VITAL DYNAMICS ,,, rtK,,,„ THE PURPLE CSliEGiiaa OF NEW ORLEANS: ;; REPORT %'$#?*>$ TO THE I N?J AMERICAN MEDICAL ASSOCIATION. 1 MAY, 1849. j> BY i ^H. BARTON, A.M., M.D u» LATE PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE AND CLINICAL PRACTICE IN THE MEDICAL COLLEGE OF LOUISIANA, ETC: ETC. ETC. ■mz. '& PHILADELPHIA: T. K. AND P. G. COLLINS, PRINTERS. 1849. VITAL DYNAMICS NEW ORLEANS: REPORT AMERICAN MEDICAL ASSOCIATION MAY, 1849. r ^ v BY E. H/BARTON, A.M., M.D., \\\ LATE PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE AND CLINICAL PRACTICE IN THE MEDICAL COLLEGE OF LOUISIANA, ETC. ETC. ETC. PHILADELPHIA: T. K. AND P. G. COLLINS, PRINTERS 1849. f; ~ V o* PREFATORY REMARKS. It is due to myself to state under what circumstances the follow- ing paper was prepared. Responding to the call of the American Medical Association, in May 1848, through its committee, to write a paper on the hygienic condition of New Orleans, the preparation of it was postponed until the winter, from a belief that, as I had been for so many years familiar with and written upon the subject, I could perform my duty in the honourable task assigned me in a brief period: but, when the time arrived, in reviewing the facts I had been collect- ing for another and more extended purpose, I found the field so vast, the facts so important, and the results so disastrous, that, to do any- thing like justice to the subject, required researches, calculations, and investigations, that no one man could accomplish, with proper facilities at hand, in months, and I had but a few weeks; and at the very commencement of my labours the epidemic cholera broke out, making a still more urgent call upon my time; so the manuscript has been prepared and sent on guttatim—as it were—by sheets, as I could find time to write it, without being able to retain a copy for correction; this is said in extenuation for that apparent disconnection which I am afraid it will exhibit, and to bespeak for it the charitable indulgence of the reader. It will be seen, by those conversant with the subject, that my cal- culation of the deaths to population does not correspond with that heretofore given. The census of 1840, by the United States govern- ment, the basis of former calculations, is well known now to have added about 27,000 to our population! but, as it did not add any to our mortuary list, it became the source of all subsequent errors in relation to sanitary calculations; and upon a correct enumeration of the population must be founded all truth as to the salubrity of a place. We have, since, another census taken by the city, in 1847, which is probably nearly correct, and I have been enabled to fill the 4 blanks so long existing in it, and have used it for my own calcu- lations; but the consequences of the error have not probably ended here—in the more abstract fact, the remarkable salubrity which seemed to result from the ratio of actual deaths to presumed popu- lation, seemed to supersede all sanitary measures for the future whatever, for, as it was already apparently the healthiest city in the Union, what more was required ? This fatal confidence, arising from ignorance of our actual condition (and it is astonishing how averse the public mind is, here, to look into the statistics which exhibit the naked facts), was lulled into farther security from the occurrence of a few healthy years following the promulgation of that United States census, nor has the two last fatal years dispelled the lethargic delusion; they are taken as exceptions! It becomes my unpleasant duty to state the facts—to disperse the seeming security—to sound the tocsin of alarm, and to warn my fellow-citizens of their danger; and if I shall, with the danger, show how it may be avoided in future —convince them how much depends upon their improper mode of living—point out ameliorations in the physical condition which will add to its salubrity—I may be pardoned for correcting an error which has been a source of so much pride and exultation. The cli- mate is more sinned against than sinning; I have said so before. More than twenty years ago, I lauded it, and enumerated the almost unparalleled advantages it offered for the use of its residents; but did not conceal that there were sources of great mortality that it was in our power to control and remove—that we should clean and pave the city—clear and drain the swamps—that we should shut up the "drunkeries," &c. And when, some fifteen years ago, I presented the frightful details (in a public address, in relation to "the true use of stimulants in a warm climate") arising from these latter, they were deemed apocryphal—nay, some were so bold as to say (over- looking their mostly official sources) that I made them! My pro- fessional assertion, that it was the greatest source of our mortality, was met by similar assertions from others of greater authority and more weight, of an opposite nature. The statistics of temperance societies, at their inception here, could not exist to confirm the astounding fact—which speaks trumpet-tongued, and now gives value to this paper—that the mortality of the members, according to the record of these societies, is less than 1 in 83; while, in our general population, it has been 1 in 19.32, on an average too of ten years. It is not too much to say, then, that this valuable record is one of the most important unpublished of this climate; it shows the now 5 undeniable fact, that temperate people have an "expectation of life" here that is positively denied to others. In few things is the American character, and particularly the southern, more reckless than in regard to life. That this should be exhibited in great emergencies where personal prowess is required, as in battle, is not at all extraordinary, for here it is less reckless- ness than heroism. In the great West, this disregard of life is more apparent in exposure to river risks, &c.; farther south, with a heed- lessness bordering on temerity, it is more obvious in the almost utter disregard of dangers affecting the health. Many of them are palpable enough; against many others, common ,sense and common experi- ence would seem to be sufficient; and then of others, they are so obviously forbidden by all we know of its (yes, its—for I mean in- temperate drinking) influence and effects, that every man who will open his eyes may read it as legibly as "the handwriting on the wall," if thou drinlcest thereof, thou shalt surely die. To my fellow- citizens of New Orleans, who desire personal health, and who wish the prosperity of the city, I dedicate the important truth—the result of long years of experience. Deny it not—your mortuary statistics bear upon them the imperishable record of its truth; your hos- pitals, your eleemosynary institutions, your courts, jails, peniten- tiaries, workhouses, and asylums, speak volumes, and are daily robbing your pockets—ME no more—of large funds due to nobler charities, almost all arising from undue use of the intoxicating bowl. During the period referred to, the moral aspect of society has greatly improved; but it lacks much of that great standard that will make the requisite laws, and dares to enforce them, which will put an effectual curb on habits and practices that are incompatible with great duration of life in this climate. It will be seen, from the text, that I do not blame the climate—that it is not lethale per se, but is with certain habits and modes of life; but, by the indulgence of the precepts of temperance, in the enlarged sense, which are now the dictates of experience, and some other recommendations noted, all the blessings of health, and extended duration of life, can be en- joyed here to a degree equal to that of any climate in our widely- expanded country. VITAL DYNAMICS OF NEW ORLEANS. New Orleans is situated in latitude 29° 57' 30" N., and longi- tude 13° 9' W. from Washington, on the alluvion banks of the Mississippi (the longest and swiftest river, susceptible of more exten- sive navigation, and draining a larger surface of country, than any on earth), and about one hundred and ten miles from its mouth, by the meandering course of the stream, and about ninety in a geogra- phical line. It is protected from inundation by the great stream that glides by its front, at the rate of four and a half miles per hour in the thread of the current, during high water, and four and a quarter miles at low water, by a levee or embankment, about nine feet higher than it is a few squares back; and the city descends by a gentle slope to the swamps and draining canals in the rear, com- mencing about-------distant from the levee, where the surface of the swamp is---------feet below high water mark; but which is now kept several feet (four to five) above water mark, by the Drain- ing Company; all of which will clearly appear by reference to the line of levels annexed {vide Appendix A), from the river through the centre of the city to the Bayou St. John. The geological formation of the soil on which the city is built, is alluvial; the surface and subsoil, to a great extent, being composed of the deposits of the river. In some places, beds of pure white sand occur, at a depth of six to ten feet, showing the former posi- tions occupied by the waters of the gulf. The height of the ground on the river bank is about fourteen feet above the level of ordinary water in the gulf. The river usually commences its rise about the last of November, attains its maximum elevation in March, remain- ing thus until the latter part of May, then falls more rapidly than it arose, till about the latter part of September, and remains sta- tionary until the autumnal rise. The city occupies a front on the river of about five miles, by an 8 average breadth of about three-quarters of a mile. It is bounded on the north by a cypress swamp, of about five miles in breadth, where it reaches Lake Pontchartrain, a large body of water extending due north about twenty-five miles, and east and west from its centre about twenty miles. The Mississippi River runs south of east from New Orleans about twelve miles, and the balance of its course south-east to the Balize. It is bounded to the east by plantations and swamps covered with forest, to Lake Borgne, an arm of the sea fifteen miles distant, of about fifteen miles of irregular diameter. On the south, it is bounded by the Mississippi River, across which are cleared land, and swamps covered with forest growth, to Lake Ouacha (a body of water, about five miles wide, and eighteen long, extending to the south-west, and thence to the sea, it is forty to fifty miles); and it is bounded due west by the meanderings of the river, fine cultivated estates, and forest growth for about eighty miles. The prevailing winds, during winter, are, according to respective prevalence, from E., N., andN.W.; during spring, from E., S., S.E.; during summer, from S.E., E., and S.; and during autumn, N., E., and N.E. A perfectly calm atmosphere is very rarely noted; result- ing, no doubt, from our alternations of land and water, and the rapid current of the Mississippi before so large a surface of the city. It has been remarked as a fact, pregnant with great consequence to us, that, as the forest is cleared back towards, and covering the swamps, and to the lake, there is more air stirring, and less disposition to stagnation ; and with the drainage there is less moisture, and the land rises. The ventilation of the city is not at all defective; the streets are nearly all at right angles (there are few or no blind alleys), of the average width of between thirty to forty feet; four or five of them being upwards of one hundred feet, and most of these planted with trees. There are six public squares, most appropriately termed the "lungs of large cities," and all the streets would be in some measure entitled to the same beneficent appellation, were they planted with forest growth. Owing to the warmth of the climate, the houses are extremely well ventilated, even those of the poor, with but few exceptions in and about the centre, and near the mar- kets, occupied by small traders and emigrants, mostly foreigners; but in general, the labouring population is comfortably provided for, if at all provident; for, such is the facility of acquiring here the necessaries, and even comforts, nay, luxuries of life, and in a few years, a competency, that nearly all provident, temperate people find little difficulty in doing so; the wages of labour, and particu- 9 larly mechanical labour, are in great demand, very high, and sup- port not costly. The average annual quantity of rain, falling in this city, is about fifty-two inches ; and although there is no proper rainy season—for, some years, there is just as much falling during one-half of the year as the other—yet in a long series of years (say ten, that I have over- looked my meteorological register for), there was a larger quantity falling in the winter, the next was in the summer, the next was dur- ing the spring, and the driest season was clearly and palpably the autumn. But, as the hygrometric condition of the atmosphere is but poorly estimated by the quantity of rain that falls from it, for sometimes it is directly the reverse, I have constructed a chart, ex- hibiting these often opposite conditions {vide Appendix C), where this is seen at a glance, and also the thermometric and barometric variations, with their respective relations to each other. The average temperature of our winter months is 53.77; of the spring, 67.76; of the summer, 79.27; and of the autumn, 67.51; making an annual average of 67.07, almost that perfect temperature thought to be most agreeable and salubrious to man. The thermo- meter rarely reaches 90° in a fair exposure, during the summer, and during the winter seldom descends below 30°. The average daily range, throughout the year, is near 10°. In more southern tropical regions, where these variations of temperature are unknown, the constitutions of the natives are rendered delicate and most sensitive, by a uniforn continuance of a high atmospheric temperature, and if a fall of the thermometer of from 2° to 5° is experienced, serious consequences to comfort, and even health, are experienced. These changes are essential to vigour of constitution, and it would be a great blessing were they much greater. The nights are cool and pleasant; and with more attention to the construction of our houses, to adapt them to our climate, the sleeping rooms in summer facing the southern quarters, whence there is almost every night a body of air stirring ; and planting trees in the principal streets, the heat would be much less, radiation from the brick buildings would be arrested, the air purified, and the great extreme at midday and towards night, almost thoroughly controlled. The effects of planting trees in the streets, and of the multiplication of public squares, are well-established facts, of' which there is now no dispute; experience here is too strong even for theory. A state- ment was published here some years ago, by one of our most respect- able journals {The New Orleans Delta), and said "to be derived 10 from one of the old respectable inhabitants, and one of the chief magistrates of the city," that there had rarely "occurred a death on the Place d'Armes, in twenty-five years." This is the most beau- tiful public square in the city, and on two of its sides has a dense population. The influence of luxuriant foliage and abundant shade in the public squares and streets of large cities, and particularly southern ones, is susceptible of very easy explanation; they absorb deleterious gases, and receive or prevent that reflected heat from brick houses, which is so oppressive to those who cannot otherwise escape their influence ; and they hence assist in likening a city to the country, between which there is so great a discrepancy in mortality, and the difference is mainly in ventilation, shade, and foliage. Truly, this may be considered a " sunny climate," for of a series of observations, extending into many years, in reference to " clear," " cloudy," and " rainy," from my meteorological journal, more than two hundred and forty days were registered " clear," seventy odd " cloudy," and about thirty "rainy" (of the three hundred and fifty noted). And from consulting a register kept here more than forty years ago, the "clear" days have greatly increased since that period; there is much less moisture in the atmosphere, less rain fall- ing, and fewer storms; the winds diminished in strength, and more regular, the heat sensibly less, and the climate, in many respects, greatly ameliorated. All this has resulted, doubtless, from cutting down the forest growth of the neighbourhood, clearing, cultivating, and " subduing" the land to the purposes of man, and instituting that system of drainage that is destined to give this country all the advantages of an elevated champaign country, together with its own, of incomparable fertility, as much moisture as is needed for the pur- poses of agriculture and health, with the assurance of ample ventila- tion. For more particular reference to the meteorology of New Orleans, I refer to Appendix B and C, embracing an average of three years (anterior to 1843), containing a pretty fair estimate of the climate. From all the exhibits, then, in relation to ventilation, it is ap- parent that the mortality of the climate arises from no noxious principle derived from stagnation of air, and that we are located in that happy medium, removed from the violence of the winds of the tropics, where the natives seem to dread it more than almost any- thing else, from their greatly enhanced susceptibility of nervous system, and the frequent stagnation of temperate regions. Here, 11 then, there is nothing stagnant, neither the elements nor man; though the latter is too "go-ahead" for his interests or his health. The city is now drained from its surface, which is extremely im- perfect, and in this climate highly objectionable. The gutters are cleared by rains; by letting in water from the river at particular points at certain stages of elevation; by a steam engine in the First Municipality, for the streets appertaining to it and running perpen- dicular to the river; and very partially by the Water Works Co., and all most imperfectly done. The mode of removing ordinary street accumulations, from constant filling up of the gutters, and the mud pressed up from a most imperfect system of paving, with large irregu- lar pebbles, on a moist mud substratum, is, to throw or scrape it up from the gutters, and about the surface into the streets, in heaps, for its more fluid parts to drain off, and then, after abundant exposure to the sun, it is carried off in uncovered carts, from time to time to the rear, to fill it up, at great expense to the city, and at some offence to our olfactories. The law now requires all offal from the houses to be thrown into the river, instead of the back lots, which it aided in filling up, at no expense of health to the vicinage, but sometimes offensive to smell. It is all most imperfectly carried out. Time does not permit me to go into a system of drainage and sewerage, that is demonstrable, from effects already produced on the swamps in the neighbourhood, can make this city as dry, and, with the water power and convenience unparalleled, always at com- mand, and at small expense, as clean as need be. It is my duty to allude to it, however briefly. It will be seen, from Appendix A, of a profile line of levels, that the river, at high water, is about fourteen feet above the level of the swamps, and that the Draining Co. has actually drained five feet below this. So we have here up- wards of fifteen feet from the level of some of our principal streets, in a distance of half a mile to a mile, for the most perfect system of drainage and sewerage that need be required. And it is a fact well known to us all, that boggy swamps that could not be passed through a very few years ago, by man, and scarcely by beast, and only inhabited by amphibious reptiles, are now high, dry, cultivated, and prepared for the residence of man, not only without consequences injurious to health, by the exposure of such a surface to the light of day and the winds of heaven, but greatly ameliorated by this increased ventilation. The moisture has sensibly diminished, and the ground has evidently risen (one of our oldest surveyors, who has been per- sonally conversant with it for more than forty years, thinks) more 12 than ten inches. This invaluable company, which has accomplished so much, and can accomplish so much more for this city, was incor- porated in 1835, and has been steadily pursuing its great destined object since, under numerous difficulties, with an intelligent engineer corps and directory. It has drained the First, Third, and part of the Second Municipalities, by digging extensive canals and ditches, to lead the water to their reservoirs, where are located their steam- engines, embracing in their range a certain section of ground, which is first levelled to prevent back water from the lake to reach it by the natural drains; the water is now pumped out of these sections, from these reservoirs, into these natural drains, and thence flows to the lake. These extensive sections, embracing an area of over two miles in diameter, are now free from water, even soon after the heaviest rains; and most of it is cleared and much built upon; and with its proposed labours of drainage, and clearing the forest growth to the lake, will accomplish more for the comfort and salubrity of New Orleans than all other improvements combined, not excepting paving. Most of the principal business streets, to six or seven blocks back from the river, are paved, and some of those perpendicular to the river much farther back; it is done mostly with round stones, which, on such a subsoil, require constant expensive repairs in moist weather. The balance, or half the city, is unpaved, and is easily and soon cut up, in wet weather, by ordinary usage. Now the sewerage and drainage, properly conducted, would dry the subsoil, remove all offensive smells and sights, keep the lots and surface dry, and take off a very large proportion of the expense in cleansing and repairing the streets. It has already had so much effect on the burial-grounds in the rear of the city, that the dead can be placed under ground, where formerly you could not dig six inches from the surface without coming to water; and, consequently, the dead had to be buried in brick tombs (or the coffins sunk below the surface of the water by boring holes in them), which, in this climate, in a few years give way, impairing the purity of the atmosphere. It would also make the climate more dry, and prevent all the consequences injurious to health, merchandise, business, or pleasure, from bein CS cs >•-< E o> bo . > 1 < 5 53.03 bn.2 S <2« .C bo 2 o cd C 5 ? bo-6 fe-b a bO ji > s 5 v ■ bo>, ".■2 < S oj V bo^ OJ 2 03 o ■ boo Jc gu 00 >'°'5 > Average age of the living. Ratio of deaths to popula-tion. Year. Average age at death. Year. Average annual deaths. For No. of years. Boston New York Philada. Baltimore Charleston N. Orleans Havana Vera Cruz Mexico U. States 114,366 421.791 101,345 124,331 29,261 100,028 162.508 5,500 170,000 1845 1846 1845 1848 1840 1847 1841 years mo. 23 5 23 1 24 1 Whites 23 1 Whites 24 3 Whites 24 1 Whites 28 22 2 1845 1840 1840 1840 1840 1830 1 in 48.87 27.83 48.92 29.37 48.36 19.32 35.87 27.76 1845 Dr. Stevens 1845 1848 1840 1841—1848 1841 1844 yrs. mo. 20 3 18 19 11 19 9 Whites 35 m Whiles 26 24 6 1845 1846 1845 1848 1848 '41-'48 1846 1.919 11.069 5.881 3 258 .739 5.177 4.568 6.122 10 yrs. 1 yr. '46 '45-'46 '35—'45 10 yrs. '35—'45 10 yrs. '41—'41 8 yrs. '36—'46 10 yrs. 1844 N. B.—In some of the cities, the population is estimated by adding the ratios of increase, where known. Of Yera Cruz and Mexico, I have seen no publication of the census; I was then told what I here state. The calculations have been made in great haste, and under many disadvantages. Mr. B. W. Cohen, of this city, has much aided in those relative to this place; and a kind friend, who would blush to see his name in print, has lent me much aid with the others. I have tried to make them correct. In the haste necessarily attendant on the entire preparation of this report, during a severe epidemic, I could only fill up its details by snatches of anxious moments, and it is thrown upon the charitable indulgence of my compeers. 26 APPENDIX E. Statement of the Winds, in New Orleans, by Months and Seasons. AVERAGE NUMBER OF DAYS BLOWING FROM THE RESPECTIVE POINTS OF THE COMPASS. N. N.E. E. S.E. S. s.w. w. N.W. BY MONTHS. January 6 31 61 31 3 21 21 2* February 3* 2 51 3* 2 31 It 4* March 3* 2 61 3* 61 21 lg 21 April It 2ft 7 4* 6ft 24 It 31 May June July August 21 H 21 3* 21 H It 3* 6 51 5 4ft 4* 4J 6 41 ft* 4i 6 3* 41 6t 4ft 4 11 21 3i 21 2i It It 2 Being on an average of 8 >. years, viz., from 1835 to 1842, inclusive. September 51 6* 6ft 2* 21 H H 2 October 61 5ft 6* H 1 01 11 31 November 8 3 4* 3* 21 11 H 31 December 71 3t 6 2* 21 u 21 41 J BY SEASONS. Winter Spring Summer 6 3 2* 3 21 2* 6 61 ft 3 4* 5 2! 61 4* 21 31 51 2 H 3 4 3 2 | Average number of day's-^ winds each month of the Autumn 6f 4f 5* 21 2 H 2* 3 Winter 171 9} 17* 9* 71 61 61 lit • 1 Spring 71 6ft 19* 16 181 9* 41 8ft 1 Total number of day's- Summer 7ft 6* 14| 151 14* 14ft 8i 51 r winds each season. Autumn 19* 14 17* 7 5ft 31 4* 8* J Winter 2d 5th 1st 4th 6th 7th 8th 3d ^ Spring 6th 7th 1st 3d 2d 4th 8th 5th 1 Relative frequency of each r wind during each season. Summer 6th 7th 2d 1st 3d 4th 5th 8th Autumn 1st 3d 2d 5th 6th 8th 7th 4th J BY THE YEAR. 2d 5th 1st 3d 4th 6th 8th 7th » Relative frequency of each [ wind during the year. Actual No. 511 36J 69| 471 45f 341 241 34 Total number of days noted having been 342*. APPENDIX F. Comparative Statement showing the Proportionate number at each interval of Ages, in every 10,000 Living, in Louisiana, America, and ^England. Y •:-'-•<■:•:-•.•: .•.vC*--, '■' • •.•'/'• '. ■Mti .y.vi-'. ■'.'■ '■!■*-*:*!• ••#•&• ■■ .■v!j!c .;;'•:■:•;:•: >*.vj ■■'■'■ :'>&$■ V, •"'•'iijfc.1'' .'•'■■•'.'.»*." •;.;*«SJtJ '■■'■: \-"-v! &?mJv» ■'•'. !•'■*.*> ■■ ■'■''.''.''£'■ k >•*' .^!::<.;::x'v'':':''":' •'•v.v.v; $i :••••.•£ ■■■?