, in its greatest elevation, 220 feet above the water of the lake. As the site of the present fort is elevated 150 feet, it is 728 feet above the level of the ocean. The island is about nine miles in circumference, and rises on its eastern and south- ern shore in abrupt rocky cliffs to the height of 150 feet. Although a large portion of the immediate shores of the lake in this vicinity is com- posed of marsh, yet there is much that presents an opposite character. From the site of old Mackinac, at the very extremity of the peninsula, the immediate shores, extending 150 miles along lake Michigan, are generally elevated, sometimes rising abruptly from 300 to 400 feet. As this post is unoccupied at the present time, it is impracticable to fur- nish the medical topography of the immediate locality of the fort. In regard to its meteorological phenomena, it will suffice to make re- ference to the preceding station, or for more ample details, to the special report on meteorology. The following abstract exhibits a condensed view of the principal diseases of this post, for the period of ten years : ABSTRACT exhibiting a condensed view of the principal diseases at Fort Mackinac, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 106 6 1830 92 1831 106 6 1832 104 10 1833 110 4 1834 108 3 1835 105 2 1836 107 1837 1838 Mean Strength 103 104 107 107 115 96 104 113 100 1 - 949 7 838 Intermittent fever - 4 1 1 . 31 Remittent " - - - - - 1 - - - - 1 - - - - 2 - 1 - - - 3 Synochal " - - 1 - - 1 - - - - - 2 - - - • - -. 1 - - - - 1 Diseases of the respiratory organs . . - 5 5 2 1 2 2 7 2b 25 - 74 4 5 4 - 8 15 7 20 - - 63 Diseases of the digestive organs - 7 8 5 3 17 6 b 23 8 - 82 8 18 8 10 14 11 8 27 - - 104 Diseases 01 the brain and nervous system - 1 - - - 3 1 - 1 5 - 11 - 2 - 1 - 2 - 8 g - 13 Rheumatic affections 1 6 4 2 2 2 3 9 18 . 47 4 14 3 . 5 7 5 1 22 o Hi - 2 60 2 1 - 2 - - 5 - - - - - 2 - - 3 - 2 Ulcers and abscesses . 2 - - - 3 - - 2 2 - 9 1 1 - 1 2 1 1 - - 7 Wounds and injuries 9 6 11 9 10 S 6 16 14 - 89 9 3 7 7 14 8 6 V - 44 Total - 28 33 27 18 60 30 25 87 89 - 397 38 49 31 29 53 62 40 95 - - 397 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years 1829 1830 1831 1832 59 1 1833 107 1 1834 112 1 1835 112 1 1836 98 1837 1838 800 13 1829 110 1830 111 1831 109 3 1832 114 9 1833 102 1834 108 1835 113 1836 105 2 1837 1838 Mean Strength 108 1 100 1 104 7 872 Intermittent fever - 14 Remittent " - - I . . . 2 . . T m 3 . r „ 1 2 r . . 3 Synochal " u . - - . . . 1 . . . 1 . . 1 _ . . . 1 Typhus " - - - . 1 _ . . . _ 1 T T T p m . . . . Diseases of the respiratory organs ... 8 8 1 3 2 6 17 21 . . 66 3 1 3 5 1 17 12 21 . . 63 Diseases of the digestive organs ... 31 15 8 10 9 23 7 34 . , 137 5 8 3 40 5 2 11 15 . . 89 Diseases of the brain and nervous system - - - - 2 2 - 3 5 . . 12 - 2 2 . 1 . 9 1 . - 15 Dropsies ... 1 - . . . , « * r . 1 , . 1 r I Rheumatic affections 3 5 3 . 3 3 4 13 - . 34 2 3 , 7 1 2 10 16 . . 41 Venereal " 1 - . . 1 . 2 3 . . 7 1 . ^ 1 1 1 . . 4 tHeers and abscesses 3 - - 2 . 1 1 3 , . 10 1 . 1 2 1 3 . , 8 Wounds and injuries 10 4 8 2 7 17 3 20 - . 71 7 3 4 31 3 7 10 17 . . 82 Ebrietas ... 1 3 . 2 . 3 - . . . 9 1 . . m . 3 . . 4 All other diseases - 8 4 7 • 7 9 H 5 ' - 54 3 2 9 3 6 1 9 6 - - 39 Total - 67 41 34 23 32 66 52 104 " - 419 23 19 27 96 18 33 63 85 - * 364 /1 Than this post, there is not a more healthful one in the United States. According to the Adjutant General's returns, there occurred but five deaths from all causes in the above ten years, being about -*-$ per cent. per annum. In the medical returns, there is not reported a single death which can be in any way ascribed to the agency of climate. In 1832, one soldier of the command died of Asiatic cholera, and of four men la- boring under this epidemic, left at this post on their march to Chicago, three died. In 1833, there was one death from a casualty, and in 1836, an officer died from neuralgia. The general character of morbid action presents so little peculiarity that scarcely any comments from the medical officers have been elicited. Fevers of malarial origin present a low ratio, that of intermitting being 8, and that of remitting fever one annually per 100 of the mean strength. The fact that intermittent fever is more than twice as prevalent in the second than in the third quarter, may be difficult to explain. The four cases of intermittent fever reported in the first quarter of 1829, are attri- buted to the circumstance of these men " having been stationed for some years past on the Mississippi." In the third quarter of the same year, " bilious cholic" was very prevalent. Of the diseases reported under the class of respiratory organs, there were of catarrh 203, pleuritis 39, pneumonia 11, and phthisis pulmonalis 3; of those under the class of digestive organs, there were of diarrhoea and dysentery 124, cholic and cholera 80, and hepatitis 4; of those under the class of brain and nerv- ous system, there were of epilepsy 6, and mania a potu 4; and of vene- real affections, there were 10 gonorrhoea and 8 syphilis. In relation to the relative salubrity of the different seasons, as calculat- ed from the number of cases reported, the annexed table exhibits the ratios : TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 9 first quarters, 8 second " 8 third " 8 fourth " Annual ratio 948 838 800 872 397 397 419 364 419 474 524 417 865 1,577 1,823 As there are, among 1,000 troops, 1,823 cases reported annually, it follows that, on an average, every man has been under treatment once in about six and a half months. 78 FORT GRATIOT. LATITUDE 43° N., LONGITUDE 82° 10' W. Fort Gratiot, situated on the river St. Clair, half a mile from the out- let of Lake Huron, is elevated 598 feet above the level of the ocean, being twenty feet above the surface of the lake. Black river, distant about one mile in a S. and W. drrectron, is the only stream, with the exception of the St. Clair, in the vicinity. " It is bordered," says Assistant Surgeon Motte, " particularly on the west, by frequent broad marshes, which have been subjected to an accumula- tion of alluvion for a sufficient period to allow a deposition of peat from vegetable decomposition. These marshes exhale, during the sum- mer and autumnal months, a pestilential atmosphere, generative of fever and ague, which is but too prevalent among the inhabitants in the vicinity." " The surrounding country is greatly undulating. The soil is mostly a sandy loam, and. the proportion of marsh is small. Clay is reached at the depth of twelve or fifteen feet. Most of the surrounding country is covered with forest; among the vegetable productions are oak, elm, maple, ash, hickoiy, black walnut, pine, &c. " The lake and river shore in the immediate vicinity of the fort," says Assistant Surgeon Motte," is a low gravelly ridge, extending nearly a quarter of a mile from the margin of the lake, when the ground sud- denly rises to the height of twenty-five feet above the surface of the lake, and retains this elevation, with little variation, to near the shores of Black river. This elevated ground gradually approximates the St. Clair towards the fort, and a few rods below it becomes a perpendicular bluff in immediate contact with the water." Between the fort and the ridge just described, there is a stagnant pond, which it has been found impracticable to drain, and which, it is suppos- ed, is the copious source of miasmata. The hospital and barracks are represented as defective, being very damp and ill adapted for ventilation. As regards the general meteorological character of this station, it dif- fers not essentially from the two preceding posts. The modifying influence of the lakes exhibits invariably the impress of its features. The following table presents a condensed view of diseases for the period of ten years :— ABSTRA C T exhibiting a condensed view of the principal diseases at Fort Gratiot, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 Mean strength 102 82 99 93 102 102 93 97 112 - 882 - 76 90 89 104 109 98 89 *44 - 699 Intermittent Fever 2 4 4 23 1 6 40 29 43 79 12 13 9 14 199 Remittent " - - 1 . . - - - - . - 1 . 3 . 1 . 3 - . . 7 Synochal " - - 3 2 2 1 - 1 - 1 - - 9 . 5 . . . 1 - - - - 6 Typhus " - 2 - - - • - - - - - 2 . . . . . . - . - - - Diseases of the respira- tory organs 3 21 7 29 5 3 27 14 30 - 139 . 9 1 6 5 11 20 10 27 - 89 Diseases of the digestive organs ... 6 13 14 4 8 10 7 4 14 - 80 . 22 15 42 8 26 5 3 7 - 128 Diseases of the brain and nervous system 1 5 1 - - 1 - 2 1 - 11 . 1 . . . 1 - 1 1 - 4 Rheumatic affections 6 13 1 3 9 1 7 4 7 - 51 . 4 . 1 3 2 2 3 7 - 22 Venereal " - 2 ■ - - - - - - 1 3 . . . . 1 1 . . 2 Ulcers and Abscesses 1 - - - 4 7 - 4 4 a, 20, m . . . 1 . 11 1 . 09 Ph 13 Wounds and injuries 12 25 12 15 11 4 6 20 16 o 121 Ph 5 16 8 5 6 3 9 3 O O 55 Ebrietas - 7 - 2 2 - 3 1 6 1 ** 221 £ . 7 . . . 3 6 4 ** 20 All other diseases 15 21 4 3 8 3 6 1 10 fc 71 fc 13 91 5 87 3 140 4 38 18 82 7 61 8 55 8 57 £ 66 Total - 57 106 47 81 47 38 55 55 84 - 570 611 * The real strength for the quarter is 89, but it is necessary to deduct one-half, as the sick report embraces but six weeks. ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. i'ears - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 91 1830 109 18 1831 99 45 1832 102 3 1833 102 18 1834 92 1835 102 4 1836 120 1837 1838 40 6 Mean strength 97 103 93 - 105 99 104 87 - - 688 857 Intermittent fever - 6 50 95 31 10 23 12 227 94 Remittent " - 6 2 . . 1 2 - . 11 1 1 Synochal " - - 1 2 . - - - - - - 3 - 1 - - - - 2 - - - 3 Typhus " - - 1 - - • - - - - - 1 - - - 1 - - - - - - 1 Diseases of the respira- tory organs 8 7 3 . 2 9 2 - - - 31 7 12 47 4 6 25 10 25 - b 142 Diseases of the digestive organs 31 35 15 . 22 48 30 14 - . 195 13 20 32 16 9 11 8 17 - V 133 Diseases of the brain and nervous system - - - . - - 1 1 1 - . 3 2 - 2 - 1 - 2 - - - 7 1 - 1 1 - - - - - l 4 Rheumatic affections 4 6 - . 6 - 3 6 - - 25 14 1 3 4 5 4 2 2 - - 35 Venereal - 1 3 2 1 - - 1 8 1 1 - 1 . . - 1 b 9 Ulcers and abscesses - . . ■c 2 1 6 - 03 OS-S' 9 - . - 2 2 2 4 4 09 Oh - 14 Wounds and injuries 6 6 6 Oh 1 6 10 6 o p 41 15 10 5 9 7 5 8 9 O 4 72 Ebrietas 5 5 7 >. 1 6 5 3 ** a 32 - 4 7 - . 9 5 7 *" 5 37 All other diseases - 16 9 10 fc 11 10 8 6 £ fc 70 10 63 3 70 8 150 2 43 4 52 5 61 5 50 26 91 55 35 63 Total - 83 123 142 - 77 92 90 49 - - 656 615 81 Although the aggregate mortality in ten years, according to the Adju- tant General's returns, is 35, being nearly 4 per cent, per annum, yet, when the twenty-one deaths which arose from epidemic cholera in the third quarter of 1832 are deducted, the ratio is found much below the mean mortality of the army, being 1^ per cent. Of the 14 deaths, ex- cluding those caused by cholera, 10 are reported in the medical returns, viz : 2 hydrothorax, 1 apoplexy, 1 typhus fever, 1 chronic bronchitis, 1 ebriety, 1 casualty, 1 sudden, and 2 from no assigned causes. It is thus apparent that, although morbific agents of a miasmatic character are un- ceasingly developed, their effects are never manifested in malignant and fatal endemics. The most important sick report—that for the third quarter of 1832—■ is wanting. It was at this period, (May, 1832,) that Asiatic cholera made its appearance on the N. E. coast of America, and spread with fatal rapidity along the great water-courses on our northern frontier. Whilst one branch of the epidemic passed down the Hudson to New York, another continued west along the great lakes, until, in September, it reached some of our military posts on the upper Mississippi. As the Sac and Fox Indians, headed by Black Hawk, were at this time in open hostility, our troops in marching towards the theatre of war became exposed to the influence of the epidemic. Speaking of this event, Major General Macomb, in his annual report, says:—" Unfortunately, however, the cholera was just at this time making its way into the United States from Canada, and infected our troops while on board the steamboats in their passage up the lakes ; and such was the rapidity with which this disease spread among them, that, in a few days, the whole of the force sent by the lakes was rendered incapable of taking the field. Some were landed at Fort Gratiot, others were stopped at Detroit, while the principal part reached Chicago in a most deplorable condition.. Of the six companies of Artillery which left Fort Monroe, five companies arrived at Chicago, a distance of 1,800 miles, in the short space of eighteen days—a rapidity which is believed to be unprecedented in mili- tary movements. The loss by cholera in that detachment alone, was equal to one out of every three men." With the exception of a few cases at Cincinnati, the epidemic did not this year sweep the valley of the Ohio. The influence of the " choleric malaria" was, however, manifested in a peculiar irritability of the bowels, as shown in the general prevalence of diarrhoea. In 1833 and 1834, this epidemic scourge attacked and re-attacked the more populous towns of the west, whilst the sparsely inhabited portions of that region were, in a great measure, exempt from its ravages. Localities favorable to the production of malarious diseases, suffered most severely from its visita- tions ; and, unlike its history in Russia, its progress generally received a check on the occurrence of severe frost. In regard to the general character of morbid action, the principal fact requiring comment is the extraordinary prevalence of intermittent fever compared with the two preceding posts. At Forts Brady, Mackinac, and Gratiot, the relative ratio of this type of fever, based on a calculation of the mean strength and total number of cases for 10 years, stands thus-— 82 40, 75, 716. At Fort Brady, in the first, ten quarters, there occurred no case, whilst at Fort Gratiot there were 40. As the general meteorologi- cal phenomena of these three stations exhibit similar features, these ef- fects must necessarily be ascribed to the agency of the local causes de- tailed in the description of the medical topography of Fort Gratiot. The annual ratio of cases of intermittent fever is 72, and that of remittent is 3, per 100 of the mean strength. The ratio of the former is higher than the average of our southern stations. Of the diseases of the respiratory organs, 346 were catarrh and influ- enza, 21 pneumonia, 32 pleuritis, and 5 phthisis pulmonalis. As there is but one death reported from this class, (phthisis,) it is apparent that the general impression in reference to the prevalence and fatality of tho- racic inflammation in the climate of the lakes, is erroneous. Under the clsss of digestive organs are comprised 213 cases of diarrhoea and dysentery, 58 cholic and cholera, and 8 hepatitis. Under the class of brain and nervous system, 7 epilepsy, 2 apoplexy, and 8 delirium tremens. Of the venereal affections, 6 were gonorrhoeal and 16 syphi- litic. The relative influence of the seasons is strikingly manifested both in relation to intermittent and remittent fever. As regards disease in gene- ral, the diversity presented in the different seasons is exhibited in the subjoined abstract: TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 9 first quarters 8 second " -7 third 9 fourth " Annual ratio 882 699 688 857 570 611 656 615 646 874 954 717 782 2,452 3,135 As there are 3,135 cases reported in the course of the year among 1,000 troops, it follows that every man, on an average, has been under treatment once in a little less than four months. The extent of sickness compared with Fort Brady is consequently more than twice as great; and in comparison with Fort Mackinac, the ratio is upwards of 50 per cent, higher. FORT DEARBORN. LATITUDE 41° 51' N., LONGITUDE 87° 15' W. This post, which is now abandoned, is situated on the south-west shore of Lake Michigan, in the State of Illinois, 12 miles from the Wis- consin line. It is distant from the lake 250 yards, and is elevated 14 feet above its surface. The river Chicago, which runs upon three sides 83 of the fort, divides, half a mile above it, into two branches; the one north and the other south, in directions nearly parallel with the lake shore. As the bank of the lake is several feet higher than the ground in the rear, the latter is sometimes covered with water. Indeed, the whole country is so low that, in its early settlement, boats frequently passed, during the spring floods, over the prairies from Chicago to the Illinois river. At this post, the prairie opens upon the lake four miles wide, extending west beyond the reach of the eye. Above and below this point, the shore of the lake is densely covered with large forest trees, such as the different varieties of oak, ash, and hickory. The soil is ge- nerally a rich loam ; in some places clay, and in others sand, predomi- nating. Limestone is found in large quantities. The diseases reported within the 10 years are comprised in the fol- lowing abstract: ABSTRACT exhibiting a condensed view of the principal diseases at Fort Dearborn, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 91 2 4 1 3 1 11 1830 90 1 5 3 1 6 4 2 22 1831 92 1 1 1 9 3 3 10 2 30 1832 01 & o o >-o 1833 104 2 6 12 3 2 20 5 13 63 1834 91 6 7 6 4 1 2 26 1835 96 3 6 1 3 6 2 21 1836 104 3 19 11 1 7 2 I 4 2 8 58 1837 s > 1838 668 5 2 1 42 52 2 20 6 19 46 8 28 231 1829 95 9 3 10 1 2 4 7 3 39 1830 83 1 1 1 9 1 1 2 3 4 .23 1831 Ul Cm o o >-o 1832 t, o P. -5 4 2 12 . 5 3 1 2 . 11 Ulcers and abscesses 5 3 2 6 Sh to Ph to &1 to 5 21 3 . 6 4 5 CO Ph to Ph to Ph to Ph 2 20 Wounds and injuries -Ebriety ... All other diseases - 12 8 5 5 5 12 20 ct) 3 o > 13 13 O o IH o O O O © o lH o O o frH o 9 14 51 8 57 10 1 8 5 1 4 16 3 9 5 2 12 2 7 O fcH o O O O O O Xh O o £5 o 6 2 54 9 30 Total - 51 44 58 - 100 - - - - 101 354 31 25 75 41 98 - - - - 58 328 90 This station presents the usual degree of healthfulness exhibited by the statistics of the posts on our northern chain of lakes. 1 he deaths from all causes, according to the Adjutant General's returns, amount to 10 being 1-A per cent, per annum. Of these deaths, eight are reported in'the medical returns, viz: five phthisis pulmonalis, one peripneumo- nia, one dropsy, and one delirium tremens, the ratio of mortality being 1-rV Per cent. . . Under the class of diseases of the respiratory organs are compnsed 203 catarrh, 19 pneumonia, 12 pleuritis, and 8 phthisis pulmonalis. Under the class of digestive organs, 136 diarrhoea and dysentery, 43 cholic and cholera, and 4 hepatitis. Under the class of brain and ner- vous system, 7 epilepsy and 3 delirium tremens; and of the venereal affections, 28 were gonorrhoea and 21 syphilis.1 The diseases of this post have at no time presented any unusual characters. In regard to fevers of the intermittent and remittent type, a singular feature, at first view, obtains. In the second quarter, the ratio of intermittents is twice as high as in the third, whilst the reverse occurs in respect to remittents. It would thus seem that the cause of these febrile lesions becomes so augmented in intensity during the third quar- ter, as to develope itself mostly in the remittent modification. In the third quarter of 1838, a detachment of troops from Florida furnished nearly all the cases of diarrhoea and intermittent fever. The annual ratio of intermittents is 24, and that of remittents is 11, per cent, of the strength. In reference to disease in general, the relative influence of the seasons is exhibited in the following abstract: TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 7 first quarters -6 second " 5 third " 6 fourth " Annual ratio - 677 561 498 544 363 394 354 328 536 702 711 603 570 1,439 2,525 It thus appears that every man, on an average, has been on the sick report once in nearly every five months. The garrison of this post also suffered from epidemic cholera in 1832, when on its march towards the theatre of Indian hostilities. Having reached Detroit on the 30th June, the troops were mustered and inspected, no man being on the sick list. The men were quartered in an old brick building on the banks of the river, in the most filthy part of the town, and surrounded by grogshops and groceries. The soldiers indulged in every kind of excess; and, on the 4th of July, says Assistant Surgeon H. Stevenson, "it may be safely 91 asserted that there were not ten sober men in the command." No case of disease was reported prior to the evening of the fifth day after arriving at Detroit. On the morning of the 6th, the first case of spasmodic cholera appeared; and up to the 20th of July, the whole number of confirmed cases treated by Assistant Surgeon Stevenson was 47, of which 21 terminated fatally. The command consisted of 78 men. From the premonitory symptoms there was scarce an instance of ex- emption. As at Fort Dearborn so here also, those of intemperate hab- its and debilitated constitutions were its first and principal victims. The cause of the sudden appearance of this disease at Detroit, leav- ing an intermediate country of considerable extent uninfected, may be difficult to explain. At the time, it was generally believed that the principle of infection existed in the steamboat in which the troops were conveyed from Buffalo to Detroit, this vessel having been employed in transporting crowds of filthy foreign emigrants westward from Montreal and Quebec. The " Henry Clay," among the troops on board of which the disease also appeared,had been engaged in the same kind of service. In tracing the progress of this disease along the line of the St. Law- rence and the lakes, as taken from Tulloch's " Statistical Report on the Sickness, Mortality, and Invaliding among the Troops in British Ameri- ca," the most remarkable fact is, its progression with post-like regu- larity. 3 Rivers between Montreal and Quebec Montreal, 180 miles above Quebec Kingston, 190 miles beyond Montreal Toronto, 184 miles beyond Kingston Fort George, 40 miles from Toronto -Detroit and Amherstburg, at the ~) extremity of Lake Erie 5 Date of appearance of the disease. 1832. 1834. 8th June. Escaped. 10th June. 16th " 28th " 14th July. 6th " 7th July. 9th " 11th " 26th « 30th " 13th Aug. CEndof Au-l gust. In view of these facts, combined with the circumstance that it was marked by the same progressive course along the other principal chan- nels of immigration, viz. the banks of the Ottawa, the Richelieu, and along Lake Champlain to New York, the doctrine of importation, (more especially as several persons died of the disease on their passage from Ireland,) and its subsequent communication by contagion, was strongly favored. Along the British frontier, strict quarantine regulations were conse- quently rigidly enforced, both in respect to the troop3 and inhabitants ; but although apparently effectual in some instances, in others, as in Europe, it proved of no avail. Prussia, for example, disputed its pre*- 92 gress foot by foot, with all the strictness of her well-known military dis- cipline ; but despite the triple cordons sanitaires of Prussia and Aus- tria, it soon penetrated the capitals of both kingdoms. Those opposed to the opinion of its propagation by specific contagion, asserted that, admitting that cholera is principally restricted to the high- ways of human intercourse, it is along navigable rivers that localities most favorable for its production, and subjects most liable to become its victims, are most apt to be found. Although the history of the disease in our country shows that malaria had considerable agency in its pro- duction, yet it prevailed on the arid sands of Arabia and the rocky ridges of the Caucasus, as well as in defiance of the winter frosts of Russia. It seems obvious, however, that some general distemperature of the atmosphere existed during the prevalence of the disease. Such meteorological conditions may obtain no less than the particular vitiation which produces the " influenzas" which prevail under every variety of season and locality. Who has ever detected by chemical analysis marsh or animal miasmata, or any contagious principle? The epidemic constitu- tion of the atmosphere was doubtless the predisposing cause, which merely required certain exciting circumstances to develope the malady. Thus may be explained the earlier appearance of the disease at Detroit. In the course of its gradual progression from the east, the epidemic consti- tution may have been less intense at Detroit than at many points in the rear; but owing to a concurrence of circumstances in regard to the ex- citing causes, such as the excesses of a camp " surrounded by grog- shops and groceries," the disease may have been developed sooner than under ordinary circumstances. This opinion is favored by the fact that previously to the prevalence of cholera epidemically, and in many places in which it did not appear, there was a marked disposition to diseases of the digestive organs, as diarrhoea and common bilious cholera. The contagious nature of the disease is rendered still more questiona- ble from the fact, confirmed by the whole current of medical testimony in Europe, Asia, and America, that neither physicians nor those in con- stant attendance exhibited any peculiar liability to it. Medical officers have slept in their hospitals; nurses, to quiet timid females, have shared their beds during the night; the bed-clothes of patients who have died have been immediately used; and yet no bad consequences have follow- ed. At Warsaw, Dr. Foy inhaled the breath, tasted the dejections, and innoculated himself with the blood of patients, without contracting the disease. There remains, however, another fact which seems the expe- rimentum crucis, viz. that thousands of persons have left infected dis- tricts, and died of the disease in various places, without communicating it to the surrounding inhabitants. It is thus apparent that the origin and nature of epidemic cholera are involved in much uncertainty, and that this seeming diversity of facts can only be reconciled by the adoption of the principle of Chalin de Vinario, one of the most celebrated physicians of the 14th century, viz : u that all epidemic diseases may become contagious, and all fevers epidemic ;" a position confirmed by observers of all subsequent ages. 93 MADISON BARRACKS. LATITUDE 43° 50'., LONGITUDE 77° 55'. This station is at Sackett's Harbour, New York. Situated on the southern side of the bay formed by the entrance of Black river into Lake Ontario, it is distant from the latter 8 miles. The color of the water in the river, as its name indicates, is quite dark ; a feature not unusual in this region. About three-fourths of a mile north-east of the post, a small creek empties into Black river. There are no marshes in the vicinity. As the barracks are elevated about 30 feet above the level of the lake, and as the surface of the lake is 232 feet above that of the ocean, it fol- lows that the barracks are 262 feet above tide-water. " The grounds around the garrison," says Assistant Surgeon T. Henderson, who has furnished a detailed description of the medical to- pography of this post, " are so level that they cannot be perfectly drain- ed. The soil is dark, with much clay, and rests on stratum of lime- stone, which is from one to three feet below the surface. The nature of the soil and this superficial calcareous stratum keep the immediate vicin- ity of the post, even after ordinary rains, boggy and favoring terraqueous exhalation. The physical aspect of the surrounding country is waving and undulating. The soil is generally rich. The forest trees are maple, beech, birch, walnut, ash, elm, and hemlock. Esculent vegetables are produced in great abundance and variety. The staple agricultural pro- duct is wheat. No minerals are found in the immediate vicinity of Madi- son Barracks. About 50 miles north-east, lead mines of great value are wrought, and iron ore is obtained in the south-east part of the county (Jefferson) in which the station is located." This post, as regards its general meteorological features, pertains to the classification common to all the preceding stations. The barracks and hospital, built of limestone, were erected in 1822. A new hospital, constructed of the same material, is now (1839) being built upon a more approved plan. The following abstract comprises the diseases reported in 10 years: ABSTRACT exhibiting a Condensed view of the principal diseases at Madison Barracks, for a period of ten years. FIRST QUARTER. SECOND QUARTER. irears - 1829 100 6 16 27 1 3 2 3 18 9 85 1830 97 2 12 29 2 5 3 2 28 18 101 1831 116 2 32 58 7 3 15 23 140 1832 107 68 16 2 4 6 2 14 12 124 1833 Ph O © o 1834 1835 j 1836 O O 1837 Ph P O is p 1838 to Ph O O 13 o 420 10 128 130 5 19 11 10 75 62 450 1829 104 31 9 39 3 1 3 17 2 105 1830 101 5 14 49 1 4 1 27 13 114 1831 1832 1833 00 O o 1834 to t H o 1835 to Ph O £ 1836 1 o is o 1837 to 1 a o 1838 to Ph P O >-O Mean strength 00 I O Ph o 1 o 118 22 93 1 7 2 34 20 179 •55 1 4 34 2 1 4 18 64 378 Intermittent fever Remittent " Synochal " Typhus " Diseases of the respirato-ry organs Diseases of the digestive organs - - -Diseases of the brain and nervous system Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -All other diseases Total - 37 49 215 4 14 3 5 82 53 462 * The strength was 102, but as the post was evacuated on the 20th May, it is equivalent to 55 for the whole quarter. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 1832 1833 to o 1834 00 Ph O o is © 1835 to © H O 1836 (0 Ph O © hi O 1837 to Ph O O 1838 343 24 5 5 24 72 5 7 11 9 25 26 672 47 13 5 46 285 10 26 14 22 122 70 1829 103 3 12 33 1 9 1 22 1 10 1830 112 3 18 41 13 15 14 1831 107 1 23 28 6 3 23 16 1832 0» Ph O o 13 O 1833 to r © 1834 CO Ph 8 is o 1835 to Ph © © © 1836 Eh O O o 1837 to Ph © © is © 1838 451 23 3 1 1 139 99 2 20 7 7 26 25 Mean strength 101 116 112 773 Intermittent fever -Remittent " -Diseases of the respira-tory organs Diseases of the digestive organs -Diseases of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -All other diseases - 5 1 6 54 2 4 1 4 34 16 127 17 7 11 66 2 10 2 35 11 161 1 5 93 I 5 9 28 17 to §• o »H © 27 6 1 1 192 201 3 48 10 8 86 1 65 Total - 159 213 660 92 104 100 353 649 96 Under the class of diseases of the respiratory organs are included 341 catarrh, 18 pneumonia, and 11 pleuritis; under the class of digestive organs, 433 diarrhoea and dysenteiy, 140 cholic and cholera, and 1 hepa- titis ; under the class of brain and nervous system, 13 eprlepsy and 7 mania a potu; and under that of venereal affections, 28 gonorrhoea and 8 syphilis. As the deaths from all causes, according to the Adjutant General's returns, amount to 11, and the aggregate mean strength is 751, the an- nual ratio of mortality is 1T5T per cent. Of the deaths, 9 are reported in the medical returns, viz. 1 congestive fever, 1 intermittent fever, 2 pneu- monia, 1 phrenitis, 1 ebriety, 1 chronic visceral obstructions, 1 atrophia, and 1 nervous irritation supervening on amputation of the right arm; the ratio of mortality, excluding the last case, being 1-^ per cent. Although this station does not exhibit a higher mortality than the mean ratio of posts on the lakes, yet it is found that disease prevails to a considerably greater extent; but the most remarkable fact is, that this excess arises mostly from diseases of the digestive organs, more especi- ally dianhoea and dysentery, whilst fevers of a malarial origin bear no cor- responding ratio. Of cases of intermitting fever, the annual ratio is 20, and of remitting fever it is 3, per 100 of the strength. Although the average of intermittent fever is higher than that of Forts Brady, Howard, or Mackinac, it is lower than the ratio of Dearborn or Niagara, and little more than one-fourth as high as that of Fort Gratiot. The following table, designed to show the relative influence of the seasons upon dis- ease in general, requires, in the present instance, some explanation. The first and second quarters exhibit the highest ratio of disease ; but it will be found, on examining the preceding abstract, that if the third and fourth quarters of 1838, when the command was large and little disease prevailed, are excluded, inasmuch as the post was unoccupied in the first two quarters of that year, that the result will not vary from the general law. TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treat-ed quarterly. 4 first quarters 4 second " - -4 third " 4 fourth " Annual ratio - 420 378 672 773 450 462 660 649 1C71 1222 982 841 561 2,221 3,959 Consequently, every man, on an average, has been reported sick once in every three months; the highest ratio yet presented. " ^v annals of Sackett's Harbour," says Assistant Surgeon Hender- son, " like those of the lake shores on the frontier generally, show that 97 formidable diseases have prevailed at all seasons of the year. During the war of 1812, the epidemic called pneumonia typhoides originated on the lines, and appeared at this place. Those who recollect that ex- traordinary disease, know that it existed in the winter and spring, ceas- ing in summer. In July, 1813, from a tenth to a fifth of the crews of Commodore Chauncey's squadron were on sick report at the harbor. In August, more than one sixth of the seamen were left on shore; and Cooper, in his Naval History, states that at one time in this season (1813) the Madison had nearly one-half of her complement, on sick list. The same author says, " in the winter of 1814, the sickness at the har- bor was of the gravest character. One-half of the crew of the Madison was sick, and one-fifth died. In the summer of that year, the opera- tions of the squadron were delayed by the illness of the mechanics at the Navy Yard." Since the peace of 1815 up to 1839, it would seem that no epidemic of a malignant tendency has prevailed at Sackett's Harbor. " In May and June, 1839," says Assistant Surgeon Henderson, " diarrhoea became very rife at Madison Barracks, with here and there a case of fatal remittent fever. In July and the subsequent months up to this date, October 25th, the diarrhoea has been almost universal. Cases of fever became more numerous in July and August, several proving fatal. " Let it be here observed, that the summer of 1838 was intemperately hot and dry; the summer of 1839 was cool and seasonable as to rain. General health prevailed east and south, except at Charleston, South Carolina, in 1838. In 1839, with a season throughout ostensibly fa- vorable to health, so far as moderate heat and moisture are concerned, epidemic dysentery prevailed in New England; the most malignant endemics existed in New Orleans, Mobile, Pensacola, St. Augustine, Charleston, Augusta, Georgia, in Illinois, and in the towns and cities on the lower Mississippi. Is it then remarkable, that Madison Barracks should have been more sickly than usual ? especially when it appears that, in several localities not far from the post, similar and severer visita- tions of fever appeared. Sackett's Harbor village has had more fever than has been known for twenty years. In the neighboring farming country, places usually healthy have suffered from fatal malarial sick- ness. " And yet, as if the caprice of malarial influence were ever to baffle search into causes successfully, at Rochester and Buffalo, I am told, the troops were healthy, and at Plattsburg most remarkably so. Nearer to Madison Barracks, at Ogdensburg on one side, and at Oswego on the other, the towns were perfectly free from disease. I was informed by a very respectable physician at Oswego, that between May and the 22d August he had not seen one case of fever. At the same time, the eighth regiment, in all its departments, officers, soldiers, and families, was affected with diarrhoea ; and as the autumn approached, remittent fever appeared very generally. In September [strength 592] there were forty-four cases of fever, exclusive of what appeared among the fami- lies. In October [strength 397] up to the 22d, there were thirty-eight 98 ca^es on the hospital register; making an aggregate, of what I have seen since the 23d of August, of about ninety cases, exclusive of jaun- dice and intermittent cases, that are forms of malarial disease; and es- pecially exclusive of diarrhosa, the cases of which are extremely nume- rous and obstinate. This last disease would readily yield to hospital treatment and diet, but recurred too readily on going to quarters and to ration diet, or it would lapse into remittent fever." In regard to the remedial management of the modification of fever alluded to above, he remarks, that " my conclusion is, that it is a tract-,, able form of disease; requiring prompt vigilance to ascertain its earliest impression, and the immediate subjection of the soldier to the sanative influence of hospital treatment; and that, looking at the number of cases of diarrhoea, fever, jaundice, and intermittent, the mortality was not great." In treating of the supposed causes of disease, it is shown that in 1838, when general health prevailed, all local circumstances, compared with 1839, when morbid action was very rife, were apparently disadvan- tageous. Again—" It is known that within a few years the lakes have risen between three and five feet, and are now falling. Popular opin- ion, which should always be attended to on such questions, though very often incorrect, has ascribed the sickness to this fall of water. I see nothing in the laying bare annually of a few inches of lake shore, nor in the draining of tributary streams, that could cause the sickness at Madison Barracks ; for in the vicinity na grounds have been covered or laid bare by the rise or fall of the water, so as to afford malaria. This rise and fall of the vast interior seas is a phenomenon which cannot be philosophically considered as a cause of endemics." In reply to the question, Is Madison Barracks a healthy station ? the answer of Assistant Surgeon Henderson is in the affinnative, based on the following reasons: ' " Although in 1813 amL1814 there was much sickness at Sackett's Harbor, yet it was incident to the state of war, to the crowd of soldiers and sailors assembled hastily at the post, to the inadequacy of good food and shelter, and to the exposures and privations endured by the seamen and soldiers. " Since the war the station has generally been healthy, and the vil- lage adjoining uniformly so. " If Madison Barracks has been more sickly during the present sea- son, so has the surrounding country in various places, heretofore per- fectly healthy. " The inference that a station is unhealthy cannot legitimately be drawn from the experience of a season. The cause of the sickness at Madison Barracks in 1839 is, like the cause of summer and autumnal diseases, inscrutable. Disease seems to move in a cycle of years, and at some period of that cycle almost all sites are sickly." It has been seen, however, that the result of statistical data show that this post, although the mortality is not higher, is more insalubrious than anv other station on the lakes; and that this excess of disease arises chrefly from the class of lesions pertaining to the digestive organs. The 99 well known talents and industry of Dr. Henderson entitle his opinions upon medical subjects to much respect; but the result shows that there are questions connected with medical science which no ordinary obser- vation, however aided by the efforts of genius, can decide. It is only by accumulating a multitude of facts, extending over diversified regions, and embracing thousands of individuals—the application of numerical analysis to the investigation of morbid action—that the comparative prevalence and influence of disease can be determined. FORT HOWARD. LATITUDE 44° 40', LONGITUDE 87°. This post is situated on the northwest bank of Fox river, one mile from the point at which it empties into Green Bay. This bay, which is an arm of Lake Michigan, indents the land for 90 miles. It commences 40 miles wide, and gradually lessens to four miles at its head, where it receives the waters of Fox river. " It is skirted about its head," says Acting Assistant Surgeon Ward, " with marshes a mile in width, cov- ered with a luxuriant growth of grass and wild rice, which embrace the mouth of the river, and continue within half a mile of the fort. The water is from six inches to six feet deep on these marshes, which, by the operation of a diurnal flux and reflux of the waters of the bay, are al- ternately flooded and drained twice every 24 hours. Twenty rods back of the fort another marsh begins, and, spreading to the right and left, extends a mile or more in each direction. It differs from the marshes just described in this, that it is partly covered with timber, thickets of al- der, evergreens and grass." Proceeding north and west two miles, the country presents a densely wooded region, as far as explorations have been made. On the opposite side of the river, as far as Lakes Michigan and Winnebago, the country is also in its primitive state, covered with dense vegetation of forest and underwood. The soil mostly consists of a vegetable mould, intermixed with clay and sand; and is generally of a character to reward the labors of the husbandman. The mean annual quantity of rain, on an average of four years, is 38.83 inches. This post, which is less under the modifying agency of the great in- iaud seas than any other of the class, has been reserved for the last in description. The diseases reported during the ten years are comprised in the fol- lowing abstract: ABST1 U.C Texh ibitin^ r a condensed view of the principal diseases at Fort Howard, for a oeriod of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 212 1830 191 1831 205 24 41 2 20 3 2 19 14 21 146 1832 104 6 3 6 5 8 28 1833 202 3 14 9 3 2 3 6 40 1834 189 17 5 4 5 7 3 16 57 1835 213 13 27 2 2 8 1 5 58 1836 212 2 2 19 9 7 5 2 13 10 69 1837 184 30 15 2 19 2 1 14 1 3 87 1838 52 8 4 3 1 1 8 2 1 28 1764 3 4 2 151 151 22 3 89 15 45 109 40 81 715 t 1829 221 6 4 28 19 1 8 4 20 22 7 7 126 1830 197 2 2 2 5 28 3 7 2 3 19 35 108 1831 200 16 1 19 3 4 4 4 2 53 1832 89 2 10 1 5 3 8 29 1833 197 4 2 6 18 2 1 2 3 9 7 54 1834 211 17 20 2 16 1 2 13 5 14 90 1835 188 9 27 2 9 1 2 12 10 15 87 1836 180 5 8 2 7 1 7 4 2 36 1837 170 2 15 28 9 3 11 5 12 85 1838 49 4 1 13 7 1 4 10 2 3 1 12 58 Mean Strength 1702 Intermittent fever -Remittent fever Synochal fever ry organs -Diseases of the digestive organs -Diseases of the brain and Dropsies Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries -Ebriety All other diseases -Total - 1 19 17 1 12 1 14 12 11 16 104 4 12 16 20 15 22 9 98 30 11 4 101 184 9 1 61 35 45 84 47 114 726 THIRD QUARTER. FOURTH QUARTER. Years - 1829 219 11 5 1 32 66 1 15 10 21 23 8 17 210 1830 225 13 26 35 57 9 7 8 38 14 34 241 1831 110 1 2 2 21 2 6 4 11 2 51 1832 o Ph CL> >-, O 6 1833 191 4 10 1 44 1 1 4 8 17 90 1834 220 1 20 91 2 9 I 6 13 6 16 165 1835 218 6 20 53 13 2 3 24 5 8 134 1836 156 2 5 14 1 3 1 3 15 5 49 1837 144 1 1 17 45 5 1 4 10 6 15 105 1838 43 4 1 12 1 2 2 4 2 28 1526 43 34 10 1 133 403 5 1 59 29 51 134 54 116 1073 1829 207 2 1 20 20 3 12 2 24 33 6 123 1830 214 2 13 16 1 2 6 5 16 11 28 100 1831 111 2 1 9 1 6 1 5 9 34 1832 192 1 6 16 1 1 8 2 3 11 4 13 66 1833 193 2 1 15 17 1 6 3 1 12 3 5 66 1834 218 29 12 2 9 6 8 6 72 1835 217 2 13 8 9 3 18 2 8 63 1836 146 1 1 9 9 1 10 5 13 3 6 58 1837 48 2 3 8 2 2 3 3 5 1 11 40 1838 48 4 3 2 1 4 14 Mean Strength 1594 Intermittent fever -Remittent fever Synochal fever Typhus fever Diseases of the respirato-ry organs ,-Diseases of the digestive organs ... Diseases of the brain and nervous system -Dropsies ... Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 17 4 1 108 118 11 3 65 36 32 121 24 96 636 102 Under the class of diseases of the respiratory organs are comprised 384 catarrh, 6 pneumonia, 60 pleuritis, and 28 phthisrs pulmonalis; under the class of digestive organs, 379 diarrhoea and dysentery, 184 cholic and cholera, and 10 hepatitis ; under the class of drseases of the brain and nervous system, 15 epilepsy, 1 mania a potu, and 2 nyctalopia; and under that of venereal affections, 67 gonorrhoea, and 46 syphilis. The deaths from all causes, according to the post returns, are 25, be- ing 1^ per cent, per annum. Of these, 15 are reported in the medical returns, viz: 4 diarrhoea, 1 gun-shot wound, 1 influenza, 1 chronic pneumonia, 1 phthisis pulmonalis induced by excessive ebriety, and 7 of causes unreported. Including all these cases, the ratio of mortality is less than one per cent.; but, as the causes of death are not regularly reported, it is impracticable to give the exact ratio of mortality from disease. In 1829, the subjects of two deaths were recruits, who were " far gone" when they joined, and in 1832, one resulted from a gun- shot wound, whilst the causes of 7 are not stated. It thus appears that this station is a very salubrious one. There is little in the history of disease at this post requiring comment. The annual ratio of intermittents is six, and that of remittents is three, per one hundred of mean strength. When it is considered that this fort, which occupies a sandy eminence about ten feet above the level of the bay, is almost surrounded by marshes, the low average of malarious fevers seems at first view inexplicable. It may be safely assumed that this exemption is owing to the circumstance that these low lands are always covered with water; and, upon the same principle, it follows that when drained and brought under cultivation, this station will be- come unhealthy. The following abstract exhibits the relative agency of the seasons in the production of disease in general. TABLE showing the relative agency oftheseasons irt, the production of disease ingeneral. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 10 first quarters 10 second " 9 third " 10 fourth " Annual ratio 1,764 1,702 1,526 1,594 715 726 1,073 636 405 425 703 399 1,647 3,150 1,913 Every man has, consequently, on an average, been reported sick about once in every six months. There are upon these ocean-lakes other posts which have recently, owing to the disturbances on that fron- tier, grown into importance, such as those at Detroit, Buffalo, and Platts- burg. The data, although insufficient to authorize the usual tabular arrangement, yet suffice to show that these stations are no less salubri- ous than those already described. A general view of the results obtained from the statistics of the class of posts described, possessing the common characters peculiar to posi- 103 tions on our northern lakes, will show that this region is extraordinarily salubrious. The annual ratio of mortality according to the medical reports is T^ per cent., and, according to the Adjutant General's returns, 1^ per cent. Although there is little difference in the ratio of mortality at the various posts, yet the extent of sickness, as determined by the number of cases reported, presents considerable diversity. Fort Brady exhibits the lowest and Madison Barracks the highest average. The following table shows these various relations at a single view, based on the results of ten years— TABLE exhibiting the ratio of sickness at different posts. Mean aggre-gate strength Deaths per Adj't Gen.'s Deaths per Medical re- Total of cases Ratio per 1,000 of mean strength under treatment returns. returns. reported. annually. Fort Brady 962 11 6 1,275 1,325 " Mackinac 865 5 n 1,577 1,823 " Gratiot 782 14* 10 2,452 3,135 " Dearborn '588 8 3* 939 1,595 " Niagara 570 10 8 1,439 2,525 Madison Barracks - 561 11 9 2,221 3,959 Fort Howard 1,647 25 15 3,150 1,913 Aggregate 5,975 84 53 13,053 - Ratio per 1,000 - - 13§ 9 - 2,185 As the ratio per 1,000 of mean strength under treatment is 2,185, it follows, pursuing the mode of calculation adopted, that each man, on an average, has been on the sick list once in every five and a half months. As cholera produced its greatest havoc among troops on the march, the results do not appear in the returns from the posts. To illustrate further the climate of the region of the great lakes, and to show the relative influence of the seasons in the production of morbid action, such diseases have been selected for elucidation in the subjoined abstract as have a manifest dependence upon meteorological causes. Typhus fever, it is true, may not belong to this class; but in order to present a complete view of all febrile affections, its inclusion has been deemed advisable. Under the head of synochal fever are condensed the cases registered as synocha, synochus, common continued, ephemeral, and inflammatory fevers; but the cases of this class, reported under the last name, constitute a majority of the whole. * 21 deaths from epidemic cholera excluded. f 1 death from epidemic cholera excluded. $ 2 deaths from epidemic cholera excluded. § This result is based on an aggregate mean strength of 6,377, whilst that of the medi- cal returns is 5,975. This difference is owing to the circumstance that some of the quarterly sick-reports are wanting. 104 TABLE exhibiting the relative influence of the A ■r. <*« ■ o O A V a ea T3 B tn a o "So o « a " o c DISEASES. m Lh m o P*H 3 o .2 "8 6 o &h o P *-< e if bD eS-o is o w o 3 © ^ 1 tt. a be" a Ratio of per 1,0 mean stre INTERMITTENT FEVER. First quarter 15 7 31 40 199 5 35 10 37 15 66 3 30 80 413 6371 5667 13 73 Third " - 17 13 227 59 47 26 43 432 5648 77 Fourth " - 5 14 94 37 27 31 17 225 6205 36 Annual ratio 37 65 560 136 121 138 93 1150 5973 193 REMITTENT FEVER. First quarter Second " - - 1 1 3 1 7 2 1 - 12 11 4 11 21 33 6371 5667 3 6 Third " - 2 3 11 22 13 31 34 116 5648 21 Fourth " - - 3 1 1 6 19 11 4 53 26 6205 4 Annual ratio 3 10 20 26 65 196 5973 33 SYNOCHAL FEVER. First quarter 4 2 9 _ - 11 2 28 6371 4 Second " - 3 1 6 1 - 12 4 27 5667 5 Third » - - - 2 1 3 _ 5 4 10 25 5648 4 Fourth " - 3 1 5 3 21 - 1 7 1 16 6205 3 Annual ratio 12 1 6 34 17 96 5973 16 TTPHUS FEVER. First quarter 3 _ 2 - _ 1 - 6 6371 1 Second " - 2 - - - - 1 - 3 5667 5-10 Third " - 1 1 1 - - - 1 4 5648 7-10 Fourth " - 9 - 1 - 1 1 - 1 11 6205 1 8-10 Annual ratio 15 1 4 - 2 24 5973 4 DIARRHOEA AND DYSEN- TERY. First quarter 23 18 36 11 55 18 58 219 6371 34 Second " - 28 36 32 16 95 26 75 308 5667 54 Third " - 39 63 92 65 160 63 203 685 5648 121 Fourth " - 29 7 53 18 123 29 43 302 6205 49 Annual ratio - 119 124 213 110 433 136 379 1514 5973 253 105 seasons in the production of morbid action, Ac DISEASES. o Ph C t, o Ph o o PH c o -e C3 O B o Ph c !S .2 o JM as be 03 tn o o X o Ph ^o Aggregate mean strength. Ratio of cases per 1,000 of mean stiength. CATARRH AND INFLU- ENZA. First quarter 74 66 119 30 102 55 129 575 6371 90 Second " - 56 47 79 8 38 54 70 352 5667 62 Third " - 46 50 24 6 32 30 94 282 5648 50 Fourth " - 72 40 124 18 183 64 91 596 6205 96 Annual ratio 248 203 346 62 355 203 384 1805 5973 300* PNEUMONIA. First quarter 3 1 4 1 4 10 1 24 6371 4 Second " - 4 2 12 1 6 5 2 32 5667 6 Third « - 16 5 - _ 5 1 _ 27 5648 5 Fourth " - 10 3 5 1 3 3 3 28 6205 5 Annual ratio 33 11 21 3 18 19 6 111 5973 19 PLEURITIS. First quarter Second " - 1 4 5 12 9 10 6 5 6 3 5 3 11 16 43 53 6371 5667 7 9 Third " - - 10 6 4 - _ 25 45 5648 8 Fourth " - 2 12 7 5 2 4 8 40 6205 7 Annual ratio 7 39 32 20 11 12 60 181 5973 30 PHTHISIS PULMONALIS. First quarter 3 1 _ 1 _ 2 10 17 6371 3 Second " - 1 _ 2 _ _ 3 6 12 5667 2 Third " - - - _ _ 1 _ _ _ 10 11 5648 2 Fourth " - 3 7 2 3 1 1 - 1 2 10 6205 2 Annual ratio 4 2 - 6 28 50 5973 8 RHEUMATISM. First quarter 23 47 51 20 19 15 89 264 6371 41 Second " - 31 60 22 8 14 14 61 210 5667 37 Third " - - - 20 34 25 17 26 23 59 204 5648 36 Fourth " - 17 41 35 11 48 20 65 237 6205 38 Annual ratio 9V 182 133 56 107 72 274 915 5973 151 * As the mean strength of each quarter is not the same, the annual ratio of cases does not quadrate with the sum of the four quarters. 11 106 As the influence of climate in the production of the class of pulmo- nary diseases, will be more fully developed in proportion as the numeri- cal results of each class of posts come under consideration, it is sufficient now to direct attention to the fact that, whilst with regard to catarrhal af- fections the influence of the seasons, in this class of posts, is strikingly manifest, the same law does not hold in relation to pleuritis, pneumonia, and phthisis pulmonalis. The ratio of cases of catarrh and influenza, which is, in the last quarter of the year, 96 per 1,000 men, gradually decreases in the first, second, and third quarters, the ratio of the last, (the season of summer,) being only fifty.* In respect to rheumatic affections, it is seen that the ratios of the second and third quarters are but little lower than the first and fourth. The results obtained in the last column are important, as indicating the actual ratio in which these diseases prevail. If 1,000 men, for ex- ample, were stationed at the several posts, the average would show that, in the first quarter 13 would be attacked with intermittent fever, in the second quarter 73, in the third 77, in the fourth 36, and in the whole year 193. As these results, based on the statistics of ten years, embrace about 6,000 individuals, occupying seven different localities, the numeri- cal ratios may be regarded as fair expressions of the general laws of this climate in relation to these diseases. Having once ascertained the laws which obtain in other regions of the United States upon these questions, as well as the precise mortality, conclusions of a valuable character may be deduced. II. THE COAST OF NEW ENGLAND. The class of posts to be nov» brought under view extends along the coast of New England, from Eastport to the harbor of New York. Al- though ananged in a distinct class, they bear a striking similitude, as regards meteorological phenomena, to those already described. It is, therefore, deemed unnecessary to enter into any detail, more especially as the peculiar climatic features of this region were referred to in the introductory remarks of the preceding class. In regard to the mean temperature of the seasons, the range of the thermometer, and the rela- tive proportion of fair and cloudy weather, there is no great disparity. Unlike the succeeding class—the inland posts remote from large bodies of water—the air is moist, and the changes of the seasons are more slow and uncertain. * In the calculations of this class, the statistics of Fort Independence in reference to pulmonary diseases have been excluded, on the ground that some error exists. The total of pleuritis and pneumonia is eight times as high as that of catarrh, whilst the ratio of the former is nearly twenty times as high as that of the remaining posts of the class. As but one death is reported among 261 cases of pleuritis and pneumonia, that a great majority bebnged to the class of catarrhal affections is probable. lor FORT SULLIVAN. LATITUDE 44° 44', LONGITUDE 67° 4' W. Fort Sullivan is the most northern post on the Atlantic coast, being near the line of the British possessions. It is situated on Moose island, which is close to the main land, a small isle intervening. The town of Eastport is on the same island, which is about four miles long and two wide, having a rocky and sterile soil. The fort is elevated about 70 feet above the level of the ocean. The diseases reported during the ten years are comprised in the fol- lowing abstract— ABSTRA C T exhibiting a condensed view of the principal diseases at Fort Sullivan, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 56 1830 62 1831 58 2 1832 55 1833 56 1834 48 1835 58 1836 62 1837 1838 Mean strength 59 64 64 65 61 50 58 63 - - 484 455 Intermittent fever - . _ m 2 1 . . . 3 2 Remittent fever 1 - - - - - 1 . - - 2 2 5 . . . . 1 . . . H Synochal fever 1 2 2 - - - - - - - 5 - . 1 . . . . . . . 1 1 Diseases of the respirato- ry organs - 3 3 10 1 9 7 8 5 - - 46 - 3 6 7 3 6 5 1 . . 31 Diseases of the digestive organs ... 14 12 11 6 1 3 2 4 - - 53 12 11 12 3 2 7 1 2 . . 50 Diseases of the brain and nervous system - 6 2 3 11 . 1 5 . 1 . . 2 . - 9 1 Rheumatic affections 4 2 2 - 3 - 1 - - - 12 5 3 1 2 2 3 1 1 . 18 Venereal " - 1 - . - - - . . - 1 . . . . 1 . . . . . 1 Ulcers and abscesses 1 - 3 - 1 1 3 1 - - 10 . . . 2 . 1 1 1 . . 5 Wounds and injuries - 3 12 4 2 6 2 7 8 - - 44 1 3 5 5 4 . 3 7 . - 28 Ebriety ... 6 2 - 2 - - - 2 - - 12 9 - 5 2 2 . . 1 - - 19 All other diseases - 3 3 6 - 1 - 1 7 - - 21 8 4 12 2 3 - 3 - - - 32 Total - 42 39 41 13 22 13 23 27 - - 220 38 30 50 23 18 17 15 15 - - 206 THIRD QUARTER. FOURTH QUARTER. Years - - - - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 389 5 2 4 18 82 20 1 14 13 27 14 22 222 1829 48 2 5 9 1 1 2 8 1830 60 5 2 11 1 " 3 2 1 5 3 1831 56 14 6 4 1 8 9 2 1832 65 2 10 3 1 6 3 1833 49 1 11 5 I 2 3 3 1 1834 61 2 19 6 1 4 4 6 1 1835 60 1 6 1 5 5 2 1836 1837 1838 Mean strength 55 2 15 8 1 1 3 2 3 35 57 2 1 2 19 2 1 1 4 3 7 42 57 2 22 6 1 4 I 3 6 6 51 55 2 9 2 1 4 2 3 23 52 1 3 8 1 5 1 6 1 26 57 4 2 7 1 2 3 2 21 56 1 7 2 3 6 4 1 24 c5 •g - 399 Intermittent fever -Synochal " -Typhus " -Diseases of the respira-tory organs Diseases of the digestive organs -Diseases of the brain and nervous system -Dropsies -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebriety All other diseases - 2 2 8 62 46 5 20 2 9 33 11 20 Total - 28 33 44 25 27 43 20 - - - 220 110 Under the class of diseases of the respiratory organs are composed 102 catarrh, 24 pneumonia, 27 pleuritis, and 3 phthisis pulmonalis. Under the class of digestive organs, 30 diarrhoea arid dysentery, bO cho- lic and cholera, and 10 hepatitis. Under the class of diseases of the brain and nervous system, 11 epilepsy, and 11 mania a jpotu ; ana un- der that of venereal affections, 2 gonorrhoea, and 2 syphrlrs. The deaths from all causes, according to the Adjutant General s re- turns, are 17, being nearly four per cent, per annum. Of these, all are reported in the medical returns, viz : three epilepsy, one apoplexy, two phthisis pulmonalis, one typhus, one remittent fever, one cynanche ma- ligna, one scorbutus, one concussion of the brain, and six from causes not designated. The rate of mortality, (four per cent.,) without some explanation, will lead to unauthorized inferences; for, excluding the year 1829, in which are reported 11 deaths, the ratio is only 1T% per cent. In this year, there were three fatal cases of epilepsy and one of apoplexy, all induced by the excessive use of ardent spirits, one of con- cussion of the brain from a fall upon the ice, also caused by inebriety, one from scurvy, and five from causes not stated, the post being attended by a civil practitioner. This post is, indeed, a very salubrious one. No disease of a malig- nant tendency has, at any time during the above ten years, prevailed. Intermittent fever may be said to be unknown; for, although seven cases are reported, yet, as none occurred in the third quarters, it is pro- bable that these cases were originally contracted in other localities. The average of diarrhoea and dysentery is also exceedingly low. The relative agency of the seasons in the causation of disease in general is shown in the following abstract— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean stiength, treated quarterly. 8 first quarters -8 second " 7 third " 7 fourth " Annual ratio - 484 455 389 399 220 206 222 220 455 453 573 551 432 868 2,009 It thus appears that each man, on an average, has been reported sick once in every six months. Ill FORT PREBLE. LATITUDE 43° 38' N., LONGITUDE 70° 18' W. This post is situated on Cape Elizabeth, on the side of Portland har- bor opposite the town of the same name. The harbor is about one mile wide at this point, at which it opens directly into the ocean. The fort is elevated about 20 feet above the level of the sea, the grounds in the rear becoming higher, and consisting mostly of masses of bare rock. The soil is dry, hard, and gravelly. The diseases reported during the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Preble, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 49 2 5 4 9 20 1830 62 3 1 2 1 8 4 4 23 1831 58 8 9 3 1 5 6 1 4 4 41 1832 53 2 2 3 1 4 7 19 1833 48 3 1 2 4 4 14 1834 66 4 4 2 5 6 21 1835 t-0 Ph o 1836 "3 | 1 o Ph >-. o CO o "ea o 03 1837 1838 Mean strength 50 2 1 2 2 6 13 62 1 3 2 1 5 7 10 29 61 4 3 4 1 1 4 3 1 4 25 54 3 16 2 1 4 26 48 2 2 1 1 4 6 16 50 2 1 2 1 6 12 o Ph s o 57 3 1 2 1 2 9 - 382 9 6 28 11 2 11 8 1 29 1 24 130 336 Remittent fever Synochal fever Typhus fever Diseases of the respirato-ry organs - - -Diseases of the digestive organs Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries -All other diseases -Total - 20 2 1 Hi 15 2 8 14 1 25 34 13* THIRD QUARTER. FOURTH QUARTER. Yeari - 1829 60 6 8 1 2 4 1 1 12 35 1830 60 3 1 8 1 1 6 3 23 1831 56 3 1 3 6 2 4 4 6 29 1832 51 2 1 4 1 1 4 9 22 1833 45 4 1 3 8 1 4 21 1834 63 4 1 1 7 2 2 2 2 21 1835 57 1 5 2 3 1 2 1 1 16 1836 1837 1838 392 4 18 3 10: 46 4 12 16 3 20 1 30 167 1829 61 2 2 3 11 10 1830 62 4 4 2 2 4 9 2 5 1831 54 3 17 3 1 4 1832 51 2 1 3 2 1 3 1833 48 1834 62 1835 56 1836 1837 1838 Mean strength 394 Intermittent fever -i_i Remittent fever Typhus fever Diseases of the respirato-ry organs -Diseases of the digestive organs . - -Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries -Ebriety ... All other diseases - 6 5 2 1 1 5 1 4 3 3 5 1 2 1 - - - 16 1 1 33 15 2 12 13 2 28 4 15 Total - 29 32 28 12 20 16 4 141 114 Under the class of diseases of the respiratory organs are comprised 49 catarrh and influenza, 12 pneumonia, 18 pleuritis, and 7 phthisis pul- monalis. Under the class of digestive organs, 35 diarrhoea and dysen- tery, and 39 cholic and cholera. Under the head of diseases of the brain and nervous system, 6 epilepsy, and 2 mania a potu; and under that of venereal affections, 32 gonorrhoea, and 19 syphilis. The total of deaths, according to the Adjutant General's returns, is 11, being 2T7U per cent, per annum. Of these, seven are reported in the medical returns, viz: 2 phthisis pulmonalis, 1 typhus fever, 3 from causes not designated, and 1 drowned; giving, without including the last, a mortality of 1^ per cent. This station is equally healthful with the preceding one. As no more than four cases of intermittent fever are reported, and as these occurred in the same quarter, it may be assumed that this disease is unknown in this locality. It is found, however, that remittent fever exhibits compara- tively a high ratio. The relative agency of the seasons in the causation of disease in general, is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 7 first quarters -6 second " 7 third " 7 fourth " Annual ratio 382 336 392 394 130 138 167 141 340 411 426 358 376 576 1,532 Each man, on an average, has consequently been reported sick once in nearly every 8 months. FORT CONSTITUTION. LATITUDE 43° 04' N., LONGITUDE 70° 49' W. Situated on a peninsula which forms the most eastern point of the State of New Hampshire, in the county of Rockingham, between two and three miles from Portsmouth, Fort Constitution is washed on the south by the Atlantic, and on the north by the Piscataqua river. The country adjacent is uneven and rocky. Small marshes, some fresh and some salt, as well as peat beds, are found on Great Island, about half a mile distant. The soil is not very productive. The mean annual quantity of rain, on an average of four years, is 28.85 inches. The diseases reported during the ten years are comprised in the fol- lowing abstract. ABSTRACT exhibiting a condensed view of the principal diseases at Fort Constitution, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 1831 61 1832 50 1833 57 1834 48 1835 59 1836 52 1837 1838 443 1829 50 1830 59 1831 53 1832 1833 1834 1835 57 1836 1837 1838 Mean Strength 55 61 53 53 46 371 Remittent " - - - - . . . . . . m .^ _ . •Synochal " - - - - . . - . 1 . _ 1 _ . 1 "o3 1 Typhus '• -Diseases of the respiratory - - - - - - - - - - 4 * - - - - 1 s o - - 4 >rgans ... 1 - - . 2 . 3 4 . m 10 4 1 2 7 Diseases of the digestive organs ... 6 21 4 . 2 1 . . . m 34 . 7 19! 3 i*H 22 Diseases of the brain and <2 nervous system - - - - - 1 . . . . m 1 . . 1 1 1 3 Dropsies ... - - . . . . . . . m , *\ Rheumatic affections - . 2 1 . 1 . . . 4 1 1 1 1 1 1 * g Venereal " - 1 - 5 . 2 - 1 3 . m 12 _ 2 3 1 2 2 a IB 10 I .'leers and abscesses Wounds and injuries 1 1 3 1 ■- 2 1 1 1 2 - - 3 10 1 1 1 3 1 s - - 3 4 Ebrietas - - . . . All other diseases - 13 22 2 27 2 14 3 4 2 11 1 5 1 6 10 - - 24 99 10 2 12 5 3 - - - o - - 10 Total - 22 7 4 7 8 - - - 70 ABSTRACT—Continued, THIRD QUARTER. FOURTH QUARTER. Year* .... 1829 1830 52 1831 46 1832 51 1833 50 1834 54 1835 55 1836 1837 1838 365. 1829 57 1830 53 1831 48 1 1832 1833 1 1834 61 1835 54 1836 1837 1838 Mean Strength 57 58 51 382 --- 2 Diseases of the respiratory 3 19 1 . 1 m 15 36 Diseases of the digestive organs ... 12 4 3 . 1 2 1 . . . 23 2 8 4 ?, 3 1 20 Diseases of the brain and 1 Rheumatic affections 1 . 1 . 2 . 1 . . . 5 1 2 3 Venereal " - . 4 . . . 2 3 4 . . . 13 5 3 1 1 ?, 1 13 Ulcers and abscesses . . . . . . 1 . . . 1 1 1 1 3 Wounds and injuries 1 1 . 1 . . 1 . . . 4 3 2 1 1 1 4 12 All other diseases - 1 - 1 2 1 - - - - - 5 - 2 - - 1 - 3 - - 6 Total - 18 9 5 3 6 5 9 - - - 55 26 18 10 4 5 22 11 --- - 96 Ot 117 Under the class of diseases of the respiratory organs are included 30 influenza and catarrhy 7 pneumonia, 4 pleuritis, and 2 phthisis pulmona- lis ; under the head of digestive organs, 7 diarrhoea and dysentery, and 82 cholic and cholera; under the class of brain and nervous system, 1 apoplexy, and 1 delirium tremens; and under that of venereal affec- tions, 31 gonorrhoea, and 17 syphilis. The deaths, according to the post returns, amount to seven, being 1-^ per cent, per annum. Of these, six are reported in the medical returns, viz: one pneumonia, one phthisis pulmonalis, one enteritis, one con- vulsions, one apoplexy, and one asphyxia from submersion; giving, without including the last, a mortality of 1-ft per cent. It is remarked by Assistant Surgeon James H. Sargent, who has been stationed at this post for many years, that " it is so healthy that the hos- pital is seldom occupied"—a fact plainly evident from the abstract given above. A case of fever is, indeed, a rare phenomenon. But one case of intermittent fever is reported, and this came from Fortress Monroe. There is no case of remittent fever. Of inflammatory fever there are two, and of typhus six cases are reported. Dr. Sargent observes that in 33 years' practice he has known, at this post or its vicinity, but one case of intermittent fever which was not of foreign origin. On referring to the history of this post prior to 1829, it will be found that in the third quarter of 1825 nearly every man in the command was attacked with cholic and cholera morbus, but that no case terminated fatally. No cause was assigned. The following abstract exhibits the relative agency of the seasons in the causation of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters, 7 second " 7 third " 7 fourth M Annual ratio 443 371 365 382 99 70 55 96 226 189 151 251 390 320 821 Consequently every man, on an average, has been reported sick but once in every seventeen months and a half. 118 FORT INDEPENDENCE. LATITUDE 42° 22' N., LONGITUDE 71° 2' W. This post, situated on Castle Island in the harbor of Boston, occu- pies an eminence of 40 feet above the sea. The island, which has a hard and gravelly soil, is in dimensions 1,000 by 900 feet, having a sandy tongue running off 700 feet. It is distant three miles southeast from the Statehouse. The nearest land on the west is the extreme point of West Boston, known by the name of Dorchester point, which is three-fourths of a mile distant. On the south, the nearest point is Thompson's Island, distant one mile and a half; and one mile north is Governour's Island, which overlooks Fort Independence 60 feet, and, in military language, commands it. " In point of situation," it was remarked by Assistant Surgeon Mann in 1827, "no post can be more salubrious than this, inasmuch as the tide ebbs and flows from 10 to 14 feet, and there are no stagnant waters in the vicinity to generate infectious miasmata productive of autumnal fever. Since I have been stationed here, there have been two seasons of epidemic pneumonia; the first in the spring of 1821, and the last, which was accompanied with many severe cases, in the spring of 1826. These epidemics were not confined to this post, but extended over the New England States, and, if I am not mistaken, as far south as Vir- ginia." The following abstract comprises the diftases reported in ten years— ABSTRA C T exhibiting a condensed view of the principal diseases at Fort Independence, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1829 1830 1831 152 1 7 18 12 4 7 1 21 2 11 84 1832 61 2 23 11 7 6 1 2 15 8 75 1833 55 13 3 2 3 6 27 1834 1835 1836 1837 1838 564 2 21 100 53 10 25 20 10 61 2 47 351 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 Mean strength 120 176 1 3 28 19 1 12 3 4 11 11 93 155 9 18 34 13 4 10 12 1 13 114 168 3 14 3 24 4 9 5 3 17 2 10 95 142 6 18 31 3 4 3 2 16 2 11 97 56 5 18 1 1 2 1 14 37 79 53 3 3 1 14 21 - - - - - 574 Intermittent Fever Synochal " -Diseases of the respira-tory organs Diseases of the digestive organs -Diseases of the brain and nervous system Rheumatic affections Venereal " -Ulcers and abscesses Wounds and injuries Ebrietas -All other diseases Total - 9 18 8 2 3 7 3 11 11 72 - - - - -, 3 1 29 1 47 110 8 27 14 16 60 5 85 406 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 570 4 16 1 49 175 7 1 36 16 13 75 1 88 483 1829 170 3 6 1 42 15 11 4 4 15 15 1830 147 3 7 16 2 3 10 12 1 6 4 1831 53 1 1 31 8 6 4 6 5 9 8 1832 56 5 3 1 4 24 1833 V o u c o >-o o 3 10 Ph © O t. 1834 1835 1836 : 1837 - 1838 : Mean strength 164 160 132 61 53 - - - 426 Intermittent fever Remittent " Synochal " Typhus " Diseases of the respirato-ry organs Diseases of the digestive organs ... Diseases of the brain and nervous system Dropsies ... Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -Ebriety ... All other diseases 2 1 8 1 17 38 1 12 8 12 22 10 132 2 5 11 31 1 1 9 3 20 7 90 3 15 50 3 12 4 18 1 16 122 3 52 2 2 1 1 8 41 110 3 4 1 7 29 - - - - 7 14 1 94 28 9 25 23 10 34 51 Total - 116 64 79 37 296 121 Under the class of diseases of the respiratory organs are comprised 33 catarrh, 222 pneumonia, 39 pleuritis, and 8 phthisis pulmonalis. Under the head of digestive organs, 172 diarrhoea and dysentery, and 81 cholic and cholera. Under the class of brain and nervous system, 20 epilepsy, and 9 delirium tremens; and under that of venereal affections, 43 gon- orrhoea, and 30 sy^philis. The deaths, according to the Adjutant General's returns, number 13, being 2fv per cent, per annum. Of these, 9 are reported in the medi- cal returns, viz: one pneumonia, two phthisis pulmonalis, one maras- mus, three from causes not designated, and two casualties, (one from suicide and the other from drowning,) giving, excluding the two last, an annual mortality of 1T3^ per cent. The only fact in the history of disease at this post requiring comment is the remarkable prevalence of pleuritis and pneumonia compared with catarrh. The ratio of the first two is eight times higher than the last; whereas it has been seen that the general law, as deduced from seven posts on the lakes, shows that the ratio of catarrh is six times higher than the average of pleuritis and pneumonia; whilst a similar comparison of the class of posts now under consideration, excluding this station, shows that the ratio of the former is five times higher than that of the latter. As but one death from pneumonia, however, is reported, it is apparent that the lesions registered under this nosological term must have been of a slight grade of intensity. The relative agency of the seasons in the causation of disease in gen- eral is exhibited as under— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 5 first quarters -5 second " 5 third " -4 fourth " -Annual ratio 564 574 570 426 351 406 483 296 622 707 847 695 533 1,536 2,882 Hence every man, on an average, has been reported sick once in eveiy four months. 16 122 FORT WOLCOTT. LATITUDE 41° 30', LONGITUDE 71° 18'. This fort is situated on Goat Island, which is 150 yards wide and half a mile long, within the harbor of Newport. It is two miles from the sea-shore, and half a mile from the town of Newport on the island of Rhode Island. The surface of Goat Island consists of a rich mould, elevated about 20 feet above the ocean. The drainage is good. On the southeast, distant about a mile, is a salt marsh half a mile square; and on the northeast, somewhat nearer than the former, is a lagoon, into which the tide flows constantly. In regard to barrack accommodations, the men occupy rooms 20 feet square, with thick and arched walls, the second story, constructed of wood, being occupied as officers' quarters. The diseases reported during the usual period of ten years are con- tained in the subjoined table— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Wolcott, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Year.-t - 1829 1830 58 1831 59 1832 51 1833 55 1834 38 1835 63 1836 50 1837 1838 429 1829 55 3 1830 57 1831 49 1832 42 1833 50 1834 37 1835 59 1836 1837 1838 Mean strength 55 349 Intermittent fever - 3 Remittent " - . . . . . . . . . m „ - . . . . . ., . ■^vnochal '' - 2 3 1 1 . . 2 . . . 9 3 . 1 1 _ 4 —; . . 9 Tvphurf " - . . . . . . , . . -« . . . Diseases of the respira- tory organs 8 2 3 8 10 5 6 4 . _ 46 - 2 2 1 . 2 11 . . 18 Diseases of the digestive o organs - - - 1 2 1 . 4 1 1 1 . . 11 4 3 5 1 5 1 7 [H . . 26 Diseases of the brain and £ nervous system - - . - 2 . . . . . . 2 1 3 . 2 1 . . . . 7 Dropsies - . . . . . . - . . . - . . . . . aj . . . Rheumatic affections 2 1 3 1 1 . 1 . . . 9 2 2 2 . 1 . fl . . 7 Venereal " - I 3 1 . . . . . . 5 - . 2 . . . 3 . . 2 Ulcers and abscesses 4 . - » . 1 1 . . ■ . fi - 1 4 . 1 . 1 > . . 32 All other diseases - 4 4 2 1 6 3 5 - - - 25 2 - 1 2 2 1 5 s - - 13 Total 23 16 24 25 22 17 17 6 - - 150 15 14 27 15 17 11 32 - - - 131 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years .... 1829 56 10 3 7 27 1830 57 1 5 3 1 1 4 6 1 22 1831 41 3 6 3 2 1 4 1 20 1832 49 1 1 1 2 9 3 17 1833 44 5 11 16 1834 57 1 2 14 3 1 4 8 7 40 1835 58 4 8 1 1 14 1836 1837 1838 362 1 2 9 49 7 6 3 2 12 46 19 156 1829 59 3 4 3 2 3 1 3 3 22 1830 60 4 2 1 1 1 1 7 17 1831 42 4 2 1 1 8 1832 60 2 1 2 1 3 7 6 22 1833 43 1 1 4 5 11 1834 65 2 28 4 2 1 6 2 2 47 1835 53 8 1 1 2 13 1836 1837 1838 Mean strength 382 Remittent fever Synochal fever Diseases of the respirato-ry organs -Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal " I fleers and abscesses Wounds and injuries Ebriety ... All other diseases -Total - 1 9 49 12 6 7 2 1 18 10 25 140 125 Under the class of diseases of the respiratory organs are included 93 catarrh, 17 pneumonia, 5 pleuritis, and 2 phthisis pulmonalis; under the head of digestive organs, 64 diarrhoea and dysentery, and 14 cholic and cholera; under the class of brain and nervous system, 2 epilepsy, and 11 delirium tremens; and under that of venereal affections, 11 gonorrhoea, and 1 syphilis. The total of deaths, according to the post returns, is 5, being 1T8T per cent, per annum. Of these, all are reported in the medical returns, viz : 2 phthisis pulmonalis, 1 maniaapotu, and 2 asphixiafrom submersion. In 1832, when the fatal case of delirium tremens was reported, it is remarked by Assistant Surgeon Wm. Turner, that it is the first death that occurred in five years in an average of more than 100 persons, in- cluding engineer officers and their families, as well as the families of enlisted men ; and this death he regards virtually a case of suicide. In 1834, in reporting a death from drowning, Dr. Turner speaks thus:— " The only three deaths amongst the troops in seven years, have occur- red one from delirium tremens and the other two from accidental drown- ing whilst in a state of intoxication." In reporting a fatal case of phthisis pulmonalis in the second quarter of 1835, it is again remarked that this case and one of mania a potu are the only two deaths from disease in the period of eight years, amongst the troops, including the officers of the corps of engineers and their families. It is observed by Assistant Surgeon Turner that no epidemic ever prevails at this station. So complete an exemption is there from all febrile affections, Avith the exception of simple inflammatory fevers, that he never met, in the course of thirty years' practice, with a single case of intermittent fever which could not be traced to foreign origin. Of remittent fever, there is but one case reported. There are many cases of " febricula from intemperance" registered, all of which are placed under the head of ebriety. Indeed, what little disease prevails among the troops at this post is ascribed by Dr. Turner mostly to the abuse of spirituous liquors. The folloAving abstract exhibits the relative agency of the seasons in the causation of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters -7 second " 7 third « 7 fourth " Annual ratio - 429 349 362 382 150 131 156 140 350 375 431 367 380 577 1,519 Hence e\ cry man, on an average, is reported sick once in eveiy eight months. It is observed, however, by Assistant Surgeon Turner, that none but hospital patients are included in his quarterly sick reports. 126 FORT TRUMBULL. LATITUDE 41° 22' N., LONGITUDE 72° 05'. This fort is situated on the right bank of the River Thames, one mile below New London, and two and a half miles from the shore of Long Island Sound. It is elevated fifty feet above the level of the ocean, the position is rocky, and the drainage good. The river opposite the fort is about half a mile wide; and within the same distance from the fort, are two small salt marshes. The soil of the surrounding country is rather sterile, presenting an undulating aspect, rising in prominent ridges of eighty or one hundred feet, with rock frequently breaking forth abruptly upon its surface. The following abstract comprises the diseases reported in the ten years— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Trumbull, for a period often years. ~~~ —----; FIRST QUARTER. SECOND QUARTER. 'Years.- - 1829 52 1830 118 1831 118 1832 56 1833 55 1834 55 1835 126 1836 55 1837 1838 635 1829 100 4 1830 1831 110 1832 55 1 1833 57 1834 71 4 1835 123 1836 1837 1838 Mean Strength 516 Intermittent fever - 9 Remittent fever - 1 . - . - - . 1 . . . . _ . . . Synochal fever - - 3 2 . - - - - . 5 - . 2 2 . „ . ^H . . 4 Typhus fever - - - - - - - - - - . . - . . . . . 0> . . . Diseases of the respirato- £ ry organs - - - 2 2 11 . 2 4 16 8 - - 45 2 . 5 1 2 1 12 2 . . 23 Diseases of the digestive tt organs ... 8 4 5 6 1 16 - - . - 40 5 . 5 2 8 4 2 &-H . . 26 Diseases of the brain and I-l nervous system - - - - - - 1 - 1 - - 2 - . - - . 2 . TR - - 2 Dropsies ... - - - - - - - - - - - . . . . . . . ■fi . . . Rheumatic affections 2 2 2 2 4 2 - 1 - . 15 3 . 2 2 1 . 3 . . 11 Venereal affections - 2 7 3 1 - - - ' . - 13 2 3 2 . . e . . 7 Ulcers and abscesses 1 - - . 1 - - . . . 2 . * . . 2 1 1 . . 4 Wounds and injuries 4 2 5 3 5 7 9 2 - - 37 - 3 2 3 2 5 - - 15 Ebriety ... - - - - 1 - - - - - 1 . . . . 4 - V? . . 4 All other diseases - 8 10 25 15 2 6 11 1 - - 78 10 fc 16 19 - 12 13 s - - 70 Total - 25 23 58 31 17 36 36 13 - - 239 26 - 36 31 16 30 36 - - - 175 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - - . 1829 1830 108 3 4 6 1 2 1 2 12 31 1831 103 2 2 4 7 2 3 4 11 35 1832 58 1 5 2 1 2 10 21 1833 72 1 1 15 3 2 22 1834 109 3 10 1 2 5 23 44 1835 117 16 4 1 I 15 13 50 1836 1837 1838 677 7 3 3 29 54 1 9 9 4 34 84 237 1829 118 3 8 3 2 10 26 1830 104 2 4 5 2 4 12 29 1831 50 3 5 4 20 32 1832 57 2 4 1 2 4 13 1833 55 1 27 1 1 1 9 3 43 1834 128 14 7 3 6 22 52 1835 76 2 1 4 6 13 1836 1837 1838 Mean Strength 110 4 1 7 3 3 3 13 34 588 Intermittent fever -Remittent fever Synochal fever - ' -ry organs ... Diseases of the digestive organs ... Diseases of the brain and Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries Ebriety ... All other diseases -Total - 5 31 51 11 3 1 29 77 208 129 Under the head of diseases of the respiratoiy organs are comprised 95 catarrh, 6 pneumonia, 16 pleuritis, and 8 phthisis pulmonalis; under the class of digestive organs, 56 diarrhoea and dysentery, and 47 cholic and cholera; under the head of brain and nervous system, 2 epilepsy, and 1 mania a potu; and under that of venereal affections, 26 gonor- rhoea, and 6 syphilis. The total of deaths, according to the Adjutant General s returns, is 13, being a little above two per cent, per annum. Of these, 7 are re- ported in the medical returns, viz : 4 phthisis pulmonalis, 1 dropsy, 1 atrophia induced by intemperance, and one compression of the brain from a rapture of a blood vessel, making about one per cent, of mortality. This post still maintains the character of salubrity found on the coast of New England. Fevers of malarial origin are scarcely known. In the second quarter of 1832, 15 cases of " spotted fever" are reported, none of which proved fatal. In the neighbo/i lg town of New London, there occurred between three and four hundred cases, which terminated fatally in the ratio of qbout four per cent. It was treated with powerful stimulants both internally and externally. The epidemic seems to have been widely diffused. The relative agency of the seasons as regards the eetiology of disease in general is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 8 first quarters -6 second " 7 third " -7 fourth " Annual ratio - 635 516 677 588 239 175 237 208 376 339 350 354 604 859 1,422 Hence every man, on an average, was reported sick once in nearly every 8k months. Contrary to a general law, this table exhibits a high- er ratio V diseases in the first and fourth than in the second and third quarters. The absence of morbific agents of a malarial nature, may have some share in the explanation of this result. 17 130 FORT COLUMBUS. LATITUDE 40° 42', LONGITUDE 74° 02'. This post is on Governor's Island, in the harbor of New York. This island, situated near the confluence of the Hudson and that arm of Long Island Sound called the East river, is distant from the main, at the nearest point, about half a mile, and from the ocean at Sandy Hook about 20 miles. It is about a mile in circumference, with a soil com- posed of sand, intermixed with fine gravel and loam, based upon ferru- ginous clay. The portion brought under cultivation yields in abun- dance the usual esculent vegetables of the climate. There are no swamps or marshes in the vicinity, and in consequence of the regular artificial slope in every direction from the fort to the water, the drainage is perfect. Exclusive of ten large cisterns, capable of containing many thousand gallons, it is abundantly supplied with excellent water from five wells. This post constitutes the last of the class noTv under examination, embracing those situated on our northern Atlantic coast. " The pre- vailing winds," says Assistant Surgeon J. P. Russell, who has furnished these facts in relation to the medical topography of this post, " are, during the summer, south to south-west, and during the winter, north-west to northeast; the mean temperature for the year is about 53° of fahrenheit, and the annual quantity of rain is from 36 to 40 inches." This island is almost constantly fanned by refreshing and invigorating breezes from the ocean. A new hospital on the south side of the island is now being finished. Well constructed and commodiously arranged, it combines all the ad- vantages of modern improvements. The wards are furnished with iron bedsteads, an improvement now being generally introduced in our hos- pitals and barracks. The diseases reported during the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Columbus, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - - - -Mean strength 1829 240 1830 244 1831 238 1832 60 4 1 5 3 8 15 31 1833 76 1834 83 1835 90 1836 60 1837 1838 1081 3 2 2 98 31 5 20 56 3 61 8 168 1829 199 7 2 3 9 8 65 94 1830 239 32 8 3 10 3 14 79 149 1831 222 3 41 17 3 12 1 25 90 192 1832 80 4 2 3 8 20 1 7 1 10 7 63 1833 80 10 1 16 1 6 2 13 1 10 60 1834 88 7 10 7 2 3 10 39 1835 90 12 3 1 2 7 1 1 10 4 4 45 1 1836 OS •c o s <2 s 1837 1838 998 Intermittent fever -Remittent fever -Synochal fever Typhus fever Diseases of the respirato-ry organs - - -Diseases of the digestive organs -Diseases of the brain and nervous system -Dropsies -Rheumatic affections Venereal Ulcers and abscesses Wounds and injuries -Ebriety -All other diseases - ' - 1 1 15 4 1 11 1 12 39 85 1 24 5 1 5 10 1 19 31 97 1 23 4 3 17 5 58 111 1 2 5 3 4 1 6 1 6 29 6 8 1 5 8 8 19 3 1 4 8 7 13 2 3 3 1 6 3 - - 3« 2 3 103 71 3 24 39 9 83 5 265 Total - 31 55 18 - - 457 642 _________,_________------ CO ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 1832 76 4 48 5 1 1 59 1833 75 7 1 31 5 1 1 11 2 1 60 1834 45 2 3 1 2 22 30 1835 60 7 4 15 1 4 2 4 3 4 44 1836 1837 1838 907 25 74 204 2 23 20 5 43 6 304 706 1829 239 8 3 48 6 4 16 3 20 24 127 1830 229 2 34 6 8 10 2 6 74 142 1831 76 13 2 2 5 1 17 40 1832 74 3 1 2 9 1 5 12 1 5 39 1833 70 1 8 7 3 1 1 6 1 5 33 1834 62 7 4 15 4 1 3 3 7 44 1835 56 3 1 3 1 I 1 2 3 23 38 1836 1837 1838 Mesa strength 203 3 51 12 8 9 10 73 166 224 7 35 5 4 1 4 109 165 224 4 9 60 1 6 I 7 94 182 806 Intermittent fever -Remittent " -Diseases of tho respira-tory organs Diseases of the digestive organs ... Diseases of the brain and Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 19 4 110 48 23 38 8 50 8 155 463 133 Under the head of diseases of the respiratory system are included 358 catanh, 2 pneumonia, 12 pleurisy, and 9 phthisis pulmonalis; under the class of digestive organs, 258 diarrhoea and dysentery, and 37 cholic and cholera; under the head of brain and nervous system, 2 epi- lepsy, and 2 mania a potu; and under that of venereal affections, 95 gonorrhoea and 91 syphilis. The total of deaths in the harbor of New York, including Forts Co- lumbus and Hamilton, according to the Adjutant General's returns, is 35, and as the mean strength for the same period is 1,444, the annual mortality is 2T%- per cent. Of these, 26 are reported in the medical re- turns, (15 at Fort Columbus and 11 at Fort Hamilton,) viz. 9 epidemic cholera, 5 phthisis pulmonalis, 1 variola, 1 paralysis, 1 sudden, 1 suicide, 2 casualties, and 6 from causes not designated. Excluding the cases of cholera, casualties, and of suicide, the ratio of mortality is about 1 per cent. As the post returns include New York harbor in the aggregate, it has been found almost impracticable to determine the precise strength of each post. That the position is salubrious is, however, plainly manifest. " Re- mittent and intennittent fevers," says Assistant Surgeon Russell, " are of rare occurrence, and never fairly attributable to this station. I have never known a case of either which may be said to have originated here." The relative agency of the seasons in the production of disease in general is shown in the following abstract— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters -7 second " 7 third " 7 fourth " Annual ratio - 1,081 998 907 806 457 423 642 1 643 706 j 779 463 574 948 2,268 2,393 It thus appears that every man, on an average, has been reported siek once in every five months. There are two other posts in the harbor of New York, which have from time to time been occupied; but the reports are not sufficiently numerous to authorize the usual tabular arrangement. Fort Wood is situated on Bedlow's Island, which contains an area of about seven acres. It is upwards of two miles from the city of New York, and a mile and a half from the shores of New Jersey and of Long Island. The fort occupies the most elevated part of the island, which is about 30 feet above high water-mark. It is old and in a state of dilapidation. The hospital accommodations are tolerably good ; but the building is so located, that it is liable to have its lower floors inundated by extraordi- 134 narv hfeh tides. The mean annual quantity of rain, on an average of S years, is 54.43 inches. This islfd of late years has been a depo for the majority of the recruits of the whole arny Th s post ha always been remarkably salubrious-fevers of mala ml o^m^rapt cases which arose from causes operating in other locality,*re'^^ Whilst intermittent and remittent fevers have prevailed to a great extent within a few miles, on Long and Staten Islands, as in the year 1828, this station has always maintained its healthfulness. The other post is Fort Hamilton, situated on the Narrows, at Long Island, about ^even miles from the city of New York. Contrary to he results given by the other posts of this class, the ratio of malanal dis- eases is found to be high. It is a remarkable fact that the laborers em- ployed in 1828 in the erection of this post—a locality which had been previously exempt from the effects of malaria—suffered greatly from intermittent and remittent fevers. The elevated coast of Long Island, in the vicinity of the Narrows, where a case of intermitting fever was unknown in the memory of the oldest inhabitant, became so rrfe wrth intennittent and remittent fever as to drive the inhabitants from their possessions. The former disease is still very prevalent at Fort Hamrl- ton. In the third quarter of 1834, in a strength of 200, 100 cases are reported; and in the third quarter of 1835, in a strength of 150,147 cases are reported. Having finished the examination of the series of posts on our north- ern Atlantic coast, constituting the second class, a general view of the results obtained will now be presented conformably to the plan adopted in the preceding class. The following table exhibits the mortality of each post and the rela- tive degree of sickness— TABLE exhibiting the mortality of each post, and the relative degree of sickness. ——^. 03 -A i ~b St e £ ths per A tant Gen l's returns. p 05 OB t-i S3 O o Oh o per 1,000 ean streng rider tre ent annua] 4> fa o fa o fa o fa o S Rati pei mea ISTEHMITTENT FBVEB. First quarter 3 2 - - 2 3 3 9 3 36 8 53 4018 3599 2 15 Third " - _ 4 1 4 - 7 25 41 3662 11 Fourth " - 2 7 - ~ 7 1 - 19 29 3377 9 Annual ratio 4 1 16 4 16 83 131 3663 36 REMITTENT FEVER. First quarter 2 9 - - - 1 2 14 4018 3 Second " - 8 20 - 1 - - 2 31 3599 9 Third " - 5 18 - 1 1 3 - 28 3662 8 Fourth " - 2 17 15 62 _ 2 1 - 4 8 21 3377 6 Annual ratio 4 94 3663 26 BTITOCHAI. FEVER. First quarter 5 6 1 21 9 5 2 49 4018 12 Second " - 1 2 I 29 9 4 3 49 3599 14 Third " - 2 _ _ 16 2 3 - 23 3662 6 Fourth " - 8 1 " 14 9 5 - 37 3377 11 Annual ratio 16 9 2 80 29 17 5 158 3663 43 TTPHC8 FEVER. First quarter 4018 - Second " - 1 1 4 1 - - - 7 3599 2 Third " - - 4 3 _ 1 - - - 8 3662 2 Fourth " - - 1 2 1 - - - 4 3377 1 Annual ratio 5 5 6 3 - - - 19 3663 5 DIARRH(EA AND DYSEN- TERY. First quarter 2 2 _ 22 4 10 16 56 4018 14 Second " - 2 2 - 36 11 8 35 94 3599 26 Third " - 18 31 6 101 40 29 172 397 3662 108 Fourth " - 8 - 1 13 9 9 35 75 3377 22 Annual ratio - 30 35 7 172 64 56 258 622 3663 170 137 seasons in the production of morbid action, <$- "3 t. o fa V fa *-• o fa i X 5 ^ c >-. \£ o fa 1 £ 1H o "o o fa 3 a 3 t-c EH o fa i a 3 "o O 1 fa 3 o EH Aggregate mean strength. Ratio of cases per 1,000 of mean strength. CATARRH ATSH INFLU- ENZA. First quarter 30 17 3 14 40 36 92 218 4018 63 Second " - 23 6 I 5 11 15 93 149 3599 49 Third " - 11 5 - 8 4 21 69 110 3662 36 Fourth " - 38 102 21 49 26 30 6 38 23 104 250 3377 85 Annual ratio 33 93 95 358 727 3663 233 PNEUMONIA. First quarter 7 3 3 85 4 2 2 21 4018 6 Second " - 1 3 - 22 1 1 - 6 3599 2 Third " , 2 2 3 31 2 2 - 11 3662 3 Fourth " - 14 4 12 1 84 222 10 17 1 - 30 3377 10 Annual ratio 24 7 6 2 68 3663 22 PLEURITIS. First quarter 6 8 _ 10 - 6 _ 20 4018 6 Second " - 7 5 4 19 5 3 4 28 3599 9 Third " - 5 1 - 7 - 3 4 13 3662 4 Fourth " - 9 27 4 4 3 - 4 4 12 21 3377 7 Annual ratio 18 39 5 16 82 3663 26 PHTHISIS PULMONALIS. First quarter 2 _ 1 1 - 1 2 6 4018 2 Second " - - 2 - 3 - 2 5 9 3599 3 Third " - - 2 - 3 1 3 - 6 3662 2 Fourth " - 1 3 1 1 - 2 2 9 3377 3 Annual ratio 3 7 2 8 1 8 9 30 3663 9 RHEUMATISM. First quarter 12 11 4 25 9 15 20 96 4018 24 Second " - 18 8 6 27 7 11 24 101 3599 28 Third " - - - 14 12 5 36 6 9 23 105 3662 29 Fourth " - 20 12 3 25 7 11 23 101 3377 30 Annual ratio 64 43 18 113 29 46 90 403 3663 110 18 138 As this class of posts is characterized by climatic features analogous to the preceding one, so it is found that the laws in relation to pulmo- nary diseases are similar. The ratios of catarrhal affections in the first and fourth quarters, are respectively 63 and 85, and in the second and third, 49 and 36. Taking the average of pleuritis and pneumonia, the influence of the seasons is equally manifest, the ratios of the four quar- ters being respectively 12, 11, 7, and 16. Among the diseases reported under the head of phthisis pulmonalis it is not found, either in this or the preceding class, that the seasons exert any control as respects the number of cases registered. In comparing the northern Atlantic coast with the region of the lakes, it is found that the ratio of intermittent fever stands as 36 to 193. However striking this contrast may appear, it will be found that the former average is far too high, inasmuch as most of the cases occurred among troops brought from malarial regions. At Fort Columbus, for example, at which post about two-thirds of the cases are reported, it is asserted, by Assistant Surgeon J. P. Russell, that he has never known a case to originate. It may be safely averred that along the coast of New England intermittent fever is unknown. In regard to remittent and ty- phus fever, there is little difference exhibited in the ratios of these re- spective regions. The average of synochal fever is more than twice ag high on the ocean as on the lakes, whilst the ratio of diarrhoea and dys- entery is 50 per cent, lower. Compared with the region of the lakes, it is seen that the ratio of pul- monary diseases is somewhat lower on the Atlantic coast. This differ- ence arises wholly from the comparative prevalence of catarrh and in- fluenza ; for, if the results of Fort Independence, which are contrary to the general laws of this class, are excluded, the mean ratio of pleuritis, pneumonia, and phthisis pulmonalis, is the same as in the preceding class, III. THE INTERIOR POSTS, REMOTE FROM LARGE BODIES OF WATER. This class embraces those stations of the northern division which are remote from the Atlantic ocean as well as inland seas. Compared with the two preceding, it is characterized by great extremes of temperature, by seasons strongly contrasted, and a corresponding dryness of the at- mosphere. The seasons follow each other in constant and rapid suc- cession ; summer succeeds winter so rapidly that there is scarcely any spring; and the phenomena of vegetation are developed with remarka- ble suddenness. The prevailing weather is fair, notwithstanding the annual quantity of rain is much greater at some of these posts than at those of the opposite localities; for in the latter the rain, though falling more frequently, descends in slighter showers. The climate of this class of posts, excepting the most southern ones, is distinguished for the extreme severity of winter. From November to May, cold weather prevails, the ground being generally covered with snow to the depth of 3 or 4 feet. The general range of the thermometer is from the freezing point to 30° below zero, The summers are equally remarkable for extremes of 139 temperature. During June, July, and August, the heat is often as op- pressive as in Florida, the mercury sometimes rising to 100° of fahrenheit in the shade. This class embraces the following posts: Hancock Barracks, West Point, Forts Snelling, Winnebago, Crawford, Armstrong, and Leavenworth. HANCOCK BARRACKS. LATITUDE 46° 5' N., LONGITUDE 67° 40' W. Hancock Barracks, according to a topographical description furnished by Assistant Surgeon Sprague, is situated in the town of Houlton, Maine. It is distant from the ocean 156 miles, and from the bay of Fundy 180 miles. The surrounding country presents an undulating aspect. The position seems to the eye to be circumscribed by a range of hills, inter- sected at two points by the passage of the Meduxnikrag, a small rapid stream which runs through the town half a mile from the fort. In the direction of this river lies a great body of low lands, covered with a dense forest, and chequered with many farms in every stage of improve- ment. The soil is rather productive. As the fort occupies an elevated position, the drainage is complete. The season of summer is short, and as frosts frequently occur before its close, the destruction of vegetation is not unusual. In the winter, snow falls to a great depth and lies upon the ground during the whole season. The seasons pass rapidly into each other. On the opening of spring, vegetation is developed with remarkable suddenness. Summer succeeds with a rapid pace ; and as the thermometer in winter sinks 30° below zero, so now it may rise to 96° in the shade. The extremes at this post are much greater than in the peninsula of Nova Scotia, owing to the circumstance that the latter has not only an insular climate, but is intersected by lakes and ba3rs. The annual quantity of ram, on an average of three years, is 36.92 inches. The following abstract comprises the diseases reported in ten years— ABSTRACT exhibiting a condensed view of the principal diseases at Hancock Barracks, for a period of ten years. FIRST QUARTER. SECOND QUARTER. iears - 1829 207 2 1830 209 1831 169 1832 182 1833 205 1834 166 1835 185 1836 130 1837,1838 120 98 1671 2 1829 197 1 1830 195 1831 151 1832 173 1833 195 1834 182 1 1835 177 1836 87 1837 97 1838 106 Mean strength 1560 Intermittent fever - 2 Remittent fever - - - 4 . . 1 . . . 5 . . . - 2 1 . . . . 3 Synochal fever - - - . 1 - 1 1 3 1 7 5 - . - 1 . 3 2 3 2 16 Diseases of the respirato- ry organs - 50 31 46 43 12 13 13 8 15 13 244 23 33 13 6 8 8 8 4 12 12 127 Diseases of the digestive organs 24 10 3 15 17 9 10 8 14 4 114 15 11 1 16 20 9 23 14 24 10 143 Diseases of the brain and nervous system - 3 - - - - • 1 2 - 1 - 7 1 3 4 1 _ 3 . . 2 . 14 Dropsies - - - 1 • - - . - 1 . 2 - - 2 . . - . . . 2 Rheumatic affections 6 6 6 3 14 4 3 3 2 . 47 20 10 5 17 8 9 6 3 6 2 86 Venereal affections 1 - 3 - • - . - - . 4 . - . . 1 2 . 2 5 Ulcers and abscesses - 1 3 - 6 13 1 6 7 6 43 7 . 1 10 11 12 . 1 1 9 4 55 Wounds and injuries 19 < 23 23 8 18 11 17 11 16 9 155 28 19 15 14 12 18 8 11 5 6 136 Ebriety 2 - 11 4 - 34 3 - - . 54 9 19 9 . . 11 8 . . 56 All other diseases - 33 140 27 98 13 109 10 87 9 77 3 88 7 58 37 11 70 2 35 115 799 19 11 13 9 6 10 9 1 3 2 83 Total - 128 106 63 73 68 83 67 36 66 38 728 THIRD QUARTER. 1 FOURTH QUARTER. Vears - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 ! 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 Mean strength 186 197 195 185 180 206 204 79 89 109 1630 195 186 188 219 173 196 202 86 92 135 1672 Intermittent fever - 3 3 3 3 Remittent fever 3 - - - . 1 - - . 2 6 ! . . . 1 „ ■ . . - . . 1 Synochal fever - - 6 3 . - - - 1 . 10 ' . . . . , . . . 1 1 2 Discuses of the respirato- 1 ry organs - - - 19 9 5 7 3 7 9 7 1 16 83 5 12 14 5 . 53 10 7 9 35 150 Diseases of the digestive organs ... 21 8 13 41 10 38 51 20 19 26 247 9 11 6 14 2 18 33 12 11 37 153 Diseases of the brain and nervous system - 4 - 7 1 - 2 1 - - 1 16 2 1 - I . 1 - - - 3 8 1 1 (iheumatic affections 8 5 6 8 6 5 10 6 2 . 56 3 9 6 12 7 5 5 . 7 5 59 Venereal affections - 2 1 - 1 1 - - . 2 7 _ 2 . 2 . . - . 9 . 13 i' leers and abscesses 4 1 3 1 15 7 7 2 1 7 48 9 2 3 12 8 2 6 2 2 3 49 Wounds and injuries 24 15 12 14 18 22 20 3 11 8 147 18 24 10 21 15 24 23 10 5 21 171 Ebriety ... 24 16 9 - 12 6 - - - - 67 i 3 8 4 . 15 7 . . - . 37 All other diseases - 29 25 81 24 6 81 37 12 104 15 113 4 42 1 36 2 64 155 23 12 81 12 55 17 85 16 63 3 113 4 81 1 32 1 45 8 117 97 Total - 136 86 102 845 72 744 142 Under the class of diseases of the respiratory organs are comprised 437 catarrh, 39 pneumonia, 83 pleuritis, and 9 phthisis pulmonalis; under the head of digestive organs, 264 diarrhoea and dysentery, 9b cho- lic and cholera, and 12 hepatitis; under the class of brain and nervous system, 13 epilepsy, and 7 mania a potu; and under that of venereal affections, 12 gonorrhoea, and 17 syphilis. The total of deaths, according to the Adjutant General s returns, is 17; the annual ratio of mortality being one per cent. Of these, 10 are reported in the medical returns, viz. 4 phthisis pulmonalis, 1 pneumo- nia, 1 hcemoptysis, 1 hepatic abscess, 2 from causes not designated, and 1 frozen, making, excluding the last, a mortality of about -fa per cent. Two of the cases of phthisis were confirmed drunkards, and the frozen man lay all night in a snow bank intoxicated. This station presents a very salubrious locality. As there is no marsh in the vicinity, and the current of streams is rapid, there are no diseases of malarial origin. The average of diarrhoea and dysentery is higher, however, than might have been a priori supposed. The vice of intem- perance is the most prolific source of disease and death. The relative agency of the seasons, in the production of disease in general, is shown in the following abstract— TAB LE showing the relative agency of the seasons in the production of disease in general. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 10 first quarters 10 second " 10 third " 10 fourth " Annual ratio - 1,671 1,560 1,630 1,672 799 728 845 744 478 466 518 445 1,633 3,116 1,908 Consequently every man, on an average, has been reported sick once in upwards of every six months. 143 WEST POINT. LATITUDE 41° 23' 33", LONGITUDE 73° 51' 15". Situated on the west bank of the Hudson, about midway in that part of the river called the Highlands, it is 50 miles from the ocean, and 170 from liake Champlain. The public buildings are on a plain about a mile square, elevated 157 feet above the river, having in its rear a range of hills varying in height from 600 to 1400 feet. On each side of the plain there are ravines which serve to carry off the torrents of water which descend from the adjacent hills after heavy rains or spring fresh- ets, a circumstance aided by the gravelly nature of the soil and the con- tinuous slope presented on every side. The nearest marshy ground is on the opposite side of the river, about a mile distant. As the meteorological data of this post, as well as the preceding one, were used in the " Meteorological Register" by way of illustration, it is sufficient to make the reference. The annual quantity of rain, on an average of four years, is 48.70 inches. The hospital and barrack accommodations are of the best kind. The diseases reported in the 10 years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at West Point, for aperiodoften years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1829 348 7 1830 354 1831 371 3 1832 353 1 1833 364 2 1834 368 1835 389 1836 353 1837 338 1838 393 3631 13 1829 341 12 1830 354 1831 362 1832 343 10 1833 351 1834 370 2 1835 381 1836 344 1837 332 1838 365 Mean strength - 3543 Intermittent fever 24 Remittent " -Synochal " - - 3 1 5 13 16 8 10 46 6 19 - 3 124 17 13 16 1 3 3 10 11 2 32 3 3 14 r, 122 Diseases of the respira-tory organs 150 117 111 61 20 140 33 49 67 128 876 109 117 111 52 85 41 8 43 49 71 686 Diseases of the digestive organs - 103 39 83 143 31 76 56 65 65 51 712 104 88 96 49 44 67 26 101 27 57 659 Diseases of the brain and nervous system 82 106 186 145 30 104 27 102 82 77 941 106 183 230 75 51 104 32 121 78 94 1074 Dropsies Rheumatic affections Venereal " -Ulcers and abscesses Wounds and injuries . 1 . . . - - - - - - 1 - - . - - - ■ - - - - - 8 13 15 5 6 22 14 8 30 13 6 52 10 6 34 63 6 20 81 6 24 11 6 9 35 37 1 23 16 9 12 28 177 21 87 344 10 1 8 32 5 59 35 7 82 25 3 63 27 2 16 63 9 3 9 63 12 1 8 40 31 3 36 47 19 4 12 47 14 8 15 65 187 or HI 561 All other diseases - 43 47 70 54 48 78 31 25 88 51 535 65 41 115 94 31 35 38 70 57 41 587 Total - - 426 347 518 491 189 578 223 308 382 372 3834 464 506 692 375 332 344 199 455 296 379 404'; THIRD QUARTER. FOURTH QUARTER. ^ Ycarg .... <0 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 398 4 19 36 72 77 7 10 43 118 51 437 3898 36 3 162 3 611 1 1227 i 936 198 74 250 613 727 4840 1829 378 6 119 67 150 7 13 19 71 452 1830 390 9 20 237 85 123 5 5 30 96 610 1831 390 10 16 246 176 132 16 10 30 64 700 1832 381 5 4 30 75 26 10 10 25 22 207 1833 373 15 26 35 59 29 4 3 33 52 256 1834 397 1 2 265 27 34 7 1 4 34 48 423 1835 373 3 15 43 37 4G 5 10 35 38 58 290 1836 365 10 1 134 73 100 19 3 22 67 429 1837 1838 Mean strength 420 10 3 8 111 137 84 23 ft) 27 104 517 395 5 11 1 208 170 161 24 42 71 693 381 14 83 109 162 26 10 94 47 545 400 2 6 29 187 39 8 5 26 36 46 384 385 8 16 21 97 80 30 16 28 71 42 409 384 2 26 1 44 169 78 25 4 27 76 71 523 376 2 41 1 9 61 30 7 17 14 35 47 264 357 2 12 18 100 106 22 13 67 80 77 497 402 1 9 52 125 119 26 9 25 34 171 571 416 5 96 78-118 19 4 25 55 48 448 402 5 69 49 49 9 3 6 43 40 273 3865 Intermittent fever • Remittent " *• Synochal " Typhus " Diseases of the respirato-ry organs Diseases of "the digestive organs ... Diseases of the brain and nervous system Dropsies - - -Rheumatic affections Venereal " Ulcers and abscesses Wounda and injuries AH otlier diseases Total - 38 15 74 1265 702 837 126 35 101 329 566 4088 146 Under the class of diseases of the respiratory organs are comprised 3,073 catarrh and influenza, 76 pneumonia, 34 pleuritis, and 7 phthisis pulmonalis; under the head of diseases of the digestive organs, 1,023 diarrhoea and dysentery, and 1,445 cholic and cholera ; and under the class of venereal affections, 129 gonorrhoea, and 26 syphilis. The total of deaths, according to the post returns, is 13, viz : 3 offi- cers, 2 professors, 4 cadets, 1 ordnance storekeeper, and 3 soldiers, the annual ratio of mortality being a fraction upwards of fa per cent. Ex- clusive of these, 6 cadets died in different parts of the United States, perhaps all of them on sick leave. Of the former, 9 are reported in the medical returns, viz: 3 phthisis pulmonalis, 1 sudden rupture of an ab- scess in the lungs', (a teacher of drawing who was treating his own case by means of animal magnetism,) 1 scarlatina, 2 continued fever, 1 ty- phus, and 1 wound of the brain. Although it will be seen that the average of cases treated is higher than at any other station, yet an examination of the above abstract, in connexion with the ratio of mortality, warrants the opinion that this post holds a place among the first in point of salubrity. It is remarked by Surgeon W. V. Wheaton, who has been stationed here 12 years, that the locality is singularly exempt from all local causes of disease, and that among 800 persons for weeks together, there is often no one seriously sick. To estimate properly the high ratio of disease, compared with the low mortality, it must be borne in mind that this command, with the exception of a detachment of enlisted men never exceeding 50, is com- posed of cadets, and that the simple circumstance of being registered on the hospital books affords respite from all mental and bodily labor. Of the 16,804 cases reported, the majority consists of such complaints as headache, toothache, cough, pain in the chest, and sore throat. Of head- ache alone there are 3,788 cases registered; and as this affection, in de- fault of a better nosological arrangement, has been placed under the head of brain and nervous system, it appears that there are but five other cases in the same class. Of the 482 cases of synochal fever, about 200 are reported under the name of ephemeral, and nearly all the rest as in- flammatory. Several diseases have, at certain periods, assumed an en- demic character. In the first quarter of 1835, there are 46 cases of cy- nanche tonsillaris reported ; and in the first quarter of 1837, 59 cases of cynanche parotidea. In the second quarter of 1832, the sick report exhibits 30 cases of measles confined to the cadets and soldiers. As re- gards the influence of age on mortality, it has been ascertained, that at the period of life between the age of 10 and 15 the ratio is lowest, and next in the order of increase comes the interval between 15 and 20. Cadets belong to the latter class, of which the annual ratio of mortality, per 1,000 is, in England 7fa, in Belgium 6^, and in Sweeden 7. Now as four cadets died at the academy, one death being the result of a wound, and six when on leave, the total arising from disease, admitting that all the latter may be fairly ascribed to causes operating at the post, may be set down as nine; and assuming the aggregate mean strength of cadets to be 3,234, that is, deducting 50 annually for officers and soldiers, 147 the ratio is only 2fa per 1,000. As contrasted with civil life, the result is, therefore, highly favorable to the regulations of this institution. The relative agency of the seasons in the causation of disease in gen- eral is shown in the following table— TABLE exhibiting the ratio of sickness* Seasons. Mean strength. Number treated. Ratio per 1,000 of mean stiength, treated quarterly. 10 first quarters -10 second " -10 third " -10 fourth " -Annual ratio - 3,631 3,543 3,898 3,865 3,834 4,042 4,840 4,088 1,056 1,141 1,242 1,058 3,734 16,804 4,500 Consequently every one has been, on an average, reported sick once in every 2§ months—the highest ratio yet presented, FORT SNELLING. LATITUDE 44° 53' N., LONGITUDE 93° 1' W. Fort Snelling, situated in the angle formed by the confluence of the St. Peter's and Mississippi, is elevated 94 feet above these waters, and about 820 feet above the level of the ocean. The St. Peter's, at its mouth, is 150 yards wide and 16 feet deep; and the Mississippi, at this point, is about 400 yards wide, but is much less deep than the former. The banks of the latter, up to the falls of St. Anthony, a distance of eight miles, are about 200 feet high, the upper strata of which consist of limestone, and the lower of sandstone. Beyond the falls the banks are less high, and the immediate valley of the river becomes more extended. The St. Peter's, which has its source about 500 miles from this point, courses through a valley, varying in breadth from one to three miles, which is marshy, owing to the inundation of the river. The surface of the surrounding country presents an undulating prairie, studded here and there with " islands" of timber. Large lakes, plentifully supplied with fish, are occasionally found. The soil, although sandy, is produc- tive. These facts have been furnished by Assistant Surgeon John Emerson. As the data of this post have been constantly used for the purpose of elucidating the various systems of climate, the necessity of any detail now is wholly superseded. The mean annual quantity of rain, on an average of three years, is 30.32 inches. The diseases reported in ten years are comprised in the following ab- stract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Snelling, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Wars - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 170 4 13 9 3. 15 11 4 59 1830 139 27 5 1 2 7 14 56 1831 145 3 38 13 10 1 34 99 183S! 150 1 29 13 1 9 5 11 4 75 1S33 122 18 22 2 5 2 9 15 12 85 1834 147 4 1 47 24 14 16 9 27 25 167 1835 154 1 14 39 20 52 6 13 20 165 1836 197 5 1 51 26 8 1 25 5 5 22 14 163 1837 181 1 2 76 26 11 7 2 1 20 11 157 1838 110 2 1 2 4 5 4 18 Mean Strength 183 147 150 8 12 10 1 2 17 6 7 63 153 26 4 2 20 2 4 12 70 134 14 4 1 9 4 8 16 56 159 1 1 31 34 4 22 4 29 14 140 165 34 19 13 16 7 19 24 132 166 48 13 7 1 16 6 10 18 119 212 1 53 11 2 4 1 2 12 7 93 78 5 1 4 3 4 4 21 1547 3 5 234 105 29 1 108 11 46 126 6 126 800 1515 Intermittent fever -Synochal " -Diseases of the respiratory organs -Diseases of tho digestive organs -Diseases of the brain and Dropsies ... Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebrietas ... All other diseases • Total - 2 2 6 6 5 3 12 16 7 59 1 9 I 2 3 7 7 17 47 13 4 8 315 178 56 1 127 18 50 131 1 142 1044 THIRD QUARTER. FOURTH QUARTER. Years - . - - 1829 1830 161 13 20 72 3 7 20 4 14 153 1831 156 13 3 58 29 2 7 2 4 16 14 148 1832 143 1 12 29 1 13 8 15 12 91 1833 118 16 45 3 5 2 4 15 14 104 1834 1835 150 149 2 1 26 9 18 16 7 10 10 20 6 4 18 13 13 18 94 97 1836 1837 1838 192 8 37 22 8 1 2 5 3 86 1424 33 24 3 205 276 26 73 21 30 111 4 121 927 1829 150 3 2 9 6 1 1 1 4 18 17 62 1830 153 9 1 16 5 7 2 7 10 1 4 62 1831 152 1 18 4 2 10 5 13 3 20 76 1832 1833 1834 169 3 47 17 6 13 2 26 21 135 1835 164 54 18 4 16 2 3 10 10 117 1836 166 2 45 10 9 2 1 4 17 90 1837 82 1 2 4 7 1838 189 4 3 7 2 7 12 35 t Mean Strength 141 3 3 3 19 1 5 1 4 8 14 61 132 9 10 12 2 2 12 47 82 1 3 14 14 2 4 1 7 46 141 14 21 3 4 4 6 20 72 133 1 1 26 16 7 17 1 9 21 7 107 1499 Intermittent fever -Remittent " -Synochal " -Diseases of the respiratory organs ... Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal " -Ulcers and abscesses Wounds and injuries Ebrietas ... All other diseases -Total - 16 5 2 234 100 23 1 84 8 37 117 4 132 763 150 Under the class of diseases of the respiratory organs are comprised 920 catarrh, 9 pneumonia, 52 pleuritis, and 4 phthisis pulmonale; under the head of diseases of the digestive organs, 321 diarrhoea and dysentery, 200 cholic and cholera, and 4 hepatitis; under the class of brain and nervous system, 20 epilepsy, 11 nyctalopia, and nearly all the rest ce- phalalgia ; and under that of venereal affections, 46 gonorrhoea and 12 syphilis. The total of deaths, according to the post returns, is 24, the annual ratio of mortality being 1T«T per cent. Of these 13 are reported in the medical returns, viz : 1 phthisis, 2 remittent fever, 1 meningitis, 2 gun- shot wounds, 2 casualties, 1 drowned, 1 suicide, and 3 from causes not designated. Excluding those reported from accidental causes, the aver- age of mortality is less than fa per cent. The diseases of this post require no special comment. As morbid action generally assumes a purely philogistic character, the therapeutic means are conespondingly simple. The relative agency of the seasons in the production of disease in general is shown in the following ab- stract— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 10 first quarters -10 second " 10 third " -10 fourth " -Annual ratio 1,547 1,515 1,424 1,499 800 1,044 927 763 517 689 651 509 1,496 3,534 2,362 Every man, on an average, has consequently been reported sick once in about every five months. FORT WINNEBAGO. LATITUDE 43° 31' N., LONGITUDE 89° 28' W. This fort is situated on the right bank of Fox river, directly opposite the portage between this river and the Wisconsin, and is elevated about 70 feet above the level of the latter. It is 81 miles west of Lake Michigan, and 112 southwest of Green Bay. Both the Fox and Wisconsin are bor- dered by extensive marshes, which are occasionally inundated, so that boats pass from one river to the other. " The formation of these marshes," says Surgeon Foot, " is a subject of much speculation. In cutting through the thick vegetable matter on the surface, from two to four feet thick, you come to a stratum of soft mud, generally a foot or two in thickness. In a few places, however, 151 tliis stratum of mud and water is from eight to ten feet deep. These are known by the name of " shaking marshes," and are dangerous to cross with horses. They appear, however, to be filling up from the same causes that have made the others more solid." Beneath the mud and water is a stratum of fine silicious sand, which is believed by Dr. Foot to be of animalcular origin. He supposes these marshes to have been originally shallow lakes or lagoons, full of aquatic plants, which were then, as now, covered with myriads of animalculse, whose shell is pure silex. As these die annually, each one deposites its particle of silex, until, in the process of time, the lagoon becomes filled up, having below a stratum of sand, and above an imperfectly organ- ized soil, formed by the annually decaying vegetation. "The soil of the upland about this post," says Dr. F., "is a light loam, mixed with silex, lime, and clay. It is what is called a warm soil, and vegetation comes forward earlier than at any place in the same latitude I have ever been stationed at. The mineral productions are very few : secondary limestone and sandstone of recent formation are the only rocks that I have ever seen." The annual quantity of rain, on an average of three years, is 31.88 inches. The following abstract comprises the diseases reported in ten years— ABSTRACT exhibiting a eondenstd view of the principal diseases at Fort Winnebago, for a period often years. FIRST QUARTER. SECOND QUARTER. Years t 1829 98 1830 143 1831 142 3 1832 186 1833 133 1834 231 1 1835 210 1836 204 1837 99 1838 89 1 1535 5 1829 97 4 1830 147 1831 191 10 1832 169 1833 121 1834 215 1 1835 188 3 1836 164 1837 92 I 1838 121 3 Mean Strength 1505 Intennittent fever - 22 Remittent fever . 2 - . . 2 2 - . . 6 . . . . _ . Synochal fever 3 - - - - - . - - - 3 . 4 . . . . . . . . 4 1 Diseases of the respirato- ry organs - - - 12 12 7 10 10 25 46 16 30 7 175 3 10 4 2 3 8 22 12 16 17 97 g« Diseases of the digestive tea organs ... 4 2 18 8 13 13 10 11 3 6 88 12 16 16 5 14 18 11 13 15 23 143 Diseases of the brain and nervous system - - - 2 - - 1 - - - - 3 1 1 2 Rheumatic affections 1 2 10 5 2 5 3 4 - 1 33 . 8 6 1 3 4 4 2 1 6 35 Venereal affections - 1 1 1 8 1 - 3 - 1 16 . . 1 1 6 3 . 8 19 Ulcers and abscesses - • 2 > - 3 11 32 1 1 50 . . 2 . 2 7 5 . 3 19 Wounds and injuries 11 6 14 6 2 6 13 6 7 7 78 7 6 14 6 7 1 10 6 10 11 78 3 1 - 4 . . . . 3 2 6 . 1 12 AU other diseases - 8 7 27 4 7 7 8 11 1 11 91 12 14 9 3 4 1 7 15 4 16 85 Total - 39 32 84 34 42 64 93 86 43 35 552 39 58 62 18 33 49 65 57 50 86 517 THIRD QUARTER. FOURTH QUARTER. Years - - . - 1829 1830 1831 193 4 1832 160 1833 186 1834 210 1 1835 217 2 1836 121 1837 68 1838 56 3 1527 28 1829 156 1830 148 9 1831 188 1832 153 1833 213 2 1834 214 o 1835 215 1836 103 1 1837 76 1838 105 7 C Mean Strength 156 2 160 16 1571 Intermittent fever - 21 Remittent fever - - 2 . . - . - 2 1 5 4 . . 2 . . . . . 4 10 Synochal fever 4 2 - - - 8 - - - . 14 - 1 - . . . - - - . 1 Diseases of the respirato- ry organs - - - 20 - 5 26 8 10 12 2 4 6 93 12 16 10 10 38 30 10 6 8 1 141 Diseases of the digestive organs ... 31 21 8 28 18 32 44 14 15 15 226 5 12 4 9 16 12 11 9 5 7 90 Diseases of the brain and nervous system - - - • - - 3 " - - . . 3 . 1 . . . . . - 1 . 2 Rheumatic affections 5 1 . 2 1 2 3 1 - . 15 1 2 2 . 6 8 5 . I 1 26 Venereal affections 2 I 2 2 5 6 2 14 2 1 37 2 2 . 2 1 1 1 14 4 . 27 Ulcers and abscesses 1 - 1 1 3 4 . 1 1 . 12 . I 1 . 7 3 . 1 1 . 14 Wounds and injuries 15 14 7 5 - 5 21 7 6 3 83 . 12 4 1 3 13 20 10 2 8 73 2 2 7 - - - 11 - - - . 3 1 2 1 3 10 All other diseases - 10 4 11 - 4 1 14 7 3 - 54 13 16 9 1 5 4 8 6 7 11 SO Total - 90 59 40 64 41 74 105 46 33 29 581 37 72 30 25 78 76 56 49 30 42 495 154 Under the class of diseases of the respiratory organs are comprised 448 catarrh, 11 pneumonia, 29 pleuritis, and 10 phthisis pulmonalis; under the head of digestive organs, 193 diarrhoea and dysentery, 149 cholic and cholera, and 17 hepatitis; under the class of brain and ner- vous system, 1 epilepsy and 2 mania a potu; and under that of venereal affections, 66 gonorrhoea, and 33 syphilis. The total of deaths, according to the post returns, is 20; the annual ratio of mortality being 1T»T per cent. Of these, 14 are reported in the medical returns, viz. 3 phthisis pulmonalis, 1 pleuritis, 2 chronic hepa- titis, 1 gastro-enteritis, 1 splenitis, 1 syphilis, 1 ebriety, 1 idiotcy, and 3 from causes not stated, being fa per cent. Two of these cases occurred in recruits, who were sick when they arrived ; and of the remaining fa- tal cases, the majority is, as usual, ascribed to the abuse of alcoholic li- quors. From a general view of the above facts, it is manifest that this station is highly salubrious. When it is considered that marshes abound in the immediate vicinity of this post, it is surprising that diseases of malarial origin are not more rife. " I have never thought," says Surgeon Foot, " that the marshes about this post produced disease, till last fall, [1838.] Last year the Wisconsin overflowed its banks in the latter part of July, covering all the extensive marshes bordering the Wisconsin and Fox ri- vers with water for two or three weeks. All plants, except aquatic, were killed. This was succeeded by excessively hot and dry weather, during the month of August and part of September, when we had a number of cases of intermittent and remittent fever, which, I think, were caused by the decomposition of the vegetable matter on the marshes." The results obtained from the statistics of ten years do not, however, warrant the conclusion that these marshes are generally the sources of miasmata in the summer season. It is only when those meteorological causes, which are essential to the production of what is called malaria, are peculiarly favorable, that intermittent or remittent fever prevails. The annexed abstract presents the relative agency of the seasons in the etiology of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 10 first quarters -10 second " 10 third " 10 fourth " Annual ratio - 1,535 1,505 1,527 1,571 552 517 581 495. 360 343 380 315 1,534 2,145 1,398 Every man, on an average, is consequently reported sick once in every eight months and a half. 155 FORT CRAWFORD. LATITUDE 43° 5', LONGITUDE 90° 55' W. Fort Crawford, situated on the Mississippi, two miles above the mouth of the Wisconsin, is on Prairie du Chien. This prairie, lying in the angle formed by these two rivers, is about 10 miles long and 2 wide, terminating on the east by a range of abrupt hills about 300 feet in height. These bluffs present almost a naked surface, studded with bold- ly projecting rocks. The fort, which is about 300 yards from the Mis- sissippi, is elevated 70 feet above its level. Directly in front of the fort is a marsh, which extends 5 miles up the river, and about as far down as the mouth of the Wisconsin. This marsh, or slough, which exists only during the low water of the summer and autumnal months, not unfrequently so abounds with putrid vegetable matter as to be ex- tremely offensive. The soil, which is generally fertile, producing wheat, corn, rye, oats, and potatoes, abundantly, consists of a dark loam com- bined with lime and silex. Lead, iron, and copper, are found at many points; and among the productions of the forest, different varieties of quercus, (oak,) acer, (maple,) betula, (birch,) salix, (willow,) juglans, (walnut,) and carya, (hickory,) stand most prominent. This post, as regards temperature, differs in no respect from the gene- ral character of the class. The annual quantity of rain, on an average of 3 years, is 29.54 inches. The diseases reported in ten years are contained in the following table— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Crawford, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1829 1830 199 1831 175 1832 227 1833 107 1834 250 1835 261 1836 267 1837 1838 63 1660 1829 130 1 1830 188 1 1831 211 24 1832 141 6 1833 185 1834 228 17 1835 225 1 1836 224 15 1837 159 3 t 1838: Mean strength 111 58 1 1749 Intermittent fever - . 2 4 5 3 4 3 21 69 1 1 - 3 Synochal " -Diseases of the respira-tory organs Diseases of the digestive organs - 11 10 12 45 8 1 91 77 54 8 1 316 7 23 14 17 37 1 46 60 38 26 6 1 274 8 14 8 10 1 21 25 17 104 11 27 31 7 55 41 19 21 12 3 227 Diseases of the brain,and nervous system - - - 3 1 3 2 - - 1 10 - - - - 3 - - - 2 2 7 Rheumatic affections 2 5 4 5 4 3 7 6 6 42 2 1 13 5 6 4 9 14 7 1 6S Venereal " - 3 2 1 - 4 - - 8 18 2 3 5 1 1 1 2 3 12 6 3e Ulcers and abscesses . 2 4 - 1 16 25 19 »H 1 68 - 1 - 1 . 23 16 20 9 . 7C Wounds and injuries - 8 15 18 15 13 9 12 10 Oh 3 103 12 22 9 8 21 17 15 5 3 5 IV Ebriety -AH other diseases - 14 8 14 32 40 2 7 14 30 8 44 9 77 o 5 41 263 20 55 5 30 114 23 119 30 75 11 28 22 68 25 43 190 22 54 193 18 93 2 26 81 31( Total - 43 73 84 124 37 195 204 195 - 32 987 162 i240 126' THIRD QUARTER. FOURTH QUARTER. Years - - - - 1829 200 6 1830 199 136 1831 251 70 1832 210 1 1833 221 7 1834 225 20 1835 211 4 1836 246 1 1837 59 7 1838 63 10 1885 262 1829 207 4 1830 183 48 1831 235 14 1832 168 1833 239 34 1834 270 10 1835 265 3 1836 182 1 1837 62 3 1838 67 8 1878 125 Mean strength Intermittent fever - Remittent fever - - 18 13 1 11 12 2 - 2 2 61 - - - - 10 1 1 - - 1 13 1 I Diseases of the respirato- ry organs - - - 16 22 29 38 9 19 10 21 6 7 177 30 6 40 8 101 102 7 b 33 7 8 411 Diseases of the digestive >—4 organs - 39 26 128 46 198 113 51 85 18 18 722 16 12 26 3 35 40 16 10 5 4 167 M Diseases of the brain and nervous system - 1 - 1 11 - 1 - - - 2 16 - - I - • - - " 1 2 Rheumatic affections 4 3 6 5 10 10 4 13 2 1 58 3 . - - 9 5 16 10 4 - 47 6 2 7 2 . 2 3 5 4 13 44 2 - 3 I I 2 8 3 2 4 26 Ulcers and abscesses 5 1 2 2 2 38 10 9 4 3 76 1 1 2 3 12 43 12 6 2 1 83 Wourid.s and injuries - 17 16 9 34 31 19 5 2 9 7 149 28 2 12 15 24 15 20 3 10 7 136 Ebriety -All other diseases - 11 . . . 5 26 17 15 - - 74 - - - 5 2 22 21 23 - - 73 30 37 102 27 8 34 30 35 4 2 309 21 9 64 4 27 18 49 8 b - 205 Total - 135 261 367 167 281 294 136 186 56 65 1948 105 78 162 39 255 258 224 97 38 34 1290 158 Under the class of diseases of the respiratory organs are mclnded 1,048 catarrh 28 pneumonia, 75 P^^^^^^aSlSB under the head of digestive organs, ^33 diarrhoea anaoy ^ cholic and cholera; under the class of brain ^d aj^JKAffections lepsy, and 20 delirium tremens; and under that of veneieal arlections, 101 gononhcea, and 23 syphilis. , , The total of deaths, according to the post returns, is 94, the annual ratio of morta ity being 2fa per cent. Of these, 35 are reported in the S^^yW,^uding 6 deaths from epiteucdjj^4 from gun-shot wounds, and 1 from exposure to low temperature, 1A per cent. The causes of death, as stated in the medical returns, are as follows : six phthisis pulmonalis, six epidemic cholera, one common cho- lera, four remittent fever, three dysentery, four gun-shot wounds, two ebriety, two chronic visceral derangement, one sudden, one disease of the heart, one gangrene of the lower extremities from exposure to cold one casualty, and three from causes not specified. The gun-shot wounds were received in battle in the expedition against Black Hawk. In the third quarter of 1832, there are reported twenty-one cases of gun-shot wounds, received in the action of the 2d of August, on the Mississippi, forty-five miles above this post. The average of disease at this post is higher than the mean oi the stations already examined. When it is considered, however, that those causes regarded as most conducive to the evolution of miasmata exist here abundantly, it seems surprising that fevers of malarial origin are not more rife. Equally remarkable is the fact of the variation in the ratio of these fevers from year to year. Thus, in the third quarter of 1830 there were 154 cases, whilst the same quarter of 1836, with a greater strength, affords but one case. The following table will show the relation between these fevers and meteorological causes at this post— TABLE showing the relation between fevers and meteorological causes. Years. Mean temper-ature for July. Mean temper-ature for Au-gust. >> to O §) & T3 CO Ct> Xi bo X Amount of rain in July and Au-gust. 1 Ratio of cases of intermittent and remittent fever per 100 of mean strength. 1829 74.33 73.76 74.09 94 Unknown. 3 1830 81.47 77.07 79.27 04 H 72 1831 76.56 71.93 74.24 98 (« 33 1832 74.41 70.09 72.25 94 « 1 1833 78.83 76.58 77.65 98 U 8 1834 80.49 77.55 79.02 98 u 14 1835 73.80 69.62 71.71 94 " 3 1836 73.00 66.66 69.83 90 5.50 in. 0 4-10 1837 73.83 70.87 72.35 95 5.48 " 17 1838 78.61 73.90 76.26 97 8.24 " 19 Although the essential causes of intermittent and remittent fever may forever remain involved in obscurity, yet the general fact that the aver- age of these fevers is highest in the third quarter of the year, in every 159 district of the United States, warrants the conclusion that heat and moisture are requisite to develope the causes. In regard to the opera- tion of these causes, however, there exists this striking difference, that heat acts in proportion to the rise of the mercury, whilst excess of mois- ture is no less inimical to the evolution of miasmata than its deficiency. This law in reference to atmospheric temperature obtains in the table just given. It is seen that the highest mean temperature of July and August, at Fort Crawford, is in 1830, when the ratio of intermittent and remittent fever in the third quarter is 72 per 100 of mean strength, and that the lowest mean temperature is in 1836, when the average of these fevers is only fa. The years 1832 and 1835 are the next lowest both in regard to the mean temperature and the ratio of these fevers. As there are doubtless many modifying causes, the precise influence of ele- vated temperature cannot be determined in each season. With the exception of cholera asphyxia, no epidemic has prevailed at this post. In August, 1833, there occurred twenty-three decided cases of cholera, and six deaths, whilst very few wholly escaped its in- fluence. Those cases, in which the premonitory symptoms continued for some time, terminated favorably. In some instances, death ensued in three or four hours after the first attack. For a short time, from forty to fifty were daily reported sick with diarrhoea, and other premonitory symptoms. In the village of Prairie du Chien, twelve or thirteen deaths occurred. It was noticed by Assistant Surgeon R. C. Wood that, in every case there existed a diminution or total suspension of urinary se- cretion, as was proven by the introduction of the catheter. The relative agency of the seasons in the production of disease in general is shown in the annexed table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 9 first quarters, 10 second " -10 third " -10 fourth " -Annual ratio - 1,660 1,749 1,885 1,878 987 1,267 1,948 1,270 595 724 1,033 676 1,793 5,472 3,052 Consequently eveiy man, on an average, has been reported sick once in nearly every four months. FORT ARMSTRONG. LATITUDE 41° 28', LONGITUDE 90° 33'. This fort is situated on Rock Island, which lies in the Mississippi, four miles above the mouth of Rock river. It is two miles long, and about four hundred yards wide, being a rich alluvial bottom based on a substratum of limestone. The diseases reported within the ten years are comprised in the following table— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Armstrong, for a period often years. FIRST QUARTER. SECOND QUARTER. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 81 3 1830 92 1 1831 1832 95 51 20 10 1833 79 1 1834 52 1 1835 84 1 1836 1837 1838 Mean strength 74 102 104 70 58 67 97 94 - - 666 534 Intermittent fever - . 1 1. 2 . 2 6 37 Remittent fever 2 1 - ' - - 1 - . . . 4 1 4 4 . . 4 3 . . . 16 Synochal fever 3 - - - - - • - - - 3 V 2 Diseases of the respirato- ry organs - - - 2 20 19 25 10 2 7 20 - . 105 7 7 20 6 21 1 5 • . . 67 Diseases of the digestive organs ... 5 10 5 4 3 2 2 9 - . 40 13 13 29 20 35 1 4 . . . 115 Diseases of the brain and nervous system - 2 - - 1 - - - . . 3 . 1 - 1 4 . . . - 6 Dropsies ... - - - - - - - - . . 1 - - - - . . - 2 Rheumatic affections 6 9 4 5 5 2 1 . . 33 6 3 18 4 2 . . . . 33 Venereal " - 1 - 4 - - . . - 6 . . 1 6 . . . . 7 Ulcers and abscesses 3 1 3 1 - 3 2 - - 14 3 1 2 7 4 3 . . 21 Wounds and injuries 9 12 24 13 4 2 5 7 - - 76 11 4 21 15 4 1 a . . 56 Ebriety - - - - - - - - 4 - - 4 - - - . - - u - - - All other diseases - 3 4 3 - 5 5 7 6 - - 33 3 2 15 5 8 2 > - - 36 Total - 35 59 59 55 27 17 26 49 - - 327 48 38 130 74 79 13 16 - - - 398 THIRD QUARTER. FOURTH QUARTER. ' Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 108 1 2 10 15 4 2 1 20 1 56 1830 110 8 5 9 5 2 26 55 1831 77 1 12 5 1 3 2 2 12 7 45 1832 35* 7 2 2 1 1 5 18 1833 73 4 5 4 1 4 10 4 32 1834 103 4 6 13 15 4 1 2 7 9 61 1835 102 4 7 19 1 1 1 10 2 2 47 1836 1837 1838 Menn strength 101 3 1 1 3 19 1 8 1 2 14-4 57 97 20 3 3 5 14 1 3 3 14 13 79 85 9 5 34 4 5 14 19 2 92 o Ph o 86 4 7 40 3 4 4 15 5 82 85 4 24 3 31 3 2 4 2 3 76 101 13 75 2 6 3 3 102 - - 555 40 41 4 23 213 5 24 6 25 72 5 30 488 608 Intermittent fever - -' Remittent " -Synochal " -Diseases of the respira-tory organs Diseases of the digestive organs ... Discuses of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 18 10 2 59 69 3 23 7 7 86 2 28 314 * The actual strength was 71, but the troops were at the post only half of the quarter. 162 Under the class of diseases of the respiratory organs are comprised 209 catarrh, 9 pneumonia, 23 pleuritis, and 3 phthisis pulmonalis ; un- der the head of digestive organs, 208 diarrhoea and dysentery, 145 cho- lic and cholera, and 6 hepatitis; under the class of brain and nervous system, 6 epilepsy, and 3 delirium tremens ; and under that of venereal affections, 22 gonorrhoea, and 4 syphilis. The total of deaths, according to the Adjutant General's returns, is twenty, the annual ratio of mortality being 3 fa per cent. Of these but eight are reported in the medical returns, viz : one mania a potu, one accidental, one frozen, and five from causes not stated. The medical reports from this post are defective in details; and, consequently, no means are afforded of detemiining the causes of the high mortality given in the post returns. On reference to the abstract exhibiting the diseases reported in ten years, it will be seen that the ratio of intermittent and remittent fever is low, whilst of typhus there is not a single case. In the post returns, seven deaths are reported in September, 1832, which, it is more than probable, arose from epidemic cholera. In the first quarter of 1834 it is noticed that, on the night of the 13th January a man deserted, and when brought back on the 17th, the right foot was mortified as high as the tarsus, and the os-calcis of each extremity was very much injured. On the 18th of March two deserted ; and on the following day, both were brought back, one dead and the other torpid. The relative agency of the seasons in the production of disease in general is exhibited in the annexed abstract— TABLE exhibiting the ratio of sickness'. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters -7 second " 6 third " -7 fourth " -Annual ratio - 666 534 555 608 327 398 488 314 491 745 879 516 591 1,527 2,584 Hence every man, on an average, has been reported sick once i wards of every four months and a half. 163 FORT LEAVENWORTH. LATITUDE 39° 20' N., LONGITUDE 95° 05' W. This post is situated on the right bank of the Missouri river, about 500 miles above its confluence with the Mississippi. As the Missouri here is not more than 300 yards wide, being one of its narrowest points, the water is deep and the current rapid. This mighty river is at times navigable for steamboats 1,750 miles above the fort, and always, unless obstructed by ice, to its mouth. The fort stands on a plain elevated about 150 feet above the surface of the river. This plain is the highest point of an undulating prairie, which extends as far south as the eye can reach. The opposite shore is an extensive alluvial bottom, covered with a dense forest of cotton-wood, (populus canadensis.) The margin of the river, north of the fort, pre- sents a similar character; but as the prevailing winds are from the south, the full effects of the exhalations from this miasmatic surface are not experienced. The soil, which is quite productive, consists of a sandy loam, covered with a rich vegetable deposite, the whole based on a strata of clay and limestone. " The forest," says Surgeon Macomb, " abounds in trees valuable for fuel or timber. With the exception of the pine, almost all kinds are to be found. The most common are the juglans nigra, carya olivafor- mis, carya alba, acer saccharinum, acer negundo, platanus occidenta- lis, cerasus virginiana, morus rubra, quercus alba, etc." The annual mean of rain and snow, on an average of 3 years, is 32.68 inches. The diseases reported within the ten years are contained in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Leavenworth, for aperiodoften years. FIRST QUARTER SECOND QUARTER. Years .... 1829 1830 1831 224 3 1832 204 4 1833 262 9 1834 96 10 1835 208 43 1836 304 38 1837 249 19 1838 300 11 2127 216 1829 1830 1831 215 15 1832 159 11 1833 138 25 1834 85 15 1835 87 31 1836 232 35 1837 303 85 1838 273 18 Mean strength 280 - 1492 Intermittent fever 79 9I3S Remittent " - 2 . 1 . . . . . . . 3 , . . . . . 2 . 1 1 4 1 Typhus " - 2 . . 1 . . . . . 1 4 Diseases of the respira- tory organs 57 . 101 82 123 5 14 81 71 45 579 . . 34 7 6 2 10 14 33 15 121 Diseases of the digestive organs ... 23 . 10 7 7 1 27 22 27 28 152 . . 20 21 20 3 16 31 37 31 179 Diseases of the brain and nervous system 1 . 3 4 - - 3 - - 7 18 . . 3 3 7 . 1 . 2 3 19 3 . . . . . 1 . 4 Rheumatic affections 20 > 26 15 26 3 13 20 5 6 134 > > 4 19 4 5 5 9 20 10 76 Venereal " - - o " ri CD *£H M o tH* o fa "3 o Eh * -5 B bn c« c bfl CD CD f-to a ^ CD a Ratio of cases per 1,000 of mean strength. INTERMITTENT FEVER. First quarter 2 13 3 5 21 6 216 266 12837 21 Second " - 2 24 13 22 69 37 235 402 11898 34 Third " - 3 36 33 28 262 40 313 715 12465 57 Fourth " - - - 3 38 16 21 125 18 302 523 13219 40 Annual ratio 10 111 65 76 477 101 1066 1906 12604 151 REMITTENT FEVER. First quarter 5 3 _ 6 _ 4 3 21 12837 2 Second " - 3 6 4 - 3 16 4 36 11898 3 Third « - - 6 3 24 5 61 41 24 164 12465 13 Fourth " - 1 15 15 5 33 10 21 13 77 10 22 53 76 13219 6 Annual ratio 27 71 297 12604 24 SYNOCHALFEVER. First quarter 7 124 5 3 _ 3 _ 142 12837 11 Second " - 16 122 8 4 _. 1 2 1 154 11898 13 Third " - 10 162 3 14 1 4 - 194 12465 16 Fourth " - 2 74 2 1 -, 2 - 81 13219 6 Annual ratio 35 482 18 22 2 11 1 571 12604 45 TYPHUS FEVER. First quarter 4 4 12837 3-10 Second " - - - - 1 - - . 1 11898 1-10 Third " - - - - 3 - - - - 2 5 12465 4-10 Fourth " - - - - 1 1 1 _ 6 1 13219 8-100 Annual ratio - 3 - 11 12604 9-10 DIARRHCEA AND DYSEN- - TERY. First quarter 47 171 29 24 51 9 84 415 12837 32 Second " - 46 151 69 40 175 61 103 644 11898 54 Third «... 100 497 173 86 588 102 491 2037 12465 163 Fourth " - 72 204 50 43 119 36 225 749 13219 56 Annual ratio - 264 1023 321 193 933 208 903 3845 12604 305 22 170 TABLE exhibiting the relative influence of the seasons in the production of ■ ■a Q „j tr. CD a a 1 ;< .'5 . gate ength. cases 00 of ?ngth. DISEASES. o fa £ ' *n CS j to " JZ -1" ' s '*"" 15 Sd"5 -H U> a g cn ■e o fa be — SS fa «-i "to 2 « o 83 O Eh H^g E Ratio per mean CATARRH AND INFLU- ' ENZA. First quarter Second " - 168 7S3 210 162 28S'; 96 537 1 2244 12837 175 83 559 314 74 255 46 92 1423 11898 120 Third " - 62 555 182 80 146 19 33 1077 12465 66 Fourth " - 124 1176 3073 214 132 448 359 48 180 2233 13219 169 Annual ratio 437 920 1048 209 842 6977 12604 552 PNEUMONIA. First quarter Second " - 19 6 15 4 3 2 5 4 6 6 3 3 15 13 66 38 12837 11898 5 3 Third " - - 11 20 3 1 2 - 7 44 12465 4 Fourth " - 5 37 76 1 1 14 28 3 2 63 13219 5 Annual ratio 41 9 11 9 37 211 12604 17 PLEURITIS. First quarter 27 20 16 6 19 6 23 117 12837 9 Second " - 3b 3 6 16 9 7 14 90 11898 8 Third " - - - 9 - 13 2 17 3 4 48 12465 4 Fourth " - 12 11 17 5 30 7 16 98 13219 7 Annual ratio 83 34 52 29 75 23 57 353 12604 28 PHTHISIS PULMONALIS. First quarter 3 6 4 1 3 - 11 28 12837 2 Second " - 1 - - 2 2 1 4 10 11898 1 Third " - - 1 - 6 5 1 - 13 12465 1 Fourth " - 5 9 7 - 1 3 1 4 14 1321S 1 Annual ratio 4 10 13 3 19 65 12604 [\ 5 RHEUMATISM. First quarter 47 177 108 33 42 33 134 574 1283' 1 45 Second " ■> 86 187 127 3b 62 33 76 606 1189* 3 48 Third " - - - 56 198 73 15 58 24 37 461 1246! i 37 Fourth " - 59 126 84 26 47 23 88 453 1321! ) 34 Annual ratio 248 688 392 109 209 113 335 2094 1260' 1 166 171 In regard to pulmonary diseases, the most striking fact, in this class of posts, is the high ratio of catarrhal affections, compared with the two preceding ones. The results also show prominently the compara- tive influence of the seasons in their causation, the ratios of the first and fourth quarters being respectively 175 and 169, and of the second and third, 120 and 86. As respects the remaining pulmonic diseases, the results are not very dissimilar from those exhibited in the foregoing classes. The various relations of our different systems of climate, in reference to these diseases, will be more fully elucidated, when the in- vestigation of each class of posts shall have been completed. Suffice it to say that on the coast of New England, as the ocean modifies the at- mospheric temperature, the annual ratio of catarrhal cases per 1,000 of strength is 233 \ on the great lakes, where a similar modifying agency is in operation, it is 300; whilst, the third class, characterized by the extreme range of the thermometer, has a ratio as high as 552. In the following table the annual results, in reference to this class of diseases, as well as the mortality from each, are exhibited. The total of deaths given are those only which occurred among men on the sick- list—a ratio considerably lower than that of the post returns, which in- clude the deaths from all causes. TABLE exhibiting the annual results and mortality of diseases. Ratio of cases per 1,000 of mean Deaths. to a CD a C3 CD 2 strength. Northern division. _g H3 a I I fa ■a CD fa o s Ph fa 9 "3 o Eh 358 -a t s !§ 1 3 'a o S a CD a fa 4 en a CD fa o a "a Ph CO '3. w JS IS fa 22 P-c E 8 X CD E = - 1 Phs! Eh° 65 CD Ph ■Jl o a CD ~ 03 CD a «a CCS "Jj O Posts on the lakes 5973 300 19 30 1 -: 9 12 Atlantic posts ... 3130 233 22 26 9 290 • - 1 - 15 - 140 16 Posts remote from the ocean and the lakes - 12604 552 1728 1 5 602 - 3 1 22 1 119 16 Total . - 21707 439 18 28 7 490 1 8 l 46 1 324 44 The following abstract exhibits, at a single glance, the relative mor- tality, extent of sickness, and comparative prevalence of certain dis- eases, in the three classes of posts adopted in reference to the northern division of the United States— 172 TABLE exhibiting the relative mortality, extent of sickness, and comparative prevalence of certain diseases. CD Ph S a a v 3 *- 2 CD CD CO 1^ a 2 0D 3 1,000 of mean under treat-nually. Ratio of cases per 1,000 of mean strength. >H CD > a > B *H CD > -> B X a A Ph * . "fj CD .2 cu N rH S ■s.g a o B a CD a to ■c s CD CIS a> a; '33 * '■5 § 2 s 1 ft X n* fa CD Eh fa 300 fa 19 fa 30 fa 9 h North'n lakes 9-10 1 3-10 2185 193 33 16 4 253 358 Atlantic coast 1 5-10 2 1912 36 26 43 5 170 233 22 26 9 290 Stations re- • mote from ocean and inland seas. 8-10 14-10 3103 151 143 24 26 45 37 5 9-10 300 552 17 28 5 602 f Average - 9-10 I 5-10 2660 2 4-10 269 439 362 18 19 28 28 7 8 490 f Average - I 1-10 1 6-10 2400 217 28 35 3 3-10 243 412 In regard to the ratio of mortality, it is seen that there is little differ- ence between the first and third class of posts. On the Atlantic coast, it is about 50 per cent, higher than the mean of the other two classes— a result to be ascribed mainly to the circumstance that the troops have more easy access to spirituous liquors. Moreover, in the last class, more than one-fourth of the aggregate mean strength consists of the cadets at the military academy, among whom the usual effects of alcoholic pot- tations among soldiers are not exhibited. As regards the relative degree of salubrity, as shown by the ratio of cases reported in each class, it appears that the third is about 50 per cent. higher than the mean of the other two; but in estimating the value of this result, it is necessary to bear in mind the high average of West Point and Fort Leavenworth, as detailed under each post respectively. In reference to intennittent fever, a striking difference is found to ob- tain. On the lakes this disease is very rife, whilst on the New England coast it is almost unknown, the cases reported being generally of foreign origin. The ratio of the third class is also high, owing more especially to the locality of the Forts Crawford and Leavenworth, the latter being near the 39th degree of latitude. At Hancock Barracks, West Point, and Forts Snelling and Winnebago, the occurrence of the disease is unu- * In the ratio of diseases of the respiratory organs, Fort Independence is excluded. f Of these two averages, the former expresses the result of a comparison between the ag- gregate strength of the three divisions, and the aggregate of cases and deaths, whilst the latter shows the mean of the results obtained in each class. The first exhibits the actual ratios given by the statistics of the posts, whereas the second supposes an equal number of troops in each division. 173 Bual. As respects remittent fever, there is no great contrast presented in the averages of the three classes—a result somewhat inconsistent with the doctrine of its common origin with intermittent fever, when it is con- sidered that the New England coast enjoys an exemption from the lat- ter. In regard to synochal fever, it is found that the ratio of the first class is much the lowest; and in the third, a great majority is furnished by West Point, many of these being reported under the name of ephe- meral. Of typhus fever, the average is far the lowest in the third class. Dianhoea and dysentery show considerable diversity in their ratios, being much the lowest on the sea-coast, thus implying a connexion with diseases of malarial origin. Pulmonary diseases in general are no less under the influence of season and climate than intermittent fever. In tracing out the com- parative prevalence of the more prominent modifications of this class of diseases, so far as relates to their annual results, it is found that, as a class, the ratio of the third is nearly twice as high as the mean of the other two systems of climate; but this result arises wholly from the greater prevalence of catanh and influenza. The averages of pneumo- nia and pleuritis exhibit little variation. The ratio of phthisis pulmo- nalis, however, contrary to the general result, is much lower in the third than in either of the other two classes; but this difference is more ap- parent than real, from the circumstance that nearly all the fatal cases of consumption are ascribed to the abuse of ardent spirits. In the third class, for example, if the results of West Point are excluded from the calculation, the ratio of cases per 1,000 rises nearly to 7; and the dif- ference still existing is doubtless owing to the greater facility of obtain- ing, at the posts along the seaboard, inebriating potations.' The following table shows the number of deaths in each month, ac- cording to the post returns, in the three classes described— TABLE showing the number of deaths in each month. Jan. Feb. March. April. May. June. July. Aug. Sept. Oct 25 Nov. 37 Dee. 22 27 26 26 32 28 55 41 39 40 The ratio of November and December may be regarded as the highest, for in the total of July are included thirty deaths from epidemic cholera,, in August six, and in September six, from the same cause. MIDDLE REGION OF THE UNITED STATES. This division comprises two general systems of climate, which bear the same meteorological relation to each other as the modified climate of the great lakes and the coast of New England does to that of the class last described. Whilst in the northern division a steady temperature predominates, this one, notwithstanding the extremes of temperature are 174 much more modified, is characterized by variableness. On reference to abstracts A, B, C, of the " Remarks" to the meteorological register, the difference in the climate of the two regions of the middle division, so far as temperature is concerned, may be seen. Thus, Jefferson Barracks shows a greater contrast in the seasons than Washington City; and on comparing Fort Gibson with Fort Monroe, which is 1° 32' north of the former, a similar result is exhibited. Of the two classes of posts pertaining to this division, the first em- braces the stations on the sea-coast and inlets of the ocean between the Delaware and Savannah rivers, viz : Forts Delaware, McHenry, Severn, Washington, and Monroe, Bellona Arsenal, Forts Moultrie, and John ston, and Oglethrope Barracks ; and the second comprises the interior posts, viz : Jefferson Barracks, Forts Gibson, Smith, and Coffee, Tow- son, and Jesup. I. THE ATLANTIC COAST. FORT DELAWARE. LATITUDE 39° 35', LONGITUDE 75° 29'. Fort Delaware is situated on a mud island, formed by the deposition of alluvion in the Delaware. The soil is of such a spongy nature that any heavy body will gradually sink for several days. It is four miles from Newcastle, and about forty miles below Philadelphia. The diseases reported within the ten years are condensed in the sub- joined abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Delaware, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Vears - - - - 1829 65 4 1 7 1 1 , 1 1 1 3 20 1830 119 6 2 34 3 1 3 1 5 12 67 1831 99 7 2 4 1 3 1 2 3 1832 116 1 23 6 2 4 4 6 1833 1834 - 1835 1836 1837 1838 -- 399 7 11 1 34 45 5 7 9 3 10 24 156 1829 102 4 2 1 9 8 3 2 9 1 10 20 85 1830 106 4 1 21 2 2 1 2 33 1831 94 12 4 5 1 3 1 1 1 29 1832 70* 3 3 I 1 1 3 12 1833 1834 1835 1836 1837 1838 Mean strength 372 Intermittent fever -Synochal fever Typhus fever Diseases of the respirato-ry organs -Diseases of the digestive organs Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries All other diseases - 23 16 2 1 17 30 10 6 13 2 12 1 26 Total 23 46 159 • Average mean strength for two months. ABSTRACT—Continued THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 95 96 20 4 2 3 125 1831 91 12 4 3 3 1 1 2 5 31 1832 § > 1833 1834 1835 1836 1837 1838 302 139 40 3 1 51 7 9 3 2 19 16 290 1829 116 35 2 6 20 6 1 5 1 14 13 103 1830 87 1 1 12 2 1 1 3 21 1831 126 11 18 2 1 4 I 2 1 5 45 1832 1833 1834 1835 1836 1837 1838 Mean Strength 116 31 36 3 28 3 6 2 1 15 8 134 329 Intermittent fever -Remittent " -Typhus " -Diseases of the respiratory Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebriety ... AU other diseases -Total - 47 2 25 32 10 3 9 2 17 1 21 169 177 I ruler the class of diseases of the respiratory organs are comprised 55 catarrh, 2 pneumonia, 6 pleuritis, and 11 phthisis pulmonalis ; under the head of digestive organs, 21 diarrhcea and dysentery, 87 cholic and r'uolera, and 20 hepatitis ; under the class of brain and nervous system, 1 epilepsy, and 4 mania a potu ; and uuder that of venereal affections, 25 gonorrhoea, and 9 syphilis. As the total of deaths, according to the post returns, is eleven, and the aggregate mean strength is three hundred and fifty, the annual ratio of mortality is a fraction above three per cent. All of the deaths are re- ported in the medical returns, viz : two remittent fever, one intermittent fever and anasarca combined, two phthisis pulmonalis, one pneumonia typhoides, two delirium tremens, one cynanche nfaligna, one aneurism of the aorta, and one ulcer in ano. Although the ratio of mortality is high, yet the causes of death are, in most instances, not ascribable to climate or local position. The high average of intermittent fever, in the summer of 1829 and 1830, is attributed to the marsh mud thrown up from a marsh ditch encircling the island. The annual ratio of inter- mittent fever is sixty-two per cent., and that of remittent fever is sixteen per cent. .In 1831, many cases of the most obstinate constipation of the bowels were reported both at this post and at Fort Severn, followed in some instances by paralysis of the hand and fore-arm. It was ascribed to the white lead used by the men in cleaning their belts and gloves. As it was necessary to moisten the material, and apply it by means of a sponge, the hands were daily exposed to its action. As the belts were also rubbed with pumice stone, particles of the lead may have been in- haled. It became necessary to abandon its use, substituting pipe clay. This post, in consequence of a conflagration, was evacuated on the 9th of February, 1831, The troops remained at Delaware City until the 28th of the same month, when the head quarters were established at Newcastle. In June, 1832, the troops were transferred to Fort Colum- bus. On referring to the history of this post, prior to 1829, it is found that in the third quarter of 1825 nearly every man suffered from diarrhcea and intermittent and remittent fever, (Vide p. 46,) and in 1827, the deleterious effects arising from the introduction of lead into the system was manifested in a large portion of the command. See pp. 56 and 57. The relative agency of the seasons in the causation of disease in gene- ral is shown in the following table—* 23 178 TABLE showing the relative agency of the seasons in the production of disease in general. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 4 first quarters 4 second " -3 third " -3 fourth «' -Annual ratio - 399 372 302 329 156 159 290 169 391 427 960 514 350 • 774 2,211 Hence every man, on an average, was reported sick once in about every five months and a half. FORT McHENRY. LATITUDE 39° 17' N., LONGITUDE 76° 36' W. Situated on a peninsula, bounded on the one side by the Patapsco ri- ver, and on the other by the harbor of Baltimore, Fort McHenry is about three miles distant from the centre of the city, in a southerly direction. It occupies the whole of the extremity of the peninsula, covering an area of 55 or 60 acres ; the fort is elevated about 36 feet above the level of the river, when at high water mark; and as this elevation has a gradual slope in every direction, the drainage is naturally good. The surrounding country is rather low and level, with occasional un- dulations ; but there are no mountains or very high lands in the vicinity. The soil is mostly argillaceous and silicious. During the summer, the prevailing winds vary from south to east, whilst those of the winter are mostly north-west. When blowing from the south, the current of air traverses some low land called Romney Marsh, on the opposite side of the Patapsco; but the distance of this marsh from the fort is upwards of a mile. The annual quantity of rain, on an average of three years, is 39 inches. The diseases reported within the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort McHenry, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - 1829 118 3 1830 119 22 1831 112 12 1832 120 5 1833 1834 61 7 1835'l836 62 60 20 2 1837 1838 652 71 1829 108 3 1830 109 29 1831 113 27 1832 91 13 1833 60 3 1834 58 5 1835 59 21 1836 1837 1838 Mean Strength 598 Intermittent fever - . 101 Remittent fever - - -' - - - - 1 - - 1 2 1 - 2 5 Synochal fever 1 yphus fever 1 - - - - - 1 - - - 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Diseases of the respirato- si ry organs - 43 17 5 11 - 7 13 4 - - 100 15 9 5 6 3 9 6 - - 53 Diseases of the digestive Ph organs' ... 8 3 - 1 - 7 8 - - - 27 28 20 8 3 7 23 9 h. - - 98 Dif>easeB of the brain and nurvous system - 1 - - - - - - - - - 1 4 - - - - - 1 - - 5 Drijpsies - 1 - - - 6 - - - - - 1 - - - - - - - a - - - Rheumatic affections 4 1 1 4 > - - 3 - - 13 4 - 3 1 - 3 4 a - - 15 Venereal affections 13 9 8 1 o 5 3 3 - - 14 2 1 - - - - - £ - - 3 "Wounds and injuries 12 8 7 19 t; 9 16 10 - - 81 11 12 13 7 4 6 10 N - - 63 Ebriety . - - 1 o 2 - 4 - - 7 4 1 1 1 2 - - ifr - -■ 9 All other disease* - 24 15 2 10 w 5 8 3 - - 67 23 6 3 4 1 4 22 ss - - 63 Total - 112 75 36 52 - 44 72 30 - - 421 104 83 63 42 22 53 74 - 441 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 Mean strength 101 108 121 57 64 59 57 - - - 567 109 107 121 56 61 58 57 - - - 569 Intermittent fever 50 55 31 3 41 53 12 . . 245 41 14 12 3 13 35 5 123 Remittent ' " - j 5 1 3 3 1 12 - - - - 25 1 - - 1 - . 1 . . - 3 Typhus " Diseases of the respirato- ry organs - - 2 2 2 3 - 2 1 - - - 12 6 11 33 4 7 29 5 . - - 95 Diseases of the digestive organs ... 24 7 17 37 7 20 10 - - - 122 5 3 5 2 .10 11 5 - - - 41 Diseases of the brain and nervous system 3 - 1 3 , - - - - - 7 2 - 1 - - - 2 - - - 5 Rheumatic afletions 4 1 3 2 - 4 - - - - 14 2 - 2 - 1 2 3 . . - 10 Venereal " 4 5 9 2 2 3 5 - - - 30 6 2 11 1 4 4 3 . - . 31 Ulcers and abscesses 4 3 - 2 2 2 3 - - - 16 2 1 1 1 - 1 5 . - . 11 Wound* and injuries 2 10 12 5 12 7 3 - - - 51 10 11 9 9 12 6 2 . - . 50 Elirietv . - 4 1 1 3 1 - - - 10 - 1 3 1 - 1 . . - . 6 All other diseases 3 5 5 3 - 13 - - - - 29 4 3 5 2 2 3 5 - - - 24 Total - . > - 101 89 87 64! 66 119 35 - - - 561 79 46 82 24 49 92 36 - - 408 181 Under the class of diseases of the respiratory organs are comprised 211 catarrh, 11 pneumonia, 30 pleuritis, oud 3 phthisis pulmonalis ; under lite head of digestive organs, 208 diarrhoea and dysentery, and 23 cholic and cholera; under the class of brain and nervous system, 6 epilepsy, and 2 mania a potu; and under that of venereal affections, 59 gonor- rhoea, and 64 syphilis. As the total of deaths, according to the post returns, is 12, and the ag- gregate mean strength is 624, the annual ratio of mortality is nearly 2 per cent. Of the deaths, 10 are reported in the medical returns, viz. 1 bilious cholic, 1 phthisis pulmonalis, 2 ebriety, 1 mania a potu, 1 chro- nic diarrhcea resulting from arr attack of epidemic cholera at Fortress Monroe, 1 wound, 1 sudden, and 2 from causes not designated, being I fa per cent. Although much disease, as will be seen, has always prevailed at this post in the summer season, yet among the causes of death just given there is scarcely one that can be ascribed to locality. The following re- marks, collated from the quarterly sick-reports, will serve to elucidate this point. In 1829 the command, as usual, went into summer encamp- ment ; but as Fort McHenry was being repaired, it was necessary that all the artificers and some of the soldiers should be employed at the fort; and consequently, of 55 cases of intermittent and remittent fever report- ed, all, with the exception of one case of the former type, were con- tracted at the fort. In the third quarter of 1830, there are 56 cases re- ported, ascribed by Assistant Surgeon French to the delay in proceeding to a summer encampment. It is his opinion that the post ought to be abandoned on the 15th June. In the summer of 1831, a camp was again formed. It is remarked that no death among the men had occur- red in two years. In 1832, in transmitting the sick-report of the 2d quarter, it is remarked—" The cases of intermittent and remittent fever begin to assume a highly bilious character, and I have no doubt that in 10 days one-half of the command will be on the sick-list, unless the men be ordered to the high ground above the city, where they ought to be every year by the 30th June." On the 23d July, the command left the fort for Camp Huntingdon; and in this quarter (the 3d) there are only six cases of fever reported. " It is gratifying to state," says Assistant Surgeon French, " that during the existence of the late epidemic in this neighborhood, no case of malignant cholera occurred among the troops stationed at this post. Out of 80 persons, (men, women, and children,) about one-half were attacked with diarrhoea, and other premonitory symptoms, which yielded readily to calomel, opium, and the lancet." The high average of cases in the 3d quarter of 1834, is attributed to the circumstance that the garrison did not form the customary encampment. Bilious intermittents and remittents were the prevailing diseases, but no case terminated fatally. The annual average of intermittent fever is very high, being 91 per cent., whilst that of remittent fever is only 6 per cent. On referring to the history of this post prior to 1829, it will be found (vide p. 46) that, in 1825, the command, in consequence of the insa- lubrity of tire position during the summer months, retired to a camp two 162 miles from Baltimore, and that this step had been rendered necessary for several preceding years. As early as 1819, much is said of a violent " bilious cholic," sometimes tenninating in delirium, apoplexy, and death, which prevailed at this post. It was at first regarded as a new modification of morbid action; but in 1822, (see p. 34,) by the acci- dental development of certain facts, it was supposed to have received a rational explanation. It would seem, however, that this station within the last few years has become more salubrious. Unoccupied by troops, the fortification has been undergoing repairs under the supervision of the Engineer Depart- ment. The grounds have been graded, a sea-wall built, and an excel- lent hospital erected. It is the opinion of Dr. Roberts, a civil practi- tioner, who has been employed at this post for several years, that the necessity of removing to a summer camp will in future be obviated. The following table exhibits the relative agency of the seasons in the etiology of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 7 first quarters -7 second " 7 third " 7 fourth " Annual ratio 652 598 567 569 421 441 561 408 646 738 989 717 596 1,831 8,076 Every man, on an average, was consequently reported sick once in every four months. FORT SEVERN. LATITUDE 38° 58', LONGITUDE 76° 27'. This post is situated on Severn river, on a point of land which makes out from the city of Annapolis. It is very little elevated above the le- vel of Chesapeake bay. The river is here about 800 yards wide. There are no marshes in the immediate vicinity. The diseases reported within the 10 years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Severn, for a period of ten years. FIRST QUARTER. SECOND QUARTER. , Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 53 4 1830 56 1831 58 17 1832 59 4 1833 63 5 1834 60 13 1835 60 2 1836 1837 1838 Mean Strength 55 61 59 64 65 56 - - - - 360 20 409 Intermittent fever - 1 2 4 7 3 3 m 45 7 4 3 1 - - - lb Synochal « - 7 1 a 4 3 1 • - - - 21 5 3 7 - - 3 - - - - 18 Typhus " - - - - - - - • - - - 1 - - - - - - - - - 1 Diseases of the respiratory T3 organs ... 4 15 11 6 12 7 - o - - 55 2 4 7 5 2 3 3 - • - 26 Diseases of the digestive fe organs ... 1 5 5 6 9 3 - £ - - 29 11 23 2 9 17 15 7 - - - 84 Diseases of the brain and nervous system - 1 1 1 1 3 - • 1 - • 7 - - - - 1 2 - - - - 3 Dropsies ... - - - - - 1 - S3 - - 1 - - - - - - - - - - - Rheumatic affections 1 2 4 1 2 5 - •fl - - 15 2 2 2 1 4 I 1 - - - 13 Venereal " - 2 - 4 1 4 2 o - • 13 1 3 1 - I 1 - - - - V Ulcers and abscesses 2 1 5 1 2 1 >- 5 - • 12 5 - 2 5 1 2 - - - - 15 Wounds and injuries 2 3 4 1 2 2 CU s - - 14 2 4 4 7 3 3 3 - - - 26 Ebriety ... 5 - - - 6 - s - - 11 3 - - - 2 - 1 - - - t> All other diseases - 1 3 9 5 5 6 fc o - - 29 4 2 13 9 1 11 1 - - - 41 Total - 27 33 52 33 51 31 • - - - 227 40 42 55 47 41 57 19 - - - 301 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. years - 1829 55 1830 52 1831 61 1832 62 1833 61 1834 61 1835 60 1836 1837 1838 412 1829 1830 57 1831 64 1832 60 1833 59 1834 59 1835 1836 1837 1838 Mean Strength - 58 - 357 Intermittent fever - 7 10 15 12 12' 17 12 . 85 . 9 11 10 9 12 3 . . . 54 Remittent fever 2 24 13 8 6 12 . - . - 65 - 2 3 1 2 - 3 - , - - 11 iSvnochal fever - > - 9 7 6 - 2 6 - - - - 30 - - 3 14 7 - - - - - 24 Typhus fever - - - - 1 - - - - - 1 - - - - 1 - - - - - 1 Diseases of the respirato- ry organs - - - - 2 4 8 3 - 1 - - - 18 - 13 28 3 6 1 2 - - - 53 Diseases of tho digestive organs ... 24 7 17 29 22 18 9 - - - 126 - 1 - 3 5 7 5 - - - 21 Diseases of the brain and nervous system - 4 1 - - 3 2 - - - - 10 - - - 1 1 - - - - - 1 Klieum.itic affections 1 3 2 -' 2 3 - - - . 11 - 3 1 3 2 - 1 - - - 10 Venereal affections 3 5 2 - 4 6 1 - - - 21 2 1 3 4 1 - - - -' 11 Ulcers and abscesses 2 9 2 2 . 4 - - - - 19 g 4 1 3 2 - - - - - 10 Wounds and injuries 4 4 2 4 1 7 - - - - 22 Ph 4 2 6 1 1 - - - 14 Ebriety ... 3 - - - 4 - - - - - 7 11 O All other diseases - I GO 5 77 4 67 3 66 60 1 76 23 --- 14 429 38 8 58 5 52 14 55 2 1 . - . 30 Total - 23 16 - 242 — »-- 185 Under the class of diseases of the respiratory organs are comprised 102 catarrh, 18 pneumonia, 17 pleuritis, and 8 phthisis pulmonalis; under the head of digestive organs, 109 diarrhcea and dysentery, 93 cholic and cholera, and 1 hepatitis; under the class of brain and nervous system, 9 epilepsy, 1 apoplexy, and 7 mania a potu ; and under that of venereal affections, 36 gonorrhoea, and 16 syphilis. As the total of deaths, according to the Adjutant General's returns, is 16, and the aggregate mean strength is 423, the annual ratio of mortali- ty is 3^ per cent. Of the deaths, 13 are reported in the medical re- turns, viz. 5 bilious congestive fever, 1 phthisis pulmonalis, 1 abscess of the lungs, 1 mania a potu, 1 broken spirit, 3 from causes not stated, and 1 suicide, being, excluding the last, about 3 per cent. As the nosological term, " broken spirit/' may require some explana- tion, the following extract is given from the report—" The subject was a discarded son. Entertaining a lively sensibility for the errors of the past, and no hope of the future, his mind for several months wandered. To avoid the coarse jests of the soldiers, he was separated from them, and placed in quietude. He uttered no complaint, but as he scarcely ate or slept, he gradually perished without consciousness of his condi- tion." At this post, diseases have generally manifested a violent grade of action. The fevers of the 3d quarter have generally appended to them the title of malignant. In the summer of 1830, Annapolis and the adjacent country suffered severely from "congestive bilious fever." In the third quarter of 1832-'3 and '4 also, all diseases assumed an aggra- vated character, and especially bilious remittents, which manifested a strong tendency to congestion. In the 2d quarter of 1830 are reported 11 cases of enteritis, which were regarded by Assistant Surgeon Smith as genuine colica pictonum, arising from the careless use of ceruse on the belts and gloves. The annual average of intermittent fever is 50 per cent., and that of remittent fever is 24 per cent. It thus appears that, whilst the former is little more than half as rife as at Fort McHenry, the latter is four times as prevalent. On reference to that portion of these papers embracing the first deci- mal period, it will be seen that in 1819, and several subsequent years, this garrison, like that of Fort McHenry, was severely harassed by a pe- culiar modification of disease, termed bilious cholic. The annexed table exhibits the relative agency of the seasons in the production of diseases in general— 24 186 TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 6 first quarters -7 second " 7 third " 6 fourth " Annual ratio - 360 409 412 357 227 301 429 242 631 736 1,041 678 385 1,199 3,114 Consequently every man, on an average, was on the sick-list once in upwards of every four months. FORT WASHINGTON. LATITUDE 38° 41', LONGITUDE 76° 58'. This fort is on the banks of the Potomac, about 16 miles below Wash- ington city. The parade of the main work is 115 feet above high- water mark, being on a ridge extending towards the river. It is sur- rounded by hills rather higher than this one, the intervening space on the south-east being a deep ravine, 400 feet wide, under cultivation, with a brook running through it. On the north is also a ravine about 300 feet wide. The diseases reported within the 10 years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Washington, for aperiodoften years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 58 1831 63 1832 1833 60 7 1834 T3 1835 59 1836 1837 1838 290 20 1829 63 1830 52 1831 59 R 1832 48 5 1833'1834 61 57 j 8 10 1835 1836 1837 1838 Mean strength 50 340 Intermittent fever - 1 1 11 31 Remittent " - - - - -- . . s - . . . 2 4 5 2 2 1 . . . . 16 8ynochal " - - - 3 - . 'u - . . . 3 . . 3 . . . . . . . 3 Typhus " - - - - - . Oh - . . . . . . . . . . . . . . . Diseases of the respira- 1 tory organs 2 8 14 - 22 4 - . . 50 8 1 11 9 1 4 . . . . 34 Diseases of the digestive £ organs - - - - 2 11 - - 1 . - . . 14 6 17 7 6 5 11 T3 s Fi . . . 52 Diseases of the brain and nervous system - 2 - 4 - . Ih - - . . 6 2 1 5 1 3 . . - . 12 Dropsies - - - - - - - - a - - . . - - - - - . . o . - . . Rheumatic affections - 1 2 - 1 ». 1 . . 5 1 2 . 1 1 2 4) . . 7 Venereal " - - 2 1 >■> . . . 3 1 . 3 2 1 jj . . 7 Ulcers and abscesses 2 - 2 2 ft .. . . 6 . . 2 1 2 s d . . 5 Wounds and injuries - 8 4 3 Oh 2 1-t O 4 - . . 21 3 8 8 5 2 3 > . . 29 Ebriety ... 7 7 - u 1 s 5 - . ' . 20 9 6 2 11 9 14 Oh . . 51 All other diseases - - 2 3 fc 1 Eh 2 - - - 8 1 3 2 2 - - fc o - - 8 Total - 22 25 55 - 37 " 17 - - - 156 33 42 56 45 31 48 - - - - 255 ABSTRACT—Continned THIRD QUARTER. Years - - - - 1829 56 1830 48 1831 54 1832 47 1833 56 1834 57 1835 1836 1837 183S Mean strength 318 Intermittent fever - 1 10 19 15 18 15 . . . . 78 Remittent fever 2 5 10 - 1 1 - - - - 19 Synochal fever - - - - - - - - - - - Typhus fever - - - - 1 - - - - - 1 Diseases of the respirato- ry organs - '2 - 1 - 2 1 - - - - 6 Diseases of the digestive organs ... 6 12 8 9 30 25 - - - - 90 Diseases of the brain and nervous system - 3 - - - - - - - - 3 Dropsies - - - - - - 1 - - - 1 Rheumatic affections - - 1 - - - - - - 1 Venereal " - 3 - - 1 - 2 - - - 6 Ulcers and abscesses 2 1 1 - 1 - - - - 5 Wounds and injuries - 1 5 9 1 2 2 - - - 20 Ebriety .5 - - 25 14 6 - - - 50 All other diseases - 3 3 6 2 2 • - - - 16 Total' - 25 36 52 57 71 55 - - - - 296 FOURTH QUARTER. 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 56 51 58 61 56 59 56 - - 397 6 14 24 7 7 4 62 - 2 5 1 . 1 . . . . 9 - - 3 - - 2 - - - - 5 - - • - - - - • - - - - 8 15 11 5 13 2 - - - 54 18 12 8 6 13 6 7 - - - 70 . 2 - . . . . . . . 2 - - - . . . • - - . . 2 1 1 . . . 1 . . . 5 - 1 1 . 1 - . . . . 3 - - 1 - - 1 2 . . . 4 3 4 2 2 - 2 3 . . . 16 - - - 5 11 2 2 . - - 20 3 - 1 7 - 3 3 - - - 17 26 36 51 56 37 37 24 - - - 267 189 Under the class of diseases of the respiratory organs are comprised 116 catarrh, 7 pneumonia, 16 pleuritis, and 4 phthisis pulmonalis; under the head of digestive organs, 154 dianhoea and dysentery, and 44 cholic and cholera; under the class of brain and nervous system, 14 epilepsy, and 4 delirium tremens; and under that of venereal affectrons, 8 gon- orrhoea, and 11 syphilis. As the total of deaths conformably to the post returns is 14, and the aggregate mean strength is 394, the annual ratio of mortality is 3 fa per cent. Of the deaths, 9 are reported in the medical returns, viz. 4 phthi- sis pulmonalis, (2 of these, perhaps all, drunkards,) 3 sudden from ebri- ety, 1 frozen when in a state of intoxication, and 1 suicide. Excluding the two last, although all might be set aside on similar grounds, the ratio of mortality is 2 per cent, per annum. The vice of intemperance is, indeed, fraught with evils, both moral and physical, of incalculable magnitude. One man, for example, in a state bordering on delirium tremens, cut off his left hand with a hatchet to avoid being compelled to work. The prevalence of intermittent fever at this post, in the summer sea- son, has generally rendered it necessary to form an encampment at this period. The fort was usually evacuated about the middle of July, and re-occupied about the 30th September. In 1831 four men, who were left behind in charge of the public property, as well as the families that remained until late in August, had frequent attacks of intermittent fever. The cases of intermittent fever reported in the first quarter of this year, occuned chiefly among recruits who had been employed the previous autumn on the Chesapeake and Ohio Canal. The annual average of intermittent fever is 57 per cent., and that of remittent fever is 10. It is seen, however, that the ratio of this post, as well as that of Fort McHenry, is much below the reality, owing to the circumstance that the troops formed summer encampments. On referring to the statistics prior to 1829 it is found that, in 1826, remittent fever prevailed at Fort Washington and the sunounding coun- try to a great extent. The comparative agency of the seasons in the production of disease in general is exhibited in the subjoined abstract— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 5 first quarters, 6 second " 6 third " 7 fourth " Annual ratio - 290 340 318 397 156 255 296 267 538 750 931 673 j 336 974 2,899 Consequently every man, on an average, was under treatment once in nearly every 4 months. 190 FORT MONROE. LATITUDE 37° 02' N., LONGITUDE 76° 12' W. This fortification occupies a low sandy point or peninsula, the termi- nation of the western shore of Chesapeake bay, bounded on the east and south-east by the waters of that bay, on the south and south-west by Hampton Roads, and on the north and north-west by Mill creek, which is an inlet of the roads. The general aspect of the country is low, and uniformly flat. The salt-water marshes, bordering Mill creek, are the only ones in the immediate vicinity, and these are inundated by eveiy influx of the tide. The principal vegetable production is the pine, (pi- nus palustris.) The annual quantity of rain, on a mean of three years, is 52.55 inches. The diseases reported within the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Monroe, for aperiodoften years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 386 8 1831 258 1832 570 18 1833 69 1834 172 4 1835 404 3 1836 218 1 1837 1838 70 17 2625 61 1829 370 2 1830 1831 1832 1833 1834 1835 1836 1837 1838 Mean strength - * 478 370 27 357 14 352 12 322 10 506 8 275 14 113 5 - 119 12 2784 Intermittent fever 10 104 1 7 - 2 10 6 14 4 6 12 - 2 - - 2 46 Synochal " - *■ 2 Typhus " - - 1 - - - - - - - - 1 - - - - - - - - - - Diseases of the respira- tory organs 193 78 98 259 24 31 81 9 - 39 812 48 30 79 154 48 88 11 13 - 27 498 Diseases of the digestive organs - 40 56 32 108 7 30 18 6 - 13 310 77 94 92 122 168 183 40 1 - 2b 803 Diseases of the brain and nervous system - - - 4 - - - - - - 4 1 - - 7 1 - 4 - - 1 14 1 1 - - - - - - 1 - - - 1 Rheumatic affections 40 14 15 26 5 10 15 3 - 5 133 19 10 19 38 11 14 4 1 - 18 134 Venereal " - 14 7 7 9 - 4 3 5 3 52 11 8 6 12 10 6 - 5 1 59 Ulcers and abscesses 3 5 4 8 - 3 3 6 6 38 5 3 6 10 8 10 3 3 ft - 48 Wounds and injuries 10 10 12 31 - 10 31 10 o 3 117 41 8 39 48 26 37 18 6 o 17 240 Ebriety ... - - - 3 - - 19 11 3 36 - - - - - - 6 - 2 8 All other diseases 32 14 - 13 - - 35 6 fc 1 101 63 29 8 18 25 13 12 4 fc lb 187 Total - 342 193 168 479 36 92 209 64 - 93 1676 275 223 267 427 319 359 115 38 ■- 121 2144 ABSTRACT—Continued. - THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 345 20 1831 317 8 1832 111 8 1833 431 68 1834 499 53 1835 280 16 1836 1837 656 36 1838 175 8 3196 244 1829 389 19 1830 319 15 1831 609 36 1832 155 16 1833 208 8 1834 1835 210 4 1836 108 10 1837 1838 Mean strength 382 27 1998 Intennittent fever - 108 Remittent fever 45 28 38 10 46 46 8 . 157 5 383 42 33 42 8 26 . 2 . . . 153 Svuoehal fever 3 - . - . - - . - - 3 4 4 Typhus fever 2 - - - - - - - - - 2 1 1 Diseases of the respirato- ry organs - 27 37 33 22 23 43 6 - 119 9 319 81 59 426 86 58 . 3 61 - - 774 Diseases of the digestive organs ... 92 55 168 77 117 255 42 . 352 42 1200 48 48 97 57 31 . 10 29 - . 320 Diseases of the brain and nervous system - - - - 1 - - 2 . - 1 4 2 - 2 1 1 Rheumatic affections 7 13 14 - 6 18 1 - 26 14 99 19 9 20 8 10 . 2 5 . . Tc Venereal affections 20 9 9 2 3 7 - 31 - 81 14 12 7 8' 2 2 3 - . 48 Ulcers and abscesses 5 . 8 2 20 8 4 t, 60 1 108 8 . 6 4 6 t, 4 . . - 28 Wounds and injuries 17 15 18 13 60 25 6 ft 140 9 303 11 28 45 18 9 ft 14 8 . - 133 12 *-c 1 - 13 - - - - - u 6 - - - t All other diseases - 5 250 177 6 302 4 139 20 363 17 472 8 105 a 97 1021 27 116 184 17 265 2 206 4 683 3 208 23 173 £ 9 56 1 117 - - 5S Total - 2945 170i 193 Under the class of diseases of the respiratory organs are composed 1,974 catarrh and influenza, 249 pneumonia, 167 P1^' ™**la phthisis pulmonalis; under the head of digestive organs, 1,671 diantoea and dysentery, 682 cholic and cholera, and 3 hepatrtrs; under the class of brain and nervous system, 3 epilepsy, 10 mama a potu and 6 nycta- lopia; and under that of venereal affections, 144 gonorrhoea, and 9b ^As the total of deaths, according to the Adjutant General's returns, is 120, and the aggregate mean strength is 2,827, the annual ratio ot mortality is 4ft per cent. Of deaths, 102 are reported in the medical returns, viz : seventeen phthisis pulmonalis, four pneumonia, three pneu- monia typhoides, four influenza, one engorgement of the lungs, thrrteen remittent fever, thirteen chronic diarrhoea, two dysentery, fourteen epi- demic cholera, six mania a potu, seven sudden from ebriety, three dropsy, one worn out, two anuerism, two gangrenous ulcer, seven casualties, and three drowned. Excluding the deaths from drowning and epidemic cholera, as in the preceding calculations, the average annual mortality is 3ft per cent. The most striking fact in the histoiy of this post is the remarkable prevalence of diseases of the respiratory organs. In attempting to assign a cause, reference is made to the circumstance that the men were quar- tered in damp casemates. It is seen that twenty-nine deaths have arisen from this class of diseases. In the first quarter of 1829 are reported ninety-six cases of catarrh, sixty-four pneumonia, thirty-two pleuritis, and one phthisis. "Of the cases reported as pneumonia," says Surgeon Everett, " nearly all were strongly marked as the pneumonia typhoides of most nosojogists, or the pneu- monitis maligna of Good. Vena sectio being found entirely inadmis- sable, my whole reliance was placed upon the free use of calomel com- bined with cordial diaphoretics, extensive and repeated vesication, and the frequent inhalation of oxygenated vapor. But four cases proved fatal, and in these there was reason to suspect hepatic derangement from spirituous potations and previous disease." In the fourth quarter of 1831 are reported 414 cases of influenza, one of which proved fatal; and in the following quarter, there were 219 cases of this epidemic catarrh. Pneumonic affections are at all times rife; but, in the first quarter of 1837, they prevailed as an epidemic at this post and in the neighboring counties. " It is probable a modification," says Assistant Surgeon Archer, "if not the same disease, which, under the name of La Grippe, now generally prevails throughout Europe." There were three deaths from this cause. In the second quarter of 1835, there were reported two deaths from phthisis. " In the lungs of one, a trombone player," says Surgeon Zina Pitcher, " there were tuberculous excavations capable of holding four ounces of fluid; those of the other, (a dissipated man,) were studded with earthy concretions." The annual ratio of intermittent fever is not high for this latitude being 19 per centum annually. The average of remittent fever is 22,' 13 deaths being- repoit^d from this cause. Of the deaths reported in 1837 and 1S38, nine were invalids from Florida, all save one having /CO 194 died of chronic diarrhoea. The high ratio of cases in the third quarter of 1837 is owing to the circumstance that the command consisted of unattached recruits, and invalids from Florida. In the third quarter of 1832, twelve deaths from cholera Asiatica are reported, there having been thirty-four unequivocal cases, and many more in the premonitory stage. In the third quarter of 1834, there are reported forty-eight cases of the same disease, of which 2 proved fatal. It is shown then, that with the exception of remittent fever, nearly all fatal cases arose from thoracic lesions. Excluding the deaths from epidemic cholera, and those from chronic diarrhcea among the invalids from Florida, it is found that nearly all other cases were casualties, or the direct effects of drunkenness. The subjoined table presents the comparative agency of the seasons in the causation of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 9 first quarters -9 second " 9 third " 7 fourth " . Annual ratio - 2,625 2,784 3,196 1,998 1,676 2,134 2,945 1,708 638 767 922 855 2,651 8,463 3,190 On an average, every man has consequently been reported sick once in every three months and three-fourths, BELLONA ARSENAL. LATITUDE 37° 30' N. This post is situated on the right bank of James river, 12 miles from Richmond. It occupies a position elevated upwards of 100 feet above the level of the river, with grounds sloping rapidly. It is about 200 yards from the river, a cultivated field intervening; and on each side is a ravine running nearly at right angles with the river, the eastern one having a small stream distant about 300 feet from the arsenal. The diseases reported within the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at BeUona Arsenal, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837|1838 1829 18301831 1832 1833 1834 1 1835 1836 L837 1838 Mean strength 48 60 55 54 47 - - - - - 264 46 61 55 44 59 - - - - - 265 1 . 1 . 2 - - . . . 4 8 6 5 13 2 2 - - - Intermittent fever - "_ - 31 8 3 5 1 ' 2 - 4 - - - - - 6 1 ■* Diseases of the respirato- „ 3 ry organs- - - 3 5 13 3 - * - * - 24 * a m 1 - Diseases of the digestive organs - - 2 3 4 10 - - - <■ 19 3 3 10 4 19 - - - - - 39 Diseases of the brain and . 2 nervous system - 1 2 - 1 1 - " - - - 5 - 2 ' Rheumatic affections Venereal " 6 2 1 1 1 3 3 1 . - - - „ 12 6 3 1 1 1 1 2 1 1 4 S 3 - - - - - 4 1 Ulcers and abscesses -Wounds and injuries -Ebriety All other diseases - 3 3 3 2 4 2 3 4 9 2 3 - - - - 4 9 13 12 114 4 23 4 6 3 2 2 2 3 4 - . - - - 17 1 17 8 Total - 19 17 27 32 19 32 38 17 35 - - - 1 ' 145 Ox r ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 57 5 11 4 1 7 1 2 1 1 33 1830 55 4 8 3 2 1 o 2 1 23 1831 57 6 7 23 1 1 7 2 1 3 1 52 1832 39 4 4 2 1 1 2 1 15 1833 1834 1835 1836 1837 1838 Mean strength 49 6 34 4 9 2 1 56 58 16 15 2 1 8 1 3 2 48 58 12 14 1 7 2 4 7 1 48 38 5 5 2 I 10 1 2 1 27 56 5 1 15 3 3 3 4 3 37 - - - - - 259 44 69 3 1 38 3 1 17 7 9 17 7 216 - - 208 Intermittent fever -Remittent " -Synochal " -Typhus " *■ Diseiscs of the respira-tory organs Diseases of the digestive organs ... Disea -es of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 19 26 30 8 3 14 5 6 8 4 123 197 Under the class of diseases of the respiratory organs are comprised 46 catarrh, 6 pneumonia, 2 pleuritis, and 0 phthisis; under the head of digestive organs, 54 diarrhoea and dysentery, 16 cholic and cholera, and 8 hepatitis; under the class of brain and nervous system, 6 epilepsy, and 5 mania a potu ; and under that of venereal affections, 29 gonor- rhoea, and 12 syphilis. As the total of deaths, according to the post returns, is 8, and the aggregate mean strength is 249, the annual ratio of mortality is 3ft per cent. Of the deaths, 6 are reported in the medical returns, viz. 1 remittent fever, 1 cholera morbus, and 4 from causes not designated, being at the rate of 2ft per cent. At this post the average of fevers of malarial origin is high, the annual ratio of intermittents being 44, and that of remittents 46 per cent. In the third quarter of 1829, this station and its vicinity suffered much from bilious remittent fever. But one death, however, occurred among the soldiers. " The diseases, principally bilious remittent," says Assistant Surgeon Monroe, " have been of the most malignant type, requiring the most energetic treatment. If ever the patient has a third chill, the case is extremely doubtful, and if a fourth, it is hopeless. I have had cases terminating in death in 12 and 24 hours after the first apparent symptoms of attack. These cases were ushered in with coma, and a bright saffron suffusion of the skin, and even of the nails. Such cases were of course hopeless from the beginning." It does not appear that any disease of similar malignity has since prevailed. On referring to the earlier history of this post, however, it is found that in the third quarter of 1825 intermittent and remittent fever prevailed, " as usual," to a very great extent. The locality was regarded as so very insalubri- ous, that a summer encampment was recommended. On the first estab- lishment of this arsenal it seems to have been quite healthy, being then well wooded and sheltered, more especially on the side next the river. The relative agency of the seasons in the production of disease in general is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean stiength, treated quarterly. 5 first quarters -5 second " 5 third " 4 fourth " Annual ratio - 264 265 259 208 114 145 216 123 432 547 834 591 249 598 2,402 It thus appears that every man, on an average, was reported sick once in every five months. 198 FORT MOULTRIE. LATITUDE 32° 42' N., LONGITUDE 79° 56' W. This post is situated on a sand island at the mouth of Charleston harbor, four miles from the city. Although there is much salt-water marsh in the rear of the island, no deleterious effects arise. The town of Moultrieville, exposed to the same agencies, is a resort in the sum- mer season. The diseases reported within the ten years are comprised in the fol- lowing abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Moultrie, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - 1829 no 3 1 15 22 1 4 2 2 5 1 13 1830 102 2 2 15 17 2 7 3 9 12 15 21 1831 88 7 4 7 3 21 1832 51 25 2 1 2 2 1833 308 13 7 47 26 5 6 6 12 47 5 11 1834 49 6 1 1 1 1 4 1835 48 7 1 3 3 5 1836 1837 1838 756 18 7 122 71 8 28 14 29 78 21 68 1829 133 2 1 6 46 3 3 3 5 12 11 7 99 1830 98 6 4 12 1 4 4 14 16 61 1831 118 5 2 27 1 5 1 2 5 32 80 1832 66 3 8 11 4 3 2 7 9 4 51 1833 170 4 2 21 50 8 3 5 12 10 14 11 140 1834 80 11 13 2 1 8 7 2 4 48 1835 53 1 2 9 1 2 7 2 3 27 1836 1837 1838 Mean strength 718 Intermittent fever -Remittent fever Synochal fever Diseases of the respirato. ry organs -Diseases of the digestive organs Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries -Ebriety All other diseases - 18 6 54 168 14 21 13 35 62 38 77 Total - 69 107 43 33 185 14 19 - - - 470 506 ABSTRACT—Continued THIRD QUARTER. FOURTH QUARTER. Years .... 1829 1830 83 1 1831 113 7 1832 54 1833 79 2 1834 57 1 1835 53 2 1 1836 1837 ! 1838 611 13 1829 1830 110 2 1831 120 i 1832 1833 1834 1835 60 52 1836 1837 1838 Mem Strength 172 - - 181 6 51 1 574 Intermittent fever - 9 Remittent " - - 2 9 - 7 - 1 - - - 19 - - 3 . 4 I 6 - - - - 14 Di eus;s of the respiratory organs - 30 8 11 3 6 4 2 - - - 64 - 12 8 28 V 8 3 - - - 66 Diseases of the digestive organs ... 107 14 32 16 24 16 8 - - - 217 - 7 2 29 4 14 2 - - - 58 Di-eases of the brain and nervous system - 4 2 - - 2 - - - - - 8 - - 3 1 4 1 Rheumatic affections 9 1 6 3 2 2 3 - - - 26 - 2 4 2 8 Vre:iereal " - 2 1 . 1 3 - - - - - 7 - 1 2 1 1 - - - - 5 Uk'Ts and abscesses 9 5 8 2 2 2 o - . - 30 }M 2 1 7 3 1 1 - - - 15 Weunds and injuries 20 14 3 4 3 1 4 - - - 49 Ph 3 3 19 4 5 1 - - - 35 5 Ebriety ... 10 . 2 I 3 2 2 - . - 20 H - 1 - 2 2 - - - - All other diseases - 10 30 17 2 6 - 3 - - - 68 £ 13 23 9 1 2 10 - - 58 Total - 201 78 95 32 60 28 27 - - - 521 " 41 49 108 24 39 17 - - - 278 to o o 201 Under the class of diseases of the respiratory organs are comprised 233 catanh, 30 pneumonia, 20 pleuritis, and 10 phthisis pulmonalis; under the head of digestive organs, 280 diarrhoea and dysentery, 71 cholic and cholera, and 1 hepatitis; under the class of brain and nervous system, 5 epilepsy, 2 apoplexy, 3 delirium tremens, and 13 nyctalopia; and under that of venereal affections, 22 gonorchcea, and 17 syphilis. As the post returns include Charleston harbor, that is, Forts Moultrie, Pinckney, and Johnson, in the aggregate, it has been found very diffi- cult, as in the case of Fort Columbus, to give the precise strength of Fort Moultrie. The total of deaths in the harbor of Charleston is 30, and as the mean strength for the same period is 1,148, the annual ratio of mortality is 2fa per cent. Of these, 20 are accounted for in the sick- reports from Fort Moultrie, viz. 7 phthisis pulmonalis, 3 chronic diar- rhcea, 2 yellow fever, 1 apoplexia, 1 delirium tremens, 2 ebriety, 1 variola, 1 atrophia, 1 worn-out, and 1 casualty. As the mean strength for Fort Moultrie, for the same period, was 665, the rate of mortality is 3 per cent. As the principal hospital accommodations were at this post, it would seem, however, that many of those most seriously ill were brought from the neighboring fortifications. The annual ratio of intermittent fever is remarkably low, being but 9 per cent., whilst that of remittent fever is 7 per cent. As yellow fever is endemic at Charleston, it has appeared several times at this post, but in no instance with much fatality. In the 3d quarter of 1834, there are 5 cases of febris icterodes reported, 2 of which proved fatal. Of these cases, 2 originated at Charleston and the other 3 at Castle Pinckney. On referring back to 1824 it is found that, whilst this disease prevailed with great malignity in the city, not more than 12 cases, none of which proved fatal, appeared on the island in a strength of 70. The comparative agency of the seasons in the causation of disease in general is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 7 first quarters -7 second " 7 third " -6 fourth " -Annual ratio - 756 718 611 574 407 506 521 278 538 705 853 484 665 1,712 2,574 Consequently every man, on an average, was registered on the hos- pital books once in a fraction less than every five months. 26 202 FORT JOHNSTON. LATITUDE 34° N., LONGITUDE 78° 05' W. This post is situated in the town of Smithville, North Carolina, im- mediately on the Atlantic coast, three miles from the mouth of Cape Fear river. There are some marshy low lands within the distance of half a mile. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Johnstori, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1829 49 1830 61 1831 52 1832 59 1833 56 1834 55 1835 63 9 1836 1837 1838 395 19 1829 52 3 1830 57 2 1831 55 3 1 18321833 1834 54 10 1835 60 ?,7 1836 1837 1838 Mean Strength 56 55 1 389 Intermittent fever - 4 2 I 1 2 46 Remittent " - . . . . ; . 1 . . _ 1 . 5 . 3 8 Synochal " - - 2 . . 1 1 . . . 4 . ; . 2 , 2 Diseases of the respiratory organs ... 8 2 11 7 8 7 2 • . . 45 2 1 3 _ , 3 t 9 Diseases of the digestive T3 organs ... 5 7 1 2 2 3 6 O . 26 5 6 6 12 1 4 4 . 38 Diseases of the brain and tu, nervous system - - 1 . . . . B . . 1 . . . ^ _ 3 . 3 Dropsies . . . . . . T3 . . . . . . . m 1 1 Rheumatic affections 1 1 . . 2 . ■a . . 4 2 . 4 . 1 4 2 13 Venereal " - 2 4 5 . 4 9 . . 24 3 2 3 . 3 2 3 „ 16 Ulcers and abscesses 1 . . 2 1 2 ti . . 7 . . 4 1 3 2 10 Wounds and injuries 4 2 4 4 1 2 . . 18 . 3 1 6 4 2 1 . _ 17 Ebriety ■> 1 . . . . 2 . . 3 . . . . . . . . . „ AH other diseases - , 7 12 5 2 - 1 2 - - 29 - 25 5 1 2 1 1 - - - 35 Total - 28 36 27 15 22 27 26 " - - 181 15 44 29 20 20 28 42 - - - 198 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 4829 55 15 1830 1831 55 2 1832 53 7 1833 53 3 1834 53 19 1835 57 17 1836 1837 1838 326 63 1829 1830 54 2 1831 61 1832 1833 54 11 1834 60 5 1835 60 14 1836 1837 1838 Mean Strength 289 Intermittent fever - 32 1 14 . 5 - . . 20 . - 1 •- 1 2 2 . . . 6 1 1 Diseases of the respirato- ry organs - 1 - 5 - - - - - - - 6 - 3 9 - - 2 2 - - - 16 Diseases of the digestive organs - 2 - 20 15 5 8 4 - . - 54 - 5 6 - . 6 3 . . - 20 Diseases of the brain and nervous system - ■ - 4 1 - - 1 - - - 6 - - 1 - - - 1 - - - 2 Rheumatic affections . - 1 1 2 - 2 - - . 6 - - 1 . . - 1 - . . 2 Venereal affections 2 1 2 - 1 - . . . 6 8 1 . 3 - - . . 12 Ulcers and abscesses . ■K 2 4 3 1 - . - . 10 I-. 3 2 ■c 1 . 1 . . . 7 Wounds and injuries 4 a, . 3 3 - 2 - - . 12 P4 1 1 a. 5 2 2 - - . 11 Ebriety ... - M - - 2 - - - - 2 2 - 1 M - 1 - - - - 2 All other diseases • 1 fc 4 - 3 - 1 - - - 9 fc 1 3 125 - 1 7 - - - 12 Total - 25 - 39 34 33 31 32 - - - 194 - 23 26 - 18 24 33 - ' 124 205 Under the class of diseases of the respiratory organs are comprised 67 catarrh, 1 pneumonia, 2 pleuritis, and 5 phthisis pulmonalis; under the head of digestive organs, 92 diarrhoea and dysentery, 28 cholic and cholera, and 3 hepatitis; under the class of brain and nervous system, 6 epilepsy, 3 mania a potu, 1 apoplexy, and 1 nyctalopia; and under that of venereal affections, 52 gonorrhoea, and 6 syphilis. As the total of deaths, according to the Adjutant General's returns, is 15, and the aggregate mean strength is 400, the annual ratio of mor- tality is 3fa per cent. Of the deaths, 11 are reported in the medical returns, viz. 1 remittent fever, 1 continued fever, 1 chronic diarrhcea, 1 phthisis pulmonalis, 1 apoplexy, and 6 from causes not designated, being 3 fa per cent. The reports from this station are not given sufficiently in detail, to be enabled to state with much precision the peculiar character of morbid action. The annual average of intermittent fever is pretty high, being 46 per cent., whilst that of remittent fever is 10 per cent. The relative agency of the seasons in the etiology of disease in gene- ral is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 7 first quarters -7 second " 6 third " 5 fourth " Annual ratio - 395 389 326 289 181 198 194 124 458 509 595 429 350 697 1,991 Every man, on an average, has consequently been reported on the sick list once in every six months. OGLETHORPE BARRACKS. LATITUDE 32° 4' 56", LONGITUDE 81° 7' 9". This post, in its present position, is in the suburbs of Savannah, which is distant about 12 miles in a direct line from the ocean. Situated upon a sandy plain, elevated about 40 feet above low-water mark, this city stands upon the southern side of the river of the same name. This ridge extends upwards of a mile along the river, terminating abruptly. At the depth of twenty or thirty feet, fine water is obtained. The city is bounded on the east and west by alluvial soil, called, in the language of the country, tide-swamp, being by the ordinary spring tides subject to inundation. It is consequently well adapted to the cultivation of rice. The city, divided by numerous and wide streets, intersecting each other at right angles, is open and spacious; and being planted with the Pride 206 of India, (melia azedarach,) the long continued heats of summer, moderated by the sea-breeze, prove less oppressive than in some more northern towns. It is necessary to bear in mind that the station to which these statis- tics have reference, had a different locality from the present barracks. Situated about a mile south of the city, their vicinity abounded in rice- fields and marshes, some of which contained an intermixture of fresh and salt water. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Oglethorpe Barracks, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - - - - 1829 110 20 1830 61 1 1831 62 3 1832 59 1833 1834 55 5 1835 46 3 1836 1837 1838 393 32 1829 79 18 1830 1831 1832 62 2 1833 63 5 1834 55 5 1835 49 11 1836 1837 1838 Mean Strength 308 Intermittent fever - 41 Remittent fever - - - - - - - - - - - - - - 3 - 2 - - - - 5 Typhus fever 1 - - - - - - . . 1 - - - - - - - - - - - Diseases of the respirato- a ry organs - 6 1 3 20 - - 3 i- - - 33 3 - - 7 1 6 2 - - - 19 Diseases of the digestive 6h jrsjaiis - 3 U 6 14 - 2 6 *. - - 42 12 - - 14 12 10 b - - - 53 Diseases of the brain and <2 o - nervous system - 1 1 - - - - - - 3 - - - 1 - 1 2 - - - 4 Drupsies ... - - - - - - 3 - - - - - - - - - - - - - - Rheumatic affections - 1 2 4 - 4 p - - 12 3 - - 4 3 - - - - - 10 Venereal affections 4 - 3 1 2 1 3 o •j: < 3 CD Oh OS 3 bo Sas t* _; tan 3 3 . 3 ft G o H s o o "So * c ■< es Rati pei mea pH pH Ph Ph Eh ra Ph Ph O Eh B INTERMITTENT FEVER. First quarter - 7 71 20 20 61 4 19 18 32 252 6134 41 Second " - - 23 101 45 31 104 31 46 18 41 440 6183 71 Third " 139 245 85 78 244 44 63 13 70 981 6211 158 Fourth " - 47 123 54 204 62 108 19 98 32 9 36 490 4871 101 Annual ratio - 216 540 191 517 160 .58 179 2163 5850 370 REMITTENT FEVER. First quarter _ 1 _ _ 10 _ 1 7 _ 19 6134 3 Second " 16 5 16 16 46 8 8 6 5 126 6183 20 Third " - 40 25 65 19 383 69 20 19 44 684 6211 110 Fourth " 56 3 11 92 9 44 153 592 26 103 6 14 46 10 232 4871 48 Annual ratio - 34 35 59 1061 5850 181 SYNOCHALFEVER. First quarter 11 2 21 3 _ 6 4 3 1 51 6134 8 Second " 2 - 18 3 2 9 2 _ _ 36 6183 6 Third " - - 30 - 3 3 - • _ _ 36 6211 6 Fourth " - - 24 5 4 - 1 - - 34 4871 7 Annual ratio - 13 2 93 ii 9 18 7 3 1 157 5850 27 TYPHUS FEVER. First quarter 1 - _ _ 1 _ _ 1 1 4 6134 0 7-10 Second " 1 - 1 - - - - - - 2 6183 0 3-10 Third " 3 - 1 1 2 - - - - 7 6211 12-10 Fourth " 2 7 --- 1 - 1 4 - 1 1 - 5 4871 1 Annual ratio - 3 1 1 1 18 5850 3 2-10 DIARRHCEA AND DTSEXTERT. First quarter 3 19 11 10 129 11 9 35 24 251 6134 41 Second " 3 70 31 25 543 22 28 74 29 825 6183 133 Third " 15 98 58 76 816 19 43 134 8 1267 6211 204 Fourth " - 21 208 9 109 43 183 2 54 12 37 9 316 4871 65 Annual ratio - 21 154 1671 92 280 70 2659 5850 455 213 seasons in the production of morbid action, fyc. DISEASES. CD a Q o Ph 3 CD X o £ ■e o Ph e > CD CD o Ph bo 3 a ^3 0 *^ CD O 3 O ft Ph OS a ~co u < Ki 3 _o "3 PQ 0 CO 3 ,3 O —5 u O Ph ~B 0 O Ph CD M O » .3 -« cd ea O 3 0 Eh OS 3 bo CD £ a 60 <° he 3 V c 0 a> "S S u d O w O Ph 1830 1831 175 5 5 8 9 31 9 12 16 6 104 1832 219 7 13 7 28 1 3 25 12 96 1833 201 14 2 2 3 13 9 6 12 16 77 1834 151 49 20 1 17 1 1 4 14 107 1835 169 56 5 6 2 6 1 5 6 12 99 1836 180 45 9 8 4 3 1 1 9 10 90 1837 117 39 2 5 4 3 3 8 64 1838 225 39 2 25 20 9 2 11 11 119 1 Mean Strength 122 37 6 1 1 3 1 6 3 58 83 27 7 3 1 6 3 3 5 55 1437 Intermittent fever -Remittent fever Synochal fever Diseases of the respirato-ry organs - - -Diseases of the digestive organs Diseases of the brain and nervous system -Dropsies Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 254 53 10 3 58 124 2 1 44 8 24 86 89 756 1 THIRD QUARTER. FOURTH QUARTER. Years - - - - 1829 1830 1831 190 26 1832 217 84 1833 195 35 1834 113 108 1835 205 110 1836 165 109 1837 112 63 1838 218 103 1415 638 1829 1830 1831 183 24 1832 1833 212 186 1834 1835 148 194 72 51 1836 140 62 1837 108 43 1838 217 22 Mean Strength - 1388 Intermittent fever - 30 70 374 Remittent " . . 25 32 30 8 10 34 9 14 162 - - 13 3 4 - 9 8 3 - 40 Synochal " - - 4 2 31 - - - - - 37 - - 4 - - - - - - - 4 Typhus " - - - - 1 - 3 - - - - 4 - - 4 - 4 - 4 - - - 12 Diseases of the respiratory organs - . . 4 6 1 2 25 2 - 9 49 - <- 8 9 2 8 13 17 2 15 74 Diseases of the digestive organs ... - - 43 46 28 5 4 63 9 31 229 - - 13 37 20 1 28 2 25 17 143 Diseases of the brain and nervous system - - - 1 - - - 1 - - 1 3 - - 4 - 1 - - 1 - - 6 1 Rheumatic affections - - 11 3 2 1 3 1 5 3 29 - - 14 8 - 8 4 3 7 3 47 Venereal " - - - - - - 1 - - 1 1 3 - - - 2 - 3 1 - 1 - 7 Ulcers and abscesses . . 19 14 16 - 5 14 - - 68 - . - 9 6 3 3 - 2 1 9 33 Wounds and injuries - - 26 11 8 - 9 4 1 16 75 - - 19 24 5 5 5 5 4 13 80 Ebriety -All other diseases - . - - - - - - 3 - - 3 - - - - - - - - - - - - - 15 26 26 2 13 15 8 16 121 - - 13 7 5 14 6 16 3 13 77 Total - - - 174 225 177 130 180 245 96 194 1421 - - 125 126 114 114 121 117 89 92 898 236 Under the class of diseases of the respiratory organs are comprise 150 catarrh, influenza, and acute bronchitis; 47 pneumonia, 36 pleu rids, and 13 phthisis pulmonalis. Under the head of digestive organs 287 diarrhoea and dysentery, 172 cholic and cholera, and 6 hepatitis Under the class of brain and nervous system, 5 epilepsy, and 1 mani a potu; and under that of venereal affections, 13 gonorrhoea and ( syphilis. As the total of deaths, according to the post returns, is 47, and th aggregate mean strength is 1,560, the annual ratio of mortality is 3 pe cent. Of the deaths, 28 are reported in the medical returns, viz: S typhus, 2 remittent and 2 congestive intermittent fever, 4 phthisis pulmo nalis, 1 pneumonia, 1 abscess of the lungs, 3 gastro-enteritis, 1 perito nitis, 2 dysentery, 1 intussusceptio, 1 gangrene, 1 drowned, 1 froze] when intoxicated, and 6 from causes not specified. Excluding the tw< cases of asphyxia from submersion and low temperature, the annua ratio of mortality is nearly two per cent. Besides these deaths, ther were six among the Arkansas volunteers, viz. four typhoid pleurisy, on bilious congestive fever, and one erysipelas adematodes. When so il as to be considered forlorn, these cases were sent in from camp to th hospital. As the volunteers and other detachments encamped at thi post in 1836 are included in the post returns, an explanation of the dis parity between the total of deaths given by these returns, and by th medical reports, is afforded. This station, keeping in view the region in which it is located, ha generally maintained a remarkable degree of salubrity. It is only whei wide-spread epidemics prevail, as in the summer of 1839, that this pos exhibits a high ratio of sickness. Intermittent fever, however, is ver rife. The annual average of this type of fever is 114 per cent., and ths of remittent is 20 per cent. In 1835, in a mean strength of 178, ther are reported 342 cases of intermitting fever. In the first quarter of thi year the sick report embraces 172 cases, of which 125 are intermittin fever. It is remarked that it yields readily to the ordinary course c treatment, but that it is liable to recur from the slightest causes. Durin the ten years, but six deaths are reported from fever. As regards th high ratio of intermittents, it would seem that a sufficient explanation : afforded in the topographical description of this station. The relative agency of the seasons in the production of disease i general is shown in the following abstract—• 237 TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters -8 second " 8 third " 8 fourth " Annual ratio - 1,157 1,437 1,415 1,388 652 756 1,421 898 563 518 1,004 647 1,349 3,727 2,763 Hence each man has been on the sick report, on an average, once in every four and a third months. FORT JESUP. LATITUDE 31° 30' N., LONGITUDE 93° 47' W. This post is situated on the ridge dividing the waters of the Red and Sabine rivers, being distant from each about twenty-five miles. On the northern side of the ridge the streams empty into Red river, mostly through Spanish lake, the nearest point of which is about twelve miles from the fort. On the opposite side, the waters are conveyed directly into the Sabine. The post is about 100 miles due north from the Gulf of Mexico. It was established in 1822. The aspect of the country on either side of the ridge is rolling and broken. Along the margins of streams some good lands are found, being a black clayey soil of a tenacious nature. The high lands are covered chiefly with pine, thinly intermixed with oak and hickory ; whilst the streams are skirted with beach, mulberry, sassafras, and occasionally cypress. The summer usually commences about the 1st of May, and continues until the last of September; during which period a high temperature, from ten o'clock until sun-set, generally prevails, the range of the ther- mometer being from 76° to 90° and 96° of fahrenheit. The nights, however, are often cool and pleasant, owing to the refreshing breezes which come in the direction of the Gulf of Mexico. What is called the rainy season begins generally in the month of February, and continues untrl the first or middle of May. The annual quantity of rain, on an average of four years, is 47.43 inches. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Jesup, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Vears .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 188 1838 227 2281 1829 145 4 1830 126 5 1831 201 8 1832 331 21 1833 1834 1835 309 6 1836 97 20 1837 295 6 1838 218 22 Mean Strength 150 223 160 277 258 268 261 269 250 5 327 8 229'J Intermittent fever - 4 4 2 13 5 2 4 9 7 10 60 105 Remittent " - - - - 5 2 5 1 - - - 13 - 7 4 5 - 2 9 - - - 27 Synochal " - - - - 2 - - - - - - 2 - 3 - - - - 18 - - - 21 7 2 . - - 9 Diseases of the respiratory organs 53 20 55 140 30 26 60 38 25 28 475 30 13 12 56 17 53 45 26 35 21 308 Diseases of the digestive organs ... 38 57 10 31 19 82 22 8 19 49 335 17 34 91 232 72 83 159 41 76 65 870 Diseases of the brain and nervous system - 2 . - - - . 1 3 11 9 26 - - - 3 . 18 1 4 4 4 34 1 - 1 1 2 1 - 6 - 1 2 - 1 . - - - 4 Rheumatic affections 2 5 - 54 15 10 4 18 3 11 122 3 2 2 42 9 23 12 17 7 9 126 Venereal " - . 6 5 3 . 1 2 1 - 3 21 4 3 6 9 . 3 4 2 . 1 32 Ulcers and abscesses . 2 - 5 2 . - 4 3 16 32 - 1 - 33 4 8 40 2 13 11 112 Wounds and injuries 10 3 3 13 30 19 40 11 21 43 193 6 11 9 57 27 60 14 11 38 30 263 Ebriety . 10 - - - - 2 13 17 16 58 - 7 - - . - . 4 11 17 39 All other diseases - 2 1 4 85 6 7 9 21 12 12 159 2 2 14 65 20 21 14 3 21 6 168 Total - 111 108 79 352 109 153 146 128 119 197 1502 66 88 147 525 154 287 324 130 211 186 2118 THIRD QUARTER. FOURTH QUARTER. Years - - - - 182S 183C 161 15 1831 178 5 1832 310 35 1833 246 7 1834 306 10 1835 318 132 1836 93 7 1837 247 14 1838 214 30 2291 283 1829 183 8 1830 137 3 1831 216 28 1832 278 8 1833 241 4 1834 271 5 1835 295 7 1836 278 15 1837 230 14 1838 201 12 Mean Strength 218 28 2330 Intermittent fever - 104 Remittent fever 18 30 20 1 2 12 - 1 2 - 86 16 - 4 - 2 2 - 4 . . 28 Synochal fever - 2 4 - 3 - - - - - 9 4 4 Typhus fever - - - 1 - 8 - - - - 9 - - - - 1 - - . - 1 2 Diseases of the respirato- ry organs - 16 - 17 50 20 16 21 19 8 7 174 43 9 19 21 34 24 39 26 14 8 237 Diseases of the digestive organs ... 38 16 24 152 73 78 101 21 56 65 624 10 13 21 32 25 55 80 48 38 13 335 Diseases of the brain and nervous system - - 1 1 - 5 3 15 16 2 7 14 64 - - - 1 - 4 21 17 - 6 49 Dropsies . . - - - - - - - 1 - 2 - 3 - - - - . 1 - - 1 . 2 Rheumatic affections 1 1- 4 30 18 11 9 3 4 12 93 . - 44 5 4 6 9 8 7 3 86 Venereal affections 8 6 8 1 - - 1 - - . 34 5 1 2 - - . 5 1 2 . 16 Ulcers and abscesses - 3 3 31 9 8 31 7 13 16 121 4 - 1 6 1 3 10 11 11 10 57 Wounds and injuries 25 14 11 88 20 56 18 12 24 33 301 7 10 37 37 26 29 25 30 12 13 226 Ebriety - 22 - - - - 9 6 6 29 72 1 5 - - - 5 8 12 9 11 51 AH other diseases - - 1 - 42 3 7 14 6 35 14 122 - - 54 22 5 - 11 11 28 2 133 Total - - - 1 45 111 96 136 158 221 353 84 171 220 1995 98 41 210 132 102 134 215 183 136 79 133U 240 Under the class of diseases of the respiratory organs are comprised 994 catarrh, 32 pneumonia, 143 pleuritis, and 19 phthisis pulmonalis; under the head of digestive organs, 1,392 diarrhoea and dysentery, 24b cholic and cholera, and 8 hepatitis; under the class of brain and nervous sys- tem, 8 epilepsy, 74 mania a potu, 2 apoplexy, and 5 nyctalopia; and under that of venereal affections, 74 gonorrhoea and 29 syphihs. As the total of deaths, according to the post returns, rs 70, and the aggregate mean strength is 2,306, the annual ratio of mortality is 3 per cent. Of the deaths, all are reported in the medical returns, viz. one remittent fever, two typhus fever, twelve phthisis pulmonalis, eight pneumonia, three hydro-thorax, one ascites, nine gastro-enteritis, two dysentery, six chronic diarrhoea, one hepatitis, three epidemic cholera, seven mania a potu, six ebriety, two apoplexy from ebriety, one casualty, two sudden, and four from causes not specified. It is a remarkable fact that among 70 deaths three only are reported from fevers. The annual average of fevers of malarial origin is low for this region, intermittents being 24, and remittents 7 per cent. The third quarter of 1835 is the only season in which a high ratio of intermitting fever is presented, being at the rate of 41 per cent, for the quarter. " In- termittents," says Surgeon P. H. Craig, "have prevailed to a greater extent than I have ever known before, and many of the cases were characterized by great obstinacy. Few of the families escaped the dis- ease ; but I report the cases only that occurred among the officers and soldiers. The sudden atmospheric vicissitudes in the months of June, July, and August, may be assigned as the proba"ble cause of its unusual prevalence." It is a singular fact that, notwithstanding the peculiar rifeness of intermitting fever, not a single case of the remitting fonn is reported. In regard to the treatment of diseases, it is remarked by Surgeon Craig, that morbid action is generally of a character requiring antiphlo- gistic means in the early stages, such as bleeding, both general and local, and the exhibition of mild purgatives* The following abstract exhibits the relative agency of the seasons in the causation of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean stiength, treated annually. 10 first quarters -10 second " -10 third " -10 fourth " -Annual ratio - 2,281 2,299 2,291 2,330 1,502 2,118 1,995 1,330 659 921 871 571 2,300 6,945 3,020 Every man, on average, has consequently been reported sick once in every four months. 241 The following table presents the mortality of each post and its relative degree i sSss, based on the statistics furnished during the period of ten years— TABLE exhibiting the mortality of each post, and the relative degree of sickness. Jefferson Barracks Fort Gibson Forts Smith and Coffee Fort Towson " Jesup - Aggregate Ratio per 1,000 Sail 3,193 4,064 234 1,349 2,300 11,140 .8 | as & ■81:2 135 259 20 47 67 528 45* e § to >- n in 180 11 26 66 394 36 — S. 10,965 16,487 906 3,727 6,945 39,030 © "& u 2 si H " a- « g « 5 *J •issi 3,434 4,057 3,872 2,763 3,020 3,504 The annual ratio of mortality, according to the medical reports, is 3fa per cent., and according to the Adjutant General's returns, 4/T per cent. As in the preceding classes, the deaths from epidemic cholera (24 at Jefferson Banacks, 18 at Fort Gibson, and 3 at Fort Jesup) have been excluded in both these calculations; and in the medical returns, those deaths also reported as drow ned, frozen, and suicide. As the ratio per 1,000 of mean strength annually under treatment is 3,504, it follows that every man, on an average, was reported sick once in nearly every 3^ months. Judging from the ratio under treatment annually as affording an index of the comparative salubrity of the several posts composing this class, it is found that Fort Gibson exhibits the highest, and Fort Towson the lowest, extreme. The ratio under treatment annually in this class is the highest yet presented. The general results obtained from this class of posts will now be exhibited, in further illustration of the diseases of this region, showing the relation of season and climate with morbid action. • The aggregate mean strength, according to the Adjutant General's returns, ia 11,739, 31 242 TABLE exhibiting the relative influence of the DISEASES. S3 P3 §i !-. O £ 2 -5 c o '6 *-< o Ph •8 VI O Eh d o ua & o Eh H o Eh d, s tn CD >-a M o Em o Eh < i a Ratio of cases per 1,000 of mean strength. INTERMITTENT FEVER. First quarter -Second " ..... Third "..... Fourth "..... 94 183 582 233 599 804 1990 1493 48 31 120 51 278 254 638 374 60 105 283 104 1079 1377 3613 2255 10611 10670 11847 11428 101 129 305 197 Annual ratio .... 1092 4886 250 1544 552 8324 11140 732 REMITTENT FEVER. First quarter ..... Second " ..... Third "..... Fourth "..... 47 49 292 137 47 70 671 228 1 26 5 19 53 162 40 13 27 86 28 126 200 1237 438 10611 10674 11847 11428 12 19 104 38 Annual ratio .... 525 1016 11 2 89 46 148 32 274 154 2001 11140 173 SYNOCHAE FEVER. First quarter ..... Second " ..... Third "..... Fourth «..... 7 1 1 1 25 4 10 37 4 2 21 9 4 18 41 161 54 10611 10674 11847 11428 2 4 14 5 Annual ratio .... 8 27 55 36 274 11140 25 TYPHUS FEVER. First quarter..... Third "..... Fourth "..... 1 2 2 1 - 3 4 12 9 9 2 2 12 16 15 10611 10674 11847 11428 0 2-10 1 14-10 13-10 Annual ratio .... 1 5 - 19 20 45 11140 3 9-10 DIARRHCEA AND DYSENTERY. First quarter..... Second " ..... Third "..... Fourth "..... 200 697 1232 515 210 588 864 574 2236 11 8 51 27 18 56 126 87 219 619 372 182 658 1968 2645 1385 10611 10674 11847 11428 62 185 223 121 Annual ratio .... 2644 97 287 1392 6656 11140 591 243 stasons in the production of morbid action, 4r. DISEASES. PQ c . O w to M *- o iB « *G H CO 1-5 c o w ,n '6 tJ o > •8 C to 50 £ » <= 1" Eh 29 2 25 13 69 a o cc is o Eh o Eh V >-! o Eh 3 o Eh Aggregate mean strength. Ratio of cases per 1,000 of mean strength. CATARRH AND INFLUENZA. First quarter ..... Second " ..... Third "..... Fourth " ..... 296 116 117 384 506 251 73 276 1106 182 33 16 28 40 30 38 42 150 426 250 139 179 1297 649 392 894 10611 10674 11847 11428 122 61 33 78 Annual ratio .... 913 994 3232 11140 294 PNEUMONIA. First quarter Second " - - -Third " - ... Fourth "..... 41 8 12 25 2 2 2 22 7 1 17 15 7 4 6 260 57 35 78 10611 10674 11847 11428 25 & 3 7 Annual ratio .... 86 259 102 39 19 38 6 2 1 1 47 7 12 7 10 32 430 11140 40 PLEURITIS. First quarter..... Second " ..... Third "..... Fourth "..... 86 33 38 54 28 45 20 50 225 130 84 153 10611 10674 11847 11428 21 12 7 13 Annual ratio .... 211 198 4 36 143 592 11140 53 PHTHISIS PULMONALIS. First quarter..... Second "..... Third "..... Fourth "..... 7 10 20 12 12 7 16 7 1 3 6 2 2 5 6 6 2 28 29 44 23 10611 10674 11847 11428 3 3 4 2 Annual ratio .... 49 42 1 13 19 124 11140 12 RHEUMATISM. First quarter..... Second " ..... Third "..... Fourth " ..... 62 61 25 81 139 96 78 85 14 7 6 7 45 44 29 47 122 126 93 86 382 334 231 306 10611 10674 11847 11428 36 31 20 27 Annual ratio - 229 398 34 165 427 1253 11140 114 244 As this class of posts maintains the same climatic relation towards thd preceding one, as the third class of the northern division does towards the first two, so a similar relation is found in regard to pulmonary diseases. Embracing a region remote from the influence of large bodies of water, the ratios of catarrhal affections, pleuritis, and pneumonia, in this, compared with those of the preceding class, are higher, notwith- standing the more southern locality of the interior stations. The two classes of the middle division stand thus— Catarrh and influenza. Pneumonia. Pleuritis. Sea-coast - - 2T1 - - 25 - 32 Interior - 290 - - 39 - 52 In the system of climate now under investigation, the comparative agency of the seasons in the causation of pulmonary diseases is more strikingly contrasted than in any other. In catarrh and influenza, the ratios of the first and third quarters stand as 122 to 33, in pneumonia as 25 to 3, and in pleuritis as 21 to 7. In regard to the comparative influence of the seasons in the produc- tion of rheumatic affections, this class is found to exhibit it also more decidedly than any other; but the general consideration of this subject will be reserved until the investigation of each class of posts shall have been completed. In the last class, a comparison was made with the mean results given in the three classes of the northern division of the United States, showing that the ratios of intermittent and remittent fever, as well as diarrhcea and dysentery, increase in proportion as more southern latitudes are reached. The class of stations just described occupies nearly the same latitudes as those constituting the preceding class; but the average of diseases of malarial origin is higher, owing doubtless, in some measure, to the circumstance that as the region is inland the heats of summer are greater. Compared with this class, it is found that the annual ratio of intermittent fever is twice as high, and that of diarrhcea and dysentery is about one-third greater; whilst the ratios of remittent, synochal, and typhus fever, present little difference. The total of deaths in each month, according to the post returns, ia exhibited in the annexed table— TABLE showing the number of deatlis in each month- Jan. 41 Feh. 34 Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total. Total of deaths in each month. 35 19 28 46 56 66 88 72 57 31 573 In this table are included 45 deaths from epidemic cholera. Of these, three occurred in January, eight in May, three in June, nine in July, ten in August, and twelve in September- 245 SOUTHERN DIVISION OF THE UNITED STATES. This region is characterized by the predominance of high tempera- ture. As we proceed south from Canada, to Florida, it is found that the contrast in the seasons grow less in proportion as the mean annual temperature increases. The peculiar character of the climate of our most southern latitudes is distinguished less by the mean annual tem- perature, than in the manner of its distribution throughout the year. At Fort Snelling, the mean winter temperature is 17° 29', and that of sum- mer is 72° 80'; and in Florida, on the other hand, the former, at Fort Brooke and Key West, is respectively 65° 02' and 70° 05', and the lat- ter, 81° 04' and 81° 39'. Thus, whilst the difference between the mean temperature of summer and winter, at Fort Snelling, is 55° 51', at Fort Brooke it is 16° 02', and at Key West only 11° 34'; and whilst the winter at Fort Snelling is 52° 76' colder than at Key West, the sum- mer of the latter is only 8° 59' warmer. We thus perceive the truth of the remark made by Humboldt, that the climate of the tropics is char- acterized much more by the duration of heat than its intensity. The remarkable uniformity of the seasons observed in the peninsula of East Florida is, however, much less striking as we proceed into Georgia. At Augusta Arsenal, for example, notwithstanding the mean annual tem- perature is nearly 8° lower than at Fort Brooke, the mean summer temperature is higher. In summer, the mercury rises higher in most parts of the United States, and even in Canada, than it does along the coast of Florida. In six years' observation at Key West, it was never known to rise above 90°. In peninsular Florida, vegetation is con- tinuous ; wild flowers never cease to unfold their petals; and the tem- perature of the waters of rivers and bays will generally admit of bathing throughout the winter. The first class comprises the following posts:—Augusta Arsenal, Fort Mitchell, Baton Rouge, New Orleans, and Forts Pike, Wood, and Jackson; and the second class embraces all the stations of East Florida. In the former, Augusta Arsenal and Fort Mitchell are included, in default of a better arrangement. FIRST CLASS. AUGUSTA ARSENAL. LATITUDE 33° 28' N., LONGITUDE 81° 53' W. The class of posts to be now described are eight in number, viz : Augusta Arsenal, Ga., Fort Mitchell, Ala., and six posts on the lower Mississippi, La., to wit: Forts Pike, Wood, St. Philip, and Jackson, and the posts at New Orleans and Baton Rouge. Augusta Arsenal, situated about three miles from the city of Augusta, occupies a high and dry position among the " sand-hills." It is distant about 130 miles from the ocean, and is elevated, it is estimated, 600 feet above its level. The nearest point of the Savannah river is 2 miles, whilst tire surrounding country presents no marshes or lakes. The 246 locality of this station has an elevation of about 200 feet above that of Augusta; and as the soil is hard, dry, and sandy, and the physical aspect of the neighboring country exhibits a succession of hills and sloping valleys, the most favorable natural circumstances obtain to facilitate drainage. The soil is rather unproductive. Culinary vegetables are very inferior in size and quality. Some varieties of fruit, however, such as the apple, plum, peach, and watermelon, are very abundant, attain a large growth, and are finely flavored. The forest trees consist chiefly of different species of the genus quercus, pinus, carya, juglans, and diospyros. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Augusta Arsenal, for a period often years. FIRST QUARTER. 1829 87 2 SECOND QUARTER. Years - 1829 59 1 1830 63 7 1831 51 1 1832 62 2 1833 232 2 1834 30 1835 63 1836 49 1837 1838 609 13 1830 93 4 1831 83 3 1832 55 1833 59 7 1834 56 2 1835 60 1836 1837 1838 Mean Strength 493 Intermittent fever - 18 Remittent fever 3 - 4 1 2 - 1 - - - 11 10 6 2 7 7 3 - - -1 35 Synochal fever 5 - - 1 - - - - - - 6 - - - 2 - 2 - " 4 Typhus fever - - - - - - - - - - - - - - " " Diseases of the respirato- S ry organs - 3 3 3 6 42 1 10 1 - - 69 1 - 2 3 6 2 6 ■e - " 20 Diseases of the digestive Eh organs ... 2 1 3 7 71 2 2 2 - - 90 19 19 8 5 2 3 6 )H - - 62 Diseases of the brain and B nervous system - - 1 - - 1 - 1 t - - 4 2 2 2 - 1 - - - - 7 Ulcers and abscesses . 2 3 2 2 9 1 1 1 1 - - 1 to - - 5 Wounds and injuries Ebriety 2 3 5 1 6 6 12 1 1 1 4 2 - . 33 11 2 2 2 4 3 1 2 1 2 IS - - 16 3 All other diseases - 8 ,5 5 2 19 3 - 10 - - 52 6 6 1 1 3 4 2 < 23 Total - 31 27 22 42 175 10 20 16 - - 343 50 42 27 24 30 19 21 - - 213 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. _. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 488 1829 69 5 2 5 3 1 4 1 2 28 1830 28 1 1 2 1 I 2 8 1831 63 2 5 2 1 2 12 1832 69 4 5 1 2 3 15 1833 17 1 1 1 2 5 1834 62 7 4 2 2 4 22 1835 51 1 4 2 2 3 12 1836 1837 1838 Mean Strength 95 78 93 50 54 65 53 - 359 Intermittent fever Remittent " Synochal " Typhus " Diseases of the respirato-ry organs Diseases of the digestive organs ... Diseases of the brain and nervous system Dropsies ... Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -Ebriety ... All other diseases Total - 10 4 1 18 4 1 7 3 1 1 2 52 4 2 10 19 2 1 3 2 5 3 4 55 8 6 10 5 2 1 4 6 42 6 6 2 12 1 1 2 30 1 4 1 7 18 7 2 5 3 2 3 1 3 26 3 1 1 4 1 1 1 2 14 - - - 36 27 2 14 75 12 2 15 9 9 13 3 20 237 6 17 12 12 10 2 17 3 9 102 249 Under the class of diseases of the respiratory organs are comprised 85 catarrh, 23 pneumonia, 2 pleuritis, and 4 phthisis pulmonalis; under the head of digestive organs, 115 diarrhoea and dysentery, and 31 cholic and cholera ; under the class of brain and nervous system, 2 epilepsy, 5 delirium tremens, and 1 nyctalopia ; and under that of venereal affec- tions, 35 gonorrhoea, and 16 syphilis. As the total of deaths, according to the Adjutant General's returns, is 18, and the aggregate mean strength is 488, the annual ratio of mor- tality is 3 fa per cent. Of the deaths, 17 are reported in the medical returns, viz. 3 remittent fever, 4 phthisis pulmonalis, 1 scarlatina ar.gi- nosa, 1 gastro-enteritis, 1 cholera morbus, 1 chronic diarrhoea, 1 chronic gastritis, attended with ulceration of the mucous tissue, 1 chronic visceral lesions, 2 mania a potu, 1 ebriety, and 1 wuund. The ratio of mor- tality, according to the medical returns, is 3fa per cent. The average of fevers of malarial origin is low, the ratio of intermit- tents being 15, and that of remittents 16 per cent. Out of 79 cases of remitting fever, 4 terminated fatally. It may be necessary to remark, however, that in several reports these two forms of fever were so regis- tered as to render it impracticable to determine the precise number of each. The fevers of this locality, which are generally of a mild and man- ageable nature, are mostly owing to exposure to solar heat, the abuse of alcoholic liquors, and perhaps the excessive use of unripe and indiges- tible fruit. During the present summer, (1839,) most of the cities of the Southern States have suffered severely from yellow fever. Although the city of Augusta experienced its worst ravages, the garrison of this post, with the exception of one case, was exempt from the fatal epidemic. This man passed a night in the city, in a state of intoxication. In regard to the origin of this endemico-epidemic, termed yellow, or "stranger's fever," much contrariety of opinion, as has been found to obtain at all periods, existed. From the report of a committee consist- ing of physicians of Augusta, by whom the question of its origin and cause was carefully investigated, it. appears that the disease was of domestic origin, and exhibited nothing of a contagious nature. The "fons et origo mali" was traced to a point called " trash-wharf,"—a slide, or inclined plane, which was erected in 1S34, for the purpose of throwing the filth of the city, including dead animals, into the river. This mass of animal and vegetable matter having accumulated to upwards of 200,000 cubic feet, it was resolved by the authorities of the city to have it removed ; and, accordingly, during the months of May and June, its interior was exposed to the action of the sun. Having penetrated the exterior crust, the heat evolved was so great that the workmen, although wearing thick shoes, were compelled to desist from their work, " for two hours at a time, so as to suffer it to cool." Our present knowledge does not, however, warrant us in saying that the same miasm which produces remittent fever is, in its more virulent state, the cause of yellow fever, or even that the latter is of paludal origin. 32 250 The advantage of position, as regards salubrity, is strikingly illustrated in this locality. On reference to the history of this garrison prior to 1829, it will be found that, during the period when the arsenal was situated on the Savannah, disease prevailed to so great an extent that it was neces- sary to abandon the post in the summer season, and encamp on the " sand-hills." The advantages of this measure were, indeed, but partial; for as it was necesssary to keep a guard at the arsenal, the men were in turn exposed to this miasmatic atmosphere. Thus, in the third quarter of 1825, all the garrison, with the exception of two men, suffered from the " country fever;" and, consequently, the only benefits of a summer encampment were, that fewer cases proved fatal, and relapses were less frequent. The comparative influence of the seasons in the causation of disease in general is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 8 first quarters -7 second " 7 third " -7 fourth " -Annual ratio . 609 493 488 359 333 213 237 102 547 432 465 284 487 885 1,817 Hence each man, on an average, has been reported sick once in every six and a half months—a low ratio. The fact that the first quarters present a higher average of sick than the third, is ascribable to the circumstance that the post had a very large command in the first quarter of 1833. The law, that an increase in the mean strength is followed by more than a corresponding ratio of disease, is one that obtains universally. FORT MITCHELL. LATITUDE 32° 19', LONGITUDE 85° 10'. This post is situated near the Chattahoochee, about ten miles below Columbus. Occupying an elevated ridge on the west side of the river, about one mile from its banks, this position is both salubrious and agree- able to the eye. Between the ridge and the river the lands are low, but generally speaking the locality is exempt from marshes. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Mitchell, for aperiodoften years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 96 183111832 D2 87 1833 1834 446 1835 1836 49 2 1 5 14 1 3 3 12 12 53 1837 1838 799 23 3 4 77 183 6 8 27 18 28 88 3 128 596 1 1829 47 4 4 2 12 1 2 3 1 6 35 1830 139 1 2 17 1 2 4 2 8 35 72 1831 83 1 9 14 1 4 3 29 61 1832 72 27 1 1 5 3 4 18 59 1833 135 15 3 2 2 3 9 40 74 1834'l835 108 -3 2 43 1 2 10 3 7 9 80 1836 103 7 12 4 47 1 1 1 3 9 27 112 1837 38 2 7 9 1 6 1 1 1 2 4 34 1838 Mean Strength 29 725 Intermittent fever -Remittent " -Synochal " -Diseases of the respira-tory organs Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -AU other diseases -Total - 3 7 1 3 1 3 18 4 6 2 3 2 6 9 32 1 3 5 2 4 7 39 61 24 5 1 2 1 2 2 5 42 -3 ta P o «s CO 00 o p 21 I 1 41 146 4 6 22 4 21 60 3 60 390 T3 > O u o i> « © X\ o %. CS 14 13 25 18 181 6 3 12 20 18 38 11 16S 527 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 86 11 1 8 1 2 3 1 o 21 7 1830 78 2 1 4 4 4 2 6 22 45 1831 93 4 2 13 1 2 2 24 1832 67 4 11 3 6 23 47 1833 130 2 10 26 2 7 9 3 15 27 1834 53 7 1 12 1 1 2 1 17 42 1835 38 7 3 2 1 1 10 24 1836 1837 36 1 4 1 11 2 2 4 7 1838 581 34 25 2 87 6 2 9 19 16 22 37 137 1829 103 6 1 6 6 5 2 3 3 31 63 1830 57 1 2 2 3 1 4 31 44 1831 91 2 2 1 1 1 2 4 26 1832 65 4 4 5 3 5 1 4 6 1833 165 5 2 7 3 2 4 3 6 7 45 84 1834 1835 35 2 1 1 10 1 4 1 3 1 24 1836 1837 1838 Mean Strength 516 Intermittent fever -Remittent fever Diseases of the respirato-ry organs - - -Dis; ases of the digestive organs ... Dis( ases of the brain and nervous system -Dropsies ... Kheuinatic affections Venereal affections Ulcers and abscesses Wounds and injuries Ebriety -All other diseases - 17 9 9 30 8 4 12 18 14 25 140 Total - 57 48 101 32 - 396 39 32 286 to 253 Under the class of diseases of the respiratory organs are comprised 90 catarrh and influenza, 5 pneumonia, 20 pleuritis, and 3 phthisis pulmo- nalis ; under the head of digestive organs, 351 diarrhoea and dysentery, 65 cholic and cholera, and 1 hepatitis; under the class of brain and nervous system, 8 epilepsy, 3 apoplexy, 8 mania a potu, and 4 nycta- lopia; and under that of venereal affections, 48 gonorrhoea, and 26 syphilis. As the total of deaths, according to the post returns, is 25, and the aggregate mean strength is 761, the annual ratio of mortality is 3 fa per cent. Of the deaths, 19 are reported in the medical returns, viz. 3 remittent fever, 3 phthisis pulmonalis, 1 chronic hepatitis, 1 chronic diar- rhoea, 2 mania a potu, 2 accidental, and 7 from causes not designated; being nearly 3 per cent. The average of intermitting and remitting fever is very low, the for- mer being 13, and the latter 8 per cent. There is nothing in the history of this post requiring special comment. Considering that it is a south- ern post, both this and the preceding one may be regarded as remark- ably salubrious. The ratio of mortality is low, with the exception of 1836, the period of the Creek difficulties. In this year it is 9 per cent., owing doubtless to the exposures incident to such a state. The following table exhibits the relative agency of the seasons in the etiology of disease in general— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated annually. 6 first quarters -8 second " 8 third " 6 fourth " Annual ratio - 799 725 581 516 596 527 396 288 746 727 682 554 655 1,805 2,756 Every man, on an average, has consequently been reported sick once in every four months and a third. BATON ROUGE. LATITUDE 30° 36' N., LONGITUDE 91° 23' W. This post is situated on the east bank of the Mississippi river, in Baton Rouge, La. This town occupies the first bluff or highland found in ascending the river—the point at which the levee or artificial embank- ment terminates. The bluff on which the barracks are situated is 22 feet above high-water, and 60 feet above low-water mark. There are no marshes in the vicinity; a cypress swamp, distant 15 miles north, being the nearest. The public grounds are bounded on the north by a 254 bayou, which empties into the Mississippi about 200 yards above the barracks. " This bayou," says Surgeon B. F. Harney, " is filled to a greater or less extent from the river, from the 1st of February to the 1st of August, of each year. It might be supposed that, as the water retires from the bayou, deposites of a nature productive of disease would take place. But experience has proven the reverse; for, as soon as the annual fall of the Mississippi commences, the ' rainy season' begins; and thus the bayou is thoroughly washed, and the deposites that might prove a source of disease are carried to the river. It also lies in a direction whence we have no winds during the sickly season." The public grounds are undulating and well drained. The country on the same side of the river, extending north and east, is of the same character; but that lying south, together with the lands west of the Mis- sissippi, consists of a rich alluvial deposite, low and level. The barracks, constructed of brick, with slate roofs, were completed in 1824. The hospital, built of the same materials, was finished in 1839. These buildings are well constructed and admirably adapted for the purposes intended. The public grounds are now well shaded by trees, such as the mulberry, pride of China, &c. These trees, planted in 1824, contribute, it is believed, very materially towards maintaining the healthfulness of the station. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Baton Rouge, for a period often years. FIRST QUARTER. SECOND QUARTER. Yean - 1829 170 14 1830 149 3 1831 207 20 1832 152 13 1833 125 6 1834 166 10 1835 150 14 1836 1837 1838 1119 80 1829 124 15 1830 204 to 1831 251 36 1832 156 34 1833 115 7 1834 121 15 1835 152 22 1836 1837 1838 Mean Strength 1123 Intermittent fever 139 Remittent " - . 3 - . 15 15 12 . . . 45 2 3 23 . 15 12 15 . . . 70 Synochal " - - 3 - - - - - - . - 3 - 5 - . . - - - . . 5 Typhus " - 3 • 1 • T - - - - . 4 1 10 5 - 3 . - - . . 19 Diseases of the respira- tory organs 9 12 39 3 6 22 13 - - - 104 5 5 16 6 4 11 6 . • . 53 Diseases of the digestive • organs - . , 26 41 51 24. 40 35 37 H3 . . 254 17 57 81 23 69 59 53 . . . 359 Diseases of the brain and 5 nervous system . 5 3 1 2 3 4 a - . 18 . 1 - 2 1 1 5 . . . 10 Dropsies - 1 - - - 1 - - - - 2 - - - - - - - - . - . Rheumatic affections 3 2 - 2 6 8 7 - . 28 . - - . 3 4 - . . . 7 Venereal " - 3 . 4 1 1 3 4 . - 16 . 2 14 2 . . 6 . . . 24 Ulcers and abscesses 6 3 8 4 4 6 6 . . 37 3 3 4 4 8 4 4 . . . 30 Wounds and injuries 13 5 12 9 12 11 9 - - 71 10 5 18 12 13 16 9 . . . 83 Ebriety , . - - 42 9 4 3 . - Ph . - 58 5 9 5 4 5 . - . . . 28 All other diseases 5 4 47 37 5 43 15 fc - - 156 1 24 65 50 22 34 13 - - - 209 Total - 83 123 194 98 101 156 121 - - - 876 59 134 267 137 150 156 133 - - - 1036 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - - - - 1829 141 1830 185 1831 150 1832 55 1833 148 1834 120 1835 144 1836 1837 1838 943 1829 95 17 1830 196 19 1831 151 7 1832 1713 20 1833 160 24 1834 125 12 1835 127 11 1836 1837 1838 Mean Strength 1027 Intermittent fever - 29 9 27 50 53 20 20 208 110 Remittent fever 8 3 13 10 28 15 18 - - - 95 19 12 9 15 16 17 12 . . . 100 Synochal fever - 5 - - - - - - - - 5 4 . . 4 . . . . . . H Typhus fever - 7 - - - - - . - . 7 . 5 . . . . . . . . 5 Diseases of the respirato- ry organs - 3 - 2 - 18 15 11 - - - 49 . 21 23 15 13 (! 6 . . . 84 Disea.es of the digestive organs ... 18 22 64 14 53 48 53 . . . 272 . 17 28 20 52 37 18 . . , 172 Diseases of the brain and nervous system - - 1 - - 3 - - - - - 4 - 1 1 3 4 l . - . . 10 Dropsies ... - - - - 2 - - - - - 2 1 - . 1 2 . . _ . . 4 Rheumatic affections 1 3 - 1 4 8 5 . - . 22 . . . 4 10 8 2 . . _ 24 Venereal " - .- - 2 1 - 4 3 - . . 10 . 1 . 3 2 2 1 _ _ . 9 Ulcers and abscesses 5 - - 2 10 7 12 . - . 36 7 . 8 . 3 4 4 . . 26 Wounds and injuries 3 7 11 4 7 10 12 - - . 54 8 13 9 7 12 6 3 . . . 58 Ebriety ... - 13 1 2 - - - - - - 16 3 . 4 7 All otlier diseases - 7 18 10 16 40 24 16 - - - 131 10 22 33 51 12 8 8 - - - 144 Total - 74 88 130 100 218 151 150 - - - 911 69 111 122 143 150 101 65 - - - 761 Under the class of diseases of the respiratory organs are comprised 220 catarrh, 24 pneumonia, 33 pleuritis, and 11 phthisis pulmonalis; under the head of digestive organs, 516 diarrhcea and dysentery, 423 cholic and cholera, and 7 hepatitis; under the class of brain and nervous system, 10 epilepsy, 13 mania a potu, and 1 apoplexy ; and under that of venereal affections, 36 gonorrhoea, and 21 syphilis. As the total of deaths, according to the post returns^ is 79, and the aggregate mean strength is 1,090, the annual ratio of mortality is 7 fa per cent. Of the deaths, 73 are reported in the medical returns, viz : 12 congestive typhus, 10 yellow fever, 1 remittent fever, 1 intermittent fever, 1 pneumonia, 1 pleuritis, 1 phthisis pulmonalis, 5 dysentery, 3 gastro-enteritis, 8 epidemic cholera, 1 erysipelas, 1 delirium tremens, 7 ebriety, 1 epilepsy, 1 chronic visceral lesions, and 19 from causes not specified. Excluding the cases of cholera, the average mortality, according to the medical returns, is 6^ per cent. The average of intermittent fever is^51, and that of remittent fever is 30 per cent. Although the ratio is not so high, for example, as that of Fort Gibson, yet the mortality from fevers of malarial origin, ov/ing to the circumstance that remittents often assume the most malignant char- acter, is considerably higher. The following extract from the quarterly report, made the 31st of December, 1829, by Surgeon B. F. Harney, will afford some explana- tion in reference to the high mortality by which this post has always been distinguished—"Adams, of 'E' company, and Lado and Small, of < K' company, died of intemperance, their constitutions having been destroyed thereby. Stettler, of < E' company, a deserter and unacch- mated, died of remittent fever—had chronic dysentery for several months previous to his death. Banta, a recruit of the 4th Infantry, unacch- mated and a prisoner, died of yellow fever. Gaflield and Smith, of (E' company, on guard and much exposed, the latter unacclimated, died of yellow fever. Thompson, a deserter, with bad constitution, of yellow fever. Salem, of ' B' company, of very intemperate habits, arrived here from Fort St, Philip with yellow fever; he recovered became affected with intermittent fever, and finally died of a second attack of yellow fever. Partridge, of ' E' company, very intemperate of remittent fever. Seven men, sent in pursuit of deserters, were, with the exception of the corporal, taken sick soon after their return, and two of these died of yellow fever." ., • , , In the second quarter of 1833, eight deaths from epidemic cholera are reported. This point seems to have wholly escaped the dreadful ravages of this disease in the preceding year. Prior to 1829, more especially from 1819 to 1824 inclusive, this post presents a melancholy history. The annual ratio of mortality, based on the results of six years, (from 1819 to 1824 inclusive,) is nearly 21 per cent.__a fatality unparalleled in our military annals. In 1822, the most fatal year, the mean was almost 26 per cent. In a recent report on the medical topography of this post, Surgeon Harney remarks—" The diseases are mostly bilious intermittents and remittents, tending to a typhoid character. The yellow fever was first 33 258 known here in 1817, re-appearing in the years 1819,-'22, and 27. There were many cases in 1829, mostly confined, however, to the European Spaniards driven from Mexico. These cases were owing to their mode of living, their filth, and their crowded condition; and being unacclimated, they were especially obnoxious to disease. " The soldiery suffered in 1821,-'2,-'3, without assignable cause, from a disease called the cold plague, during which years the village was free from disease. It has not been known here since 1823. This disease prevailed in the month of May and part of June in each year. The symptoms were very similar to those of cholera, and were treated with mercurial cathartics in very large doses, sinapisms, the warm bath, &c " The causes of general sickness, in 182l,-'2,-'3, were exposure while at work on the barracks' then building, intemperance, and labor in the Cypress swamp, about fifteen miles from this point, in procuring timber." The relative influence of the seasons in the production of diseases generally is shown in the following table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 7 first quarters -7 second " 7 third 7 fourth " Annual ratio - 1,119 1,123 943 1,027 876 1,036 911 761 783 923 966 741 1,053 3,584 3,404 Hence every man, on an average, has been reported sick once in every three and a Jialf montlis, NEW ORLEANS. LATITUDE 29° 57' N„ LONGITUDE 90° 14' W. The barracks, erected in 1834 and '35, are situated on the left bank of the Mississippi, three miles below the city proper. They form a parallelogram of about 300 feet on the river, extending back 900 feet. Built of granite and brick, the quarters are commodious, dry, and well ventilated. The grounds within the parallelogram have been raised thirty inches by means of earth, the external surface consisting of a stratum of shells; intersected by ditches, these grounds are easily maintained in a dry state. The quarters are sheltered from the north and northeast winds by a forest of cypress and other trees, which, commencing about 500 yard." from the river, extends back towards Lake Ponchartrain. 259 As the troops have until recently been always quartered in New Orleans, this city is the station to be now described. Situated on the left bank of the Mississippi in a large bend of the river, it is distant 105 miles by the channel from its mouth, and 80 miles in a direct line, southeast; it is 50 miles from the Gulf of Mexico, south; 40 miles from Chandeleur bay, southeast; 15 miles from Lake Borgne, east; and 6 miles from Lake Ponchartrain, north. The city is built upon a sloping surface, which descends gently from the river to the lakes. It is not elevated more than eleven feet above the level of the ocean; and when the Mississippi becomes full, the streets are three or four feet below its surface, protected from inundation by the dyke or levee—an embank- ment made from a few miles above the Balize to the high lands about Baton Rouge on the east, and to Point Coupee, seven miles above Natchez, on the west side of the river. The draining company, estab- lished for the purpose of reclaiming the marshy lands between the city and Lake Ponchartrain, have been successsful in rendering a large por- tion of the ground fit for cultivation. There are no hills in the vicinity of the city, the surrounding country being low and flat, and the soil alluvial. Cypress, laurel, and oak, the first most abundantly, are found. As the well-water of the city contains muriates of lime, magnesia, and soda, and bi-carbonate of lime and iron, rain and river water are used for culinary and all other purposes. The annual amount of rain, on a mean of six years, is 51.85 inches. The following monthly results, based on three years' observation, are given by Surgeon Hawkins— January 4.66 May 2.95 September 5.60 February 2.25 June 6.10 October 1.37 March 2.59 July 6.38 November 3.18 April 6.21 August 5.72 December 2.87 The diseases reported within the ten years are comprised in tho following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at New Orleans, for aperiodoften years. FIRST QUARTER. SECOND QUARTER. Y"ears .... 1829 1830 1831 1832 93 8 35 6 29 5 4 2 7 2 98 1833 77 4 3 8 10 22 1 2 1 3 54 1834 1835 113 16 38 35 80 3 3 2 1 178 1836 1837 1838 283 28 3 81 51 131 6 9 6 12 3 330 1829 1830 1831 1832 92 14 15 12 21 2 1 9 2 77 1833 86 4 1 9 45 1 5 65 1834 102 5 2 18 39 13 1 79 1835 115 7 43 2 2 54 1836 1837 1838 Mean Strength 395 Intermittent fever -Remittent fever Synochal fever Diseases of the Tespirato-Diseases of the digestive Diseases of the brain and nervous system -Rheumatic affections Venereal affections > Ulcers and abscesses Wounds and injuries All other diseases - 23 23 14 1 27 148 1 3 3 29 3 275 THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 1832 1833 108 7 1834 1835 1836 115 -11 11 1837 1838 223 11 18 1829 1830 1831 82 4 28 14 2 1832 1833 73 3 2 4 1834 96 12 2 2 1835 95 10 6 6 1 1836 1837 1838 Mean Strength - - 346 Intermittent fever Remittent " Synochal " - • 29 38 26 3- Typhus - , - - ■ - - - " "< Diseases of the respirato- 5 7 12 8 Ifi 8 8 . . 40 ry organs Diseases of the digestive organs - . . . - 25 - 60 - - - 85 - - 37 - 7 26 21 - - - 91 Diseases of the brain and 31 1 m m 32 nervous system - - - " ' Rheumatic affections . . . . - - 2 ,- - - 2 - - 1 - - 2 2 4 2 - - - 5 5 8 16 Venereal " Ulcers and abscesses - - - - 2 2 3 2 - - • Wounds and injuries - - - - - - - 23 - - - 23 - - 5 " 4 7 All other diseases - - - - - - 8 124 - - 8 161 - - 8 140 - 5 44 1 66 1 58 --- ------------------------'■ - 15 Total - - - - - 37 - 308 :\ 262 Under the class of diseases of the respiratory organs are comprised 114 catarrh, 4 pneumonia, 11 pleuritis, and 2 phthisis pulmonalis; under the head of digestive organs, 290 diarrhcea and dysentery, 145 cholic and cholera, and 1 hepatitis; under the class of brain and nervous system, 33 epilepsy and 1 apoplexy ; and under that of venereal affec- tions, 10 gonorrhoea and 9 syphilis. As the total of deaths, according to the post returns, is 59, and the aggregate mean strength is 486, the annual ratio of mortality is 12 per cent. Of the deaths, 33 are reported in the medical returns ; and as the mean strength, during the same period, was 312, the ratio of mor- tality is 10^ per cent. The causes of the deaths are as follows : 3 yellow fever, 1 phthisis pulmonalis, 2 chronic diarrhcea, 19 epidemic cholera, 5 epilepsy, 1 suicide, and 2 from causes not specified. Ex- cluding the cases of cholera and suicide, the average is only 4-j^ per cent. The statistics given in the above abstract cannot be regarded as affording any very precise results. To avoid the sickly season, the troops were removed, every summer, to the Bay of St. Louis ; and the data furnished by the year 1838 are entirely excluded, inasmuch as most of the sick consisted of invalids from Florida. The ratio of mor- tality is high, but the majority of deaths is the result of accidental causes. In the fourth quarter of 1831, for example, 26 cases of epi- lepsy are reported. This disease and cholic (27 cases) were extraordi- narily severe. Of the former, " not more than 5 or 6," says Surgeon Lawson, " had ever before labored under the disease. Two of the sub- jects expired in the first fit; three sank, after enduring, for 18 or 20 hours, an almost uninterrupted succession of paroxysms; and several were left in a state of paralysis, which continued for some weeks." Upon investigating every probable source of these dreadful disorders, it was traced to the agency of the wine sold by the sutler, which proved to contain a great quantity of acet. plumbi. Although the data given in the foregoing abstract of diseases are too limited to afford any definite statistical results, yet, to maintain uni- formity, the table showing the relative influence of the seasons in the causation of disease in general is given below— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 3 first quarters -4 second " 2 third " 4 fourth " Annual ratio - 283 395 223 346 330 275 161 308 1,166 696 722 890 312 1,074 3,442 Hence every man, on an average, has been reported sick once in everv three and a half months. m The total of deaths by epidemic cholera is 19. In relation to this disease, the following extracts from the official reports of Surgeon Thomas Lawson, the senior surgeon at New Orleans in 1832, are given. " This dreadful scourge invaded Louisiana near the close of October, 1832, the city of New Orleans being the first point attacked, and the last position maintained, by the enemy. Without pretending to determine the cause of this mysterious disease, or its mode of propagation, one fact is certain, viz. that no case of the disease manifested itself among us until the arrival in port of the steamer Constitution, which had several cases on board—a number of her passengers having already fallen vic- tims to the disease. So fearfully rapid was the pestilence in its progress, that in less than 48 hours it reached the lowest plantation on the Mis- sissippi, desolating almost every spot inhabited by man. Like a skilful general, it seems to have advanced at once upon the capitol, leaving the minor posts on the line of march untouched ; for it was not until it had ravaged New Orleans, and desolated the lower country, that it made any hostile demonstration above the city. Whether the cause of this mysterious disease was wafted to us in a current of air down the river, or was brought among us pent up in a steamer, or whether the atmos- phere of the city, which had been throughout the season very insalubri- ous, had reached its acme of pestilential explosion, we know not; but one thing is certain, that cholera, at least in that dreadful form which it afterwards assumed, was unknown among us until the steamer ' Con- stitution' arrived in port. " One of its peculiarities, observed both above the city and in the lower country, is, that it frequently passes over a village or plantation, whilst the destruction around is terrible; and this, too, without any manifest cause, either as regards the local circumstances or the habits and condition of the people. On the east bank of the Mississippi it advanced, after scourging New Orleans and the lower country, to within a few miles of Baton Rouge ; and on the west side, some distance above that point. As it was limited on each side by a range of high hills, it is more than probable that malaria exerts a powerful influence as an exciting cause of the disease. " In New Orleans, the effects of the epidemic were first manifested among the dissolute and the intemperate; those who were necessarily or accidentally exposed to the inclemency of the weather; those who were without the means of providing themselves with wholesome food and raiment; and the miserable occupants of the damp, filthy, and crowded hovels of the upper Fauxburg. Having desolated the suburbs, the disease invaded the heart of the city, striking down men, women, and children, indiscriminately. Here again the disease exhibited some of its eccentricities; for in many instances a house was wholly exempt from its ravages, whilst those on every side were places of mourning and distress. The occupants of the first seemed to be secure from injury under every circumstance of exposure, while the inmates of the last places could not peep out of their own windows without letting in the disease. For three days the ravages of the disease were confined to the upper Fauxburg, and the town proper. On the fourth day, however, it 261 appeared in the lower town with aggravated malignity, sweeping away like a tonent the poor and miserable foreigners held here against their will, whom the yellow fever had spared. The assault upon the garri- son occurred simultaneously with that upon the foreigners; ami, although the shock was not so sensibly felt at first, its effect upon us was but little less severe in the end. " On the first day and second morning, 12 decided cases occurred among the troops, of whom 3 died immediately—the others being within the control of medicine, survived the shock. One of these subjects while walking about suddenly fell to the ground, with a livid aspect; violent spasms, vomiting, and purging, quickly supervened ; the disease soon ran into the stage of collapse, and terminated fatally about the eleventh hour. To this man calomel was administered at first to the extent of 25 grains, and repeated in doses of 10 grains. To accelerate its opera- tion castor oil was given, and warm enemata of salt and water were also employed. At one period, with the view of allaying spasm and arrest- ing vomiting, opium was administered. In addition to these remedies, heat was unceasingly applied to the superficies of the body generally, mustard cataplasms to the arms and thighs ; and to the same parts, as well as along the course of the spine, friction with the hand simply with dry mustard, and with a liniment composed of mercurial ointment, cam- phor, and cayenne pepper. But it was all to no puipose ; the patient, despite every effort to save him, steadily progressed towards dissolu- tion. " Another man was afflicted in the first instance with excessive vomiting and great commotion in the bowels, which symptoms subsid- ing or yielding to the influence of an emetic of sulph : cupri and ipe- cac : combined, the patient became tranquil, and remained some length of time apparently in a safe condition. After the lapse of some hours, however, the pulse, which was before very perceptible, began to sink, the extremities became cold, and spasms ensued; the vomiting then recurring with inordinate purging, the disease was soon ushered into a stage of collapse, and the man died after lingering to the thirtieth hour. To this man, after the operation of the emetic, and the subsequent sub- sidence of the vomiting, I gave calomel in repeated doses of ten grains, and persisted in this course until the pressing and terrible symptoms, which afterwards ensued, suspended my regular operations and com- pelled me to desist from my purpose. " In this instance, also, heat was applied to the extremities and along the spine, blisters and cataplasms to the arms and thighs, and over the thoracic and abdominal regions, and friction to every part of the body not already under the action of some other agent. These remedial means and personal efforts were persevered in with the view of keeping up the warmth and continuing the action on the superficies of the body, with the hope of prolonging life until the calomel could reach the secretory organs, and restore them to a healthy action. In the hope, too, of arresting the vomiting, I repeatedly administered a spoonful or two of mint julap, occasionally combined with laudanum ; and, with the view of arousing the system to a state of re-action, or at least of 265 sustaining its sinking energies for a while, I entered upon the adminis- tration of some of the diffusible stimuli. Soon finding, however, that these last produced no useful result, while they occasioned the most intolerable pain along the sesophagus and in the stomach, I desisted from their further use. In this case, as in the preceding one, all that was accomplished was the partial remission of spasm, and this was effected more particularly by friction with the warm hand of the attend- ants, vigorously and unremittingly applied: no actual impression could be made upon the system ; nothing could stay, even for a moment, its onward tendency towards dissolution. " A third man having reported to me that he had just been taken with diarrhoea, I was in the act of administering to him a dose of rheu- barb and calomel, when a flood of rice-water fluid came from him, suc- ceeded by vomiting and spasm ; and the stage of collapse quickly after- wards supervening, the patient was hurried off by the sixth hour. The same remedies, or nearly the same, were resorted to in this, as in the preceding cases, with but little hope of success. The fourth of the 12 men that came under my care, and whose case eventually terminated fatally, was affected with vomiting, which pro- ducing great exhaustion, his extremities became cold, the pulsation at the wrist ceased, or nearly so, and spasm ensued. The irritability of the stomach, however, having been allayed by small draughts of chamo- mile tea, the heat restored to the surface of the body, and the circulation brought back to the extreme vessels, the patient recovered from the shock ; and under the influence of calomel in repeated small doses was steadily advancing towards health, when, by some neglect or impru- dence, as I afterwards understood, secondary inflammation was induced, which eventually proved fatal." Having detailed, also, several of the cases which terminated favorably under the mercurial remedies, combined occasionally with opium and camphor—the method of treatment pursued throughout—the following remarks are made in conclusion—" In support of the position that persons debilitated by previous disease are peculiarly liable to an attack of cholera, I can aver that many of those affected were convalescents from yellow fever, or some other affection. I am also convinced that those constandy with the sick, respiring the atmosphere of the hospital, acquire a similar liability to an attack, the opinion of many physicians to the contrary notwithstanding. The disease seized me on the third morning after its appearance among the troops, having exerted myself continuously in the hospital. On the following day the hospital steward was attacked; two acting stewards took the disease successively, and all the attendants were at one period or another affected with the disease. I am now just regaining my health; the hospital steward is not yet well, and the two acting stewards, and four of the six attendants, died. " It is true, the steward and myself, having for the period of six weeks devoted our time by day and by night to the numerous cases of yellow fever among the troops, were much exhausted ; as regards the attend- ants, however, this was not the case. These last were fresh and vigor- ous, being frequently relieved froji their duties of watching, , LONGITUDE 89° 38'. The island of Petites Coquilles, as its name imports, seems to have been originally formed of a congeries of small shells, with an admixture of earthly deposite, based on a substratum of argillaceous earth, rendered black or blue by the oxide of iron. The post is situated on the northern margin of this alluvial island, which divides Lake Borgne from Lake Ponchartrain, the waters of which communicate by means of the passes Rigolets and Chef-menteur, exhibiting an area whose diameter from north to south is about 7 miles, and from east to west 12 miles. It ia distant about 35 miles northeast from New Orleans. The island is intersected with tortuous bayous resembling artificial canals. As their beds are never exposed to solar action, being under the influence of the tides, they are at no time a source of miasmata. The natural elevation of the surface of the island above the lake.no where exceeds two feet. The soil is fertile, being well adapted for the cultivation of vegetables. In the summer, the prevailing wind is from the Gulf of Mexico. This tropical east wind prevails with such constancy, that the trees on the shores of the lakes and the gulf have acquired an inclination from the sea, supposed to be the effects of its continued action at the period when their growth is most rapid. Three posts more remain to be described south of this point, situated in a region comparatively of recent formation. It may be important, therefore, to determine the laws which obtain in this respect. A discol- oration of the water of the ocean from the deposites of. the Mississippi, when 30 miles distant from its debouchure, is perceptible. As the coast is approached, it is found that the bed of the ocean rises one fathom in every mile—the result of the alluvial deposites from the river. As the bed of the ocean in deep water is not disturbed by the force of the billows, this law is found to hold generally. In shallow soundings, however, the soft deposite is thrown, by the force of wind and wave, into ridges and ravines. The delta of the Mississippi, according to the account of a pilot who has lived there 19 years, has advanced by its deposites, during that period, two and a half miles into the Gulf of Mexico. As the outlets of the Mississippi comprise a line of about 100 miles along the coast, the alluvial lands between these mouths give an addition of 250 square miles, in 19 years, to our continent. The bar at the mouth of the river keeps pace with this encroach- ment upon the ocean. Nineteen years ago, it was two and a half miles further inland with 12 feet of water. In its present position it has 14 feet, whilst the place of the former bar has 30 feet water. By the operation of the same principle, we find at New Orleans, at "which point the shallow bar of the river some centuries ago may have existed, water 30 fathoms in depth. Following out this theory of the deposition of alluvion, it would be interesting to determine the change produced in 5,000 years. 271 When these deposites of alluvial matter once rise to the surface of the water, vegetation rapidly succeeds. Under the genial influence of the sun, all the seeds germinate; those of an aquatic nature live and flourish, whilst the rest quickly perish. As the deposites of mud are now more effectually intercepted, the soil becomes more dry and finn; plants of various kinds begin to spring up, and by and by large trees appear; whilst here and there are still found marsh and swamp, inter- sected by lagoons and bayous. Thus has the Mississippi constantly pushed forward her delta, gradually encroaching upon the domains of Neptune. Thirty or forty yards from the Mississippi is what is called the second bank, which is higher than the lands behind-^a feature common to all rivers. This admits of a ready explanation. Whenever the river over- flows its banks, the water, no longer confined to its channel, is dimin- ished in velocity; and as the transportation of alluvion depends upon this rapidity, it is at once deposited—a result favored by the stems and leaves of vegetables, which perform the part of so many strainers. As this alluvial soil presents the most luxuriant vegetation, it is here that the pioneer of civilization first strikes his axe into the mighty oak of the forest; and it is here that the Destroying Angel makes his most desolating visitations under the form of frebile endemics. The low lands contiguous to plantations which border the Mississippi, extending back generally from one to two miles, are annually inundated. It is only when the levee, or embankment, gives way that the planta- tions are overflowed. The waters generally overflow their banks in May, and subside in the latter part of August. During the intervening period, these lands afford excellent pasturage for cattle and wild animals, It is by means of creeks and bayous that the water of the Mississippi, in times of freshets, mostly escapes; and as the floods subside, part of it returns to the river by the same channels or drains. Much the greater part, however, is left to disappear by absorption and evaporation. At the Balize, the difference between the highest and lowest stage of water is about 3 feet; at New Orleans, about 12 feet; at Baton Rouge, 25 feet; and thence, to the mouth of the Ohio, it gradually increases to 45 feet. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Pike, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 59 1831 61 1832 58 1833 50 1834 47 1835 63 1836 1837 1838 67 464 1829 61 9 2 1 3 1 2 5 1 24 1830 61 4 2 14 2 * 24 1831 60 3 1 2 15 1 3 1 5 31 1832 58 2 1 1 6 1 1 1 6 2 5 26 1833 49 4 2 1 1 2 10 1834 47 1 1 4 2 8 1835 59 3 6 1 6 6 2 3 2 3 32 1836 1837 1838 Mean Strength 59 395 Intermittent fever -Synochal " -Diseases of the respira-tory organs Diseases of the digestive organs - - -Diseases of the brain and nervous system -Rheumatic affections Venereal " Ulcers and abscesses Wounds and injuries -All other diseases - I 3 1 3 1 3 1 1 1 8 3 4 3 4 3 5 2 1 2 2 3 4 2 11 2 1 2 4 3 5 1 1 5 1 2 6 6 1 3 3 2 5 - - 6 2 4 3 1 3 1 1 I 8 13 2 45 18 2 1 15 1 6 13 15 24 22 9 3 16 50 4 7 3 2 16 4 19 Total - 9 5 23 24 23 13 28 - - 30 155 155 THIRD QUARTER. FOURTH QUARTER. Years - 1829 58 6 4 1 1 6 2 1 2 6 29 1830 62 7 3 20 3 3 4 40 1831 57 6 1 1 8 2 3 5 4 30 1832 53 I 1 1 14 2 2 4 1 5 31 1833 48 1 3 8 1 1 3 17 1834 45 2 1 13 1 2 . 1 1 2 23 1835 1836 1837 1838 323 23 9 2 6 69 8 11 5 12 1 24 170 1829 57 1 1 3 . 1 1 7 1830 62 3 6 'l 2 1 5 2 4 24 1831 58 2 3 2 1 2 3 1 14 1832 49 1 6 2 1 4 1 15 1833 46 2 1 3 2 1 9 1834 51 5 5 6 5 1 2 2 1 2 29 1835 V M o o >-. PQ >-. o o H3 " ™ -. 3 2L c « 3 P« O PC 9 "S "3 "g g.a o O ^ CJ -'^ E 3 " £ P p H Oh Augusta Arsenal - 487 18 17 885 1,817 Fort Mitchell 655 25 19 1,805 2,756 Baton Rouge 1,053 71 65 3,584 3,404 New Orleans 312 40 13 1,074 3,442 Fort Pike - 376 11 6 578 1,537 " Wood - 334 23 19 1,236 3,700 " Jackson 164 14 9 507 3,091 Aggregate 3,381 202 148 9,669 - Ratio per 1,000 - 53* 44 - 2,860 The annual ratio of mortality, according to the medical reports, is A fa per cent., and according to the post returns, 5 fa per cent. As in the preceding classes, the deaths from epidemic cholera (8 at Baton Rouge, 19 at New Orleans, and 2 at Fort Wood) have been excluded in both calculations; and in the medical returns, those deaths also reported under the heads of drowned, frozen, and suicide. The ratio per 1,000 of mean strength annually under treatment being 2,860, it follows that every man, on an average, was on the sick-list once in a little upwards of every four months. Assuming this ratio as an index of the comparative salubrity of the several posts constituting this class, it is found that Fort Wood exhibits the highest, and Fort Pike die lowest extreme. Although the ratio annually sick is lower in this class than in the preceding one, yet the mortality, owing to the circumstance that fevers are of a more malignant nature, is higher. In further illustration of the diseases of this region, showing the relation of season and climate with morbid action, the general results obtained from this class will now be exhibited. * The aggregate mean strength, according to the post returns, is 3,810. 284 TABLE exhibiting the relative influence of the DISEASES. i. < GO cd 3 3 < "3 p3 u s 1 p* to 3 o « § PQ to 0 is pC p. -3 0 0 0 % 1-5 PH O 6- 13 0 si « 3 bo v 8 ■& Eb <" bn s < s 6 Ratio of cases per 1,000 of mean strength. INTERMITTENT FEVER. First quarter - 13 23 80 28 13 64 18 239 3872 62 Second " ... 18 14 139 23 22 44 18 278 3591 77 Third " ... 36 34 208 11 23 104 89 505 2974 170 Fourth " ... 6 17 110 29 13 40 62 277 3087 90 Annual ratio - 73 88 537 91 71 252 187 1299 3381 385 REMITTENT FEVER. First quarter ... 11 3 45 3 2 1 1 66 3872 17 Second " ... 35 13 70 23 9 18 1 169 3591 47 Third " ... 27 25 95 18 9 67 14 255 2974 86 Fourth " ... 6 9 100 38 7 5 9 174 3087 56 Annual ratio - 79 50 310 82 27 91 25 664 3381 196 SYNOCHAL FEVER. First quarter ... 6 4 3 81 _ i 1 96 3872 25 Second " ... 4 25 5 14 3 2 1 54 3591 15 Third " ... - _ 5 _ 2 1 _ 8 2974 3 Fourth " ... 8 - 8 26 - 2 - 44 3087 14 Annual ratio - 18 29 21 121 5 6 2 202 3381 60 TYPHUS FEVER. First quarter ... _ _ 4 _ _ 1 1 6 3872 2 Second " ... - - 19 1 _ _ _ 20 3591 6 Third " ... 2 - 7 - _ _ _ 9 2974 3 Fourth " ... - - 5 3 - - 1 9 3087 3 Annual ratio - 2 - 35 4 - 1 2 44 3381 13 DIARRHCEA AND DYSENTERY. First quarter ... 28 129 160 100 6 41 22 486 3872 126 Second " ... 46 114 179 80 20 39 8 486 3591 135 Third " ... 35 87 111 50 25 26 14 348 2974 117 Fourth " ... 6 21 66 60 9 42 17 221 3087 72 Annual ratio ... 115 351 516 290 60 148 61 1541 3381 456 285 veasons in l/ie production of morbid action, SfC DISEASES. < 3-a ui cd 3 3 < -3 o 1 PH o Ph o bo 3 o « C o "S PP 77 41 36 66 § o is 49 22 5 38 PH o Ph 30 6 6 17 -3 O o o Ph 68 26 22 40 3 o so pM u ca p-s ■e o Ph 6 2 6 3 o Eh pC H^ to «S 3 V PH W> 3 E Ratio of cases per 1,000 of mean strength. CATARRH ANn INFLUENZA. First quarter - - -Second " ... Third « ... Fourth " ... 61 10 8 7 86 64 14 12 355 121 77 186 3872 3591 2974 3087 92 34 26 60 Annual ratio - - - 90 2 1 2 220 114 59 156 14 739 3381 218 PNEUMONIA. First quarter Second " ... Third " Fourth " ... 7 7 4 3 17 2 5 3 3 3 5 2 1 2 1 2 33 17 5 17 3872 3591 2974 3087 9 5 2 5 Annual ratio - 21 5 24 3 11 3 5 72 3381 22 PLEURITIS. First quarter . - -Second " -Third " ... Fourth " ... I 1 19 1 8 4 11 10 2 1 6 2 8 4 1 2 3 1 4 3 4 44 16 18 18 3872 3591 2974 3087 11 4 6 6 Annual ratio - 2 20 33 11 13 6 11 96 3381 28 PHTHISIS PULMONALIS. First quarter - . -Second " ... Third " -Fourth " ... 2 2 1 1 1 2 5 2 2 1 1 3 2 2 1 2 10 10 5 5 3872 3591 2974 3087 3 3 2 2 Annual ratio - 4 3 11 2 7 1 2 30 3381 9 RHEUMATISM. First quarter Second " ... Third " ... Fourth " - 20 13 15 12 60 27 12 9 12 28 7 22 24 81 1 2 5 8 15 ' 7 11 1 10 11 4 10 35 10 6 4 8 110 57 67 72 3872 3591 2974 3087 3381 28 16 22 23 Annual ratio - 60 34 28 306 90 286 Compared with the last class, the following relations are found to obtain—In the former, the ratio of intermittent fever is nearly twice as high, whilst that of remittent fever is lower, being as 180 to 196. The annual average of diarrhcea and dysentery is lower in the class now under investigation, owing, in a great measure, to the circumstance that the troops were generally removed to healthy summer encampments ; and to the same cause may doubtless be ascribed the result exhibited in the third quarter, which gives a lower ratio than either the first or second. The two classes of the southern division exhibit a low ratio of pul- monary diseases as a class. As most of the stations of the class now under investigation are on the Lower Mississippi, and are much under the influence of large bodies of water, the ratios are correspondingly low. With the exception of phthisis pulmonalis, the average of each disease exhibits the usual diversity in reference to the seasons. As respects the first and third quarters, the ratios of catarrhal affections stand as 92 to 26, pneumonia as 9 to 2, and pleuritis as 11 to 6. As these posts, with the exception of the first two, are very much under the modifying influence of large bodies of water, the ratio of catarrh and influenza is correspondingly low. Baton Rouge, it is true, does not acknowledge this equalizing agency in so eminent a degree as the stations that follow. Compared with the last class, the ratios are consequently much lower; and, owing to similar causes, the class of posts between the Delaware and Savannah presents averages corres- pondingly low. In comparison with the mean ratios of the three classes of the northern division of the United States, it is found that the average of catarrh and influenza, in this class, is not quite half as high; whilst the mean ratio of pneumonia and pleuritis is about the same, and that of phthisis pulmonalis is a little higher. The annexed table exhibits, according to the Adjutant General's returns, the total of deaths in each month. TABLE showing the number of deaths in each month. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total. Total of deaths in each month. 8 6 12 21 29 21 22 24 27 30 20 11 231 In this table, 29 deaths from epidemic cholera are included. So far as the quarters of the year are concerned, the number of deaths from this cause, that occuned in each, is as follows—In the first, 1; in the second, 11 ; in the third, 5; and in the fourth, 12. SECOND CLASS.—EAST FLORIDA. FORT MARION. LATITUDE 29° 50' N., LONGITUDE 81° 27' W. This cla^s of posts, which constitutes the last to be described, lies in a climate of a nature very distinct from any region yet under investiga- 287 tion. The peculiar character of the climate consists less, as compared with more northern latitudes, in the mean annual temperature, than in the manner of its distribution throughout the year. Possessing an insular climate, the extremes of temperature are much modified. Although the winter at Fort Snelling is 47° 73' colder than at Tampa Bay, the sum- mer, at the latter place, is only 8° 24' warmer. Although the mean annual temperature of Petite Coquille is nearly 2° lower, that of Augusta, Georgia, nearly 8°, and that of Fort Gibson upwards of 10° lower than at Tampa Bay, yet in all the mean summer temperaLuie is higher. In the summer season, the mercury rises higher in every other portion of the United States, and even in Canada, than it does along the coast of Florida. In six years' observation at Key West, it was never known to rise above 90°. On reference to the tables given in the " Meteorological Register" these various relations, with many others, may be traced out and clearly ascertained. Fort Marion is in the city of St. Augustine, which is situated on the bay of the same name. It is distant about two miles from the ocean, and about half a mile from Anastasia Island, which divides the bay from the ocean. The St. Sebastian, a small stream, runs within half a mile of the town; and North river, which rises about 35 miles north of the city, empties into the ocean immediately opposite the fort. There are a few marshes in the vicinity, but they are inundated twice every 24 hours by the tides; and there are also some low hammock lands from two to six miles distant, from which, when the wind prevails from the southwest, clouds of musquitoes issue in the month of June, subject to be driven back as the wind changes. The site of the city is slightly elevated, being about twelve feet above the level of the ponds and marshes in the vicinity. The adjacent country is level and generally sandy, some parts being sufficiently rich in calcareous and vegetable matter to produce most of the vegetables cultivated at the north. Oranges flourish here most luxuriantly ; but, in the early part of 1835, all the groves in the northern half of the peninsula were wholly destroyed by frost—an occurrence previously unknown. St. Augustine has long been celebrated as a winter residence for pul- monary invalids; but the city itself has claims upon the traveller's attention, not the least being the fact that it is the oldest town in the United States. The fort is also one of the oldest in the United States. It was finished, as appears by its now nearly illegible inscription, in 1756,in the reign of Ferdinand the Sixth. The walls consist of a con- cretion of sea shells obtained from quarries on Anastasia island; and as the material, under a bombardment, crumbles away without suffering fractures, the fort duly manned would be almost impregnable. The barracks'and hospital are situated directly on the bay, about a mile south of the fort. The position of these buildings is elegible in every respect. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Fort Marion, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years .... 1829 45 6 3 1 1 1 2 4 3 21 1830 58 2 4 2 2 1 1 2 1 15 1831 54 1 4 2 2 1 1 6 2 19 1832 58 2 20 10 4 1 4 6 3 50 1833 1834 1835 1836 1837 1838 305 4 2 1 44 22 3 }* 6 12 25 14 145 1829 62 4 3 9 2 5 1 2 2 4 32 1830 56 3 15 1 1 1 3 24 1831 57 4 5 9 1 2 4 1 26 1832 54 3 5 9 2 4 2 25 1833 49 2 11 17 4 1 35 1834 43 2 5 16 3 3 4 2 35 1835 1836 1837 1838 Mean Strength 48 7 5 2 2 2 6 2 26 42 2 3 2 1 2 1 3 14 321 Intermittent fever -Synochal fever Typhus fever Diseases of the respirato-ry organs - . -Diseases of the digestive organs Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries -All other diseases -Total - 10 5 32 75 2 12 1 8 19 13 177 THIRD QUARTER. FOURTH QUARTER. Years - - - - j 1829 1830 1831 1832 183311834 1835 1836 1837 1838 379 37 24 24 47 12 20 11 9 25 8 15 232 1829 1830 53 4 3 3 1 2 2 3 4 3 25 1831 1832 I 55 ! 50 1833 48 1 1 11 4 3 6 29 1834 1835 1836 1807 1838 Mean Strength 55 3 3 11 1 2 2 2 8 32 53 3 3 2 3 10 3 2 3 1 30 56 2 4 4 2 2 2 4 2 22 53 6 4 5 13 2 1 4 4 39 48 4 1 10 9 2 3 5 4 1 39 51 4 2 5 4 5 20 63 15 9 1 4 1 5 1 2 2 8 o 50 206 CO Intermittent fever -Remittent " -Diseases of the respiratory organs ... Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal " -Ulcers and abscesses Wounds and injuries Ebviety All other diseases -Total - 2 10 3 1 3 5 4 28 3 5 7 2 1 2 6 5 32 10 3 19 25 1 5 6 14 17 14 114 290 Under the class of diseases of the respiratory organs are comprised 80 catarrh, 14 pneumonia, 8 pleuritis, and 9 phthisis pulmonalis; under the head of digestive organs, 92 diarrhcea and dysentery and 65 cholic and cholera; under the class of brain and nervous system, 1 epilepsy and 2 mania a potu ; and under that of venereal affections, 22 gonoi- rhoea and 2 syphilis. The above abstract includes no returns later than 1835, as this post became, after that period, a general hospital for the troops in the field. As the total of deaths, according to the Adjutant General's returns, is 9, and the aggregate mean strength is 350, the annual ratio of mortality for seven years is 2fa per cent. Of the deaths, 8 are reported in the medical returns, viz. 1 remittent fever, 2 convulsions from intemper- ance, and 5 from causes not specified. This post has been at all times justly esteemed for its salubrity. Compared with the average mortality of southern posts in general, this station is found to exhibit a much lower ratio. The annual average of fevers of malarial origin is very low, that of intermitting fever being 20, and that of remitting fever 11, per cent. It is seldom that diseases of a malignant character appear at St. Augustine. Towards the close of the present year, (1839,) yellow fever, which ravaged the principal cities of our southern States, made its appearance at this station. This is only the second time that this epidemic has prevailed in this city within the period of 20 years, whilst at Charleston, we are told by Professor Dick- son, that in 24 years' practice, but three have passed without his know- ing the occurrence of yellow fever. The period at which it prevailed first at St. Augustine was immediately after the cession of the province by Spain. As much filth had been allowed to accumulate during a succession of years, both at this place and at Pensacola, the circum- stances incident to its removal by the American authorities were regarded as the exciting cause of the disease by the medical officers of the army. The experience of a century and a half teaches us that the causes of yellow fever are perennially present in our southern cities. Indissolubly connected with our soil and climate, it maintains the same relation towards the animal economy, as the malaria of our immense low country. As regards the essential cause of yellow fever, we still remain in the dark. It is manifest, however, that to develope the cause, and to keep up its action, requires a high range of atmospheric temper- ature ; and as this condition seldom obtains on the coast of Florida, it would seem to afford an apparent explanation of its infrequent occur- rence in this region. As the extremes of temperature are much modi- fied by geographical position, and as the combined influence of the various causes acting in the most intense degree appears necessary for its development, a link in the chain seems to be wanting. At Key West, as in the islands generally of the West Indies, yellow fever has prevailed with much malignity. The relative influence of the seasons in the production of disease in general is shown in the following table— 291 TABLE exhibiting the ratio of sichiess. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 6 first quarters -6 second " 7 third " 4 fourth " Annual ratio - 305 321 379 206 145 177 232 114 475 551 612 553 304 668 2,197 Hence every man, on an average, has been reported sick once in every five and a half months. FORT KING. LATITUDE 29° 12' N., LONGITUDE 82° 12' W. The following extracts, in regard to the medical topography of Fort King, are taken from a paper transmitted to the Surgeon General's office, in 1837, by Assistant Surgeon Forry. " As regards geographical position, this station is about 95 miles N. E. of the head of Tampa Bay, 130 S. W. of St. Augustine, perhaps 40 miles due west from the Gulf of Mexico, and 60 due east from the At- lantic ocean. The fort, which has been recently rebuilt, is situated on rising ground, partially encompassed by a hammock, which describes almost a semicircle, at an average distance of 500 yards from the pickets. The surface of the surrounding country is slightly undulating. The soil of the so-called pine barren consists of loose sand and a light ad- mixture of vegetable mould, with an argillaceous substratum. Its prin- cipal vegetable productions are, the pitch pine, (pinus vigida,) black jack (quercus nigra,) scrub oak, {quercus catesbaei,) palmetto, (cha- mcerops ) and coarse herbaceous plants. The hammocks are rich marshy bottoms' composed of vegetable deposition, overgrown with redundant vegetation. Here flourish the live oak, with other species of the same genus the cypress, magnolia, cabbage-tree, and several varieties of hic- kory (carya,) all united by a cordage of vines and brambles, extending from trunk to trunk and from limb to limb, constituting an immense net-work of vegetation. « Mv observations on vegetation have been limited. The dew-berry, or creeping blackberty, rubus trivialis, I discovered ripe m the Wahoo swamp, near Dade's battle-ground, in the middle of April. On our arrival at this post, on the 28th April, the dandelion, leontodon taraxi- cum had already bloomed, and the magnolia grandijiora was just ex- nandin°- its blossoms. The chenopodium anthelmmticum, found here in the greatest abundance, is now (August 1st) just putting forth its organs of fructification. The Spanish moss, {tzllandsia usneoides,) 292 which is produced very exubeiantly, I discovered in every stage of exist- ence in the month of June. My attention w% first attracted by the manifest state of its organs, the stamens and pistils being half an inch long. The seed of this parasite has an egret more than six lines in length, consisting of a bundle of simple hairs without branches. " The mineral productions of this region seem to be all of secondary formation. These stratified rocks contain organic remains, both animal and vegetable. They consist chiefly of carbonate of lime, and in some the most delicate structure of shelis is preserved. " No large bodies of water exist in the vicinity of this post. Three miles from this point is Silver spring, the source of a beautiful stream of the same name. From this fountain, remarkable for its transparency, Silver creek emerges at once a bold stream, 60 yards wide and 20 feet deep, running into the Ocklewaha about 12 miles from this post. A remarkable peculiarity is often found in regard to the course of waters ; considerable streams sometimes disappear, and, after mnning several miles subterraneously, again emerge. Near Dade's battle-ground is a small lake, into which a rapid creek empties, but no outlet is visible. These waters are generally well stored with the finny tribe, whilst the forest abounds in every kind of game pertaining to the country.* " Although large bodies of water do not exist in the vicinity, yet the actual quantity is very great, owing to the extensive marshy low lands, swamps, and stagnant pools ; and as the soil is not completely covered with water, the circumstances most conducive to the evolution of those morbific agents resulting from solar influence obtain. The humidity of the vicinal hammocks gives rise to constant exhalations, which fall in heavy dews ; and perhaps to this cause is to be ascribed, in some meas- ure, the prevalence of intermitting fever. " This post, which had been for some years the Seminole agency, has always maintained the character of being a healthy station. A striking advantage over most other localities in Florida is, the existence of a never-failing spring of excellent water." The diseases reported within the ten years are comprised in the following abstract— * Since the date of this report, a singular phenomenon occurred at the post of Micanopy. The waters of Lake Tuskawilla, perhaps a mile in length, suddenly disappeared subterrane- ously, leaving its inhabitants upon dry land. Orange lake is running off in a similar man- ner, about ten thousand acres having been completely drained. A BSTRA C T exhibiting a condensed view of the principal diseases at Fort King, for a period of ten years. FIRST QUARTER. f SECOND QUARTER. Years - 1829 52 6 1 4 8 2 7 4 1 33 1830 1831 1832 1833 45 10 4 5 2 1 4 8 34 1834 57 2 1 8 8 1 2 2 2 26 1835 191 23 4 17 6 1 4 19 4 78 1836 1837 1838 345 41 2 20 38 9 1 8 29 8 15 171 1829 52 2 2 6 7 3 2 7 3 32 1830 1831 1832 1833 39 2 2 7 10 1 1 1 2 6 32 1834 56 4 3 4 7 1 2 3 3 29 1835 266 74 10 8 32 1 5 9 12 151 1836 1837 1838 - Mo-iii Strength - 413 Intermittent fever -Remittent fever Diseases of the respirato-ry organs ... Diseases of the digestive organs ... Diseases of the brain and nervous system -Rheumatic affections Venereal affections Ulcers and abscesses Wounds and injuries Ebriety All otlier diseases -Total - 82 17 I 25 56 2 1 10 1 4 19 5 21 244 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1829 1830 1831 1832 49 9 1833 57 6 1834 75 2 1835 246 160 1836 1837 1838 59 55 4 331 199 - - - 445 205 427 Intermittent fever 2 177 Remittent " 6 4 30 - - . 40 - . . . 4 1 19 m m 24 Synochal " - - - - - - - . - - . - . . . 2 . 12 m m m 14 Typhus " * 2 Diseases of the respirato- ry organs - - - - b - 1 - - - 6 - . • . 1 . 2 9 . m 1? Diseases of the digestive 6 8 20 - - - 34 . . . 5 4 8 34 m . m 51 Diseases of the brain and nervous system - - - - . - - - - .. . T3 . . 1 . , . . m m i Dropsies ... - - - • - 1 - - - . 1 Rheumatic affections - - - - 1 - 6 - - - 7 3 . . . . 3 fi m 9 Venereal " - - • - 2 - . . . . 2 >-? . . m . 1 1 Ulcers and abscesses 4 3 . . . 7 T3 0> . .' . 4 3 8 m 15 Wounds and injuries - 3 2 18 - - - 23 3 . . 9 . 6 20 . . m 35 Ebriety - - - - - 2 - - - - - 2 . . 10 8 . . . . m 18 All other diseases - * - - 11 5 4 - - - 20 W - - 13 - 7 9 - - - 29 Total - 38 28 281 - - - 347 - - - 48 30 32 278 - . - • 388 295 Under the class of diseases of the respiratory organs are comprised 47 catarrh, 8 pneumonia, 4 pleuritis, and 4 phthisis pulmonalis; under the head of digestive organs, 117 diarrhoea and dysenteiy, 21 cholic and cholera, and 5 hepatitis; and under that of venereal affections, 4 gonorrhoea, and 1 syphilis. This post was evacuated July 3d, 1829, and re-occupied July, 1832; abandoned in May, 1836, and re-established in April, 1837. As in the preceding station, no reports are included in the above abstract since the commencement of the present Indian disturbances. As the total of deaths, according to the post returns, is 14, and the aggregate mean strength is 420, the annual ratio of mortality is 3 fa per cent. Of the deaths, 7 are reported in the medical returns, viz. 2 remittent fever, 1 phthisis pulmonalis, 1 phrenitis, and 3 from causes not designated, being at the rate of 1-^ per cent. In the post returns, 10 deaths are reported in 1835, whilst but 3 are given in the sick reports, excluding the death of Lieut. Smith, who, with Gen. Wiley Thompson, the Indian agent, was massacred by a party of Seminoles. Assuming eight deaths as the total from all causes, with the exception of casualties, the annual ratio of mortality is nearly 2 per cent. The annual average of fevers of malarial origin is high, that of inter- mitting fever being 123, and that of remitting fever 20, per cen<.; but the ratio is very much reduced, if the year 1835 is excluded, the former being 38, and the latter 19, per cent. This post, however, has always been regarded as decidedly salubrious, Avith the exception of the liability to fever and ague. Violent fevers of the remittent form, and intermit- tents running into the same type, occuned in the latter part of the sum- mer of 1837, owing doubtless to the circumstance that the smaller trees and undergrowth of a neighboring hammock had been cut down as a precaution against Indian ambuscade. It is a well known fact that military stations, near jungles, often continue healthy until the soil is brought under cultivation, or the trees and shrubbery cut down, expos- ing the boggy surface to the agency of solar action. The following remarks are from the report of Assistant Surgeon Forry— " Fevers generally assume the intermittent form. They are mostly of the tertian type, sometimes the quotidian, and very rarely the quortan or quintan. After the employment of mercurial cathartics, emetics, and blood-letting, according to the indications presented, the disease speedily and invariably yields to the use of sulph : quinine. It is seldom, how- ever, that venesection is required. When not contra-indicated by diar- rhoea, I always use the solution of quinine saturated with the sulph : magnesia?. According to my experience, it not only adds much efficacy to the remedy, but its employment is admissible when slight febrile symptoms still contra-indicate the usual preparations of quinine. The happy effects of this prescription have been displayed also in cases that have assumed a chronic character, attended by visceral indurations and enlargements. In several neglected cases among the friendly Creeks, the continued use of this preparation alone speedily arrested the parox- ysms, removed the icterode hue of the skin, and reduced the liver and spleen to their nonnal condition. 296 " Several cases of scorbutus have been presented. The disease mani- fests itself with most of the symptoms by which it is generally described. Muscular power is completely prostrated, the gums are swollen, spongy, and livid, the legs are anasarcous and covered with blotches of extrava- sated blood, and the nates sometimes, but very rarely, become the seat of bloody abscesses. These lesions gradually yield to the plentiful use of lemon acid and vegetables with vinegar. The only therapeutic means employed in conjunction is, the sulph : quinine dissolved in elixir vitriol. When stationed at Fort Armstrong, several cases of this disease occurred. Deprived of vegetables, they grew worse from day to day, until the free use of wild pepper-grass, (lepidium virginicum,) fdund in a neighboring swamp, was prescribed. At this post, we have the good fortune to find in great abundance purslane, renowned among the older physicians as an anti-scorbutic." The comparative agency of the seasons in the causation of disease in general is shown in the annexed table— TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength treated quarterly. 4 first quarters -4 second " 3 third 4 fourth " Annual ratio 345 413 445 427 171 244 347 388 496 591 780 909 408 1,150 Z.819 Consequently every man, on an average, has been reported sick once in every four and a quarter months. FORT BROOKE. LATITUDE 27° 57' N., LONGITUDE 82° 35' W. This post is situated at the head of Hillsboro' Bay, which is an arm of Espiritu Santo,* about 30 miles from the Gulf of Mexico. The Hillsboro' river empties into the bay at this point. The general aspect of the sur- rounding country is low and level. This post has always been regarded as a delightful station. Here'tropical fruits, such as the lime, the orange, and the fig, find a genial soil. Vegetation, as already remarked, may be regarded as continuous throughout the year, wild flowers blooming, and culinary vegetables growing, in the month of January; and, at the same season, the water of the bay is generally of a temperature to admit of bathing. The diseases reported within the ten years are comprised in the sub- joined abstract— • The whole bay is now generally known by the name of Tampa. ABSTRACT exhibiting a condensed view of the principal diseases at Fort Brooke, for a period of ten years. FIRST QUARTER. SECOND QUARTER. Years .... 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 746 1829 1830 80 50 6 5 34 1 2 1 3 13 1 1 117 1831 97 5 3 2 24 1 3 7 7 10 64 1832,1833 1834 1835 1836 1837 1838 CO Mean Strength 183 193 92 105 - - 173 - - 104 10 1 23 39 1 3 5 23 11 116 172 21 1 7 41 8 8 30 15 6 138 453 Intermittent fever -Remittent " -Diseases of the respiratory organs ... Diseases of the digestive organs . - -Diseases of the brain and nervous system -Dropsies ... Rheumatic affections Venereal " -Ulcers and abscesses Wounds and injuries Ebriety All other diseases -Total - 13 3 35 1 3 10 9 33 107 25 10 22 58 1 6 2 11 24 3 9 171 9 8 25 1 10 3 56 6 17 18 2 1 1 12 19 11 87 - 7 21 34 6 2 10 17 6 18 121 - - 60 10 71 170 1 1 17 5 33 1'Z 28 i 74 j 542 86 11 1 37 138 4 14 1 19 73 23 28 435 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 90 21 1831 93 8 1832 1S33 1834 1835 164 97 1836 1837 1838 578 178 1829 234 30 1830 95 23 1831 93 8 1832 1833 1834 1835 186 50 1836 1837 1838 Mean Strength 225 52 60S Intennittent fever - 111 15 5 Remittent fever 13 - 2 - - - 1 - - - 16 10 3 - - - - 2 - " Diseases of the respirato-ry organs - - 28 8 12 - - - 6 - - - 54 24 5 6 - - : 3 - - - 38 Diseases of the digestive organs ... 58 38 34 . . . 32 . . - 162 62 47 20 - - x> S 25 - - - 154 Diseases of the brain and O nervous svstem - . 1 - C3 - - i - - - 4 - - 2 - - p - - - - 2 1 12 4 Dropsies .... Rheumatic affections 1 . 2 ft, CD : . 2 . - - 5 1 4 - 3 - - 5 - - - Venereal affections . 1 - - - - - - - 1 4 - - - - XI - Ulcers and abscesses 10 8 12 01 - - 4 - - - 34 5 14 5 - • X 3 • - - 27 Wounds and injuries Ebriety ... All other diseases - 12 3 15 9 7 6 10 13 4 US 3 y pi H . . 7 4 16 . - _ 38 27 41 18 3 14 5 1 7 8 6 13 - - B 12 18 - - - 43 10 52 Total - 192 99 97 - - - 172 - - - 560 180 105 71 - - 118 - • - 474 299 Under the class of diseases of the respiratory organs are comprised 154 catarrh, 9 pneumonia, 2b pleuritis, and 1 phthisis pulmonalis; under the head of digestive organs, 364 diarrhoea and dysentery, 86 cholic and cholera, and 3 hepatitis ; under the class of brain and nervous system, 4 epilepsy and 1 mania a potu; and under that of venereal affections, 9 gonorrhoea and 2 syphilis. As a general hospital was established at this post as soon as the Sem- inole war began, no reports subsequent to the year 1835 are embraced in these statistics. As the total of deaths, according to the Adjutant General's returns, is 15, and the aggregate mean strength is 651, the annual ratio of mortality is 2^ per cent. Of the deaths, 12 are reported in the medical returns, viz. 3 remittent fever, 1 continued fever, 1 inter- mittent fever, (in the cold stage of a quarter.) 1 cynanche trachealis, 1 meningitis, 1 acute hepatitis, 1 chronic diarrhcea, 1 atrophia, 1 drowned, and oik.1 from no specified cause. Excluding the case of asphyxia, the ratio, according to the medical returns, is 1^ per cent. Like the two preceding posts, this one has always been regarded as highly salubrious. The ratio of mortality is equally low. As regards fevers of malarious origin, the annual average of intermitting fever is 73, and (hat of remitting fever is 9, per cent. The high ratio of inter- mittent fever, both at this post and the preceding one, is owing in some measure to the exposure incident, to detached service. The following extract is taken from the report for the third quarter of 1835, made by Assistant Surgeon H. L. Heiskeli—" By a reference to the diary of the weather, it will be perceived that there were 57 days' rain during the quarter. The unusually wet season was doubtless a most prolific source of disease; to which may be added the exposed condition of a number of the men on detached duty. Of the three who died, one sickened of bilious remittent fever at a temporary post about 60 miles south, where he remained a number of days before he could be brought to this place; the second died of effusion upon the brain, produced by exposure on a distant boating expedition as an oarsman; and the third died of emaci- ation. The prevailing disease (intermitting fever) is irregular in its form, and assumes various protean characters. Sometimes the fever is preceded by a regular ague; at other times, by a slight chill; but oftener by none at all. One had the masked form of the disease, as described by Senac, attacking the eyes, onhy, with regular periodical pains; and in another case, the force of the disease was spent upon the arm and shoulder. Both were cured by quinine." The following table exhibits the relative influence of the seasons in the production of disease in general— 300 TABLE exhibiting the ratio of sickness. • Seasons. j Mean strength, j Number treated. i f Ratio per 1,000 of mean stiength, treated quarterly. 5 first quarters -4 second " 4 third " 4 fourtli " Annual ratio - 746 453 578 608 542 435 560 474 726 960 969 780 596 j 2,011 3,374 Every man, on an average, has consequently been reported sick once in every four months and a half. KEY WEST. LATITUDE 24° 33' N., LONCITUDE 81° 52' W. Key West, or Thompson's Island, lies about 60 mile3 southwest of Cape Sable. It is about ten miles long, and from one to three in breadth. Low and level as regards its general surface, the southeastern shore presents the most elevated point. This ridge, consisting chiefly of sand and shells thrown up by the sea, rises about five feet above high water-mark. In the interior of the island arc found many marshes and lagoons, some of which are lower than the surface of the surrounding ocean. These marshy Ioav lands, covered in some parts with fresh, and in others with salt water, doubtless constitute a prolific source of mias- mata. Another important feature in the medical topography of this island is the occasional appearance upon the beach of an immense quantity of marine substances, both animal and vegetable. The mass thus accumulated, during the prevalence of a south or southwesterly wind, lies in some places to the depth of several feet, and extends sev- eral miles along the shore. Although these decomposing materials emit in a few hours effluvia of the most offensive character, yet their agency in the production of disease is a question admitting of disputation. This island is the most southern settlement of the United States. It contains about 1,400 inhabitants, and is a place of some commerce, chiefly in the way of wrecked goods. Having a good harbor, it has been from time to time the station of our West India squadron. The mean annual quantity of rain, on an average of five years, is 31.39 inches. The diseases reported within the ten years are comprised in the following abstract— ABSTRACT exhibiting a condensed view of the principal diseases at Key West, for a period often years. FIRST QUARTER. SECOND QUARTER. Years - 1829 1830 1831 54 1832 55 1833 50 6 1834 53 2 1835 59 4 1836 1837 1838 271 19 1829 1830 1831 64 3 1832 55 4 i 1833 1834 1835 59 2 1S36 1837 1838 Mean Strength - 53 3 231 Intermittent fever - " " 7 12 Remittent " - - - - 3 - - - - - 3 - - - - - - - - ■ - - Synochal " - - 8 - - 1 - - - - 9 - - 3 - - - 1 - - - 4 Diseases of the respira- tory organs - 3 9 2 1 4 eo - - 19 - - 3 3 - 2 1 - - - 9 Diseases of the digestive 1 organs - - - - 1 - 26 21 20 7 16 y? k - - 90 - - 4 13 - 13 22 - - - 52 Diseases of the brain and 1 nervous system - - - 6 10 - 3 3 - - 22 - - 9 22 - 1 7 - - - 39 Dropsies ... - - 1 - - - - CO P c - - 1 - - • • - - - * - * - Rheumatic affections - - 1 9 1 2 8 - - 21 - - 2 6 - - 4 - - - 12 Venereal " - - - 1 - - - - - 1 - - - " - - 1 - - - I Ulcers and abscesses . . 2 3 1 6 2 a - - 14 - - 2 4 - 3 - - - - 9 Wounds and injuries - - - 1 8 6 12 17 2 - - 44 - - 3 9 - - 3 - - - 15 Ebriety - - - - 21 - 6 - a - - 27 - - - 11 - 6 2 - - - 19 All other diseases - - - 4 5 1 20 18 W - - 48 - - 24 15 * 8 8 • - - 55 Total - - - 52 94 40 60 72 - - - 318 - - 53 87 - 36 51 - - - 227 ABSTRACT—Continued. THIRD QUARTER. FOURTH QUARTER. Years - 1829 1830 1831 55 1 13 18 18 1 4 3 10 11 6 85 1832 55 5 23 10 13 4 10 25 29 119 1833 1834 1835 56 16 2 14 10 4 5 5 50 1836 1837 1838 166 1 16 20 55 1 38 1 21 7 20 41 40 260 1829 183011831 - 55 5 - 10 - 14 3 2 3 2 - 16 8 • - 63 1832 54 22 3 6 12 1 15 13 22 2 96 1833 1834 1835 55 4 2 13 5 2 4 3 5 38 1836 1837 1838 Mean Strength 164 Intermittent fever -Synochal fever Discuses of the respirato-ry organs -Diseases of the digestive organs -Diseases of the brain and nervous system -Dropsies - -Rheumatic affections Ulcers and abscesses Wounds and injuries Ebriety -All other diseases -Total - 9 15 33 15 1 22 5 19 41 15 197 303 Under the class of diseases of the respiratory organs are comprised 41 catarrh, 3 pneumonia, 11 pleuritis, and 3 phthisis pulmonalis; under the head of digestive organs, 112 diarrhcea and dysentery, 22 cholic and cholera, and 27 hepatitis; under the class of brain and nervous system, 1 epilepsy and 11 delirium tremens; and under that of venereal affec- tions, 2 gonorrhoea. As the total of deaths, according to the Adjutant General's returns, is 24, and the aggregate mean strength is 268, the annual ratio of mortality is nearly 9 per cent. Of the deaths, 20 are reported in the medical returns, viz. 5 inflammatory fever, 2 phthisis pulmonalis, 2 hydrothorax, 1 chronic hepatitis, 1 casualty, 1 ebriety, and 8 from causes not desig- nated, being at the rate of 9 fa per cent. The mortality of this station is extraordinarily high. In April, 1833, the garrison, in consequence of sickness, evacuated the post temporarily, and occupied Fort Clinch. The quarterly sick-reports are not suf- ficiently full in details to be enabled to determine the precise character of the prevailing diseases. Of the 20 deaths, the causes of 8 are not specified; and the 5 fatal febrile cases, in the third quarter of 1835, are ascribed to the " fever of the climate," whilst the 16 cases which occur- red are registered under the head of inflammatory fever. Fevers of malarial origin present a very low ratio, the average of intermitting fever being 20 per cent., and that of remitting fever less than 2 per cent. The cases of phthisis pulmonalis occurred in old drunkards; and to the agency of inebriation, combined with the influence of the summer season upon northern constitutions, the mortality is doubtless chiefly attributable. Yellow fever prevailed among the naval forces stationed at this island in 1824. The epidemic is well described by Dr. Benjamin Ticknor, of the United States Navy. Independently of the operation of local causes, reference is made to excessive fatigue, unwholesome food, and the intemperate use of ardent spirits. The sailors drank not only to gratify the appetite, but to guard against an attack of fever. Agreeably to a regulation of the naval service, every man received a daily allow- ance of half a pint of rum or whiskey; but this quantity served only to whet the appetite, and to excite the well-known ingenuity of the soldier and the saiior in its obtainment. The effects of this excessive potation were rendered more pernicious in consequence of atmospheric vicissi- tudes ; for the men, when in a state of high excitement, with the per- spiration streaming from every pore, would throw themselves upon the floor or ground, and, falling asleep, lie thus exposed to the damp night air. The relative agency of the seasons in the causation of disease in general is shown in the following table— 304 TABLE exhibiting the ratio of sickness. Seasons. Mean strength, i Number treated. 1 Ratio per 1,000 of mean strength treated quarterly. 5 first quarters 4 second " 3 third " 3 fourth " Annual ratio - 271 231 166 164 318 227 260 197 1,173 939 1,566 1,201 208 1,002 4,817 Hence every man, on an average, has been reported sick once in every two months and a half—a ratio exceedingly high. TEMPORARY POSTS. We come now, in conclusion, to the consideration of the posts tem- porarily established in various parts of the present theatre of military operations. The results, based upon the statistics of 31 stations, are confined to a single )^ear, inasmuch as an exact separation previously between the regulars and volunteers is impracticable. The topographical descriptions of the posts of this class, already given, afford some idea of the general features of this region, which consists of a succession of marshes, savannahs, and sandy pine forests. The soil of this coast is frequently of a deep alluvial character, and of compara- tively recent formation. As the rivers annually bring down immense quantities of deposite, the land gains so rapidly upon the ocean that its waters have, as for instance at the mouth of the Mississippi, receded three or four miles within a century. Owing to this peculiarity in its formation, the country is a vast flat, with an occasional elevation pro- duced by a sand-reef, covered with rank and tall grass, or with dense forests. Little elevated above the level of the sea, the southern portion of the peninsula presents, with the exception of a belt along the coast, an endless succession of swamps and marshes, called " everglades." The dry " sand barren," covered with a forest of pines, forms much the greater part of the northern portion. A rich soil for cultivation is found along the coast, on the banks of rivers, or in those dense jungles, called hammocks, which seem to have been once lakes. Thepine bar- rens are composed principally of siiicious sand, more or less mixed with calcareous and vegetable matter. The swamps on the borders of rivers seem to be formed by inundation. Immediately after leaving the chan- nel, the grosser part of the alluvial matter is deposited, forming a ridge; and this embankment, as the water subsides, prevents its complete return. The whole country being a dead level, the superabundant moisture remains until evaporated by the sun's rays; and the winds, traversing the grounds thus saturated.it is supposed,possess considerable agency in the causation of fevers. 305 The following abstract comprises the diseases reported in one year, at 31 posts, and among troops on the march— ABSTRACT of diseases reported in one year at thirty-one posts, and among troops on the march. 4th qr. 1838. lstqr. 1839. 2d qr. 1839. 3d qr. 1839. Whole year. Strength 3,016. 3,467. 3,280. 2,606. 3,092. j; » w T3 *0 T3 T3 T3 ■ _! c« a "3 Diseases. X V o Oim n 2 H P H P Eh P fcH P H P 2 Ph Intermittent fever - 303 1 142 304 607 1 1356 1 in 678 Remittent " 59 8 31 _ 59 4 151 8 300 20 1 in 15 Synochal " 4 _ - - 3 - 4 - 11 - 0 in 11 Typhus " 0 in 0 Diseases of the respi- ratory organs 103 1 171 3 76 2 116 1 466 7 1 in 67 Diseases of the di- gestive organs 492 17 517 8 626 4 464 7 2099 36 1 in 58 Diseases of the brain and nervous sys- tem - - - 30 2 39 1 37 2 40 1 146 6 1 in 24 Rheumatic affections 69 _ 137 - 60 - 74 - 340 - 0 in 340 Venereal " 45 - 18 - 15 - 16 - 94 - 0 in 94 Scorbutic " 6 _ 1 1 25 1 28 1 60 3 1 in 20 Dropsical " 4 3 1 3 1 4 - 14 2 1 in 7 Ulcers and abscesses 81 _ 85 - 49 - 105 - 320 - 0 in 320 Wounds and injuries 145 _ 192 - 160 - 148 7 645 7 1 in 92 All other diseases - 143 - 106 14 204 - 206 - 659 - 0 in 659 Total 1484 492 29 1442 1621 14 1963 26 6510 83 27 1 in 78 Ratio per 1,000 9 6-10 416 4 491 4 3-10 753 8 8-10 2105 — Under the class of diseases of the respiratory organs are comprised 330 catanh, 3 acute bronchitis, 34 pneumonia, 62 pleuritis, 23 phthisis pul- monalis, 4 hoemoptysis, and 6 asthma; under the head of digestive organs, 1,594 diarrhcea and dysentery, 113 cholic and cholera, and 22 hepatitis; under the class of brain and nervous system, 49 nyctalopia, 6 apoplexy, 12 epilepsy, and 15 mania a potu ; and under that of venereal affections, 51 gonorrhoea, and 43 syphilis. The 83 deaths are reported from the following causes, viz. 20 remit- tent fever, 2 intermittent fever, 1 pleuritis, 6 phthisis pulmonalis, 15 dysentery, 16 chronic diarrhoea, 5 gastro-enteritis, 2 apoplexy, 1 epilepsy, 1 phrenitis, 2 mania a potu, 3 scorbutus, 2 dropsy, 5 gun-shot wounds, and 2 casualties. The ratio of mortality is consequently 2fa per cent.; but inasmuch as 7 deaths arose from wounds and injuries, and 1 from yellow fever contracted at Savannah, the total of deaths is reduced to 75, and the average mortality to 2fa per cent. 306 It thus appears that the mortality, during a period of Indian hostilities, when the troops occupy "a number of posts which dot the whole surface of the Peninsula, is, like the ratio prior to the war, remarkably low. It is seen, too, that a large proportion of the deaths arose from that class of diseases of a chronic character, to which soldiers of intemperate habits are peculiarly liable—29 fatal cases of phthisis pulmonalis, chronic diar- rhcea, mania a potu, and dropsical and scorbutic affections being reported. As regards fevers of malarial origin, the annual average of intermittents is 44, and that of remittents is 10, per cent. In the latter, the ratio of fatal cases is 1 in 15. On comparing the second and third quarters, a singular relation between intermittent fever and the class of diseases of the digestive organs is perceived. In the former, the ratio of intermit- tent fever is 9, and that of the diseases of the digestive organs is 23, per cent.; and in the third quarter, the ratio of the former is 19, whilst that of the latter is only 17, per cent. As the average of the former is more than doubled in the third quarter, whilst that of the latter is decreased, it would seem, assuming an identity of cause, that the same morbific agents operating in a less intense degree produce, as in the second quarter, diseases of the digestive organs, and when more concentrated in their action, as in the third quarter, intermittent fever.* It appears that intermittent and remittent fevers are both more frequent and fatal in that portion of Florida bordering on Georgia. Positions along the coast, and in many parts of the interior of the Peninsula, are often found very salubrious. Along the eastern coast, there are several posts at which a case of fever has not been reported in one, and even two quarters. Other localities again, many being selected less with reference to salubrity than military advantages, have proven very un- healthy. Fort Roger Jones, for example, established on the Oscilla river in Middle Florida, in March, 1839, by one company of Infantry, (42 men,) became so sickly that it was necessary to abandon it on the 13th June. The sickness commenced towards the end of May, and continued progressively to increase, not only numerically but in severity. All the fatal cases were confined to the commissioned officers, Captain Mitchell and Lieut. Pew having died at the post, and Surgeon Richard Clark on the sixteenth day after its abandonment. " In Captain Mitchell's cases," says Assistant Surgeon McCormick, " the tertian type was plain and evident. On the 7th day, he was doing so well that I thought him free from danger, inasmuch as on that day he missed his regular paroxysm of fever, his mouth began to show evi- dence of mercurial impression, and the dejections from his bowels were dark and of a tarry consistence. I favored the evacuation by a dose of ol: ricini, which brought away free discharges of this vitiated bile ; but, notwithstanding I pursued the active treatment adopted in the commence- ment of his disease, he was seized towards noon of the day following, viz., the eighth, with a chill, which lasted a considerable time, followed by fever and a remission on the following morning. As the mercurial impression, however, entirely disappeared, and the dejections from the * The disposition in intermittents to observe septenary periods has been frequently re- marked by medical officers in Florida. 307 bowels lost their favorable appearance, I began to fear that the disease was taking a very unfavorable turn. I therefore desired Surgeon Richard Clark in consultation; and as there was at our post a civil surgeon in the employment of Government, I concluded to ride over myself, and have some conversation with Dr. Clark on returning with him to Fort Roger Jones. Having got there in the evening, I found that Capt. M. had had a repetition of the chill, and although recourse was had to the most active remedies, we could scarcely produce any reaction. On the day following, he was seized with another chill, and no remedies we could use, although we applied the most powerful external stimulants, and continued the administration of the calomel in large doses every two hours, and by the advice of Surgeon Clark resorted to powerful in- ternal stimulants, such as carb : ammoniae, wine and brandy, were of any avail in overcoming the great congestion which had taken place, and which finally proved fatal." Assistant Surgeon McCormick himself labored under an irregular form of intermittent fever, and on the day following the abandonment of Fort Roger Jones, Surgeon Clark was seized with a violent head-ache, a constant disposition to emesis, and a sense of great anxiety about the pnecordia. After an illness of fifteen days, during which period con- stant efforts were unavailingly made to induce ptyalism, Surgeon Clark died at Welaunee, the residence of Col. Robert Gamble. These details are given to show with what concentrated virulence of action the effects of that mysterious agent termed malaria are sometimes manifested. Under the class of diseases of the brain and nervous system are reported 49 cases of nyctalopia, hcemeralopia, or par opsis noctifuga, an affection of very unusual occurrence in other parts of the United States. In the application of these learned terms much confusion exists among authors, hoemeralopia and nyctalopia being used to express both night-blindness and day-blindness. The affections here reported are all, it is believed, cases of night-blindness ; and as Hippocrates applied the term hoemera- lopia to this form of the disease, it may be well to follow his example. As the cause of hcemeralopia seems to consist in an exhaustion of the power of the letina in consequence of exposure to strong light during the day, the disease is rarely met with except in intertropical climates, or those regions in which the ground is covered many months with snow. In the West Indies Europeans, more especially soldiers and sailors, suf- fer much from this affection. The same causes operating here are found to obtain in Florida, such as the full glare of a vertical sun in an un- clouded sky, and the reflection of solar rays from the surface of water or a sandy soil. In Florida, its duration varies from one night to six or twelve months, whilst relapses are frequent. The treatment usually adopted consists in the use of cathartics, and the application of cups and blisters to the temples and the nape of the neck ; but these remedies, as well as salivation, prove in many cases wholly unavailing. The following table exhibits the relative influence of tho reasons in the production of disease in general— 308 TABLE exhibiting the ratio of sickness. Seasons. Mean strength. Number treated. Ratio per 1,000 of mean strength, treated quarterly. 1 first quarter 1 second " 1 third " 1 fourth " Annual ratio - 3,467 3,280 2,606 3,016 1,442 1,621 1,963 1,484 330 491 753 492 3,092 6,510 2,105 Consequently every man, on an average, has been reported sick once in every five months and a half. It will be seen, according to the regimental returns, that there has been a progressive decrease each year in the mortality arising from all causes—" ordinary, killed in action, died of wounds, and accidental." In 1836 it was 11TV, in 1837 6fa, in 1838 Afa, and in 1839 4T\ per cent., the average for the four years being 6fa per cent. In the summer of 1836, the troops remaining in the Territory being chiefly concentrated on the frontier settlements, suffered much from disease. On the Suwa- nee river, the 4th Infantry experienced a high mortality. The follow- ing remarks from the report of Assistant Surgeon A. F. Suter, for the last quarter of 1836, at Fort Clinch, on the Withlacoochee, to which point the troops at Suwanee Old Town had removed on the 10th of November, will illustrate the general character of morbid action: " It may not be inapplicable to this report to give a slight sketch of the fevers treated at Suwanee Old Town, during the past and early part of the quarter. In the month of July, the prevailing diseases were in- termittents, remittents, and continued fevers and diarrhcea, mild in their general character, and yielding readily to the usual remedies. Towards the first of August the sickness of the post began to increase rapidly, the diseases being principally intermittent, remittent, cont., and yellow fever of a most malignant and congestive type, which, as the season advanced into September, became more violent and fatal. As regards their general course, they usually commenced as an intermittent, running immediately into a remittent or yellow fever, or terminating fatally in the second or third paroxysm in a state of congestion, although the previous exacerba- tions may have been very slight. The plan of treatment pursued and found most successful consisted in the administration of the sub : mur: hydrarg: in doses of xxv. or xxx. grains, followed in four or six hours by castor oil, if the calomel did not operate sufficiently. The sub : mur : hydrarg : was then continued in smaller doses, combined with the sulph : quina, every hour or two, to prevent a return of the paroxysm, and change the character of the discharges which were dark and foetid. If these indications were not fulfilled before the return of the next paroxysm, and if the patient, in the cold stage, fell into a state of congestion, which was most usually the case if the disease had not been arrested, recourse 309 was then had to the most potent stimulants and tonics. Sinapisms were applied to the feet, calves of the legs, inside of the thighs, epigastrium, arms, wrists, and frequently to the chest and spine; and in some cases cups to the abdomen, followed by a blister dressed afterwards by ungt: hydrarg: fort. Internally were given wine, brandy, carb: ammoniae, camphor, opium, serpentaria, and sulph: quiniee. Enemata of infus : sem : lini: and tr: opii, were administered and frequently repeated to check the discharges from the bowels, which, by this time, invariably became frequent, involuntary, profuse, and watery, speedily reducing the patient to the most extreme state of debility compatible with life. The pulse became scarcely perceptible, the surface of the skin shrunken and overspread with a peculiar and foetid perspiration exuded from every pore, the extremities cold, and the countenance of a leaden hue. If re- action could not be induced, all the symptoms increased, the abdomen became tympanitic, the breathing difficult, and finally a violent convul- sion terminated life. On the 10th November, 1836, the command left the Suwanee for Fort Clinch. From that period to the end of the quarter the principal cases treated were scurvy and cachexia, among those brought from the Suwanee. All the deaths occurred among these, their constitutions being entirely destroyed by repeated attacks of fever." The 22 deaths reported this quarter are from the following causes: continued fever, 1; remittent, 1 ; congestive, 3; malignant intermit- tent, 1; and typhus fever, 1 ; dysentery, 3 ; chronic diarrhcea, 2; pneu- monia, 1; hydrothorax, 2; dropsy, 1 ; apoplexy, 1 ; epilepsy, 1; and cachexy and scurvy, 4. Along the frontiers of Florida, as in our Southern States generally, may be seen deplorable examples of the physical, and perhaps moral, abjection, induced by marsh miasmata. In earliest infancy, the com- plexion becomes sallow, and the eye assumes a bilious tint. Advancing # towards the years of maturity, the growth is arrested, the limbs become attenuated, and the viscera engorged. Boys of 15 years may be seen bowed down with premature old age—a mere vegetating being, with an obstructed, bloated, and dropsical system, subject to periodical fevers, passive hoemonhages, and those other forms of disease which follow in the train of malaria. Many localities consequently proved very unhealthy. Whilst some fell under the direct influence of disease, others brought away its germ. Not a few persons, who had maintained unihtenupted health in Florida, took sick upon returning north. It is, indeed, a remarkable fact in the medical history of fleets and armies, that, during the active progress of warlike operations, troops are little subject to the influence of disease. It seems as though the excitement of the passions has the power of steeling the system against the agency of morbific causes. On the con- trary, as soon as the excitement is withdrawn, by a cessation of opera- tions, and a return to the monotony of a garrison, the constitution mani- fests the consequences of recent fatigue and exposure. A general opinion obtains that, to preserve health in localities sub- ject to malaria, full living and a liberal allowance of wine are requisite. This opinion, so far as Florida is concerned, is founded in error. Irrogu- 310 larities in diet and drink, more especially when the person has been unduly exposed to the direct influence of the sun, are found to be among the most frequent exciting causes of fever. It is a truth that holds good in every clime that, in proportion to the healthy state of the digestive organs, is the constitution enabled to resist the causes of dis- ease, or to pass through it safely when under its influence. A plain and moderate diet is always most conducive to the preservation of health; and it is unreasonable to suppose that a regimen, leading to a deranged state of the digestive functions, can fortify the system against the influence of marsh miasmata. A stimulating regimen might prove a prophylactic in the damp and chilly atmosphere of Holland, but it is wholly inadmissible in the exciting climate of Florida.* It is a law of the animal system, that a gradual and protracted expo- sure to morbific agents insensibly diminishes its natural susceptibility to their influence. Hence, the acclimated natives of insalubrious re- gions possess a comparative immunity from the diseases of the climate; or, rather, the system merely loses its susceptibility of being excited into those violent febrile commotions to which strangers, arriving from north- ern latitudes, are so peculiarly obnoxious in many localities in our Southern States. In the former class, the agency of this poison may be compared to a slow and concealed combustion ; whilst in the latter, its operation is manifested in a raging and rapidly consuming flame. As the regular troops in Florida were almost wholly from the North, those that escaped the first summer, instead of gaining an immunity from disease by exposure to the climate, acquired an increased suscepti- bility of the system to it, in a less violent form. The power of resisting morbific agents, inherent in the animal organization, is so much dimin- ished every succeeding summer, that the ratio constantly sick in each company, more especially as regards intermittent fever, bears a close relation to its period of service in the territory. # Those who advocate the doctrine of acclimatization, will be surprised to find how much the theory is opposed by numerical results. The statistical data, furnished in the West India commands, leads to the following conclusions: " 1. That troops are likely to gain but little immunity from either disease or mortality by a prolonged residence in the West Indies. 2. That soldiers are not, in general, liable to any greater mortality during their first year of service there, than at any sub- sequent period. 3. That though, in years of ordinary mortality, corps long resident in the Island suffer as much, or even more, than those recently arrived, yet, during the ravages of epidemics, there appears a partial exemption in favor of the former." This partial exemption, however, may be reasonably ascribed to the fact that, as fear and des- pondency augment the susceptibility to fever, the minds of those newly arrived would be acted upon more powerfully than of those who had survived similar epidemics. The following table exhibits, in ratios per * " I aver, from my own knowledge and custom, as well as from the custom and observa- tion of others, that those who drink nothing but water, are but little affected by the cli- mate, and can undergo the greatest fatigue without inconvenience."—Mosely on Tropical Diseases. 311 thousand of the mean strength, based upon extensive data, the influ- ence of length of residence in the windward and leeward command: Years. 1st. 77 2d. 87 3d. 89' 4th. 63 5th. 61 6th. 79 7th. 83 8th. 73 9th. 120 10th. 109 11th. General average. Ratio of deaths per 1,000 of mean strength 140 85 From the table giving these results it appears that, whilst the mor- tality, during the first year, is in nine instances above the average, it is in twelve below it; that the mortality has increased, as often as dimin- ished, with length of residence; and that, upon an average, the ratio of the last years is higher than the first. The prevailing opinion in regard to acclimatization is, therefore, disproved by numerical results. It may be worthy of observation that, whilst in the West Indies, and on the west coast of Africa, an attack of yellow fever secures no subsequent immunity, in Gibraltar, the same individual is seldom twice attacked— a phenomenon also observed at New Orleans. The ensuing statistical details have been compiled from monthly returns in the Adjutant General's office. The following table exhibits the ratio of mortality, from all causes, in Florida, in 1836,-'7,-'8,-'9: Commissioned officers, rank and file. Commissioned officers. Years. Mean strength. Total of deaths. Ratio of deaths per 1,000 of mean strength. Years. Mean strength. Total of deaths. Ratio of deaths per 1,000 of mean strength. 1836 1837 1838 1839 1,345 2,753 3,218 3,160 153 191 151 149 114 69 47 47 1836 1837 1838 75 113 108 10 12 4 133 116 37 Total - 10,476 644 - Total - 296 26 - Average - - 61 Average - - 88 The ratio of the troops in Florida, 6fa per cent., varies little from the general average of troops serving in the South in time of peace—a fact established by the results of statistical inquiries. It will be seen that this ratio is lower than that of the 4th Infantry, on an average of 10 years. As an evidence that no extraordinary mortality has been experienced in Florida, it is found that the average of the last three years, taking all the regiments in the army, is 4^ per cent., whilst that of the last ten years is 4TV per cent. ; and that, although more than. one-third of the actual strength of the army served in Florida in 1838, 312 yet the mortality of the whole army is only Afa per cent.—a ratio lower than the mean of ten years. It may be supposed that the mortality among the invalids sent out of Florida will increase the ratio; but, on investigation, it is found that it does not materially affect the result. The only return of invalids, in the Adjutant General's office, that left Florida this year, (1839,) exhibits 54 in the harbor of New York. Of these, two died of chronic diarrhcea, one of whom was excessively intemperate. Amongst the invalids sent out of Florida during the years 1836,-'7,-'8, no more than 17 deaths can be traced. Of these, in 1837, one died in New York harbor, and five at Fortress Monroe; and in 1838, four deaths are reported at New Orleans, and seven at Fortress Monroe. Including these fatal cases, the annual mortality in Florida, from all causes, is increased from 6fa to 6fa per cent. The ratio of mortality among commissioned officers, (8-^ per cent.,) is higher than that of the troops in general. The ratio of sickness, however, it wTill be seen, is much lower. Of the 26 deaths, 7 were caused by wounds received in battle, 2 by the explosion of a steam- boiler, and 17 by disease. Computing those only that died from dis- ease, the ratio is 5fa per cent. In this calculation, those officers only who are reported present are embraced, excluding those on detached service, and absent on furlough or with leave. As the foregoing table is confined to the years 1836,-'7,-'8, the aggregate of killed and wounded, as exhibited below, is much greater. Amongst the officers killed, eight fell in December, 1835 ; and in the same month, in the affairs of Clinch and Dade, 100 of the rank and file were killed. STATEMENT of the number of commissioned officers of the regular army, killed and wounded, and who died of disease, in Florida, up to the 1st January, 1839. Killed. Wounded. Died. Regiments and Corps. "3 c j2 *o O B a> P 1 1 2 o "ec? > P 1 1 c '3 O 3 1 4 a "3 p 6 2 2 10 s o a> be *. B CD to to < 1 1 m o Eh 10 5 2 1 18 a tu O to t-o m 2 2 CO •~~ o > 1H p l l l 3 to B •a o l l CO a & o > o M 2 2 to e 08 a "3 P 5 2 7 to a o CJ be a GQ CO CO < 1 1 "ea o Eh 2 8 4 1 1 16 to "a3 B _o "o O P P 1 1 to :-O '5s 1 1 to — o ■J? a> > 0} p 1 1 to B ■a f o 2 2 4 to C CO B a> B 11 28 Average - - - ■ 184 A verag - 31 315 The most striking result in this table is, the contrast between the ratio constantly sick among officers and that of the troops in general. The ratio of the officer being 3 fa per cent., and that of the troops generally 18TV, the number constantly sick is six times greater among the latter. As 184 men out of every 1,000 serving in Florida are constantly sick, this number multiplied by 365 shows the annual average of days of sickness to 1,000 troops to be 67.160, or to each about 67 days in the course of the )rear ; and pursuing a similar calculation in regard to the officer, we find that he is subject to no more than 11^ days of sickness in each year. But this striking disproportion is more apparent than real; for, among soldiers, every case of disease, however slight, is regis- tered on the hospital books—a circumstance favored by him as it relieves him from duty. Moreover, as the sick left behind, or sent to a general hospital, are not immediately on recovery ordered to their proper com- panies, the average may be from this cause a little too high. This supposition is rendered probable by the sudden decrease, from 250 to 192, in the ratios of September and October—the period when each company gathers up its men in preparation for the opening campaign ; but in referring to this result it is necessary to ascribe appropriate influ- ence to other causes, such as change of season, as well as the accession of fresh troops from the north, by which the force is generally aug- mented one-half. The officer, on the contrary, seldom comes on the sick-list for slight ailments; moreover, his military pride induces him to make an effort to be reported on duty at the period of making the monthly returns. The high ratio constantly sick is to be ascribed less to the agency of climate than to the arduous and unceasing duties required of the soldier. On comparing these results with those observed among civilians, simi- lar remarks are applicable. The following table, showing the number constantly sick, the average extent of sickness throughout the year, and the duration of each attack, is given in Tulloch's Statistical Reports— TABLE showing the number constantly sick, the average sickness throughout the year, and the duration of each attack—from Tulloch's Statistical Reports. * Ages. By tables of Scotch benefit so-cieties. By tables ofEnglish benefit so-cieties. Returns of E.Ind.Co. lab'rers in London. Returns of Portsm'th dock la-borers. Returns of Wo'lwich dock la-borers. Constantly sick per one 5 thousand, - - - - 5 Average number of days 5 sick in each year, 3 Average duration of each 5 attack of sickness, 5 20 to 30 30 to 40 20 to 30 30 to 40 20 to 30 30 to 40 11.4 13.2 DATS. 4.1 4.8 15.4 18.3 DATS. 56 6.6 13.6 7 13.8 5 DATS. 4.02 5 5.06 5 18.7 5 22.6 5 19.9 DATS. 7.3 13.2 23.4 DATS. 8.5 316 The striking disproportion between the ratios annually under treatment, among soldiers and among the class of civil population here presented, arises from the circumstance, that among these laborers it is cases only of so serious a nature as to create a disability for manual labor that are recorded; for, whilst among soldiers an admission upon the sick-list secures an exemption from labor, among the working classes it is attended by loss of wages. Among troops, nearly two-thirds of all the diseases are of that class which seldom incapacitate a man for the labors of civil life. In a comparison of the relative extent of sickness among the civil and military population, these facts must be kept in view. In the Prussian army, the number constantly sick, on an average of ten years, amounts to 44 per 1,000. Among troops serving in the United Kingdom, it is about 40 per 1,000. In the Mediterranean sta- tions, the average of Gibraltar, Malta, and the Ionian Islands, is 44. The average of the stations in British America is about 45. In the West Indies, in the Jamaica command, 63, and in the windward and leeward command, 87 are constantly ineffective from sickness. With the exception of Florida, which exhibits a ratio of 184 per 1,000, the average of none of our stations has ever been ascertained. The numerical results furnished in the above table confirm the opinions derived from ordinary observation in regard to the comparative unhealthfulness of the seasons. The ratio per 1,000 constantly sick in each quarter of the year is as follows—First quarter, 151; second, 175 ; third, 241; and fourth, 169. Having concluded the investigation of the various stations in east and middle Florida, the results obtained as a class will be determined. The following table exhibits the mean strength, the mortality, and the rela- tive degree of sickness at each post prior to the present Indian difficul- ties, and the same in regard to the aggregate of posts for the year ending 30th September, 1839— TABLE exhibiting the mean strength, mortality, and relative degree of sickness of the posts in East and Middle Florida. 1. it 5-0) eaths per Ad-jutant Gene-ral's returns. a £ Z e » 5 to ►« 01 03 a o S o itio per 1,000 of mean strength, under treat. ment annually. s P P E-> « Fort Marion 304 9 8 668 2,197 " King 408 13 7 1,150 2,819 " Brooke 596 15 11 2,011 3,374 Key West - 208 24 20 1,002 4,817 Temporary Posts - 3,092 125 76 6,510 2,105 Aggregate 4,608 186 122 11,341 - Ratio per 1,000 - 39* 26 • 2,461 • The aggregate mean strength, according to the Adjutant General's returns, is 4,781. 317 The annual ratio of mortality, according to the medical reports, is 2fa per cent., and according to the post returns, 3fa per cent. This is the only class in which no death from epidemic cholera is reported; and in the total mortality given in the medical returns, but 8 deaths are excluded, viz. 1 drowned, and 7 from wounds. In the mortality of the temporary stations, as exhibited in the post returns, every death inci- dental to a state of war is given ; and although the total of deaths is 49 greater than the number reported as arising from diseases, yet the average mortality is much lower than either of the two preceding classes. The ratio per 1,000 of mean strength annually under treatment being 2,461, it follows that every man, on an average, was under treatment once in nearly every five months. With the exception of the first two classes, this average is the lowest. Assuming this ratio as an exponent of the comparative salubrity of the several posts constituting this class, Key West is found in the highest extreme, and the temporary posts in the lowest. The following table exhibits the relation of season and climate with morbid action, as illustrative of the diseases of this region— 318 TABLE exhibiting the relative influence of the DISEASES. e o 'S o fa 00 .3 W o fa ai J* o o u m o fa to Oi a> " Eh 43 S "& o* C OO 0. Ed w to e < I S Ratio of cases per 1,000 of mean strength. INTERMITTENT FEVEB. First quarter Second " ..... Third " ..... Fourth " ..... 4 10 37 10 41 82 205 177 60 86 178 111 19 12 1 9 142 304 607 303 266 494 1028 610 5134 4698 4174 4421 52 105 244 138 Annual ratio..... 61 505 435 41 1356 2398 4608 520 REMITTENT FEVEB. First quarter - - -Second " ..... Third " ..... Fourth " ..... 5 24 3 2 17 40 24 10 11 16 15 3 31 59 151 59 46 92 231 101 5134 4698 4174 4421 9 20 55 23 Annual ratio..... 32 83 52 3 300 470 4608 102 SYNOCHALFEVEB. First quarter -Second " ..... Fourth " ...... 2 1 14 1 5 9 4 16 22 3 4 4 11 9 20 45 5134 4698 4174 4421 2 2 5 10 Annual ratio - - - - - 2 15 6 51 11 85 4608 18 TTPHUS FEVEB. First quarter..... Fourth " ..... 1 1 2 2 - - - 1 2 5134 4698 4174 4421 2-10 5-10 Annual ratio..... - - - 3 4608 7-10 DIABBHCEA AND DTSENTEBT. First quarter..... Second " . . - - -Third " ..... Fourth " ..... 11 46 18 17 14 41 26 36 117 119 68 98 79 53 23 21 15 373 463 358 400 570 641 521 547 2279 5134 4698 4174 4421 4608 111 136 125 124 Annual ratio - - - - - 92 364 112 1594 495 319 seasons in the production of morbid action, 4-c. DISEASES. CATARRH AND INFLUENZA. First quarter Second " * Third " ... Fourth " ... Annual ratio - PNEUMONIA. First quarter Second " ... Third « Fourth " - " - Annual ratio - - - PLEUBITIS. First quarter ... Second " Third " ■» Fourth " ... Annual ratio - PHTHISIS PULMONAIIS. First quarter - - - Second " ... Third " ... Fourth " ... Annual ratio - - - RHEUMATISM. First quarter Second " . - - Third " ... Fourth " " Annual ratio - - - 86 14 12 12 20 5 49 2 n 47 153 be J2 a <» Socl be" < 114 41 94 82 41 _: S M bo t* bc 6 a> t! .e! S 'Id 229 114 167 148 331 658 28 11 34 62 5134 4698 4174 4421 4608 143 5134 4698 4174 4421 68 4608 17 14 5 12 48 21 12 21 22 76 23 137 60 74 69 340 113 5134 4698 4174 4421 4608 5134 4698 4174 4421 40 4608 196 108 127 117 548 5134 38 4698 23 4174 30 4421 26 4608 119 320 With the exception of the south-western region, the ratio of intermit- tents in this class is higher than that of any other; but as regards remit- tents, it is found that the three preceding classes present higher ratios. As respects diarrhoea and dysentery, the relation is the same as that of intermitting fever. As this class of posts is comprised in a region characterized by a mild, insular climate, the numerical results in reference to the class of pulmo- nary diseases, as might be anticipated, are correspondingly low. The annual ratio of all pulmonary diseases, as is seen below, is only 191, whilst in the third class of the northern division it is as high as 602. Contrary to the preceding classes, the usual diversity in the averages of the seasons is not here presented, as will be subsequently explained. The annual results in reference to the class of pulmonary diseases, as well as the moitality from each, are exhibited in the subjoined table. As it is intended to make a comparison between our northern and south- ern regions, it has been deemed expedient to take the mean of the mid- dle and southern divisions; as in the northern division the total of deaths is limited to thos e reported in the medical returns— TABLE exhibiting the annual results and mortality of diseases Ratio of cases per 1,000 of mean Deaths « s strength. Southern region. c 271 0* •a o a 3 CD a fa 25 •a a> fa 32 o a 3 a, .m 13 "a •*> o E-341 -a J-H s ■a o a 3 a fa 1 05 CD fa 6 a *3 a. 03 3 3 -<= a fa on "ffi a. o a a X h e2w 196 4> CD. CQ o 1-8 Coast from Del. to Savannah* 3199 1 19 18 South-western stations - - 11140 290 39 52 11 392 _ 31 2 61 2 458 75 Posts on lower Mississippi - 3381 218 22 28 9 277 - 2 2 10 _ 178 30 Posts in East Florida - - 4607 143 15 24 9 191 - - 1 9 - 131 17 Total 22327 246 29 40 10 326 - 34 6 99 2 963 140 The total Of deaths in each month, according to the Adjutant Gene- ral's returnsi, is exhibited in the annexed table— TABLE showing the number of deaths in each month. Total of deaths in each month. Jan. 9 Feb. 17 Man 7 Apr. 10 May. 11 June 16 July. 20 Aug. 22 Sept. 28 Oct. 14 Nov. 13 Dec. 19 Total. 186 * Fort Monroe is excluded from this class. There are reported 4 deaths from influenza, 8 from pneumonia, and 17 from phthisis pulmonalis. 321 GENERAL RESULTS. Having completed the specific details of each division, and of each class of posts, the numerical results of these classes will be given, with the view to general conclusions. The ratio of mortality, and the relative degree of sickness in each class, are exhibited in the following table, the divisions being limited to two, the northern and the southern— TABLE exhibiting ike ratio of mortality and the relative degree of sickness in each class. Mean aggregate strength. Ratio of deaths per 1,000 by Adjt.Gen'ral's returns. Ratio of deaths per 1,000 by Medical re-turns. Cfi <-J :4 — o B * o £ Eh Ratio per 1,000 mean strength under treat-ment annually 1st Class, Northern Lakes 2d " Coast of New England -3d " Posts north of latitude 39°, and remote from the ocean and lakes 5,975 3,663 12,604 13 20 14 9 15 8 13,053 7,004 39,104 2,185 1,912 3,103 Ratio of Northern Division 22,242 15 9 59,161 2,660 4th Class, Coast from Delaware bay to Savannah .... 5th Class, South-western stations 6th " Posts on the lower Missis-7th Class, Posts in East Florida 5,850 11,140 3,381 4,608 34 45 53 39 30 36 44 26 16,907 39,030 9,669 11,341 2,890 3,501 2,860 2,461 Ratio ef Southern Division 24,979 42 34 76,947 3,080 47,221 30 22 136,108 2,882 The annual ratio of mortality, on an average of all the posts, is, according to the Adjutant General's returns, 3 per cent., and according fo the medical reports 2fa per cent. In each calculation, the deaths from epidemic cholera (130) are excluded; and in the latter, those also reported as suicide, asphyxia from cold or submersion, &c. The mortality, by the medical returns, may be therefore regarded as a pretty fair expression of climatic influence. The difference between the ratio of mortality of the northern and southern division is quite striking, the average of the latter being, according to the medical returns, nearly four- fold greater, and, according to the post returns, nearly three times higher, than that of the former. This disparity is equally manifest in the statistics of the first part, as shown by the results of four years/terminat- ing with 1825. In 1822, this inequality, according to the post returns, is very remarkable, the annual ratio of mortality in the southern division 41 322 being 13^, and in the northern no more than 1 fa, per cent. A distin- guishing feature between these two divisions is, that the northern exhibits little variation in the annual mortality, whilst the southern, in conse- quence of more fatal epidemic visitations, shows great extremes. In regard to the comparative state of health among the troops, this table affords the following conclusions :—The ratio per 1,000 of mean strength annually under treatment, in the Northern division, being 2,660, it follows that eveiy man, on an average, was reported sick once in every four months and a half. Pursuing the same calculation in respect to the the Southern division, the period is found to be very nearly four months; whilst the average of all posts included in these statistics is four months and a sixth. Assuming this ratio of sickness as an index of the compar- ative salubrity of the several regions represented by each class of posts, it is found that the coast of New England is on the lowest extreme, and the southwestern stations on the highest. The high ratio of the third class of the Northern division is more apparent than real, inasmuch as an extraordinary number of slight affections are reported among the cadets of the Military Academy. It has been already shown that, as diseases differ in their tendency to a favorable issue, this average is liable to lead to error ; thus, although the extent of disease in the sixth class is comparatively low, yet the mortality, owing to the malignant nature of febrile diseases, is higher than any other class. During the ravages of epidemic fever, the mortality may be very great without the average number in the hospital being materially augmented. In the windward and leeward command of the West Indies, for example, the mortality is six times as high as in the United Kingdom, although the extent of sickness, as shown by the number of admissions into hospital, is but twice as great. The disproportion between the relative extent of sickness among the military and civilians was brought under notice in considering the general results of the second class of the Southern division; but this striking disparity, it was shown, is ascribable to peculiarities of condition not ap- parent at first view. The extent and duration of sickness among the working classes have frequently engaged the attention of British legisla- tion. In regard to the influence of age on disease and mortality, it has been determined that from birth to the age of puberty they decline, and that from this period they increase slowly, but in geometrical pro- gression, up to the 50th or 60th year, and then more rapidly to the end of life. In continuation of the subject of mortality, the following abstract, ex- hibiting the mean strength of every regiment, and the deaths in each for the period of ten years, compiled from monthly returns in the Adjutant General's office, is given— ABSTRACT exhibiting the mean strength of every Regiment, and the deaths in each for a period often years, compiled from the monthly returns in the Adjutant GoicraFs office. 1st Art'y. 2d Art'y. 3d Art'y- 4th Art'y. 1st Inf 'y. 2d Inf'y. 3d Inf'y. 4th Inf'y. 5th Inf'y. 6th Inf'y. 7th Inf'y. 1st Drag. 2d Drag. t-H x\ bo G CD CD co Xi cl CD p x\ to G CD 1h 00 en Xi a o P x\ CD 3 02 03 Xi a CD P x\ bb a CD !-. CD CO Xi a CD P x\ "So G a> CD oa Xi "3 a> P G o CD Xi ca CD P bo G c 02 CO Xi P x\ to G o CD to Xi d a P x] bo G CD »H CD 0? Xi a CD P Xi G CD 03 x: CD p x\ be G CD CD CO Xi C3 CD P M G CD U CD CO Xi CD P Xi bD G CD L. CD CO Xi ta CD P 1829 519 15 481 29 499 15 516 14 441 8 496 9 432 26 453 17 499 6 432 29 415 Ifi 1830 527 21 464 21 507 8 498 8 474 14 486 9 469 18 477 31 489 10 469 16 464 17 1831 528 15 471 20 475 11 505 9 468 11 472 6 454 16 485 31 515 4 454 5 446 24 1832 472 54 4(35 8 470 28 492 66 415 19 459 34 502 7 457 51 456 8 502 63 493 15 1833 495 7 456 18 461 20 488 14 399 13 512 3 442 5 446 31 440 6 442 7 496 34 *147 6 R34 485 22 431 12 481 15 495 7 480 6 494 4 452 37 452 21 513 10 452 22 446 72 463 91 1835 512 12 491 81 506 48 4 93 11 488 10 514 . 3 468 13 442 20 505 2 468 32 483 38 530 18 1836 459 45 401 26 440 28 476 8 421 9 484 11 418 13 369 70 396 4 418 17 451 9 559 15 i ,-m 374 17 401 23 414 24 407 16 342 7 498 7 378 13 460 49 250 0 378 46 421 21 583 33 578 33 1838 521 23 477 34 506 21 547 14 521 29 538 29 450 13 480 23 388 9 450 18 495 18 522 13 747 34 Tot'l 4892 231 4538 272 4759 218 4917 167 4449 126 4953 115 4465 161 4521 344 4451 59 4465 255 461C 264 2804 176 1325 67 go tc w * The mean strength is 353; but, as the corps was organized but five months in this year, it is equivalent to 147. 324 TABLE showing'the annual ratio of mortality in each regiment, condensed from the pre- ceding abstract. Ratio of deaths CORPS. Strength. Deaths. per 1000 of mean strength. 1st Artillery, - 4,892 231 47 2d Artillery, - 4,538 272 60 3d Artillery, - 4,759 218 46 4th Artillery, - 4,917 167 34 1st Infantry, - 4,449 126 29 2d Infantry, - 4,953 115 23 3d Infantry, - 4,465 161 36 4th Infantry, - 4,521 344 76 5th Infantry, - 4,451 59 13 6 th Infantry, - 4,465 255 57 7th Infantry, - 4,610 264 57 1st Dragoons, - 2,804 176 63 2d Dragoons, -Total Average, 1,325 67 51 55,149 2,455 - - 44 TABLE showing the annual ratio of mortality in the aggregate of Regiments. i Ratio of deaths Years. Strength. Deaths. per 1,000 of i mean strength. 1829 5,183 184 36 1830 5,324 173 32 1831 5,273 153 29 1832 5,183 354 68 1833 5,224 159 30 1834 5,644 320 57 1835 5,900 289 49 j 1836 5,292 256 48 1837 5,484 289 53 1838 Total - -Average 6,642 278 42 ! i 55,149 2,455 | i - - 44 From these calculations it appears that the annual ratio of mortality in the United States army, from all causes—" ordinary, killed in action, died of wounds, and accidental"—is 4^ per cent. This average is a fraction higher than the ratio of the three years ending with 1825, being 325 3tV Per cent. The mortality of the four years commencing with 1819, although not precisely determined, is considerably higher. Compared with the results obtained in other countries, considerable diversity is presented. In the West Indies, the mortality of British troops, on an average of a period of twenty years terminating with 1836, is 9fa per cent., and among the black troops 3T8^ per cent., the mean being 7fa per cent. This ratio, both among white and black troops, is about 50 per cent, lower than during the preceding twenty years. In British America we have the following results, based on the statistics of twenty years, ending with 1836—the Bennudas, 2fa per cent.; Nova Scotia and New Brunswick, lfa per cent.; Canada, lfa, and Newfoundland, (on an average of 12 years,) 3fa per cent. In the Mediterranean, on an aver- age of twenty years, the annual rate of mortality at Gibraltar is 2fa per cent.; at Malta, lfa, and the Ionian Islands, 2fa per cent. The rate of the British troops serving at home, being the result of the statistics of seven years commencing with 1830, is 1^ per cent. In the East Indies, at Bengal, the mortality of European troops is 5fa per cent., whilst that of the native troops in the Madras Presidency is only lfa per cent. The mortality of the French army on the home station is about 2 per cent. In the Prussian army, the ratio is lfa per cent.; but this low scale of mor- tality is attributable less to greater salubrity of climate than to the circum • stance that the soldiers are almost entirely between the ages of 20 and 25. The mean ratios of the following British stations, on an average of six years, from 1831 to 1837, stand thus: Ceylon Afa, Mauritius 3T^, Cape of Good Hope lfa, Bombay 3fa, Madras 5fa, and New South Wales lfa. The profession of arms during peace, as shown among the troops serving in the United Kingdom, involves no greater risk of life than that which attends civil pursuits. The ratio of mortality among the Dragoon Guards and Dragoons, whose average age was from 29 to 30, is 15 fa per thousand of the force annually. Taking a mean of the Carlisle Tables, the Government Annuity Calculations, and the Population Returns, the mortality among civilians at this period of life amounts to 11^ per 1,000; but as this calculation is based on the average of town and country, whilst the troops are quartered principally in towns, the ratio is nearly equal. Marts of commerce have been truly designated " the sepulchres of the dead, and hospitals of the living." The unfavorable influence of density of population on health, is apparent from the single fact, that the average of 17 of the principal towns in Great Britain, taken from Parliamentary returns, shows the mortality of the civil population to be, instead of 11^, upwards of 16 per 1,000. The result is, therefore, in favor of the military. In the tables just given, showing the mortality of each regiment, some striking facts are presented. The extremes of mortality are exhibited in the 4th and 5th regiments of Infantry. The latter, which has had a kind of home station on our northern lakes, gives an annual rate as low as 1^ ; whilst the fonner, which has borne the " tug of war " in climes less genial, shows an average of 7 fa per cent. The attention is also arrested by the results presented in the last three years ; for, it is seen that the Florida war, as already shown, has not augmented the general mortality. The average of these three years is about the same as the ratio of ten years- 326 The subjoined outline of the stations occupied, and the duties per- formed, by each regiment, will serve to illustrate the numerical results furnished by the statistical data. Having investigated the medical topo- graphy of our military posts, we are now enabled to study with profit, in proportion as a correct knowledge of the relative influence of each region has been attained, the connexion between the mortality exhibited and the positions occupied. Proceeding on the scale of increasing mortality, the lowest ratio, lfa per cent., is that of the 5th Infantry, which, in 1829, garrisoned Forts Brady, Howard, Mackinac, and Dearborn, and continued, during the ten years, in nearly the same position on the lakes. The 2d Infantry, 2-fa per cent., occupied in 1829 Hancock and Mad- ison Barracks, and Forts Gratiot and Niagara. It continued in the same region until 1837, when six companies were ordered to Florida ; and in 1838 the whole regiment served in the Seminole campaigns. The 1st Infantry, 2fa per cent., in 1829 was stationed at Forts Snel- ling, Crawford, and Winnebago. It remained in the Northwestern Territory until 1837, in which year, and in 1838, it served in Florida. The 4th Artillery, 3fa per cent., in 1829, garrisoned Forts Columbus, Delaware, McHenry, and Severn. Until 1836, no company got farther south than Charleston Harbor. In 1836-'7-'8, it served among the Creeks, Seminoles, and Cherokees. The 3d Infantry, 3fa per cent., in 1829, occupied Fort Armstrong and Jefferson Barracks. In 1830, the same posts—four companies be- ing detached on Red river, and two in the Creek nation. In 1831, it was removed to Forts Jesup and Towson, on which frontier the regi- ment remained. The 3d Artillery, Afa per cent., from 1829 to 1835 inclusive, was stationed on the coast of New England. In 1831, three companies were detached to Fort Monroe; in 1832, two to Charleston harbor; in 1833, two to the Creek nation; and in 1834, two to Fort Brooke, Florida. In 1836-'7, the regiment served in Florida; and in 1838, it marched to the Cherokee nation and back to Florida. The 1st Artillery, Afa per cent., garrisoned in 1829 Forts Monroe, Johnston, and Washington, and Bellona Arsenal. In 1830,-'1,-'2, the same posts, three companies having, in the last year, removed to Charles- ton harbor. In 1833-'4L-'5, it was still on the middle coast. In 1836-'7, it served in Florida; and in 1838, on the frontiers of Canada. The 2d Dragoons, 5fa per cent., served nearly altogether in East Florida. The 6th Infantry, 5fa per cent., in 1829-'30-T-'2-'3, was stationed at Jefferson Barracks and Cantonment Leavenworth ; in 1834-'5, at Jefferson Barracks ; in 1836, on the Sabine ; and in 1837-'8, in Florida. The 7th Infantry, 5fa per cent., in 1829 occupied Forts Gibson and Jesup, and continued on the southwestern frontier. The 2d Artillery, 6 per cent., from 1829 to 1835 inclusive, was sta- tioned on the sea-board from Charleston to New Orleans, and at Fort Mitchell and Augusta Arsenal. In l°36-'7, it served in Florida; and in 1838, marched to (.he Cherokee Nation, and thence to the frontiers of Canada. 327 The 1st Dragoons, fifa per cent., in 1834 garrisoned Forts Gibson, Des Moines, and Leavenworth. Its operations have been confined to the same region, making fiequent tours among the Indian tribes. In 1834, one company was detached as an escort to a caravan of traders to Santa Fe in Mexico. ^ The 4th Infantry, 7fa per cent., from 1829 to 1835, occupied Foits Clinch, Brooke, King, Mitchell, and St. Philip, Augusta Arsenal, Key West, New Orleans, and Baton Rouge. In 1836-'7, it served in the Seminole campaigns, and in 1838 in the Cherokee nation. Having already determined the comparative salubrity of each system of climate, confirmation is afforded in the fact that the mortality of each regiment bears a ratio conesponding to these laws. The high mortality of our army, compared with that of British troops at home, in the Me- diterranean, and in British America, is, in a great measure, susceptible of explanation. Although our troops are better paid, fed, and clothed than those of any other nation, yet, as they are distributed along a sea- board of more than 3,000 miles, and an inland frontier of perhaps equal extent, and as the condition of our Indian tribes and other causes demand their frequent removal from one extremity to the other, the duties of the soldier are often very arduous. A regiment recently, in the course of one year, marched 4,000 miles, 1,000 of which were performed on foot. Independently of marching and fighting, the duties required of the sol- dier are generally very laborious. Cutting roads, building bridges, con- structing forts, &c, also fall to his share of duty. Scarce a year passes without some hostile demonstration. In 1829, the unsettled state of the Creeks, and the intrusion upon the lands of the Cherokees, required the advance of troops ; and to afford protection to the trade carried on with the Mexican States, a detachment was or- dered to escort the caravans as far as our boundary line. In 1830, our troops were kept in motion by Indian disturbance on Red river; by threatened hostilities among the tribes inhabiting the country around Prairie du Chien ; by the lawless intruders upon the mineral district of the Cherokees within the limits of Georgia; and by negro insurrection- ary movements about New Orleans. In 1831, we had disturbance among the Sac Indians, and servile insurrection in Virginia. In 1832 came the war of Black Hawk, when the most formidable enemy encoun- tered was cholera. In 1834, Colonel Dodge's command, in his expe- dition among the Camanches, Pawnees, and Kiowas, suffered much from sickness. In 1835 the Dragoons, divided into three squadrons, made tours through almost the entire extent of our territory west of the Mississippi, below the 44° of latitude. In the same year occurred Dade's disaster. In 1836, we had the Seminole war, Creek and Cherokee diffi- culties, and threatened hostilities on the Texian frontier. In 1837, the Florida war and Cherokee troubles continued ; and, in 1838, in addition to these difficulties, disturbances were manifested on the Canada frontier. In continuation of the " General Results" a condensed view of the facts developed in each class, in reference to certain specific diseases having a close relation with season and climate, will be given. The following table show's the ratio of cases of each disease, per 1,000 of mean strength, reported quarterly and annually— TABLE exhibiting the ratio of cases of each disease per 1,000 ofmean strength, reported quarterly and annually. Feb. Intermit. Feb. Remit. Feb. Synoch. Feb. Typhus. Diarrhoea and Dysentery. i p CO 13 2 21 15 & ©* 73 15 34 41 B §< CO 77 11 57 55 M CD CO s ■«^ 36 9 40 35 £ . _ in cd xi 3 G C CO - CD 193 36 151 143 c CD OS 10 3 3 2 2 CD tH CO 3 CT T3 -, %CD CO 03 S o " *c« -° o ^! a> P. a g B tg Total cases of feb. syn-och. Total cases of feb. ty-phus. Total cases of diarrhoea and dysen-tery. 1st quarter ... 2d quarter -3d quarter ... 4 th quarter - 23,226 21,164 21,775 22,801 354 868 1,188 777 56 100 308 123 219 230 242 134 10 11 17 16 690 1,046 3,119 1,126 Total - 22,240 3,187 587 825 54 5,981 Southern Division. 1st quarter -2d quarter 3d quarter 4 th quarter 25,751 25,146 25,206 24,817 1,836 2,589 6,127 3,632 257 587 2,407 945 176 140 225 177 13 34 32 31 1,965 3,92(1 4,781 2,469 Total - 24,9-^ 14,184 4,196 718 110 13,135 Aggregate 47,219 17,371 4,783 1,543 164 19,116 The results afforded in these tables are valuable as indicating the ac- tual ratio in which these diseases prevail, both in reference to the influ- ences of season and climate. As regards the comparative prevalence of intermittent fever in the northern and southern divisions, the annual ratio per 1,000 is as 143 to 568. In the northern division the second class, or coast of New England, is nearly wholly exempt from this dis- ease, most of the cases reported being of foreign origin. The first class, or region of the lakes, gives the highest ratio. The third, comprising the posts remote from the ocean and the great lakes, also gives_a high average ; but this is owing chiefly to the locality and latitude of Forts Crawford and Leavenworth, the disease being little known at the re- maining stations of this class. In the southern division, the results demonstrate that diseases of malarial origin increase in proportion as southern latitudes are reached ; but this law receives modification in this that inland regions, contrasted with those on the coast in the same latitude, have, owing doubtless to the greater summer heats, a higher average. The annual ratio of the fourth class, embracing the posts on the sea-coast and the estuaries between the Delaware and Savannah rivers, is, for example, 370, whilst the average of the southwestern sta- tions rises to 747. The ratio of the sixth class is only 385, but it is to be remarked that the troops were generally removed to healthy summer encampments. The ratio of the seventh class (East Florida) is 520. 42 330 In relation to diarrhcea and dysentery the same haws, it is seen, hold good generally in both divisions. This general fact is confirmed by the singular relation, on comparing the second and third quarters in Florida, between intermitting and remitting fevers and the class of diseases of the digestive organs, already brought under notice. Whilst, in the second quarter, the ratio of the former is lower than that of the latter, in the third the reverse occurs. Assuming an identity of cause, it would seem that the same morbific agents, in proportion to their degree of intensity of action, may produce either class of lesions. Before proceeding further in tracing out these relations, it will be ne- cessary to frame a general summary of the mortality arising from specific diseases. In the course of this inquiry, those diseases which have a manifest dependance on season and climate have been more particularly investigated ; but the following table, including these results, exhibits a more general view of diseases. TABLE exhibiting a general view of diseases in the Northern and Southern divisions. Northern division. Southern division. Specific diseases. OS co CO a . O rQ Cm CO Eh CO Xi ctf -g 1 . £3 co 3 TS g -3 G B 2-S33 Feb. Intermittens - - -" Remittens ... " Synochus ... " Typhus Catanh and influenza -Pneumonia -Pleuritis .... Phthisis pulmonalis Hoemoptysis -Dysenteria ? Diarrhcea 5 Gastritis and enteritis Cholic and cholera Epidemic cholera -Hepatitis, acut. et chron. Phrenitis and meningitis Apoplexia .... Epilepsia .... Mania a potu ... Ebrietas - - - -Nyctalopia - - - -Rheumatismus ... Gonorrhoea - - - -Syphilis .... Hydrops. .... Atrophia and chronic visceral lesions -Casualties .... Suddenly .... All other diseases ... 3,187 587 825 54 9,538 610 652 152 83 5,981 289 3,221 302 98 18 6 166 102 1,370 18 3,412 971 462 50 I, 12' 2 8 1 8 1 46 h 1 2 103 3 3 4 5 3 5 I 4 9 35 3 11 lin 3,187 lin 49 lin 412 lin 7 1 in 9,538 lin 76 1 in 652 lin33-10 lin 83 1 in 665 1 in 289 1 in 1,610 lin 3 lin 33 ;iin 6 linl5-10 lin 33 lin 34 1 in 274 Oin 18 Oin 3,412 Oin 971 1 in 462 lin 12 14,094 4,196 718 110 7,471 900 1,060 257 84 13,135 633 3,282 384 166 31 25 188 306 2,616 191 2,845 929 584 206 13 145 " 11 24 4 42 6 116 2 38^ 55 5 26 7 88 4 5 10 9 39 58 1 19 16 50 7 28 1 in 1,084 lin 29 lin 65 lin 5 1 in 1,868 lin 21 lin 177 lin 2 lin 42 1 in 141 lin 24 1 in 469 lin4 3-10 lin 41 lin 6 1 in2 5-10 lin 21 lin 8 lin 45 Oin 191 lin 2,845 0 in 929 0 in 584 lin 11 Total 32,154 281 1 in 144 54,411 823 lin 75 3J1 In addition to this mortality,there are reported in the northern division 43 deaths, the causes of which are not specified, making an aggregate of 321; and in the southern division 140 deaths of the same class, making an aggregate of 963. The conclusions deduced from this table arc, therefore, merely approximations to the truth ; inasmuch as in the former division, the causes of about one-eighth, and in the latter the causes of about one-seventh, of the deaths, are not reported. It may be fairly inferred, however, that the majority of these last belong to the class of sudden or casualties. It is of course impossible in the narrow limits of these observations to do more than direct attention to the most important facts; but to him, disposed to inquire more minutely into these subjects, the necessary materials are here afforded. On a comparison of the northern and southern divisions in relation to remittent fever, the annual ratio of cases per 1,000 ofmean strength, stands as 26 to 168. In the northern division, the contrast in the aver- ages of the three classes is not so great as might, a priori, have been inferred, on the supposition of its common origin with intermitting fever, and in view of the comparative exemption of the coast of New Eng- land from this form of fever. In the southern division, in which the ratio is more than six times higher than in the northern, the classes present no great extremes. It is worthy of remark that the sixth class, remarkable for a low ratio of intermitting fever, gives.the highest aver- age of remitting fever. The ratio of mortality from intermitting fever, it is seen, is exceed- ingly low. It may be said that it is only in our southern latitudes, when violent congestions of internal organs occur, that death takes place in this disease. The mortality from remittent fever, in the north- ern division, is fa, and in the southern, 6, per 1,000 of the mean strength. In the former the proportion of deaths to the number of cases is 1 in 49, and in the latter 1 in 29. Of the fatal cases of remit- tent fever, 23 are reported under the name of yellow fever; but some are doubtless registered under the former term. Amongst the troops in Canada, the annual ratio of mortality from remittent fever is one per 3,571 of the strength; whilst in Nova Scotia and New Brunswick, no death arose from this cause in 20 years. The cases registered as synocha, synochus, common continued, ephemeral, and inflammatory fevers, aie included under the head of synochal fever, but the majority of the whole consist of cases reported under the last name. The ratio is higher in the northern than in the southern division, being as 37 to 25 ; but the average mortality is lower. In the former, the proportion of deaths to the number treated is one in 412, and in the latter, one in 65. In the former, the ratio per 1,000 of strength is 1 in 11,120 ; and in the latter, 1 in 2,271. In Canada it is 1 in 574, and in. Nova Scotia and New Brunswick, 1 in 737. In Nova Scotia and New Brunswick, nearly all fevers are of the common con- tinued type, prevalent in every climate. Whilst in Lower Canada the ratio of intermitting and remitting fever is exceedingly low, in Upper Canada it is comparatively high, being as 13 to 89. Besides, many of 332 the cases reported in Lower Canada occurred among soldiers who hud come from the upper provinces. The same relation has been observed between the coast of New England and the region of the lakes. What seems inexplicable, however, is the fact, as remarked by the British reporter, that whilst they prevail along the shores of the lakes and the margins of the streams in Upper Canada, they are comparatively rare in similar situations in the lower provinces. The troops and inhabitants at Windsor, Annapolis, Fort Cumberland, and Frederickton, possess this exemption, notwithstanding their situation at the embouchure of rivers, and exposure to the influence of that combination of mud and marsh regarded as its prolific source. Although typhus fever, regarded as a contagious disease, may have little connexion with general atmospheric causes, yet it is placed here to complete the view of febrile affections. It is a disease of compar- ative infrequency; for, in the northern division only 24, and in the southern 44, cases per 10,000 men have been annually reported. Sub- ject to vague and arbitrary application, the term typhus is doubtless often used to designate a typhoid state of fever—a supposition favored by the fact that the ratio is higher in the southern than in the northern division. Genuine typhus is generated by that species of miasmata evolved in crowded, ill-ventilated ships, jails, hospitals, and the sordid hovels of the poor; and when once developed, there is every reason to believe that it elaborates a peculiar virus communicable to those coming within the sphere of its activity. In the northern division, 54 cases and 8 deaths, and in the southern, 110 cases and 24 deaths, are reported. Of the latter, 12 fatal cases are reported at Baton Rouge under the name of congestive typhus. In the United States, the annual ratio of deaths from this disease is 1 in 1,476 of the strength; in Canada, it is 1 in 4,944; and in Nova Scotia and New Brunswick, 1 in 6,635. The average annual mortality from all the fevers brought under notice, per 1,000 of the mean strength, is, among our troops, 4^, and among the British forces serving in Canada, it is 2fa—in Nova Scotia and New Brunswick, lfa—and in the West Indies, in the windward and leeward command, 37, and in the Jamaica command, 102. In the last, then, based upon the statistics of 20 years, and embracing an aggregate strength of 51,567, the ratio is 25 times higher than among our forces. It must be borne in mind, however, that one-eighth of the causes of death, in our reports, is not specified. In respect to cholic and common cholera, the annual ratio of cases, per 1,000 of mean strength, in the northern division, is 145, and in the southern, 131. It is found, however, that in the former division nearly one-half the cases (1,445) are reported at a single post, (West Point,) with a mean aggregate" strength of 3,734. It has been already remarked that many of the diseases registered among the cadets are of a veiy trivial nature. Leaving these data out of the calculation, the ratio of this division is reduced to 96. As the striking contrast between the northern and southern divisions, in regard to intermittent and remittent fever,and diarrhoea and dysentery, does not obtain in relation to cholera and cholic, the inference, that these diseases are not much dependent upon malarious causes, is fairly warranted. 333 In the northern division, 2 deaths are reported from these affections, and in the southern, 7. Of epidemic cholera there are 686 cases reported, of which 191 terminated fatally. The history of this epidemic has been given in the details of the posts, as the subject presented itself, but it is believed that some cases and deaths have not been reported, at least in the campaign against Black Hawk, when two medical officers became its victims. An extraordinary feature of this epidemic is, that the ratio of deaths, to the number of cases treated, varies very little in all the military com- mands—the statistics of which have been investigated. Thus, the pro- portion of deaths, to the number of cases, is as under— United Kingdom, in 1832,-'3,-'4 - - - 32 per centum. Gibraltar, in 1834 - - - - - 30 " Nova Scotia and New Brunswick, in 1834 - 28 " Canada, in 1832......36 " Canada, in 1834......34 « , Black troops, at Honduras, in 1836 - - - 32 United States army, in 1832,-'3,-'4 - 28 " Hence it seems that, under the various modes of treatment adopted, little variation is presented in the results. Among our troops, however, it appears that the disease was considerably more fatal in the northern than in the southern division, the ratio of deaths to cases being in the former 1 to 3, and in the latter 1 to Afa. It may be well to add that all cases reported as chole?°ine have been included under the head of com- mon cholera. The influence of the seasons is apparent from the fact that, in the first quarter 4 deaths, in the second 22, in the third 153, and in the fourth 12, are reported. From gastritis and enteritis, there are reported in the northern division I death, and in the southern 26—the proportion of deaths to the num- ber treated being in the former 1 in 289, and in the latter 1 in 24. In regard to the relative prevalence of diarrhcea and dysentery, refer- ence has already been made, both in respect to season and climate. These cases have been condensed under one head, but the mortality arising from each is given separately. In the northern division, the proportion of deaths to the number treated is 1 in 665, and in the southern, 1 in 141; and the mortality per 10,000 of the strength is respectively 4 and 37. In the northern division, there is no death reported as arising from dysenteiy at any posts, except Forts Crawford and Leavenworth. In the West Indies the ratio of deaths from these diseases, per 1,000 of the strength, is, in the windward and leeward command, 19, and in the Jamaica command, 4; thus reversing the rela- tive mortality arising from fevers. The reputed agency of diet in the production of diseases of the bowels has been confirmed by numerical results in the West Indies. In one command, in which for five days in the week the diet consisted of salt provisions, the mortality from diseases of this class was nine times greater than among the officers; whilst in another, (Jamaica,) in which only two days' salt provisions were istucd weekly, the mortality 334 of the two classes presented veiy little difference. Tliese are no isolated facts, but uniform results deduced from 20 years' observation. But the elevated temperature of tropical regions, independently of other causes, seems positively detrimental to health. The absorbents of the intestines being maintained in a state of erethism by the constant evaporation by cutaneous and pulmonary transpiration, a morbid condition is readily assumed under favorable exciting influences. Diarrhoea, dysentery, cholera, hepatitis, and those bilious derangements which accompany fevers, are consequently prevailing affections. Of acute and chronic hepatitis, the total of cases in the northern division is 98, and in the southern 166, the ratio of the former per 1,000 being Afa, and of the latter 6 fa. It thus appears that in the southern division the ratio is one-half higher. That tliese diseases pre- vail to a greater extent, more especially in our southern latitudes, than is here indicated, is no doubt generally believed. It is found, how- ever, that the ratio of these affections, including icterus, is no more than 18 per 1,000 in the West India commands, whilst the deaths average lfa. It is in the East Indies that hepatitis finds a climate peculiarly favorable to its development. Although the mortality is low in the West Indies, yet it is found, among our troops, to be not more than one-tenth as high. As regards the ratio of deaths to the number of cases, there is little difference in our northern and southern latitudes. Of apoplexy in the northern division, the total of cases is 4, and in the southern 25, the ratio of the latter being six times as high. As the exciting causes of these cases were chiefly the intemperate use of spiritu- ous liquors, and exposure to the direct rays of the sun, several being reported as ictus solis, the higher average in the south ljiight have been readily anticipated. In the southern division, the ratio of deaths to the cases treated is nearly twice as high as in the northern. As regards phrenitis and meningitis, it is found that the relative results, on a com- parison of the north and south, are very like those of the preceding disease. The dreadful effects induced by inebriation have been shown in the details of each post. It has been attempted, as is seen in the table of each post, to condense certain cases under the head of " ebriety ;" but as some medical officers reported no such cases, except under the general head of " all other diseases," the result, as regards the number of cases, falls short of the reality. Its agency, directly and indirectly, in the causation of phthisis pulmonalis and epidemic cholera, has been abundantly pointed out; and its intimate connexion with febrile dis- eases, diarrhoea and dysentery, and hepatitis, although not definitely determined, is so apparent that it is constantly dwelt upon in the reports of medical officers. Its relation with apoplexy has just been brought under notice; and now the subject of " ebrietas" comes under con- sideration. In the northern division, the total of cases reported as ebiiety is 1,370, and the deaths, 5, being one in 274; and in the southern, the total of cases is 2,616, and the deaths 58, being 1 in 45. Assuming that inebri- ation prevails to an equal extent in the two divisions, it appears that in 335 northern latitudes it is attended with comparative immunity, as regards its immediate effects ; for the deaths from this cause average in the northern division 2, and in the southern 23, annually, per 10,000 of the strength. But this subject admits of further elucidation. Of delirium tremens there are reported, in the northern division, 102 cases and 3 deaths, being 1 in 34; and in the southern, 306 cases and 39 deaths, being 1 in 8. The annual mortality per 10,000 is, therefore, in the north upwards of one, and in the south 16. The total of epileptic cases, which generally arise from the excessive use of ardent spirits, is, in the northern division, 166 and in the south- ern 188, the annual ratio of each being 7fa per 1,000; but in this affection, too, the mortality is higher in southern latitudes, being in the former division 1 in 33, and in the latter 1 in 21 cases. These are not, however, the only deaths arising from drunkenness. Of the 10 deaths reported as sudden, the majority is doubtless attribu- table to this cause. Of the 25 deaths from various chronic visceral lesions, the greater proportion has no doubt been induced by the same agent. The 85 deaths under the head of casualties have been reported principally as drowned, frozen, suicide, homicide, wounds, and injuries— the result, in a great measure, of intemperance. The aggregate of deaths in the table furnishing these data is 1,104, more than one-half of which are traced to that war against nature, which claims more victims than the most fatal epidemics—epidemics, the visitations of which are viewed with dreadful apprehensions, whilst this moral pesti- lence is continuously in our midst, almost unnoticed. An important step in suppressing habits of inebriety among our troops has been effected by the abolition of the issue of spirits as a part of the daily ration of the soldier. When a man was obliged to swallow or throw away his ration of spirits, it was not to be expected that the best directed efforts of commanding officers could effect any thing towards suppressing the evil; and to convert temperate men into drunk- ards, it were difficult to invent a more successful plan. " To swallow nearly half a pint of spirits daily was," says Henry Marshall, Deputy Inspector General of Hospitals in the British army, " until the abolition of spirit-rations, a part of the duty of a soldier; and that this duty might be effectually executed, it was the usage of the service in many stations to have it performed under the immediate superintendence of a commissioned officer, who certified to his commanding officer that he had actually seen each man drink his drams." Of dropsies, there are reported in the northern division 50 cases and 4 deaths, and in the southern 206 cases and 19 deaths; the ratio of mortality to the cases treated being the same. In the former, the annual average of cases per 1,000 is 2, and in the latter 8. As these effusions result mostly as the sequelae of febrile affections, the difference in the two divisions may be ascribed to the relative agency of malarious causes; and no doubt,in some measure, to the more delete- rious effects induced by ebriety in southern climates. Of gonorrhoea there are 1,900 cases reported, and no death. This disease prevails to an equal extent in both divisions. Of syphilis there 336 are 1,046 cases, one of which terminated fatally, being complicated with chronic diarrhoea. Of nyctalopia or hoemeralopia, there are reported in the northern division 18 cases, and in the southern 191. With the exception of our most northern and southern posts, this affection is almost unknown in the United States. As these statistics, however, include but one year "of the data furnished by the troops serving in Florida, the prevalence of the disease is not fully apparent. Of rheumatic affections the annual ratio of cases per 1,000 is, in the northern division 15, and in the southern 11. In 6,257 cases, but one death is reported. This subject, as well as the class of pulmo- nary diseases, has, however, been already fully investigated. In the results of the latter, Forts Independence and Monroe are here included. In determining the general results in reference to the diseases just detailed, the deaths given under the last four heads of the table are not taken into the calculation; the total of the northern division being 223, and of the southern 722. It is found that in the latter division the ratio of cases is 50 per cent, higher than in the former; that the proportion of deaths to the number treated is nearly twice as high, (1 in 75, and 1 in 144,) and that the average mortality compared with the mean strength is as three to one. The total of monthly deaths in each division, according to the post returns, is exhibited in the annexed table— TABLE exhibiting the total of monthly deaths in each division. Jan. Feb. Mar. Apr. 26 61 May. 32 84 June 28 105 July. 55 117 Aug. 41 144 Sept. 39 160 Oct. 25 139 Nov. Dec. Total. Northern di-vision 22 77 27 76 26 74 37 40 398 Southern di-vision 115 82 1,234 This abstract shows not only the relative influence of the different months and seasons in the production of fatal diseases, but the compa- rative mortality of each division, the northern having an aggregate mean strength of 22,242, and the southern of 24,979. On a mean of 10 years, from 1829 to 1838 inclusive, the annual mortality, accord- ing to the post returns of the Adjutant General's office, is, in the northern division lfa per cent., and in the southern 4^, whilst the average of the two divisions is 3^ per cent. It is thus seen that the mean mortality of the posts is less than that by the regimental returns, the latter being Afa per cent. The mortality of British troops on the western coast of Africa shows that region to be decidedly hostile to European life. The most striking climatic features are extreme heat and moisture. " Upwards of 300 inches of rain," says Major Tulloch, " have frequently fallen during the 337 Wet season ; and more has been measured in two nights than falls in Great Britain during a year." The principal militaiy stations are, Gambia, Sierra Leone, and the Isles de Loss. Of 1,685 white troops which arrived on this coast in 1822,-'3,-'4,-'5, there died from 1823 to 1827 inclusive, 1,298, and 387 were invalided. Of the latter, 17 died on their passage home, and only 33 of the remainder were, on inspec- tion, found fit for further service. Of officers, 209 per 1,000 died annu- ally, and 197 per 1,000 returned home invalided. On the average of healthy and unhealthy years, upwards of a fifth have died, and nearly an equal proportion have been invalided annually. So fatal is the influence of this climate on European constitutions, that two-fifths of the white troops are annually cut off by fevers, whilst the blacks are almost exempt. The natives, however, are subject to many diseases from which Europeans are exempt, more especially small pox. Among the black troops, on an average of 19 years, the mortality was only 3 per cent. The mortality of British troops an the Australian Colonies, on an average of 20 years, is only 14 per 1,000. Having completed the investigation of each class of posts in refer- ence to pulmonary diseases, the subject may now be considered in its general relations. The etiology of catarrhal affections has been beau- tifully illustrated in each system of climate. In the northern division af the United States, consisting of three regions, two uniform and one excessive, the annual ratios of the two former are 233 and 300, whilst that of the other is 552. In the middle division, the modified climate of the sea coast presents an annual ratio of 271, whilst that of the interior posts,—a region lying somewhat farther south,—is 290. In the southern division, as the posts of the first class are mostly on the Lower Mississippi, the annual average is 218; and in the other class, comprising the mild, insular climate of East Florida, the ratio is only 143. • It would seem, then, that sudden atmospheric vicissitudes combined with moisture do not excite a strong susceptibility to catarrhal diseases, else the sea coast and the lakes should give a higher ratio than the dry and cold atmosphere of the opposite localities. The results, on every hand, afford satisfactory proof that the ratios of these lesions are highest when the seasons are well marked, producing a decided impression on the animal economy, and that they are less dependent upon daily vari- ations of temperature than upon its extreme range, as connected with the seasons. To these laws no exceptions have been presented. The rule holds good, that wherever the seasons are violently contrasted the ratio of catarrh and influenza is highest, decreasing in proportion as the differ- ence in the mean temperature of summer and winter grows less. As the mean winter temperature of the region of the lakes is three degrees higher, and that of summer is ten degrees lower, than the class of posts in the same latitude removed from the agency of large bodies of water, so the annual overage of catarrhal diseases is found to be little more than half as high in the former as in the latter. 43 338 As the middle division is subject to the extremes of northern and southern latitudes, so it is found prolific in pulmonic lesions in general. The first class of posts, situated on the sea-coast and inlets between the Delaware and Savannah, gives an average of catarrh and influenza higher than that of the New England coast, where a low temperature prevails, as well as that of more southern latitudes, in which a high temperature predominates. Compared with the second class of this division, of which Jefferson Bairacks is the most northern, and Fort Jesup the most southern, post, the usual relation between mild and excessive climates is observed. Although the southwestern posts, con- sidered in the aggregate, lie farther south than the other class, yet the annual ratio is as 290 to 271. In the southern division, the ratio of catarrhal diseases is found the lowest. The second class of posts, situated in East Florida, a region possessing all the advantages of the most favored insular climate, pre- sents an annual ratio of only 143 ; whilst the first class, in consequence of the modified atmosphere of the Lower Mississippi, holds an interme- diate relation, (the average being 218,) in respect to the climate of East Florida and that of the southwestern posts. Having thus determined the law of climate, in regard to the annual average of catarrhal lesions, the quarterly ratios, as illustrative of the influence of the seasons, will next engage attention. Compared with the relative agency of the seasons, in the causation of intermittent fever, it is found that catarrhal diseases acknowledge this influence in a more eminent degree. This subject has been fully illustrated in the remarks appended to each class of posts. It has been seen that the ratios of the first and fourth quarters, in obedience to a general law, are always the highest, and (he third invariably the lowest. The peninsula of Florida, which affords no marked distinction of seasons, exhibits an apparent exception to this rule, the third quarter having a higher ratio than the second or fourth ; but this evidently arises from the circumstance, that amongst'the causes which determine the prevalence of catanhal lesions, those that are secondary in other systems of climate, become in this the primary ones. The general law developed in regard to the comparative influence of the seasons in reference to catarrh and influenza, is further confirmed by the totals given in each quarter by the seven systems of climate investigated. These stand as follows— 1st quarter. 2d quarter. 3d quarter. 4th quarter. 689 395 294 618 To a person laboring under chronic bronchitis, the advantage of a winter residence in a more southern latitude thus becomes at once apparent. If he can avoid the transition of the seasons—that meteor- ological condition of the atmosphere which maintains the first place among the causes which induce catarrhal lesions—he will do much towards controlling his malady. Let us suppose him on the coast of New England in the third quarter, the ratio being as low as 36, when the sudden transition of the season brings it up to 85. The conse- quences will inevitably be an aggravation of that disorder to which he 339 is predisposed; for the respiratory organs, even when healthy, are pecu- liarly susceptible, at this season, to abnormal action. Let us, on the contrary, suppose him gradually moving south with the change of the season, and the fourth quarter will find him in a climate whose ratio is even lower than that of the preceding quarter in the region which he had left. On the coast of New England, the ratio of the third quarter is 36, and that of the 4th is 85, whereas the average of the latter quarter in penin- sula Florida is only 33. These are not isolated facts, but uniform results obtained from ten years' observation. The assemblage of morbid phenomena, usually designated by the term consumption, ox phthisis pulmonalis, it is well known, may arise from various pathological conditions of the respiratory organs; but, as regards the advantages of change of climate, reference has been made only to chronic bronchitis, although, reasoning from analogy, the infer- ence might be warranted, that similar effects would follow in other forms of consumption. As it is, however, the catarrhal or pituitous consumption of authors that probably constitutes the majority of the reputed cases of phthisis pulmonalis in northern latitudes, and as this is the only form that can be really considered remediable, the importance of determining the comparative influence of season and climate in rela- tion to catarrhal lesions becomes more strikingly manifest. The subject oi pleuritis and pneumonia will next engage attention. As these lesions, so far as climate is concerned, are probably owing to the same causes, the results will be investigated conjointly. It has been seen that the laws in regard to pleuritis and pneumonia, as expressed by the numerical results, differ in some respects from those peculiar to catarrhal diseases. In the northern division, the modifying agency of the ocean and the lakes is not manifested in the results; but in all the other systems of climate, the laws of pleuritis and pneumonia are anal- ogous to those of catarrhal affections. On the coast of New England, the annual ratio of cases of pleuritis and pneumonia, per 1,000 of the mean strength, is 41, on the lakes 49, and in the third class of this divi- sion, characterized by extremes of temperature, it is only 45. In the middle division, the difference between the two classes is very striking, the annual ratio of the first being 57, and of the second class 92. In regard to the influence of the seasons, also, the law compared with that of catarrh and influenza will show some variation. In the three classes of the northern division, notwithstanding the third quarter is the lowest, the agency of the seasons is not very obvious. In all the others the difference is very striking ; and the same result is exhibited by the totals given in each quarter by all the classes of posts. These averages, which give a fair expression of the relative influence of the seasons in the production of pleuritis and pneumonia throughout the United States, stand thus— 1st quarter. 2d quarter. 3d quarter. 4th quarter. 138 84 58 86 Contrary to general opinion, it is found that the average of pleuritis and pneumonia is lower in the cold and variable climate of our northern 340 and eastern States than in the middle and southwestern regions of the United States. In catarrhal lesions, the same law obtains eo far as the coast of New England is concerned. In pleuritis and pneumonia, the law in respect to contrasted seasons, as connected with catarrhal diseases, receives some modification. In the northern division, for example, the class of posts remote from large bodies of water has a ratio only half as high as that of the southwestern stations. It would seem to be a law, that in proportion as the high temperature of summer makes a decided impression on the system, do the lungs become susceptible to the mor- bific agency of the opposite season. At Fort Snelling, the difference in the mean temperature of winter and summer is nearly 19° greater than at Fort Gibson; but at the former the summers, notwithstanding the mercury rises very high, are short, whilst at the latter, the summer heats are both very great and long continued. In the northern States, as the animal economy is little impressed by the short summer, the annual ratio of pleuritis and pneumonia is not only low, but there is little difference in the ratio of the seasons; but at the southwestern posts, remarkable for high and long continued summer heats, the annual ratio is about twice as high as in the northern States, whilst the difference in the seasons is very considerable, the ratio of the third quarter being less than one-ninth of the annual average. This contrast is rendered still more striking by the fact, that whilst the ratios of the summer at our northern and southwestern posts are the same, the latter in the first quarter is nearly four times as high. At Fort Gibson, a point at which the mercury rises higher than at any otlier post, the averages stand thus— 1st quarter. 2d quarter. 3d quarter. 4th quarter. Annual ratio. 71 19 9 15 112 On comparing the two classes of posts constituting the middle divi- sion, the general law in reference to the modifying influence of the ocean is very decidedly expressed. In the southern division, as the seasons grow less contrasted, the annual ratio decreases rapidly. In the second class, in which, for example, at Fort Brooke and at Key West, the difference in the mean temperature of winter and summer is respectively only 16° 02' and 11° 34', the lowest average is presented. In determining the laws of climate in reference to pleuritis and pneu- monia, it seems necessary to consider not only the degree of contrast in the seasons, but the duration of high temperature. In reference to phthisis pulmonalis, it would appear that the numer- ical results do not warrant any principles of general application. In the northern division, the third class, contrary to the general average of the class of diseases of the respiratory organs, gives the lowest ratio; but this difference, as nearly all the fatal cases of consumption are ascribed to the abuse of ardent spirits, is more apparent than real; for if the results of West Point, a command consisting mainly of officers and cadets, are excluded, the ratio of this class rises about 40 per cent. That the ratio of chronic bronchitis is obedient to the same laws which control catarrhal lesions, is very probable; but in regard to phthisis 311 pulmonalis in general these laws are not recognised". It is an important fact, that whilst the averages of catarrh and influenza, pleuritis, and pneumonia, in the first class of the middle division, are reduced nearly 50 per cent, by excluding the statistics of Fort Monroe, that of phthisis pulmonalis is increased. It confirms the opinion that this disease, although much under the influence of season and climate, is still more, especially among troops, under the control of other agents. In regard to the specific diseases composing this class, tabular abstracts have been exhibited, showing the annual average of cases and the mor- tality in each in every system of climate. The simple distinction of northern and southern regions of the United States has been made, the former comprising the three classes of posts embraced in the northern division, and the latter the four constituting the middle and southern divisions. It appears that, with the exception of catarrhal diseases, the ratio of pulmonary lesions is higher in the southern than in the northern regions. It is in the middle districts of the United States, however, that pleuritis, pneumonia, and phthisis pulmonalis, are most prevalent—the peninsula of Florida having the lowest average. In respect to the mortality, it is found, too, that the same law obtains, the deaths per 1,000 of mean strength being as under— Phthisis pulmonalis. Pneumonia, pleuritis, and catarrh. Northern region - - 2fa - - §fa Southern " Afa lfa The high mortality of our southern region is caused by the middle division of the United States, the average on our southern coast being comparatively low. Taking the statistics of the posts in East Florida and those on the Lower Mississippi alone, the ratio of phthisis pulmo- nalis is found to be only lfa, and that of the remaining diseases of this class to be no more than fa, per 1,000 of the mean strength. It is also ascertained that these diseases are of a more fatal tendency in the south- ern than in the northern region. In the latter, the average mortality from phthisis pulmonalis is 32, and in the former 42, per 100 cases; and as regards pleuritis and pneumonia^ the difference is much greater, the ratio of mortality in the northern region being 9, and in the southern 26, per 1,000 cases. It is necessary to add, however, that this high mortality is limited to the southwestern stations, 33 deaths (out of 40} the total of the southern region) being reported in this class. It is thus seen that, as regards pleuritis, pneumonia, and phthisis pul- monalis, the ratio of cases and deaths is greater in our middle region, including the southwestern stations, than at either extreme. In endea- voring to explain this result, much may, perhaps, be justly ascribed to the circumstance that the subjects are generally from our northern States or from Europe. As all causes by which the energies of the human frame are sapped conduce to the development of the tubercular form of consumption, so it may be safely asserted that the majority of cases of this disease at our southern posts, supervene upon febrile diseases, more especially in constitutions broken down by intemperance, bearing the 342 same relation to fevers' as those other geffueke—dropsy", jallndice, and the various chronic lesions of the viscera. In our reports from the southern and the southwestern stations, it is very usual to find death ascribed to phthisis pulmonalis supervening, more especially in cases of intemperate habits, on intermittent and remittent fever, dysenteiy, or other affections, which gradually exhaust the vital energies. On the the Lower Mississippi—a class of posts which presents the highest mor- tality—the average of phthisis pulmonalis is low, owing very probably to the circumstance that fevers are of the most fatal tendency, termi- nating either in speedy death or rapid recovery. At the southwestern stations, or those along our middle coast, the malarial poison acts more slowly, thus developing, by a gradual deterioration of the constitution, a tubercular form of consumption. It follows, then, that a continuous residence in the south, so far from being beneficial in this disease, will often hasten its fatal issue. This fact does not, however, in the least mili- tate against the doctrine which maintains that advantage will be derived from change of climate in the way of a winter residence; and so far as regards the propriety of the measure in chronic bronchitis, when it is known that pulmonary diseases as a class are more under the influence of the seasons than intermitting fever, no reasonable doubt can be enter- tained. In regard to rheumatic affections in general, few remarks are demanded. This disease, which is generally ascribed to sudden vari- ations of temperature, conjoined with excess of moisture, is found to he less under the influence of atmospheric agency than is usually supposed. That these affections are controlled in some measure by the same laws which govern pulmonary diseases is, however, apparent. Were cold, moisture, and sudden alternations of temperature, powerful exciting causes, the highest ratio should be given on the coast of New England and the northern chain of lakes; on the contrary it is found that, like pulmonic lesions, the disease is most rife in the dry and cold atmosphere of the interior, characterized by an extreme range of the thermometer, and a striking contrast of the seasons. On the New England coast, the annual ratio of cases per 1,000 men is 110, in the region of the lakes 151, and in the opposite climate of this division 166. In the middle division this law is reversed, the averages of the two classes being 126 and 112; but if the results given by Fort Monroe, as in pulmonary dis- eases, are excluded, the annual ratio of the former is reduced to 93. The ratios of the seasons present no striking contrasts. The first and second quarters give the highest ratios; but, contrary to the law which governs pulmonary diseases, the averages of the third and fourth are the same. The totals given in each quarter, by the statistics of the whole United States, are as under— 1st quarter. 2d quarter. 3d quarter. 4th quarter. 249 219 201 202 Among 6>257 cases of rheumatic disease reported, only one death occuned. 343 The following abstract is taken from the report upon the medical statistics of the British troops— I & a> .3 -o L: O •a* 'o'is -O d 0 XI CO C4 -a s CO "io « ard an comm ft ingd -3 O O u "3 S ovaS< Brun eimuc "3 a .2 'S 5 "3 .c a -a a s ;*3 <*H O CD Ph 1-9 a m S 0 O 0 S ? & O Admissions from rheumatic affections annually per 1,000 ofmean strength - - 29 30 ^33 34, 34_ 1 38 40 46 49 50 57 The reporter directs attention to the fact that rheumatic diseases are less prevalent in the Mediterranean than in Canada and Nova Scotia, and that " though some of the provinces of the Cape of Good Hope have occasionally been without rain for several years, these diseases are more frequent in the diy climate of that command than in the West Indies, where the condition of the atmosphere is as remarkably the reverse: yet have extreme cold and atmospheric vicissitudes, coupled with excess of moisture, been assigned as satisfactory causes for their prevalence." In the northern division of the United States, it has been seen that rheumatic diseases, like those of the lungs, obey in some measure the inflexions of the isotheral and isocheimal lines. [Note.—The latitudes and longitudes given in this book are generally taken from Tan- ner's Map of the United States.] ERRATA. Page 29, continue the quotation from the word "command" down to the word "blast." Page 68, third line from bottom, for "6 feet" read " 18 feet." Page 264, twentieth line from the top, insert commma (,) between the words " simply" and "with" ERRATA. Since this work has been bound up the following additional errata have been discovered. page 4, line 9 from top, for "has" read "■have." " 5, " 5 from top, for "considerarion" read "consideration." " 11, " 25 from top, erase the word "min," occurring twice. " 16, " 24 from top, erase the word "min." " 16, " 39 from top, for "reviewed" read "viewed." " 17, " 24 from top, after "every" insert "other." " 25, " 37 from top, for "may" read "nay." " 42, " 4 from top, for "comas" read "coma." " 98, " 4 from bottom, for "shew" read "shews.'' " 125, " 9 from top, for "asphixia" read "asphyxia." " 150, " 15 from top, for "philogistic" read "phlogistic." " 163, " 18 from top, for 'strata" read "stratum" " 167, 2d & 3d lines from thetop, for "ca/.gr. 21, ya/ajo 10," read "cal.gr.10, jalap 21.': " 225, line 18 from top, insert a comma (,) for the period (.) after the word "details." " 236, " 18 from top, for "adematodes" read "sedematodes." " 270, " 1, for "petite" at end of line, read "petites." " 271, " 21 from top, for "frebile" read "febrile." " 274, " 30 from top, for "Dr. Ball" read "Dr. Bell." " 282, " 10 from top, erase the word "and." " 291, " 24 from bottom, for "west" read "east," and "east," "west." " 299, " 13 from top, for "quarter" read ".uartan." " 322, " 9 from bottom, for "legislation," read "legislators." 31o INDEX. Page. Introduction .,-.-.------- J PART FIRST. Report on the diseases, &c. of 1818 and 1819 ..-.---5 « « « 1820.......10 « « « 1821.......27 « » « 1822.......33 « « « 1823.......41 « .« « 1828.......60 PART SECOND. Won T HERN BEOI0 1T. Class first - ..........67 Fort Brady..............68 74 " Mackinac .---...... " Gratiot.............78 " Dearborn.............82 " Niagara.............87 Madison Barracks --..........93 Fort Howard............." Class second. Fort Sullivan.............107 " Preble.............ll1 " Constitution - -......." " -114 " Independence - - - - - * - " * ~ " -118 « Wolcott.............122 •' Trumbull.............126 " Columbus - ...........130 Class third. Hancock Barracks............139 West Point........... " 143 Fort Snelling........ " 147 " Winnebago.............150 " Crawford.............155 " Armstrong - ..... .. . .....163 •' Leavenworth 44 346 JIIDDIE BF.GIO.V, • Pa?«v Class first........ . . . .173 Fort Delaware --........ -.174 " McHenry.............l7g " Severn.............182 " Washington............ ibr " Monroe ------.... iqn Bellona Arsenal.......... .„. Fort Moultrie........... .„_ " Johnston -----..... _,,<> Oglethorpe Barracks............2Qr Class second. Jefferson Barracks .... _, ------- 21 0 Fort Gibson.......... " Smith and Coffee............229 " Towson............"232 " JeSUP..............237 SODTHIRK REGIOX. Class first. Augusta Arsenal --.-... _, ........245 Fort Mitchell........... Baton Rouge......... j. ~ " " **-fO New Orleans ------.._ 5cq Forti>ike.........- - - - -270 " Wood.............27g " Jackson.............279 « St. Philip's..........." .' 292 Class second. Fort Marion ----------._. oflfi " KinS...............291 " Brooke ----'------... 29