Q/e ' WCK 18b 7 NOTICES OF THE REPORT OF THE SANITARY COMMISSION. The following message from his Honor, the Mayor was read, and, on motion, it was referred to the Committee on Health. Mayorality of New Orleans, ) City Hall, December 12, 1854. \ To the President and Members of the Common Council: Gentlemen:—I herewith present the report of the Sanitary Commis- sion appointed by the City council, to investigate the origin and mode of transmission of the great epidemic fever of last year, together with all causes affecting the salubrity of the city. It is with feelings of just pride that I call your attention to this volu- luminous record of the labors of the Commission, which does nearly as much honor to the city's liberality as to the gentlemen composing vit, being the first of its kind, in this country. No subject affecting these important relations has been left unex- amined. These researches have extended back to the first origin of the great enemy of our prosperity (yellow fever) among us, and each year of its progress and causation traced to the present time, embracing, it is believed, nearly every record of value. No less minute have been the details of remedies to meet the conditions pointed out; and it is most gra- tifying to me to say to you that, although our condition has subjected us to calamitous visitations of disease, it is the unanimous opinion of the scientific and intelligent gentlemen composing that Commission, that it is entirely removable, and that as bountiful a store of health can be enjoyed here as in any large city of our Union, if the proper steps are taken to insure it. These are specialty pointed out. The project of a Health Department is given as the organ to carry out these views, and to this subject I particularly invite your earliest attention. No large city is without a Board of Health of some kind; no city suffers so much for the want of one as this. We have had occasional boards, without much power, and but of very transient duration, for some thirty years back. It is full time something permanent was organized, for its im- portant bearing upon our sanitary condition, and to remove the reproach of carelessness and recklessness to which we have been so long subject in relation to health and life. There is another reason for immediate action, which a cursory exam- ination of this valuable work will suggest to you. Many of our public works of the greatest moment to us can only be carried on with safety to the public health during the cool months, which are already fast passing away. And again, the subject of quarantine, so deeply interesting to the public, I am pleased to find this Commission reporting upon with entire 2 unanimity, and taking the only rational ground, that, while it is not recommended as a substitute for sanitary measures, it should be enforced only upon unsound subjects and filth-vessels. This, I am sure, will en- tirely fulfil the public wants and meet public expectation, without placing any unnecessary restriction upon commerce. There is an urgent demand at this moment for the action of such a Board. Vessels are constantly arriving here requiring their instant sur- veillance and attention, with authority to make such temporary arrange- ments, for a quarantine establishment, as may supply the present necessities, until the Legislature (soon to convene,) shall make such appropriations as will put it upon a permanent footing. No great improvement, affecting our sanitary relations, can be ex- pected, without attendant expenses. These are necessarily incidental to all benefits ; they are, as it were, its price; a full organization of a Health Department will probably cost, the first year, near $20,000, and during subsequent years about two-thirds of that sum. It may, and probably would save, directly and indirectly, millions to this city ; remove her reputation for perennial insalubrity, now retarding her prosperity, pre- venting immigration, and enhancing the price of every marketable com- modity. The improvements required in the opinion of the commission, to produce this invaluable change in our sanitary condition, are recom- mended to be met by sources of revenue and means entirely indepen- dent of any additional burthen on our tax ridden community, and are highly worthy of your most serious consideration. In addition to these, I would take the liberty of suggesting, that as the canal of the Canal Bank, will soon become the property of the State, by expiration of its chartered privileges, an early application should be made to the Legislature for the transfer of the State's rights to the city, that a credit may be predicated upon its value or income, and appropriated to the purpose of our sanitary condition. With the developments made in this report, taken in connection with our great railroad improvements, it is clear to my mind that we have arrived at an era of the most critical magnitude to our city. With the adoption of both, now clearly demonstrated to be within our reach, there can be no limit to our advancement, and we shall be enabled to realize all the fond anticipations of our true-hearted citizens. Very respectfully, s JOHN L. LEWIS, Mayor. Extract from letters from Prof. Chas. A. Lee, Bowdoin College, Maine. *'* * * * * * * " I hardly know how to express my thanks to you, or the importance which I attach to your labors. That you have made the most impor- tant additions to sanitary science, as influenced by meteorological or climatic causes, yet given to the world, is beyond all question in my mind. I am amazed at the amount of labor you have found time to 3 expend on this work. You have grappled with all the elements which enter into the causation of epidemic and endemic diseases, and you have demonstrated and developed them with the hand of a master. Your conclusions are irrefutable, because they are logically deduced from the facts and reasoning presented. You have succeeded in elucidating mysteries which have never before been unravelled. You have cleared up diflSculties which have been a stumbling block to all preceding writers. You have been able to demonstrate what I have theoretically held for twenty years—that the hygrometical state of the atmosphere is one of the essential conditions for the prevalence and existence of epidemic and endemic diseases. You are aware that I stated this in Forry's Work on Climate and in the Boston Medical and Surgical Journal, some fifteen years ago. But I have never been able to demonstrate it, for want of proper observations. You have now set it at rest." " We should try and explain hoiv it is, that an atmosphere, nearly surcharged with vapor, proves so powerful a cause of disease. I hope your attention will be particularly directed to this point. I heartily agree with your views as to the nature of malaria. It is not any single, specific poison, but an impurity of the air, from foreign contamination or other causes. This is a great point gained. It reconciles conflicting views, and opposing and diverse doctrines and theories. You have, for the first time, established a great principle of universal application, and you will be regarded, not only as a great public benefactor, but as one who has discovered a truth not less important to the world than that of the protecting power of the vaccine virus against Variola. We now under- stand why the fires, in Capt. Cook's vessels, preserved his men from sickness, even in tropical climes, so that he lost but one man in his whole fleet, in his voyage around the world. " I need not say, that I discover no flaws in your reasoning, nothing in your conclusions to which I do not cordially subscribe. At a meeting of the New York State Medical Society held last week at Albany, Dr. Coventry, the President, in his address before the Society and the Legislature, spoke of your report as a proof of the advance now making in Medical Science, and as throwing great light on a subject of univer- sal importance to the community. In a recent letter to me, he says he considers it one of the most important documents ever published in this or any other country, the present century, and says it inaugurates a new era in sanitary science." And in an other: * * * "but you know there is high authority for the statement, a prophet is not without honor, save in his own country. It is what we constantly observe. * * * I regard it as a sure sign that we are doing something likely to be creditable to ourselves and useful to man- kind. Jenner and Harvey, were they alive, would tell the same story, and Rush would reecho it, in still more emphatic tones (I do not mean, by the above to compare myself with either of these, but I do think you may, without presumption.) You have produced the most complete 4 and most satisfactory sanitary document ever given to the world. Such is my deliberate conviction, after reading it twice over. I am acquaint- ed with productions of this class—both foreign and domestic ; and I know not a single one, in any language, which embraces so fully all the necessary scientific elements to render its conclusions decisive, as yours. I know no one which has cost one tythe of the labor and study,—nor do I know one where the results have been arrived at, after such careful observation and scrutiny of all the facts bearing upon them. Your rep0rt—as a specimen of philosophical analysis and pure inductive reasoning, may well stand as a model among writings of this^ class. Considering the difficulties you had to encounter, weighed down by the cares and anxieties incident to a large practice—surrounded by the sick —the dving and the dead ;—to say nothing of the depression of both mind and body, incident to the hot and relaxing summer climate of New Orleans, you have performed a Herculanean task. And, when I contemplate the mass of observations you have made, under all these disadvantages, and that too, single-handed and almost alone ; and when I consider, moreover, the inestimable nature of the results you have established, and the facts you have, for the first time, given to the world, I scarcely find words adequate to express my estimate of your labors ; not only to your own city—but to mankind at large. I sin- cerely hope you may be rewarded for your efforts. It is rare to find men who have the moral courage to stem popular opinions and prejudice, to risk their popularity by exposing the insalubrity of their own local- ities ; although, at the same time, they demonstrate both the causes and the means for their removal. Merchants, in particular, have always been very sensitive with regard to any published statements, which go to show that their city is more insalubrious than others, or that an epidemic is raging, and they seem to regard it in the light of a personal injury almost, for medical men, to sacrifice their time, their health, and often, their lives, in efiorts to improve the salubrity of their residences, to do which, it is necessary, first, to prove that they are sickly. You have done a noble work;—its value can never be estimated in money. You will have that, which is worth far more,—the gratitude and thanks of the scientific world—a prominent rank among the true disinterested and great benefactors of the world. Were I a citizen of New Orleans, I would delight to use my influence to do you special honor, by seeking to obtain for you a public recognition of your valuable services, in votes of thanks from your enlightened municipal government, and also some- thing more substantial, though labors, like yours can never be sufficient- ly remunerated by money. Extract from letters from Prof. S. B. Hint, of Buffalo. " Your report is, by far, the most complete thing of its kind our country has produced, and cannot fail to have a large influence on the future fortunes of New Orleans. You told the disagreeable truth with so much firmness and pointed out the remedy so clearly, that it ought 5 to win you some reputation as a man of fearless character, as well as scientific skill. "I am, as I give the subject more study and reflection, more and more convinced that you have solved the riddle of malaria on common sense principles. The laws of miasma and contagion may now be said to be understood, the real chemical nature, the entity of miasma, may remain as a puzzle for chemists, but were we to ascertain all about its real nature, it would not help us practically in avoiding its consequences, we know already how to do that. "I hope that your efforts may bring about some sanitary action which will result in reducing your mortality. No one can study this subject closely without adopting your conclusion that these epidemics are 'preventable.'" Extract from a letter from Prof E. B. Coventry, President of the Medical Society of the State of New York, dbc. " I know of no work which has emanated from the medical press, since I first entered the profession, which is now over thirty years, cal- culated to do so much good to the public and medical science as this report. It has been a work of great labor, but the reward must be in the consciousness of the unlimited blessing which it will confer, if properly appreciated and the suggestions adopted. I think the long disputed question of the contagiousness of yellow fever is set at rest." Extract of a letter from Dr. R. La Roche, of Philadelphia. " Without flattery, I can. say you have produced a capital work. One which will do you infinite credit. The work will compare advan- tageously with anything of the kind I have seen, even with the great Cholera Report of the London College of Physicians, and this is not saying a trifle. Extract from letters from Prof. P. Blodgett, of the "Smithsonian Institution" " I am sure this report will be received as decisive of the influences causing epidemic yellow fever." "I have been struck by the force and conclusiveness of your researches respecting an epidemic atmosphere and the predominance of atmospheric over all other agencies in most cases. " I cannot do less than express my strong sense of the advance which these researches make in pure science, as well as in its collateral or applied relations. No fields in physical science, since nor before, have opened so widely and so favorably." Extract of a letter from a distinguished gentleman in------- " It is certainly a most important work on matters of the deepest interest to the well being and prosperity, not only of our own mighty south, but every country on the habitable globe, from the 40® South to 6 the 40° North. It embraces, I am satisfied, an extent and accuracy of observation, a patience of inquiry, an amount of experience and skill, and a fullness of facts, illustrations and reasonings that have never before been applied to the subjects of which it treats. Your name, Dr. Barton, will go down to posterity connected with these subjects. That your efforts may prove the commencement of a new era in epide- mic, endemic and infectious diseases, and may contribute largely to the mitigation of their prevalence and virulence, and in bringing them under the control of the enlightened and intelligent physician is the earnest wish of, my dear sir, yours, ----------• Extracts from Letters from Dr. G. Bettner, of New York * * * * * * * * * "I cannot commend your labours too highly. I regard this report as being the most profound, as conveying the mostrational and philoso- phical opinions upon the important subject of etiology, that has ever been compiled in this or any other country." From Prof Forshey. * * %• * * * * * " It is a contribution to knowledge and public welfare. This report is quite without a parellel in the scope of my reading. All sides of the questions of contagion—importibility—domestic and foreign origin, seem fairly represented; and the varied phenomena of outbreak and subsi- dence may be read, and the deductions made by the candid reader for himself. Aud, without speaking very positively, I think that most of these will arrive at the general conclusions stated by the Commission. New Orleans should be proud of this book, and the edition should have been large enough to be widely distributed. " Your first diagram, or chart B, is one of the most instructive and interesting sheets, (if not the most so) the volume contains. Indeed I am not yet done studying it. The relation of the 'drying power'1 to the two great epidemic diseases, would appear to be in an inverse ratio. Did you not tell me that the meteorology of the epidemic portion of 1854 gave the like result ? [I did.] " The difference in the temperature in the sun and shade, is a new enquiry —or rather, a new key to some important sanitary influences. I have never seen a systematic representation of this great difference at the epidemic period, until in your charts. Every one in the habit of watch- ing his own sensations, knows that in September, particularly, this difference of temperature is insalubrious. I have, for many years, watched my sensations, and avoided these extremes." Extract from a Letter from GenH Jno. Henderson of New Orleans. ******** " I have read with an interest, surprising to myself, your forthcoming work, modestly styled a i Report''—on everything connected with the sanitary condition of New Orleans. It is a monument of scientific 1 reasoning—research and practical observations—and, if generally read, can scarcely fail to establish your views with the community of New Orleans—whilst (as a prophet always has least honor at home) it must be greatly appreciated by the scientific and professional world abroad." Extract from a Letter from Thos. Hord, Esq., an Intelligent Planter, Near Centreville, Attakapas. ******** "I find it to be, what I consider the only scientific view, that has ever been furnished of the true origin of what are generally called epidemic diseases. If your citizens, and generally through the country—more especially the villages, would only read, and understand such a work, and be governed by it, and follow the principles laid down, how soon would our country be a model for the whole world V Extract from a Letter from a Gentleman in Virginia. ******** " All I can now say of it, is:—that the conception of Lieut. Maury— that he could point out a road upon the trackless waters that would shorten distance and promote safety,—that by looking at the logs of numerous vessels for years and for every season when storms were there natural—their character and how to avoid, in great measure, their force and danger;—and then, the indomitable industry with which he pursued his theory to practical results—was, and is a monument—a proud one too, to the intellect of man. But, yours,—what can I say of it; the mere conception, that a finite mind could explore, and find in the atmosphere—the exhalations of the earth—at mid-day and in the njo-ht—which, like the wind, none knoweth whither it comes, or where it goeth—the labour to obtain the materials upon which to build a theory—the uncertainty to what the facts would attain—their value, if it could be attained, and this research made with medical theories, and from great names too, weighing down and depressing, or calculated so to do, the most energetic mind, is, in my judgment, the grandest, the most benevolent object, to which the hnman intellect was ever before applied. I do hope—not for the applause of mankind, but, that in your own heart, you may reap, in the fullest measure, the happiness that must arise in the belief of any man, that he has benefitted his kind." Brief notices from Medical Journals.—New York Medical Times. ******** " The result is a volume unsurpassed in extent and variety of infor- mation respecting yellow fever, which reflects great credit both on the city which originated it and the physicians who have executed it. By far, the most elaborate and extended of the separate reports, is that by Dr. Barton, to whom was assigned the arduous duty of making a thorough examination into the sanitary condition of New Orleans. This report is drawn up with great care', and embraces an amount of 8 information which will be sought for, in vain, elsewhere. The range of his labors extends through all the realms of the yellow fever zone, in both South and North America, the West Indies and the East Indies. "Two principles are thought to have been settled by the commission, that yellow fever is, and always has been, a preventible disease, and that the presence of two general hygienic conditions are absolutely indispen- sible to the origination and transmission of the disease, the one atmos- pheric, the other terrene; both of which must meet in combination to produce the result." From the Boston Medical and Surgical Journal. ******** "It is a work of laborious research, of extended and reliable testi- mony, and, to all appearance, of the most zealous and honest endeavor after truth. We heartily commend it to the inspection of all who would learn facts in reference to yellow fever, even if they never expect to cope with the disease. We firmly believe that atmospheric causes, the state of the dew-point, and every hygrometric condition, have a powerful effect upon disease. "Dr. Barton has the boldness to tell the authorities of New Orleans the whole truth about their city, and both they and all the inhabitants should thank him and his associates for the information and the facts contained in this volume. If one-half, only, be true, it .is an invaluable gift to make to the city. The extended research and entire devotion to their duties, which are manifested, command our admiration. They have spoken out boldly like honest men and medical philosophers. The report is a monument for transmitting the names of those, who have recorded their observations in it, to after ages. They discovered filth enough in the city to create a plague, and have had the honesty and fearlessness to proclaim it in the ears of the magnates. With reliable intelligence to guide the civil authorities, if the Board of Health permit another epidemic of yellow fever to mow down the citizens, their own fortunes may be involved in the ruin. Clean your streets, gentlemen, drain the bogs, carry off the night soil, air the base- ment rooms, sleep in dry apartments, and obey the ordinary laws of health, as the first movement towards putting the city on the defensive. We feel a deep interest in regard to the sanitary action of the authori- ties of New Orleans. Dr. Barton can do no more to enlighten the people or direct the magistrates. By following out in detail the inferences which he has drawn from the facts presented, and on which this report is based, New Orleans may yet establish a reputation for cleanliness and exemption from fatal epidemics." From the Western Lancet. ******** " The fearful^epidemic of 1853 aroused the public sentiment of New Orleans to the importance of adopting some better sanitary regulations. The Sanitary Commission has' exhibited much industry and perseverance 9 in collecting such a vast amount of material information ; and the City Council has manifested an unusual degree of liberality in affording the means for this publication; showing that all parties concerned have taken hold of the subject with energy, and a determination to fathom, if possible, to their lowest depths, the mysterious causes of the two greatest scourges of cities, yellow fever and cholera" From the Bufalo Medical Journal. ******** "This Report has been long and anxiously expected by the student of etiology. Great expectations have been raised from the liberal provision made for it, from the scope of discussion allowed, and particu- larly, from the high character of the gentlemen appointed to prepare it. At the head of this commission was Prof. E. H. Barton, who has better claims to distinction as a meteorologist, than any other man in the country, when we take into consideration the time through which his observations have extended, and their care, accuracy and daily fre- quency. There is no one-idea-ism, no hobby riding about this produc- tion. In assigning to terrene and atmospherical causes their proper share in the causation of disease, we find neither the exclusive doctrines of the miasmatists, nor the absurdity of those who, recognizing the weak points of the malarial hypothesis, fly wildly to the other extreme, and claim to find in the filth and foul odors of a dirty city its protection and safe guard against the ravages of epidemics. The mid- dle ground is the safest, and to use Dr. Barton's expressive phrase, we have in the meteorological and terrene causes, the two blades of a pair of shears, useless when single but the very shears of Atropos, when combined. " The principal arguments enumerated to show the influence of this combination are briefly these :—In all the yellow fever zone, where ever the meteoric condition was observed, a high dew point was the unfailing accompaniment of the disease. With what is usually called the 'caprice1 of epidemics, one uncleanly city suffered, while its equally dirty neigh- bor, escaped. Here, those places which were kept clean were healthy, though they had a high dew point. Those that were uncleanly, suffered if they had a high dew point; and, wherever a high dew point and uncleanliness were associated, the epidemic prevailed in a direct ratio to the intensity of these two conditions. "These are the results in places where the meteoric condition was known by actual observation. In other places, it was arrived at by approximation—judging from the frequency of the showers, the pres- ence of mould, and the decay and imperfect nutrition of the fruits of the earth. Fortunately these observations, which extend over the whole yellow fever zone, from Philadelphia to Rio Janeiro, are supported by the most careful testimony. " The reasonings derived from these facts cannot be confined to the yellow fever zone. We have found it at Buffalo, where the cholera 2 10 confined its ravages to the low lying districts, and to those situations, where filth and lack of draining invited it to localize. There also _ we found the allied diseases of the summer season, and when our investiga- tion of the favorite localities of all the zymotic diseases is completed, there we expect to find the habitat of typhus—of scarlatina—of rubeola and the other exanthemata. Again we may refer to the cholera of 1852 in this placo, where Prof. Hamilton traced so clearly the influence of the upturning of the earth, with a stagnant atmosphere, in the immediate causation of cholera. The investigation of modern meteorology, has settled the whole question of miasm. There is no longer room for two opinions on the subject." Report Select Committee U. S. Senate on the Sickness and Mortality on Emigrant Ships. Senator Fish points out the fact that typhus, cholera and variola are the peculiar curses of the immigrant on ship-board, that these do not exist there without a local cause, and then demonstrating what is the cause, he calh for reforms precisely analogous to those demanded by his southern confrere in hygiene. In this iaical report, by a gentleman whose study has been civil policy rather than natural science, we have the calm unprejudiced convictions of a logical mind, reaching the same conclusions which are more amply proved by the researches of science. " Both, then, assert distinctly the doctrine of the preventibility of zymotic disease—Senator Fish in the narrower sphere allotted to him— Dr. Barton in the whole range of zymotic disease. We believe that the evidence warrants the conclusion. The additional responsibility thus thrown upon the shoulders of governments becomes a serious study for the statesman." "The report of this Commission will, in itself, be a monument to Dr. Barton's untiring industry and devotion to the public good. Should his suggestions and recommendations be faithfully carried out, he will have a nobler monument in the health and prosperity of the great city of which he is so valuable a citizen." Extracts from the Southern Medical and Surgical Journal. ******** "The report upon the sanitary condition of New Orleans, by Dr. Barton, embodies an immense store of interesting matter, illustrated by tables, charts, &c. It is indicative of great industry as well as familiar- ity with the subject on the part of the learned reporter, and must take place among the most valuable documents of the kind. The table No. 2, " showing the life-cost of acclimation, or liabilities to yellow fever from nativity," as exhibited by the epidemic of 1853, in New Orleans, is very striking; from these data it would appear that southern nativity, both in America and Europe, is singularly protective or antidotal, &c." From DeBouPs Review. "We have no hesitation in saying that this report is the ablest work upon sanitary matters ever published in America." 11 From the Bee. THE SANITARY COMMISSION. The ancient and approved maxim in the policy of enlightened gov- ernments, that in peace it is well to prepare for war, may be applied with equal appositeness to the Sanitary regulation of our city. In health prepare for sickness. New Orleans is now free from epidemic visitations. The advent of winter has completely annihilated the germ of that scourge which has so often desolated our community, and which, by its ravages for the two past summers, has inflicted more injury upon us than could possibly have resulted from the most wide spread and disastrous commercial crisis. It is the part of true wisdom to take warning from experience, and of sound policy to provide safeguards for the future. Vain and futile will be our best devised schemes and most persevering efforts to build up the prosperity of New Orleans, and to render her the paramount mistress of Southern commerce, until we shall have succeeded in banishing from our midst the pest which from time to time decimates our population, and produces panics that effec- tually prevent its steady and rapid increase. Thus far, we are bound to confess, our city authorities upon whom the labor and responsibility of watching over public health particularly devolve, have evinced ignorance, apathy and neglect. The dreadful mortality of 1853, seemed to bewilder and sfupify without adequately arousing them ; the mitigated but yet serious pestilence of last summer scarcely awoke them to the consciousness of duty. Surely the epidemic of 1853 would have startled any other city in the world into the neces- sity of active and unremitting exertions to discover its cause and to prevent its recurrence. But with us two such visitations occurring in immediate succession were required, ere the languid sympathies and drowsy consciences of the Council could be effectually stimulated into action. Something, however, though not much, has at length been accomplished. A sanitary commission was appointed, and vested with authority to institute an elaborate investigation into the subject, and report thereon. This commission was composed of some of the ablest and most learned members of the medical faculty, and at its head was placed Dr. Edward H. Barton, whose prolonged experience, profound study of epidemics, admirable qualities as a careful and minute observer, and thoughtful and sagacious reasoner, make him eminently fit for the position. After long and laborious research the commission has reported, and the results are before us in a volume of considerably over 500 pages. It is quite impossible for us, within the stinted limits of a newspaper article, to do the scantiest justice to the merits of this report, embodying as it does not alone the testimony of a large number of physicians, but a copious paper on the sanitary condition of New Orleans, by Dr. Barton, in which are displayed patient and long continued study, a painfully exact record of meteorological and other phenomena and con- ditions which are concomitants of epidemics, comparisons of mortality carried through a period of nearly two generations, and deductions 12 drawn with the utmost care from an almost gigantic collection of premises. Asa monument of individual industry; as the evidence of what can be performed by a single earnest, well taught, vigorous and inquiring intellect, this work is probably unrivalled in the annate of medical investigation. Let it never be forgotten that the conclusion reached by Dr. Barton is, that "yellow fever is an evil, remediable and extinguishable by human agency." Having demonstrated this impor- tant truth, the author of the report sets forth in detail the various measures to be employed for the gradual but certain banishment of the epidemic. They are, of course, hygienic in their character, and comprise many suggestions heretofore offered, with some others, peculiar, we believe, to the writer. The theory that yellow fever is the invariable sequel to a marked disturbance of the soil of the country, is one which we do not remember to have ever seen advanced before, and we must admit that the anologies cited by Dr. Barton, and the illustrations and arguments used by him in support of his views, seem to us to bear the impresss of truth. We do not propose to extract from the report the various plans recommended by the author for the removal of the causes of pestilence, and for effectually precluding its recurrence. The subject has under- gone a rigorous scrutiny, and the Council to which properly belongs the task of preserving public health, have before them the conclusions of the commission embodied in the report. We fervently trust that this matter will not, with habitual recklessness and indifference, be suffered to die away and be forgotten. Do not let us repose in supine sluggishness, until the coming of another storm. Let the authorities take up the report of the Sanitary Commission, examine it deliberately, give their sanction to its views, and resolve to enforce them practically. What if the adoption of an extended system of hygiene should prove somewhat expensive! Balance the cost against the enormous outlay, positive and prospective injury occasioned to New Orleans by every epidemic visitation, and say whether, if immunity from the scourge can be secured by an expenditure of half the annual revenue of the city, it will not be cheaply purchased ? The direst folly is that candle end and cheese-paring economy which revolts from the appropriation of money designed to guard against evils which inflict more than twenty times the pecuniary loss. From the National Intelligencer. THE YELLOW FEVER OF 1853. We have received from Dr. Edward H. Barton a copy of the "Report of the Sanitary Commission of New Orleans, on the epidemic yellow fever of 1853, published by authority of the City Council of New Orleans." The subject is undoubtedly one of great interest, not only to that city, which has recently suffered so much from the ravages of the epidemic, but to all other large commercial cities of the Union, most of which have been, at one time or another, the scenes of its desolating visits, and all of which are liable to the operation of the causes which are « 13 supposed to produce it. We understand that only a limited number of copies of this very able report have been published for distribution among the correspondents of the learned and scientific members of the Commis- sion ; and we have therefore thought it our duty to refer, in a brief and summary manner, to some of the principles enunciated in the report, and to the sanitary measures which the Commission, in their joint wis- dom, have deemed it proper to recommend. Four subjects were submitted by the Board of Health to a special commission, composed of the most experienced and scientific physicians of the city, for inquiry and investigation. These were: " let. To inquire into the origin and mode of transmission or propaga- tion of the late epidemic yellow fever. " 2d. To inquire into the subject of sewerage and common drains, their adaptability to the situation of our city, and their influence on health. " 3d. To inquire into the subject of quarantine, its uses and appli- cability here, and its influence in protecting the city from epidemic and contagious maladies; and " 4th. To make a thorough examination into the sanitary condition of the city, into all causes influencing it in present and previous years, and to suggest the requisite sanitary measures to remove or prevent them, and into the causes of yellow fever in ports and other localities having intercourse with New Orleans." These several subjects of inquiry were distributed among the differ- ent members of the Commission as follows: The first to Drs. Axson and McNeil; the second to Dr. Riddell; the third to Dr. Simonds; and the fourth to Dr. Barton, whose report occupies more than two hundred pages of the volume. It is most ably and elaborately drawn up, and is accompanied by numerous maps, charts, and tabular statements of great interest. But, as we could not hope to do justice to its merits by any abstract so brief as our want of time and space would compel us to make of it, we must content ourselves with stating, in a few words, the most important results of the investigation entrusted to the Commission. These will be found to be of a cheering character, furnishing good grounds for hope that, if the sanitary measures recommended by the Commission should be adopted, the time is not distant when the dread of this terrible epidemic will no longer be felt in any of our commercial cities. The gratifying conclusions to which their extended inquiries and examinations have led the Commission are, first, that yellow fever is and always has been, in New Orleans and elsewhere, a preventible disease ; and the second is, that the presence of two general hygienic conditions are absolutely indispensable to the origination and transmission of the disease, the one of them atmospheric, the other terrene. These must meet in combination, or the disease is not generated. The absence of one, so far as yellow fever is concerned, is equivalent to the absence of both ; and, as one of these conditions is almost wholly within the control of man and the other partially so, it must follow that his power extends to its prevention and expulsion. The corollary from this is, that the 14 disease is of local origin; that it is under no circumstances personally contagious ; and that its infectious proprieties are only communicable in a foul or infectious atmosphere. It is not by this intended to be denied that the disease is often imported; that is, persons infected with it may arrive from abroad, or vitiated and infectious air may be brought in goods and various ways ; but neither the one nor the other can propa- gate the disease, except under the combination of the conditions men- tioned. We cannot but hope that a second edition of this valuable report will be published, sufficiently extensive to afford every physician and every Board of Health in our large cities an opportunity of procuring a copy. We do not pretend to decide whether the opinions delivered in it or the principles established by it are legitimately derived, in a professional point of view; but there seems to be to us a great deal of important information, collected with much labor from a great variety of sources, which ought in some way or other to be spread before the public. From the South Carolinian. YELLOW FEVER. Report of the Sanitary Commission on the Epidemic Yellow Fever o/1853. Published by authority of the City Council of New Orleans. We are indebted to the Chairman of the Committee for a copy of this very valuable and interesting report on a subject of much importance to New Orleans, the medical fraternity, and the public generally. Dr. E. H. Barton, the Chairman, is the most fit and proper man who could have been selected to collect the testimony on this topic. A long residence in New Orleans, in Cuba, and in Vera Cruz, under the most favorable circumstances for observation, with extensive correspondence abroad, entitle him to great respect for his opinions; and, in addition to his own views, we are favored with those of other eminent co-laborers in New Orleans, and various localities where the terrible malady periodically exists. The limits of a newspaper will not allow us to do more than briefly to allude to the results of the laborious investigation here published. The most important to the general reader is that the accumulated testimony of those who have communicated their experience to the commission is in accordance with the opinion of the medical profession generally, that the disease is not contagious. Hear what they say: We are sensible there is great difference of opinion among the members of the profession, and in the community, in relation to the communicability of yellow fever, and have investigated the subject with great care in the following pages, and the conclusion we have come to is that yellow fever is not a disease personally contagious; that its infectious properties are only communicable in a foul or infectious atmosphere; that is, that a foul vessel or individual with the disease, will only propagate it under atmospherical and local conditions similar to that which furnished its nativity. That although vitiated or infectious air may be conveyed in goods, and in various ways to distant places, ventilation speedily despatches 15 it; and that if disease results, when it is much concentrated, or with very susceptible individuals, it extends no further, except under the conditions above specified. The occurrences of the last season, and, we believe, all antecedent years, supply us with innumerable illustrations in the establishment and corroboration of these important principles." We would call particular attention to the principles announced in this report, of two conditions being required to be in unison and combi- nation to produce yellow fever, The meteorological and terrene. For that of the first, a certain state of the dew point is essential, (this is more especially developed in the " Introduction ;") and the worst state of the other is the disturbance of the original soil of the country. It is within the knowledge of our old citizens, that the digging of the Columbia Canal, in 1819, was attended by the development of a serious and fatal fever, and these excavations of earth have been often noticed elsewhere as producing sickness. We must defer to a more leisure period an analysis of the volume here noticed. We trust its publication will have the effect of causing observers to institute meteorological experiments, and to look to the dew-point as an important weather-gauge—as an indication of public health, in connection always with the most thorough cleanliness. We would commend to the,attention of city councils generally the advice given so freely and so much in detail in the report—to adopt sanitary regulations for the sake of their reputation as well as their interests, and to put them right before the world ; and we would advise them to place in their health departments, men whose characters are guarantees of their sincerity as guardians of public hygiene. As the report has been only published for private distribution by the City Council of New Orleans, we would suggest to the chairman of the committee the importance of an edition being issued for sale, as the mass of testimony in relation to yellow fever should be widely circulated. From the Journal of Commerce. REPORT OF THE SANITARY COMMISSION OF NEW ORLEANS. Dr. Barton's essay on the sanitary condition of the city, is the most voluminous contribution of all, and makes up nearly half of the entire volume. In addition to maps, and several elaborate statistical tables, there are accompanying contributions from eminent medical men in Rio, Pernambuco, Buenos Ayres, Guayaquil, Puerto Cabello, Barbados, Mar- tinique, St. Thomas, Vera Cruz, Texas, and Bolivia, besides many towns and rural districts at the South. The mass of collaterial testimony thus collected is very valuable, and embodies many important truths. The opinions of Dr. Barton, from his long course of professional ex- perience, and his well-known scientific attainments, are entitled to the highest consideration. He considers that the yellow fever owes its 16 origin to a combination of terrene and meteorological causes, both of which are necessary for its development and propagation. The local origin of the fever is clearly established, and contagion repudiated. These are very important deductions, and show the necessity of associa- ting the healing art with the natural sciences, and looking to Nature for the elucidation of pathological phenomena. In the present stagnation of medical science, while the orthodox mem- bers of the profession are still clinging with pertinacity to obsolete ideas; and the new lights, ox fantoccini, are amusing themselves with puerile fanc: , and speculating upon credulity of others through them,—at such a time the advent of this volume is eminently propitious, and will do more to establish rational views of etiology, than auy work that has issued from the press for mauy years back. This report, moreover, affords incontestable evidence to the value and necessity of efficient and competent Boards of Health for all cities, wherever located. They should be composed of experienced and well- qualified medical men, and should be invested with co-ordinate powers in the municipal government of the city. In a recent address before one of the Medical Associations here, Dr. Griscom paid the flattering com- pliment to the New York Board of Health, of asserting that, out of the fifteen or twenty persons who composed it, there was not a single physician among them, nor any indivi'dual with sufficient skill to discriminate between a mosquito bite and an incipient pustule of small pox. In nearly every paper of the collection, the views expressed are sound and philosophical. This volume, we repeat, is a decided step in advance, in the correct and faithful exposition of professional truth. That it will command the attention, at home and abroad, which is justly due to its merits, there can be little doubt. It is an honor to the different co-laborators of the joint commission, and to the city through whose enlightened liberality it has been given to the world. 1Y [From the New Jersey Medical Reporter.] * * * « The city of New Orleans did something for science when her Board of Health appointed the Sanitary Commission, whose Report lies before us. The value of such a work can scarcely be estimated, and, if anything is lacking, it is a record of the names of the men composing the Board who ordered the Commission." [Prom the Nashville Journal of Medicine and Surgery.] " The same number of pages upon no topic, since the appearance of Jenner's Essay on Vaccination, has laid the profession and the public tender so deep an obligation. Appearing at a time when m; licipal authorities were blundering and hesitating among hygienic abs,:rdities, in search of means to drive back or restrain the "pestilence tb it walk- eth in darkness," it will arouse and intensify the popular mind tpon the subject, and insure the adoption of the regulations, it so eloquently and logically enforces. Dr. Barton shows that the efficient cause of yellow fever requires for its evolution a conjunction of meteorological and ter- rene phenomena which man can prevent, and ^therefore, that it is within his power to drive this scourge from our shores, and resuscitate the wan- ing prosperity of cities heretofore devoted to its ravages." [From the New Orleans Medical News and Hospital Gatette.] " The fourth and last branch of the Report, by Dr. Barton, on the sanitary condition of the city and causes influencing it, presents a wide field, which the author has labored with an imposing, valuable and irre- sistible array of facts to demonstrate wh? t is in accordance with the common sense, common feeling, and common experience of mankind— the antecedent necessity of vitiated atmosphere from vegetable ana ani- mal effluvia to generate epidemic disease. This, with certain meteoro- logical conditions, high temperature, great humidity, stagnant atmos- phere, &c, are essential to the production of yellow fever. "The Doctor has argued this point with the enthusiasm of the philan- thropist, of the lover of truth for its own sake, and with the detailed experience of the sage, in a treatise of great length, every proposition of which is fortified by fact, or pregnant with suggestion. There is no citizen of New Orleans who can fulfill bis public duties as intelligently without the information given in this Report, as he can with it; and to all to whom health individually, as controlled by persona habits or health as modified by general influences of which the individual has no control, except as a part of the governing power; to all to whom the individual prosperity, as controlled by the general prosperity, is a mat- ter of deep concern, (and to whom are they not of the deepest?) we recommend to make themselves conversant with this Report and to act resolutely in their several spheres to bring about the remedies it suggests. [From the New York Medical Times.] "Dr Barton has furnished us a reprint of his very valuable Report, read as Chairman of the Sanitary Commission of New Orleans, on the epidemic yellow fever of 1853, of which we took occasion, in a former number, to speak in the most favorable terms; and we, are happy it will thus enjoy a more extensive circulation than it could m its original 18 shape We regard it as one of the most important contributions to medicine of the present day. The testimonials which Dr. B. has received, to its excellence from the highest sources in our courtry, show the tayor with which it has been received. That yellow fever is ^preventable dis- ease is a proposition full of encouragement, and one which Dr. Barton believes to be very satisfftctorily sustained by his observations at New Orleans." [From the New Orleans Creole.] REPORT OF THE SANITARY COMMISSION. " This most important volume has been placed in our hands by the kindness of Dr. Barton. It contains a fund of information on the inter- esting subject of the public health of New Orleans which is invaluable. It manifests vast labor and long research, and from a cursory glance at its contents we are led to believe that no views are expressed not sus- tained by an astonishing array of facts. " Of one thing we are convinced that this work will demonstrate the fearful mortality occasionally witnessed in this city to be the result of gross neglect of sanitary laws by our public authorities. " We have presented the singular spectacle of a great commercial city, with interests, vast and growing in magnitude each year, to a great de- cree dependent upon the prevalence of health, without taking a single step to prevent the prevalence of epidemics. Experience should have long ere this, taught wisdom, but we seem, with stoicism of the Orien- tal fatalist, to have patiently borne whatever fate presented, without at- tempting to avert its blow or enquire into its cause. "That there are laws governing the appearance of yellow fever in this city must be evident to all: for nature never Avorks by chance. When our population had been repeatedly almost decimated in a few months, bsuiness arrested and the prospects of the future blasted by this terrible scourge, it was the dictate of reason to have inquired into the cause ; to have brought all the powers of observation and reflection to a solu- tion of the question, how the health of New Orleans could be preserv- ed—the fearful visitation averted. " And yet the public authority has virtually done nothing. With diffi- culty was means obtained from the treasury to put into durable form the result of the long and careful labors of the profession best qualified to investigate the facts presented and deduce conclusions from them. " The views contained in this volume are so important, and the conclu- sions reached furnish such uumistakeable evidence that human means may ameliorate, perhaps absolutely prevent, the recurrence of epidem- ics, that we must take the liberty on a future occasion to condense and popularize them in the hope of inducing a more enlightened attention to the subject of public health." [From the Philadelphia Medical Examiner.J "If the calamitous invasion of the pestilence of 1853 had produced no better ultimate effect upon the sanitary fortunes of the Crescent City than the development cf this voluminous and most elaborate Report there would be reason for material consolation in the vitally important 19 lesson it thus teaches for the future in regard to the etiology and proph- ylaxis, or rather aggravation and modification, of the dreaded epidemic. "We have been greatly interested in the copious details and various practical suggestions of Dr. Barton and his colleagues, and can safely recommend their manifesto to the attention of all who take interest in the study of public hygiene, as well as to all investigators of the course of the present epidemic scourges of the world. The growing extent of popularity of these sanitary inquests, afford gratifying evidence of a far more enlightened appreciation of the benefit of hygienic regulations than formerly prevailed in the councils of the nation and among the people generally ; and we are so fully convinced of the value of the feel- ing thus awakened, that we are anxious to encourage, in any proper way, a mark that is so well calculated to make a good impression as the one before us. There is much striking evidence collected in its pages; and the practical conclusions are so freely and forcibly presented, not- withstanding a little very natural extaavagance, that we earnestly hope it may exert a lasting influence, not only upon the community to whom it was addressed, but upon their more favored neighbours in other por- tions of this continent. In fact, much that is stigmatised and recom- mended in relation to yellow fever in the South, will equally well apply to the cholera and other malignant diseases in any portion of the coun- try, and may hence be profitably pondered over in all quarters of the land. "The Report of Dr. Barton, with its accompanying maps, charts, hy- geometrical and other meteorological tables, occupies, as it should, by far the liou's share of the whole production. It is a monument of pains taking iudustry, abounding in zealous discussion and explanation of his ideas respecting the origin .md causes of yellow fever and the best mode of counteracting them. "We would be glad to notice, to some extent at least, the table in which he has presented what he calls "Climatic or meteorological elements of yellow fever at New Orleans" in different years. The deductions from this table are among the most interesting peculiarities of the whole Re- port. Although they may afford no decisive information with the present data, they are certainly very hopeful indications of an extensive and yet, unexplored field. "The cenclusions of Dr. Barton are substantially the same as those of the British General Board of Health, which he quotes in full, with the strongest expressions of approval. We could not, if it wore desira- ble, repeat those conclusions here, or explain them in detail Suffice it to say, that yellow fever is local in its origin ; that the conditions which influence its localization are known, definite, to a great extent remova- ble, and very much the same as those of cholera and all other epidemic diseases ; that it be«onies more rare, more mild, or disappears in propor- tion as the local causes are abated or removed, and that, consequently, the means of protection are not quarantine restrictions and cordons, but sanitary works and operations, having for their objects the removal^ of the population from exposure within the infected districts of the operation of those sources. 20 "No resident of New Orleans, or indeed of any other city of our Union, could candidly examine the exposition of Dr. Barton without instruction ; and we hope for the sake of the common weal, that it may be carefully and widely studied, in the North as well as in the South. There are many hints to be found in it which would be well worth at- tending to in places north of Mason and Dixon's line, no less than in the warmer regions of our more exposed neighbors. " It was intended for the public at large, and is therefore addressed to the nation instead of the profession : and should it meet with but a small share of the consideration to which it is entitled, the people of New Orleans cannot fail sooner or later to derive a lasting and inestima- ble benefit." [Ex'ract of a letter from Wm. Brawne, M. D., of Fredricksburg, Va.] " Receive my grateful thanks for a copy of the Report of the Sani- tary Commission. I do not flatter you when I say that your paper on the sanitary condition of the city, contains a map of valuable informa- tion well digested and most judiciously arranged, that cannot be found in any paper I have ever read, and I have read much on the subject." * * * * u rpijg varj0lls circumstances which you have embodied and arranged connected with the disturbance of the soil—the hygrome- tric and other conditions of the atmosphere,—the comparison now in- stituted between the local position of your city, the peculiarity of its soil and its proximity to water courses, marshes, &c, with others throughout the whole range of the yellow fever zone, requiring an im- mense amount of labor which few could have been found to encounter, hare gone far, if not to the entire extent of elucidating those conditions in yellow fever districts which produce the causes of the disease, to prove its local origin—and that proper hygienic regulations judiciously administered, will, most probably form an effectual barrier against the encroachments of this most fatal malady. " I have not had sufficient time to give this report the thorough ex- amination I could wish and which I design to do. The Immense mass of facts it contains—and the variety of information derived from such various sources upon which its reasoning and conclusions are deduced, render it necessary that it should be studied not merely read." And in another from the same : * * * * " The protracted aud onerous labors of the members of the Commission, and the immense benefits likely to accrue to the best interests of the city from them, is eminently entitled to the high- est appreciation by the civil authorities. If I am not much mistaken, the publication of the several reports of your sanitarv commission will form a new era in the investigation of the causes of "epidemic diseases and result in incalculable blessings to couutries subject to epidemic in- fluences. It is only those who are by education capable of placing a proper estimate on the value of such services as have been rendered who can properly appreciate the obligation which the city owes to the members of the Commission. Money can scarcely remove it." From the New Orleans "Creole," IMPROVEMENT IN PRIMITIVE MEDICINE. We cordially invite the attention of our new Council and scientific men to the extracts be- low, which we have made—the first from the last number of the British Medico-OhirurgU cat Review—the highest authority, we are informed, in such matters, in England, and the second from the last volume of the American Medical Association—the highest source in this country, in relation to the estimation of the labors and improvements in primitive medicine of our distinguished fellow-citizen, Dr. Barton, are held by those eminent authori- ties. And we have seen letters from Paris showing how these same labors are appreciated by such men as Louis, Clot Bey, Baudin, and other savans. All unite in saying that the practi- cal application of the views put forth by Dr. B. would be of immeasurable importance to New Orleans. That these remarkable doctrines, now so extensively approved of not only at home but abroad, should have their paternity in our midst, should make us feel proud of their source, and we hope no time will be lost by our civic authorities In applying them for the benefit of our suffering city. From the British and Foreign Medico- Chirurgical Review. From an article on the history and origin of cholera, and signed by Dr. Bradlam Grkenhow. ****** "Ample materials for this investigation are furnished by the very valuable and interesting reports of the Committee for Scientific Inquiries, appointed by the Medical Council of the General Board of Health in 1854, and by Dr. Babton s most elaborate repo't, '• on the sanitary condition of New Orleans," whicli occupies 2oi> pages of the report of the Sanitary Commission, appointed to inquire into the recent fatal visitation of yel- low fever into that city. Dr. Bartons report, which is unique, comprises the result of many years careful observation and inquiry as a voluntary laborer in the field of sanitary investiga- tion. It is well worthy of the highest commendation, and if duly appreciated by the au- thorities of New Orleans, will be the means of inaugurating a system of Medical inquiry and hygienic supervision in, that city, notoriously one of the most pestilential in the United States, which cannot but eventuate in much public benefit. Dr. Barton seems of opinion that epidemic diseases are usually the production of the locality in which they ap- pear; and we presume he would assert that cholera is of indigenous origin, requiring only a certain season and certain local conditions for its development." ********* "No evidence of so precise and accurate a character as that furnished by Dr. Barton and Mr. Glaisher on the meteorology of cholera seasons is procurable from any other source." *****" That meteorological conditions have a great influence over the development and spread of cholera no one who has followed us throughout this investigation will hesitate to admit. How important is it then, that the inquiries set on foot in lr5t, and then only when the pestilence had attained its acme, should be systematically continued; that the climatic phenomena of different towns bo compared, a careful register of disease, as well as of mortality, be instituted, and a comparison of the meteorological phenomena of dis- tricts and towns visited by the same classes of disease be made; lastly, that the atmospheric, electrical and thermometric phenomena of those parts of towns which are found to bo noto- riously insalubrious be placed in juxtaposition with those of the suburbs and healthier por- tions of the same." " Hitherto meteorological inquiries have been made almost exclusively with a view to the discovery of the laws which regulate the weather and climatic character of seasons. The re- sults obtained from the limited and partial inquiries of last year in the direction of meteo- rology, as applied to the investigation of epidemic disease, are so important; the promises of still more valuable information as regards the causation of disease held out by meteorology, if these inquiries be pushed into the normal as well as the unusual influences of season, so large, that wo cannot resist expressing a confident hope that some system will be adopted for their continuance." * * * * * " From a careful classification of such facts, placed side by side with the meteorological 2 phenomena of the time and place in which they have been observed, we should gradually ob- tain a more precise, knowledge of the efl'ects of weather, season, and climate upon the human constitution is a common topic of conversation in this changeable climate of ours. It is, by common consent, allowed to be great, yet we absolutely possess no accurate acquaintance with the result produced on man's organization by a rise or fall of the barometer or thermo- meter, or the electrical state of the atmosphere." " The presence of another co-efticient, at least is, however, necessary to give character ana energy to this influence. This, as we have before said, is to bo sought in the existence of certain occasional and therefore remedial conditions, which, by common consent, are termed localising causes. This constitutes wnat Dr. Barton has termed the other blade ot the shears.'" Extracts from a paper read before tho American Medical Association, by Professor 8. B. Hunt, of the University, " On the Hygrometrlcal state of the Atmosphere, and its influ- ence on health." **•»***♦" Among those to whom I am most indebted for en- couragement and assistance in my labours, I take, thus early, the opportunity to mention Prof. K. H. Barton, of New Orleans, a gentleman distinguished for his long continued atten- tion to this specialty, and deserving from his unwearied industry and talent in associating it with the phenomena of epidemics, to be considered as the leading mind in the country, so far as this branch of etiology is concerned." * * * * " Dr. Barton has studied climate with an almost entire devotion to the interests of the medical science and sanitary reform " * * * * "During the past year Prof. Barton furnished to the city of New Orleans his elaborate report on the causation of yellow fever, as chairman of the Sanitary Commission appointed for that purpose. This report, .from the novelty of its doctrines, the earnestness with which they were urged, and the vast array of facts brought to support them has deservedly added much to the reputation of its author." * * * * "It will be borne in mind, that we are not authorized to ascribe Zymotic disease or the common epidemics of the country to the hygrometric condition alone. And this, I believe, is the position assumed by all intelligent meteorologists, and more especi- ally by Dr. Barton, in his Sanitary Report, which has been strongly misrepresented in this regard." *****" Dr. Barton has shown, that no epidemic of yellow fever has ever occurred in New Orleans, without the presence of two causes, which he personifies as "the two blades of the shears." Of these, one is a high dew point; the other, a mass of causes, grouped under the generic name, " terrene causes." Either one, without the other, he represents as powerless; combined, they are the shears of fate." "After a careful consideration of Dr. Barton's argument, 1 am more than ever impressed with its truth and importance. Heretofore, our notions of the causes of epidemics have been obscure and contradictory; the theory which seemed perfect one season, was worthless the next." * * * "That while in some seasons the evidence of the existence and power of •malaria' in certain districts seems incontrovertible, in the very next year we have the same terrene conditions, existing without results in the form of disease. The causes, the heat, the stagnant water, the decaying vegetation—all are there, the effect only is wanting. So wide- spread and common is this condition, that, even in high places, in the medical profession, we now hear the connection of filth and disease denied and derided. They tell us that New'Or- leans and other ' malaria' towns are always filthy in 1832 and healthy; in 1853 filthy and un- healthy. By this reasoning from a single condition, truthful in its premises, but presenting them only in part, the public confidence in the efficacy of sanitary police has been under mined, and the public mind was fast settling into a Turkish fatalism and apathy. The most common sense principles of cleanliness seemed to be contradicted by stubborn facts ' Mala- rialism.' as supported and explained by Dr. La Roche, had no hold upon the medical mind for its phenomena were too contradictory to base a belief upon " '• It was at this juncture that Dr. Harton declared that no epidemic of yellow fever had ever occurred in Mew Orleans when the city was cleanly; that every epidemic had been ac- companied by some upheaval of the soil, and that, whether dirty or cleanly no epidemic had ever occurred without thepresence of a high dew-point. So far as the sanitary condition of New Orleans was known, tor a long series of years, the two conditions, high dew-point and filth, had gone together in every epidemic of whatever kind" "This position is sustained by a crowd of witnesses, and thus far contradictory evidence has been adduced, With a curious misconception of the true issue, one writer lias an- nounced that such a city, though dirty, was healthy: another, that his ocality had a remark- ably high dew-point without epidemic disease; but no one lias yet provelthaVthetwo o7?lt!Ccat7o™ terrene^'^e ">**<* together without an increase in tliemoHaUtl " All the numerous contradictions in the laws of epidemic progress seem harmonized bv this theory So far as evidence extends, we may, by it, account for either the P™ialo7 en tire exemption ot a c.ty from, cholera, while evidently under the epidemic influence for the escape othe higher and cleanlier portions, for its occasional irruptions into rural disriots and. particularly, for its sudden departures from any given point " " ' "I will repeat the remark made once before, viz.: that after careful search, J am unable tn find any history qf epidemic disease which militatesvAih tU broad and phUosophictl^, to ably advanced by these gentlemen.' v—wjime meory 11 Office of the Sanitary Commission, ) Nov. 17 th, 1854. j To E. H. Barton, M. D., Member of the Sanitary Commission of New Orleans. Dear Sir :—At a meeting of the Sanitary Commission, held Novem- ber 17th, 1854, the following Resolution was unanimously adopted: Resolved, That the Members of this Commission desire to testify their high appreciation of the important services rendered by their confrere, E. H. Barton, M. D., of the labor and research evinced in the collection of the materials embodied in his Report; of the devotion paid to an im- portant branch of physical science, illustrative of climatic influences on zymotic diseases, thus furnishing important facts for the elucidation of the subjects submitted to the Commission; and of the consistent energy and perseverance with which he has aided to carry out the duties of the Commission from its inception to the close of its arduous task. Resolved, That this Commission, sensible of the truth conveyed in the preceding resolution, return their united thanks to E. H. Barton, M. D., for his co-operation in bringing to a successful close the deliberations in which we have for a period of more than twelve months been continu- ously engaged. [Signed.] C D. CROSSMAN, Mayor of the City of New Orleans, and President of the Sanitary Commission. A. F. AXSON, M. D. J. C. SIMONDS, M. D. J. L. RIDDELL, M. D. S. D. McNEIL, M. D. OPTME Exhibiting i/whcation of the various IN USANCES andoffwr causes affecting tie SALUBRITY of the CITY, as siiewn in Hie occurrence of near 30,000 Cases of yeUuwTever in tftelpidemic of 1853, ku^^iSJKlCTS&WAHDSrespectiwlfiacwrdmgWwfuchtJie U.S. Census was taUnut 1850,so thatthe ratio to the estimatedpopulauun shouldhe shemias in TaUe R intended toiUmtrate die influence of these causes upon health. 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I L-i.--.i-tJ I. i I,,, j iEt □ ft Dm □ EH □ □ WJVE u a a®ii m BROAD ■^=M L_J ] a v^ :G\^ uou\u laar; 0 s DGiGGGH 21CJ a □ a □ api 'EG l_j lj t_i amoGL/b^jaaiD LJGLIGl/jrJIJLJGGfc) 3 U : J G m _! l J l J l£j y_\ Gt v J G _J Gfo HlGiyU-LGi v/ <3 ID —..MTV/Mil id iQGGi±l[]feG El ill ID Jfc_J □ U _ fiGGU 1^1 ,jt>'i mi j*; |? |k.| |]~! liv.'.leJ. . ; ■ Mlfflllll jQUiiMGa ilLLU I explanation The------Tines indicate Plank roads, or streets. ,-, ^^^ ,, „ where theParements are of Stone .Where neither of these exist,the indication that there is nojjavemettt. The w^mm Vuies indicate disturbances of die soil,as digging for Railroads, earth tiirownfrom Canals,Drains orj)itche$-,or buddings or laying down pipes for mater or gas. TheWKHliries indicate such Nuisances us Cemetams, Slaughter lun/ses Vaclieruis,lA very stables, Markets, Sugar depots on tlie levee, lAtoaifacto -ries of soap, tailor, bone, Open oasins St unfilled'lots, Canals, Drains, Gas works,Ferer nests, Crowded boarding houses *r &> «v* :/ ?>"> 1 ^ ^ a\< i*m>'>jjaammiL THE CAUSE AND PREVENTION YELLOW FEVER $kfo ©rtans anb o%r Cities in America, E. H. BAKTON, A.M., M. D., Chairman of the Sanitary Commission; late President of the Louisiana State Medical Society and of the New Orleans Academy of Sciences; late Chairman of the Committee on Epidemics of the American Medical Association; Corresponding Membkr of the Epidemio- logical Society of London; former Professor of the Theory and Practice of Medicine and Clinical Practice in the Medical College of Louisiana, » T> V NEW YORK: H. BAILLIERE, 290 BROADWAY. LONDON, 219 REGENT STREET, and PARIS, 19 RUE HAUTEFEUELLE 1857. VVCK $L7 &2 Entered according to Act of Congress, in the year 1855, by E. H. BAETON, In the Clerk's Office of the District Court of the United States for the Eastern District of Louisiana. M. B. Wynkoop, Book and Job Printer, No. 12 Ann Street, New York. INDEX TO PREFATORY REMARKS. TO SECOND EDITION. FAQI Effect of the " disturbances of the soil" at Natchez in 1825-'37-'39, 6 Do. in Baton Rouge in 1827................................ 6 Do. in Dunaldsonville in 1827............................... 6 Do. at Terre au Beuf, Louisiana............................. 7 Do. at Wilmington, Delaware, in 1852—influence of fogs....... 7 Do. at Columbia, S. C, in 1819............................. 7 Do. at Savannah, Ga., in 1810-20—do. in 1854............... 7 Do. at Buffalo, N. Y., in 1852............................... 8 Do. in Louisiana in 1832-3................................ 8 Custom in Sierra Leone of using fires at night................... 9 Experience of Captains Cook and Peyrouse on influence of moisture, and how to protect crews from it at sea.................... 9 Error in supposing only aqueous vapor exhales from the body..... 9 Effect of a sudden change of weather on the dew-point and the fever—remarkable proof of it............................. 10 When and how the body becomes its own poisoner—mode of action of a high dew-point...................................... 10 Effect of the Harmattan wind................................. 11 Limit of malignant fevers—humidity here...................... 12 Error in relation to the mean dew-point of the United States....... 18 At what periods of the year the highest dew-point.............. 12 Meteorological elements at Savannah during the epidemic yellow fever of 1854............................................ 14 Corollories and deductions.................................... 16, 16 INDEX TO PREFATORY REMARKS TO THIRD EDITION. PAOa Errors corrected—the statement of my real position............. 10 Only two objections, so far, made to the report, viz.: to the first, or 10 The examination of Dr. La Roche—being the only alleged experi- ment of dew-point influence............................... 10 Influence of elevation on moisture........................... 11 Alleged objections at South-west—replied to.................... 11 Value of former recollections as to certain matters................ 13 Dr. W. Stone's statement before the "New York Academy of Medicine ".............................................. 14 Mis-statements as to New Orleans weather—by Lillie, corrected— in a note............................................... 13 Prediction of the great Epidemic of 1853....................... 16 Yellow fever always accompanied with a high dew-point......... 19 Do. do. do. do. do. temperature....... 19 Commencement of the epidemic in 1847-'53-'55, not as stated..... 17 Influence of preceding seasons on yellow fever.................. 17 Foundation for scientific prediction............................ 16 Prediction of the epidemics of 1853-'4-'5—grounds for quotation, in a note, from Dr. La Roche's work on yellow fever, and the published proceedings of the Academy of Sciences of New Orleans................................................. 16 Amount of rain in the spring and summer of 1855............... 17 The occurrence of yellow fever always dependant on meteoro- logical conditions....................................... 17 Meaning of the term epidemic................................. 1^ Origin of the record of the amount of meteorological elements in yellow fever............................................ 18 What is the actual condition of the atmosphere in what is called " drought" or " dryness"—their meaning.................... 13 Fogs, what their effect and influence........................... 13 Amount of moisture in the atmosphere not correctly estimated by the precipitation........................................ 23 Proofs from Prof. Hunt's Journal at Buffalo and experiments...... ifl INDEX. V. n.aa Proofs from my journal for a number of years................... 20 Large amount of rain generally during epidemics and a high de- gree of moisture......................................... 20 Requirements for "sun stroke"................................ 21 Influence of temperature on humidity.......................... 21 Error as to the climate of New Orleans—its true climate......... 22 Different effects of different combinations of heat and moisture.... 23 The conditions in which the greatest health is enjoyed at New Orleans................................................ 23 The probable law as to the requirements of temperature and mois- ture for greatest health in different climates................. 23 Always climatic changes when yellow fever first occurs in any climate................................................. 23 Explanation of yellow fever occurring in the rural districts....... 24 Successive stages of epidemic influence how known.............. 25 Explanation in relation to the Barometer....................... 25 The numerous occurrences in history only explicable on these principles............................................... 25 Why filth and offal do not always produce disease................ 26 Why disturbing the soil do. .................. 26 Why exposure of the dead—dry ships—letter from an officer in the Navy............................................... 26 Why dry goods injured in New Orleans....................... 26 Why flour sours, and when—circumstances in relation thereto.... 26 How the entire crop of the State, and may be, that of the whole Valley of the Mississippi estimated from conditions in New Orleans................................................. 26 The " certain meteorological conditions" of the late Prof. Harrison now first pointed out.............................,....... 27 The condition at Memphis during late yellow fever epidemic...... 28 Do. at Charleston................................... 28 The meteorological elements identical with those at New Orleans and Savannah, &c........................................ 28 Do. at Norfolk and Portsmouth—meteorological and epidemic facta and proofs—as here................................ 29 yj, INDEX. PASS 31 The true causes at do........................................ On the probability of importation—the ship Ben Franklin........ 30 Letter from J. S. Pickett, Esq., United States Consul at Vera Cruz, , ............ 30 in a note.......................................... The fever at Norfolk and Portsmouth fully accounted for......... 30 Further proofs of Philadelphia, New York and Baltimore, of the DO cause of their fevers...................................... Value of Sanitary ordinances—results of experience............. 33 oo Epidemics—useful sometimes.................................. II. " The specific poison"—special not specific causes,............ 34 Not from animalculse......................................... Cause of our not understanding yellow fever................... 35 The true cause is a combination of ingredients in definite propor- tions—illustrations....................................... 35 What combined—why yellow fever always in cities............. 38 Combination necessary for all specific diseases................... 38 Solar influence cause of difference in climates and diseases........ 38 Illustrations................................................ 39 The admission by our opponents of the spontaneous birth of yellow fever, &c, is giving up the whole ground................... 40 Why sporadic cases no disproof of our positions................. 40 Analysis of solar spectrum—influence of the different rays........ 40 Proofs and illustrations....................................... 42 Diseases requiring only meteorological causes for their production, 44 Value of a knowledge derived from meteorology—basis of etiology, 45 Illustrations................................................ 45 Concluding remarks—confirmation of my views................. 46, 47 ERRATA. "In Special Instructions of the Sanitary Commission." Insert Alex. Campbell, United States Consul at St. Pierre, Martinique, after Bolivia, in fifth line from bottom, page 5. In Index to the Report of the Sanitary Commission. Insert 98 for " 68," at sixth line from bottom page 2. Insert "Death's harvest's fields," after thirteenth line from top page 6. For "Additional Errata in Body of the Report." For "members" read numbers, in sixteenth line from bottom page 6. For "Thermometor" read Barometor, at fourth line from bottom page 20. Insert that after "proves," at sixth line from bottom page 62. Insert "and cutting down the banks of the river, and spreading the mate- rials on the streets—and at a subsequent year wherever there were these ex- posures of earth, there and almost there alone, the fever broke out; to fol- low "offensive," seventeenth line from top page 107. Read ever for "never," at fifteenth line from top page 132. Additional Errata in the Body of the " Report on the Sanitary Condition of New Orleans." In table 2, "last of acclimation, for average for United States and British America, for 12.39 read 29.11, page 36. Do., for average for Europe, for 111.91 read 146.45, page 36. For " record" read records, at seventeenth line from bottom page 50. For "The statement of," read To stale, at tenth line from bottom page 50. For " from" read by, at eleventh line from top page 51. Erase "condition" at twelfth line from bottom page 51. Insert that after prove, at sixth line from bottom page 62. For "compels" read compel, at thirteenth line from bottom page 67. For "has written" readwote, at line fifteenth from top page 83. For "has" read have, at line^thirteenth from bottom page 87. Insert a before " dew," at line sixth from bottom page 87. Insert the following note to sixth line from bottom:—"This I have since shown is not the fact, but that it is the effect of high temperature with satu- ration only," at page 88. For "extends" read extend, at line seventeenth from top page 92. For "it" read its, at fifth line from bottom page 94. Insert we after "and," at fourth line from bottom page 94. Erase "five times that amount here" and insert 627-1000, and on an average of several years more than one-third, at page 172. Erase "two-thirds" and insert three-fourths, at twelfth line from bottom page 202. Erase "nature" and insert influence, nineteenth line from bottom, and for "fellow" read fever, page 200. For "renewal" read removal, at fifteenth line from top page 207. Insert ofmoistute after "amount," at twelfth line from top page 211. 8 ERRATA. For "secured" read severed, fourth line from bottom page 224. For "parts" read ports, twentieth line from bottom page 226. For " Manoxyrinal" read Monoxyrimial, at eight line from top page 239. Insert respectively after "burthens," at ninth line from top page 249. For "200,000" read "2,000,000," at fourteenth line from bottom page 247. For "men" read even, at second line from top page 247. After line seven insert "In sandy soils the filth is sinking into the soil, remains there until brought into activity when suitable atmospherical con- ditions supervenes," page 227. In Table of Contents to Supplement. Erase " primitive" and insert preventive, in eighth line from bottom page 257. Erase one of the "theres" at sixth line from top page 260. Insert be at line sixth after "an," page 262. Erase "two-thirds" at line fifteen from top, and insert three-fourths, page 263. After " extensive," at line fifteen from top, insert cross streets, page 268. Erase "53," at line sixteen from bottom, and insert 54, page 272. Erase "information," at line eight from top, and insert inundation, page 273. After " instance," next line, insert of which, at eighteenth line from bot- tom, after "have," insert here, page 274. At second line from top, for "atmoic" insert atomic, page 276. Erase "which," at seventeenth line from bottom; for acclimated on bot- tom line, read unacclimated, page 283. In Prefatory Remarks to Second Edition. For "Wm. Elam, Esq.," at bottom of page, read J". M. Mam, Esq., page 6. For Dr. N. W. Gibbes," at botton of page, read Dr. Robt. W. Gibbes, p. 7. For "countries," at line fourteen from bottom read sourers, page 8. For " doubtless," at line ten from top, read unquestionably, page 9. Erase "to" at line from bottom, after "pro-tanto, page 9. Erase "external" after "disease," line second from top, page 10. Insert I at line fifteen from top, between "me" and "in," page 10. Erase "and" at line 9th from bottom, preceding "it is," page 10. For "capalaries," read capillaries, in fourth line from top, page 11. Insert to after apply, at tenth line from top, page 16. For "may produce," read produces, at ninth line from bottom, page 16. Erase "and" at last line from bottom, page 16. Errata in Prefatory Remarks to Third Edition. Erase "to" and substitute and,' eleventh line from bottom page 11. Insert even after "immunity," eight line from bottom page 11. Erase "actual," second line from bottom page 11. Erase "saw" and insert felt, twenty-seventh line from bottom page 14. Erase "form" and insert from, tenth line from top page 18. Erase " ever" and insert men, ninth line from top page 37. PREFATORY REMARKS TO THE THIRD EDITION. -*♦- Another edition of this Report being required, the reporter em- braces the opportunity to consider all the points raised and objections made to the original that he has met with, which have not been satis- factorily replied to in the second edition, and to add such further in- formation in relation to the causes of the occurrences of yellow fever, in other places, as he has been able to procure, in illustration of the principles set forth in the Report. The Report upon the Sanitary condition of New Orleans was pre- pared for the use, and under the special direction, of the public au- thorities. Its main object was an investigation into the circumstances and conditions causing and influencing yellow fever, so as to predicate upon them sanitary and preventive measures. It is believed they have been fully pointed out, and that the causa sine qua non of yel- low fever, as a basis upon which to erect sanitary and police ordi- nances, are amply laid down. It was not then deemed necessary, in the elucidation of the subject, to go extensively into the causa causans. Sufficient, however, was said to indicate the general views entertained. It is now my object to explain them more fully, to answer such ob- jections as have been raised against them, and to fortify assailed points. My first object is to set myself right—to be thoroughly understood. I have before corrected some of these misinterpretations. It was never said then—1st. " That disturbing the soil" alone would produce yellow fever—or that there would or could be no yellow 2 10 fever without it. I likened this to the disturbance or presence of all decomposed or decomposing organic matter—may be aggravated—as there had been no great disturbance without an epidemic here. 2d. It was never said that a high dew-point always produced yel- low fever, or that it was rife in proportion to its elevation—but that a high dew-point was essential to its existence and duration, and that whenever it fell to a certain degree, the epidemic uniformly fell here, and I believe elsewhere, as is shown at Savannah, Charleston, &c. My position is, that an elevated temperature and dew-point, with much disturbance of the soil, or its equivalent, a large amount of filth and abnormally elevated solar radiation, continued for a certain duration, are all requisite to meet in combination (not one alone, nor in proportion to the extent of any one) to constitute that atmospheric condition necessary for the origination of epidemic yellow fever. I reiterate it now. In all the discussions to which the subject-matter and principles in- volved in the Report have given rise, there are but two upon which there seems now to be any skepticism. 1st. In relation to the requirement of a high dew-point for the origination of yellow fever, and 2d. As to the necessity of some " specific poison" for its existence, " whose nature is extremely indefinite, and whose origin is deemed very obscure." The respectability of the quarters whence these emanate is entitled to great consideration, and I rejoice at any opportunity to clear up what may have been left obscure—to give farther illustrations and explanations, and to remove difficulties upon a subject on which there has actually been so little experience, or rather experiments, as to the direct application of climatic conditions to the origination, production and evolvement of zymotic disease. It seems necessary for me now to repeat, in limine, what I have so often done already, that my remarks apply to that aggravated con- dition giving rise to epidemic yellow fever. Endemic and sporadic cases usually depend upon local circumstances and conditions which no general experiments can either prove or disprove. The only real case, brought forward to test the principles involved (of the necessity of a high dew point), is that mentioned by Dr. La Roche, in his truly great work on yellow fever, as occurring in Phila- 11 delphia, in 1853. Now here, really, there is no applicability what- ever—for 1st. There was no epidemic. 170 cases (and 128 deaths) is no more a proof of an epidemic in a population of near half a million of souls, than the appearance of one swallow is to constitute a summer. 2d. If there was an epidemic, the experiments were not made where the disease existed, but a mile or so off, in a high, dry, healthy local- ity, where a different air must necessarily have existed. The estimated difference of temperature according to elevation, gives near one degree less for every hundred yards of ascent; it is actually much greater from constant experience. So a difference of elevation gives a still greater difference in the hygrometric condition. The fol- lowing decisive experiment of Prof. S. B. Hunt, at Buffalo, beautifully illustrates this.* Relative To which add No. of graini ; humidity. to each cubic foot. .616. 2.634. .487. 1.6T7. All observant people know that there is a sensible difference in the few feet between one story and another, and although the above difference appears small in figures, it is really very great. So a dif- ference in a city from the damp neighborhood of the wharves, to humid slips with an exposed surface at every tide, to a high, dry, well-paved neighborhood, not crowded with houses, must be very considerable. The effect of these elevations on cholera, has been repeatedly shown to be very striking in London, as well as Buffalo, and elsewhere. This is so well known in yellow fever, that it rarely ascends hills, but is usually confined to low places in cities; and indeed, there is often found entire immunity in an upper story. In a low and alluvion country—on the bunks of the Mississippi—where all is moist, with the winds blowing over immense swamps, the difference would not probably be so great, although we often find the disease confining itself to one of these localities, without attacking the other, as at Bayou-Sara, Natchez, Vicksburg, &c. Now this is the actual fact, which I have found by actual experiments in this city, at elevations varying from four feet above the soil, to upwards of 200 feet, and I have At the surface, At 60 ft elevation, In belfry of church. Temp, of Temp, of the air. evaporatioa 49. 34.4. 38. 23.9. • Vide Buffalo Journal for Nov. 1855. 12 not found the difference half so great as Prof. Hunt found at Buffalo, in a different geological region. No condition which is not present can be properly referred to as influencing morbid action. This is eminently true of the hygrometric, which may be limited to a neighborhood, lot, cellar, sink, slip, sewer, that no great change has ever been produced in this disease, without- some very sensible alteration in some of the meteorological elements,— usually the dew-point; in 1853 it was more especially in the solar radiation. It is further proper to explain in relation to the pressure of the at- mosphere on yellow fever, that it does not appear as obvious, from the table at page 13 "Introduction," as the real facts would justify. Previous to 1848 the barometer I used was not standard, it was the best I could procure here; on setting it aside for the standard instru- ment in use since, I omitted, in the hurry of preparing my calcula- tions, to add nearly 2-10ths to its readings, this being the difference between the former and the latter instrument, and would make the record to correspond nearer to the statement in the text—viz., that these epidemics occur during period of high atmospheric pressure. In the application of these important meteorological principles we have the true key to the explanation of phenomena, which heretofore have been the constant theme for controversy among professional men;— why, for instance, with the exposure of 50,000 victims annually, for- merly, in the high and dry city of Mexico in their inhuman sacrifices, and of 40,000 offered up at the dedication of the great temple, whose altars and vicinity were ever reeking with human gore, pestilence did not immolate the population, as it would in this humid country;—why oc- casionally, only, a mortal fever follows exposure of the dead on fields of carnage, and sometimes depopulates whole villages;—why a dead whale cast upon the coast of Holland has, by its putrefaction, created a pestilential fever ; and why it then produces no effect;—why Cap- tain Cook with his system of dry rubbing the decks of his vessel, instead of deluging them with water, (as is the more common custom,) circumnavigated the globe without losing but one man ; why it is so 3 26 fatal watering a vessel on a pestilential coast—those alone suffering (and uniformly) who remain during a night on shore.* Why fires in our rooms in the wet and sickly autumns of the lower countries tends to retain our health, and thus the salubrity of our negroes is preserved under their habitual system of kindling great fires in their cabins ;—why woollen clothes, from their attraction for moisture, are so retentive of fomites and offensive smells;—why, in fine, is it that filth and offal of all kinds, nay every species of decomposition, appears at times entirely innocuous, but at others shows its deadly fatality. We can thus explain how it is that digging and disturbing the soil is not so injurious in a dry atmosphere as in humid hot weather. Medi- cal history teems with similar examples which it is useless to multi- ply, for it is clear that this is the only reasonable interpretation, as it applies with admirable fidelity to all these numerous variations and reconciles so many apparent contradictions. And here we could draw * I have received, since the above was written, the following interesting letter from a dis- tinguished and long experienced Captain in our Navy, as eminent for the strictness of his discipline as far as the salubrity of his men, and respected and beloved by alL Fredericksburg, Va.., November 8th, 1856. My Dear Sir :—As the late cruise of the Frigate Constitution on the coast of Africa, has attracted some attention on account of the unprecedented good health of her crew, I attribute that happy result principally to the following circumstances:—" The crew having been clad in flannel;" " the ship kept as dry as possible;'''' " letting nowater from the sea into the hold;'' "the galley (the cooking apparatus,) being on the birth or lower deck;1' "and the most rigid enforcement of the Sanitar y Regulations of the Navy Department" The decks of the ship were not permitted to be washed except in good weather, and then only when necessity required it, so as to keep her clean—after the lower deck was done (which was frequently with hot water)—the cinders from the coal at the galley were put in hanging stoves about different parts of the deck. The old practice of letting water in the hold was entirely aband- oned, she was pumped out twice every day, so as to keep her dry below, and from that usage we never had any smell. During the cruise of the Frigate Macedonian in the West Indies in 1822, when I was attached to her, the contrary was the usage, even in the harbor of Havana, the fatal consequences are well known, the yellow fever broke out, and in three months we lost 105 of our crew with that disease. I met, some years after that in the Pacific, Captain Coglan, of the British Navy, who informed me, that during the French War, he was in a frigate on the West India Station, that they kept every thing dry, and her crew re- mained healthy; the rest of the fleet had the yellow fever, caused by their continued wetting. The galley being below added very much to the good health of the ship, not only keeping her dry, but purifying the atmosphere, the only objection urged was, that it was more difficult to keep it clean on account of the darkness of the lower deck. The Sanitary rules of the Navy Department which were in force, did not permit any person to be on shore after sunset or be- fore sunrise. I have briefly submitted to you these remarks relative to the cruise, if they can be of any service in any way to you, I shall be much pleased. I remain, with great regard and friendship, Yours, &o,, Dr. Edward H. Barton. jjtq grjDD. 27 a most useful and profitable lesson in our own city, not only for the purposes of health on which I have enlarged so much in the report, but for domestic and commercial purposes. Excess of humidity is the greatest embarrassment our situation exposes us to, these have been mostly mentioned in the text, with the mode of remedying them.* The finest goods become spoiled by passing a summer in our stores, built with an utter disregard of all our climatic liabilities; flour sometimes sours in a few hours, while with a careful watching of the hygrometric condition such a loss (by purchase at least) would never be experienced. By watching the meteorological conditions, as occurring in this city, a very near approximation can be made, at least sufficient for all practical purposes, to that of its conditions throughout (probably) the entire delta of the Mississippi; hence the condition of the crops, the rise of the rivers, and the early or tardy reception of that crop in market, can almost always be foretold with very tolerable precision. By neglect we thus disregard the teachings of science and the lessons of experience, sacrifice health, and with it the reputation of our city, and the wealth and enjoyments of life. Here there are precisely those " certain meteorological conditions" which the philosophical sagacity of the late Professor Harrison, of our city, deemed alone as needed to explain the phenomena required for the development of epidemic yellow fever, to give activity, force and life to the second or terrene condition. We several times con- versed upon the subject, but the experiments were not sufficiently nu- merous at that time (1843-4) to authorize conclusions; and it was not until the disastrous year 1853. that they became extensive and unequivocal enough to justify fully the conclusions now derived from them. The truth at last burst upon us, and the aggregation of ante- cedent and subsequent experiments now fully authorizes us, we hope to say, there is no longer any room left for reasonable doubt. I trust now, after this minute if not tedious recital of facts, that the position in the report of the necessity of a high dew-point for the existence of yellow fever has been fully sustained. It might have been corroborated by illustrative facts from other regions, but they were deemed superfluous. Detail, exactitude is, at once, the creation and creator of modern science, indeed there is no science without it; * And for farther illustrated see my report on the mortality and meteorology of New Or- leans for 1855. 28 in the language of Lord Bacon—" It is leading mankind to particu- lars." Science is created by laws, and these are formed by the gene- ralization of a " multitude of facts repeatedly and accurately observed and carefully noted." The same great authority has said that " he that cannot contract the sight of his mind as well as disperse and dilate it, wanteth a great faculty." Detail and generalization in all things are equally subservient to master minds, and their intimate personal history eminently shows it. It affords me much satisfaction to state, that since the last edition of this work was issued, much farther testimony has reached me, that the meteorological and terrene causes of yellow fever, laid down in the text, have been most fully borne out in a variety of places, corrobo- rating the facts and principles advocated. As full details of these as might be desirable, it has been found impossible to procure. So few medical men keep minute meteorological journals, or pay but a pass- ing attention to the weather, or note improvements, changes, or pass- ing events, that special exactitude is rarely to be found. The following, however, may be relied on as far as they go: The recent (1855) fever at Memphis, Tenn., if not mainly owing to the cutting down and levelling the streets in the spring and sum- mer season, has certainly been greatly aggravated thereby.* At Charleston, in 1854, there was a filling up of lots in the neighborhood of the Marine Hospital, and disturbance of the streets for the purpose of laying down the gas-pipes, and repairs. But the most remarkable similarity will be found in the meteorological ele- ments, which prevailed during the successive periods of the epidemic, and which will be found to correspond in all essential particulars (so far as they go) with those prevailing in New Orleans and Savannah, as exhibited at page xm of the " Introduction," and page xiv of these " Prefatory Remarks," although the hygrometer was recorded only once daily (at sun-rise). These are comprehended in the following table : * Professor Merrill, 29 Meteorological elements prevalent during the existence of the Epidemic Yellow Fevers in Charleston, in 1854. Periods of Date of these. 8 o a o a 1. Commencement, 2. Maximum in- 1 tensity, j 3. Decline, between Aug. 30th & Sep. 3d Sept. 18th and 25th. Oct. 26th and 30th. 80.86 73.33 67.22 none made. 75.40 70.16 68 33 30.259 30 279 30.176 S. E N. E. N. E. .845 .902 .882 5.46 8.17 8.89 After much trouble, I have to express my regret that I have found it finally impossible to procure the meteorological or mortuary data prevalent at Augusta during the epidemic yellow fever of 1854. Norfolk and Portsmouth, although surrounded (as it were) by government establishments—proper meteorological records, it is be- lieved, were not kept during the existence of the epidemic. Never- theless, I have procured from eye-witnesses information which leaves not a doubt that the same kind of weather which characterized yellow fever seasons elsewhere, was eminently exhibited here,—viz.: that the temperature in the sun was extraordinarily high and oppressive, and in the shade varied from 85 to 95 for more than two months ; that the chilly north-east wind greatly augmented the cases; that the air was close, stagnant and humid, so much so as to render it difficult at times to light a lucifer match ; that a thick green mould gathered almost everywhere, even on counters and shelving, sometimes to the extent of half an inch in thickness; that the rains were frequent in July and August, but instead of cooling the atmosphere, were invari- ably followed by more intense heat; and the disease was finally put an end to by a heavy rain and north-west wind, lowering the temperature, early in October. The epidemic influence was farther shewn on fruit, which prematurely rotted in the trees, many of the leaves of the shade trees changed color and withered at an early period; not a bird v. as seen within the city limits, and many dogs and cats fell victims to hemorrhages from the nose and mouth. The noxious effluvia of the city was so concentrated and offensive as to be perceived far beyond its neighborhood. * For the materials to make this Table, I have to express my obligations to that lover and promoter of science, the Hon. M. King, of Charleston. 30 With regard to the coefficient or terrene causes of this fever, inves- tigation has not left a doubt on my mind. The intelligent letter of the United States Consul at Vera Cruz (J. S. Pickett, Esq.,) whose ex- perience in yellow fever should attest his qualifications as a most com- petent witness, and who was incidentally a passenger in the much- abused "Ben. Franklin," to whose arrival from Porto Rico the fever has been attributed,—I give below.* On a careful perusal of that letter, every candid and unprejudiced mind must fully exempt that vessel from having had any agency in the origination of the fever, and consequently from its being imported from abroad. It has been clearly demonstrated by those who have thoroughly investigated this subject on the spot, that so far from this ship having originated this fever, that cases occurred some days before her arrival at Gosport; that of all the men who worked upon her, and they were nume- rous, at this filthy spot only two were attacked with the fever, and they were exposed to other much greater liabilities than this vessel af- Vera CRtrz, September 21st, 1855. To the Editor of the Norfolk Herald:—From the reiterrated statements in the public press of the United States, the impression has been made that the awful mortality at Norfolk and Portsmouth is traceble to the steamship Ben Franklin, which arrived at the latter port from St Thomas early in June. As such an impression is calculated to mislead and baffle scientific research as to the true orgin of the plague now desolating those cities, suffer me to disabuse the public mind by stating a few facts The Ben Franklin left St. Thomas for New York on the 27th of May, with thirty-three passengers—men, women and children—most of them unacclimated persons. The second or third day out several of the crew and firemen were on the sick list, but whether from rum, fatigue, or malingering, (commonly called " sogering,") I shall not pretend to say. Certain it is, there were no cases of yellow fever among them, and the writer has, he thinks, seen enough of that disease to recognise it when existing. On the fifth or sixth day, one of the men (who had been up and about the day before) died suddenly, and without having exhibited the least symptom of yellow fever. I attributed his death to some organic functional derangement, most probably of the bowels, for neither pur- gatives nor enemata had any effect upon him. The tenth day out we put into Hampton Roads, in distress, having for the preceedlng two or three days made scarcely any progress, the ship leaking badly, and the engine almost entirely "broken down." At the very time of getting in, the only other death occurred— that of one of the firemen, who had been at his duty the day before. Could his have been a case of yellow fever 1 I think not. We had not anchored when the boat from Norfolk to Baltimore came in hail, and with a single exception every passenger was transferred, bag and baggage, on board of her, and found themselves safe and sound in Baltimore next morning. I have either seen or heard from every one of those passengers, and that one left on board since then, and not one of them has had the slightest symptoms of yellow fever. Now, when we bear in mind that the cabin of the Ben Franklin is below deck and that it had constantly open communication with the hold, and that the delicate sea-sick women and 31 forded; that the first case occurred at least one and a half miles from her, at a house on Scott's Creek, north-west of Portsmouth, in a patient for a long time bed-ridden, and having no communication with Gosport,—and soon after at Barry's row, to the north-east, and then at Gosport; these three positions, forming the angles of an equi- lateral triangle, the sides being one and a half miles in length, and all independent of each other. But the cause of that terrible malady is not left in a moment's doubt,—with the presence of the meteorological ingredients mention- ed,—the aggregation of filth and disturbance of soil now to be referred to, were amply sufficient to account for any amount of pestilence which prevailed, and although these were not exclusively confined to this year, yet there is no evidence that the meteoric elements were present to the same extent before, although there were cases of yellow fever. We are informed that a number of wharves were most culpably, (al- though economically), made years ago " of green timber, logs and brush, which had now begun to decay, and were filed in with city filth, refuse, and low marshy debris, drawn up from the half-stagnant streams and pools in the neighborhood of both places, and with the shav- ings and refuse of the yard. That the hot sun and tides had alternate children were shut up there most of the time, and that the male passengers were two days and nights constantly at the pumps—being, withal of the class fruges consumere nati, and not" drawers of water," except for the nonce—is it not passing strange that none of us suffered from the pestilence with which, according to the newspapers, the vessel was reeking? Moreover, the Ben Franklin had positively no cargo, except coal and cannon—none of which did she discharge. The " Breaking bulk," so much harped upon, could relate only to a few heavy articles of passengers' luggage, left on board, but which were stowed under an open hatchway. My impression is, Mr. Editor, that the Ben Franklin is more sinned against than sinning. I believe she caught the infection at Gosport, instead of taking it there. Several men-of-war and other vessels had arrived in those waters a short time previously, all teeming with yellow fever. Why, then, make this most unfortunate of vessels, (you have heard and will hear more of her history,) the scape goat for the sins of others 1 We have been reproached for leaving the vessel so unceremoniously the moment we got abreast of Old Point Comfort, and without waiting for the visits of medical or custom-house officers. To that I would say, even to rats is accorded the innocent privilege of quitting a sinking ship when they can. We had nothing to smuggle, and knew there was no yellow fever on board. This was the second time I had left a vessel under similar circumstances, and with equally little ceremony at Hampton Roads, and without ever hearing of quarantine or custom-house. I desire this to be published, to vindicate myself the officers of the ship and fellow-passen- gers, from the implied charge of a culpable recklessness, which, if merited, could not but— in view of ite awful consequences—disturb the conscience of a fiend. I am anxious, too, that the medical faculty, in their noble labors and investigations as to the cause of the direful cal- amity, may have facta and data at command. J. T. PICKETT. 82 access to these putrifiable and offensive materials, and that this debris was farther used to fill up low places in the vicinity and suburbs; that so offensive were the wharves and yards in these infected localities where the fever first broke out and spread, and also near where the Ben. Frank- lin was moored, that a piece of meat exposed a short time within a few feet of the surface of the earth, became speedily putrid.1'' Here* then, there is nothing wanting to complete the ingredients for the most fatal pestilence, and in conformity with those laws, with which I doubt if there has ever yet been an exception, it came to fulfil the des- tiny man's folly and ignorance had prepared for it! Farther proofs of the correctness of our position, are, I am sure, not needed; yet the appositeness of the following will not permit me to forego them. That there was great moisture in the atmosphere during the yellow fever of 1793 in Philadelphia, notwithstanding the great drought which prevailed, is shown by the universal complaint of the great op- pressiveness of the heat. Laborers were often compelled to cease work when the mercury stood no higher than °84. It was observed, too, that the sweat on the surface of the body dried but slowly. It rained heavily on the 25th of August, and then not until the 15th of October. The stagnant air teemed with deadly vapors, scarcely a breeze ruffled the unbroken calm. " The light of the sun shone steadily and fiercely from the blue arch—hot and stifling like the dome of a furnace." In New York, in 1795, the yellow fever was confined to the neigh- borhood of some unfinished docks, which were full of all manner of animal and vegetable corruption ; across one of these, an obstruction had been erected, in consequence of which a pool of stagnant water was enclosed and suffered to putrify under a burning sun. There was much made ground in the same region derived from the offals from the streets and cellars of the city." In 1798, the yellow fever prevailed in Boston, Wilmington, New York, Philadelphia, and the weather in each was characterised as " re- markably hot and moist," and with the presence of similar conditions as those expressed above. It prevailed in Baltimore, in 1800, and was said to have been much aggravated by the "exposure of fresh earth to the action of the sun in the filling up of docks," &c. Thus then, wherever records have been made, the meteorological 33 conditions, I have deemed essential for this class of fevers, viz: much heat, fiery sun, humid atmosphere, much stagnant air, and when winds, usually from the East or N. East, together with great filth, crowded population, newly made ground, and disturbance of soil ever characterised the conditions—only varying according to circumstances and liabilities. After all, it must, nevertheless, be acknowledged, notwithstanding all the sufferings temporally experienced, that epidemics are not entirely without their advantages; they, at once, exhibit the value and neglect by the authorities of sanitary ordinances, and point out, with an un- erring eye, to those rotten ulcerous spots—those pest-houses in cities which are ever their seat, of almost whatever kind of disease prevailing, whenever a city is so invaded. Filth is man's great enemy—one of the chief objects of government, nay, one of the special ends of muni- cipal institutions, where disease is so much more rife than in the rural districts, is the protection of the citizens by police regulations, and I cannot but think it is ever the fault of municipal authorities, if a city is invaded by epidemic disease, and especially of the zymotic class. The value of sanitary ordinances has been widely experienced in almost every part of America, (may be excepting New Orleans, where they have only been applied to the most limited extent.) Baltimore, a few years ago, was unquestionably saved from cholera, then prevail- ing in neighboring cities and sections, when even the usual prodrome of the disease had made its advent, by extraordinary attention to her sanitary condition. In Boston it was once almost entirely prevented, and on another occasion was modified and ameliorated, and when it did occur, it was mostly in the neighborhood of her weak parts, the filthy and neglected spots, which were thus pointed out by it. We shall see this summer the effect of the alarm and apprehension of a visit of yellow fever, in producing increased attention to sanitary police. Indeed I deem these occasional alarms greatly salutary, as conducive to the preservation of order and cleanliness, and therefore health. In New Orleans, the liberality and devotion to the sick is without a parallel when the epidemic arives, but very little is done to prevent its occurrence. In the paraphrase of a celebrated motto :— " millions may be given for cure, but not a cent for prevention.'" 4 34 II. The second difficulty met with is in relation to some " specific poi- son," in order to develop yellow fever, " whose nature is said to be extremely indefinite, and whose origin is very obscure." It is admit ted that of this germ or poison we absolutely know nothing—merely inferring its existence from its effects—or supposed effects. No man doubts but that a specific effect may occur, without there being required any one specific thing to produce it always, and all medical experience is replete with instances to prove it. I need only mention one or two, thus: intermittent and bilious fevers —so much like yellow fever—may be produced by an almost infinite number of circumstances—a debauch—"taking cold"—a fall—an accident—a moral emotion, &c, &c: the same with regard to the greater part of the extensive class of zymotic, and some other classes of disease— excepting, probably, the unequivocally contagious maladies. Why, then, should we look to some "specific poison," and to that alone, to produce yellow fever, and by men too who do not believe in its con- tagious properties? Now, all these diseases are recognized as the same, from whichever of the causes they originate. In the text as well as in the " supplement," it is shown that all these fevers may originate from the same cause, differing in degree—that is, combina- tions of the same elementary principles in different proportions—and in each be followed by a specific effect or result, differing from the other. The grounds of this opinion are therein detailed, and need not be repeated. To this class of causes belong that supposed to be derived from animalculae. The allegation of a specific, tangible material cause of a fever, requires something more than mere assertion, and this it has never had. At all times, and especially during the existence of malig- nant epidemics, the air is filled with microscopic animalculae. The material world is everywhere and at all times teeming with life—each successive chain of being feeds upon his predecessor—some seek their sustenance upon man—and when their influence amounts to disease, it is, as far as we know, of a traumatic nature. The mystery of idio- pathic fevers has never been even plausibly ascribed to them. Poi- Bons, to affect the system, act in two ways—on the sentient extremi- ties of the nerves, and by absorption. For the first there is required a special poisonous quality—this needs proof here, which is impossible —it is not even alleged. For the second, previous solution is indispens- 35 able, and this would change their qualities. The whole view of it is preposterous, and is contrary to the entire analogy of nature, and none but those entertaining a gross misconception of the character of insect transformations could, for a moment, entertain such an idea. It requires a large amount of credulity to believe that the combina- tion alleged to produce this disease, could produce the spontaneous birth of animalculae possessed of such poisonous properties. In the elements to produce the " poison" (if you will), the true causa causans, there is no evidence whatever to show that these constituents are of an animal or cryptogamic nature, but every one to convince us that they are of no animated quality whatever, but producing their effect through an jeriform nature, influencing the organism directly through the nervous system, and this is clearly the first and most affected in yellow fever. Leibig has satisfactorily shown the impossibility of explaining, on chemical principles, the existence of even the lowest connecting parts of an organism of a cell or a muscular fibre; and Rokitansky has demonstrated the utter futility of the microscope as an instrument of diagnosis, between malignant and harmless growths and tumors. Is it saying too much, then, thar he must be truly transcendental, who can see animalculae the cause of disease so obscure as the idiopathic fevers. It is alleged, besides the combination alluded to, or the agencies meant, there is a "secret agency"—a "peculiar something," product- ive of, or rather constituting the epidemic principle, which is the cause of its power and extension. There is no proof of this opinion, it is devoid of plausibility—it is at once an acknowledgment of our ignorance, and a poor excuse for the indolence which makes no exer- tion to ascertain it. These secret agencies and occult mysteries are the bane of the science, and are only a remnant of that feeling which gave rise to astrology, which clothes with suppositious virtues empiri- cal medicine, and bolsters up all the isms and pathies of the day Thev must give way to experimental medicine and philosophical induction. If the profession would put their shoulders seriously to the wheel, instead of speculating in their closets, these ridiculous mysteries would soon give way to facts; endless disputes and false facts would no longer be a by-word and reproach, and the world would cease to 36 laugh at our interminable differences, and the " uncei'tainty of physic." No apology is needed in giving my own views of what I believe to be the true theory of the causa causans of yellow fever more in ex- tenso than in the report itself, originally intended mostly for laymen, and I avail myself of the opportunity presented (by this edition) of giving more fully the grounds for the " faith that is within me." How far, then, have we progressed in a strictly scientific understanding of the true etiology of yellow fever ? What principles are fixed and stable upon the basis of scientific laws, during more than two centu- ries of its ravages ? What a reflexion upon the profession, and why is it ? We have had a vast amount of speculation as to its cause, but in America, at least, the experiments have been meagre and the facts few. In Norfolk even as recent as 1855, surrounded by govern- ment establishments, but the scantiest record of the weather was kept*—none worth the name, and at Augusta, for 1854, none could be procured. Too many are content with the beaten track—too many confine themselves to its pathology and treatment—too many are satisfied with limited views, confining their observations to a nar- row circle, content with one series of circumstances not reaching a principle. I am too much afraid routine has been substituted for ex- periment, and that hypothetical assumption and defective observation have cast a cloud over the profession, and poisoned the great stream of truth even to its fountain head. Such is unfortunately too much the experience in all human investigations, dependant upon imperfect observation, until science, with her magic wand, is made to shed her vivifying rays upon them, it then progresses under the guidance of its laws, and the results are—final truth. I have by no means the vanity to suppose that I shall be able to dispel this cloud, but, at least, I shall give facts that do not admit of a doubt, and if I must neces- sarily speculate beyund merely generalising, it will be, I trust, upon their stable basis. Let us then have something fixed, something established, and the sooner we begin the better. The true understanding of the etiology of yellow fever, which has become now the great bane of our country, » To the first named place I sent the necessary instruments, with blanks and instructions but no resultSjWere procured. 37 is demanded of the profession, and implicates its deepest and most serious honor. Encouragement should be extended, instead of cast- ing ridicule on every experiment, tending, however remotely, to de- velope the conditions or the laws influencing it. There must be a cause of yellow fever, there must be principles and laws governing it; these are only to be obtained by observations and experiments assiduously made for a series of years and carefully re- corded. Do we truly know the real bona fide cause of any one spe- cific disease ? Has ever the vaccine or small-pox virus been analysed ? Do we know the proportions of their elementary constituents ? Yet they must be formed of a combination of elements in definite propor- tions, whose union forms them alone, and these are the most special of all tangible causes ; they are not only tangible but visible, the others are not, and yet no one has ever recomposed them from their ele- mentary constituents. Except, then, the unequivocally contagious maladies thus formed, I know of no diseases that' are more compara- tively simple in their causation, except those requiring no coefficient. The folly then of ascribing yellow fever to any such cause as has been ascribed to these is obvious enough, the attempt so to limit it has puzzled physicians for ages. In all the discussions upon this subject a certain high range of atmospheric temperature was heretofore ad- mitted as essential, that is now denied.* There is, however, a general admission by the profession everywhere of the necessity of a high temperature, moisture, and organic decomposition, and by many a special poison. My own impression is, that to the three first high solar radiation is to be superadded, that these all combined in some definite proportions constitute the agent (or " poison," if you will,) that developes that type of fever, yellow fever. The analogies illus- trating this position are innumerable. Combination is necessary to produce all the forms of matter; almost every substance we meet with on earth is but a temporary compound of ultimate atoms, to be hereafter resolved into its original elements —these again to be re combined with other forms and according to other laws—scarcely anything exists in its elementary condition, in any department of nature without it; and all the forms of organic * Vide ut amtea—records of the Academy of Medicine, New York, p. 65. 38 matter, and everything that is of a character denominated specific is combined in proportions that are definite. No other proportions can constitute them; not only is this so, but a condition, or third ingredi- ent, is usually required for this union, to give it this specific quality : thus oxygen and nitrogen may be mixed together in the definite pro- portions to constitute atmospheric air; oxygen and hydrogen in the atomic proportions to form water; yet these last results will not take place, unless pressure or electricity, or some other means be used to effect it. Chlorine and hydrogen, when mixed together in combining proportions, will not unite chemically in the dark; by exposing them to sunshine for a short time, they immediately combine with a violent explosion. Chlorine, when exposed alone to sunshine, seems to absorb the actinic principle, and now when mixed with hydrogen, unites with it in the dark. The combinations to which I refer are believed to be the re- sult of the putrefactive process—a class of chemical actions, different in form and manifestation from ordinary decom- position ;* and this may be one of the principal reasons why yellow fever is mostly confined to cities. These actions are dependent for precise results upon identical conditions; where these vary in the slightest degree in the quantity of heat, light, mois- ture, and more or less of oxygen,