Southern Medical Reports : Consisting of General and Special
Reports of the Medical Topography, Meteorology and Prevalent
Diseases in the following States : Louisiana, Alabama, Mis-
sissippi, North Carolina, South Carolina, Georgia, Florida,
Arkansas, Tennessee and Texas ; to be published annually.
Edited by E. D. Fenner, M. D., of New Orleans, Member of
the American Medical Association, &c. &c. Vol. I. 1850.
New Orleans, B. M. Norman ; New York, Samuel S. and Wm.
Wood. pp. 472. 8vo.
Another valuable contribution to a knowledge of the Medical
Topography and Diseases of the South and West. The design
and general character of these Reports, are highly creditable to
their editor, Dr. Fenner. He proposes to fill up in detail the great
outlines so ably sketched by Dr. Drake, in the work noticed in
our last number ; and for this purpose he has appealed to his medi-
cal brethren in that region, with a success of which the present
volume furnishes a gratifying proof. For vague generalities, spe-
culations, and not seldom declamation too, are now to be substi-
tuted detailed descriptions of the required facts, and their legiti-
mate deductions, expressed in plain prose. If figures are intro-
duced, they will be those of arithmetical and algebraical for-
mulae rather than of poetry.
Doctor Fenner, in his Introductory Address, shows the wide
field and the ample materials and necessity, also, for careful and
connected histories of the etiology, characteristic phenomena and
treatment of the diseases of that vast region, of which he is him-
self a denizen,—“ already inhabited by millions of human beings,
and capable of maintaining tens of millions.” While paying a
merited compliment to the distinguished physicians of which the
South could boast, a century ago, he laments “ the long lapse of
silent indolence which followed their departure and then he
asks : “ Where shall we look for the records of the deadly pesti-
lence which decimated the inhabited portion of the Southern
States half a century ago, or even twenty-five years ? With the
exception of a few detached essays scattered through the periodi-
cals of our more literary brethren of the North, there is scarcely
anything to be found.” But, of late, a happy change has come
o’er the spirit of their dream.
“ Since 1844 we have had as many as four medical journals in
the South at one time, three of which are still sustained with much
ability, lacking nothing but a better pecuniary support to insure
their continuance. Since that period works on practical medicine
have, also, recently emanated from Professor S. H. Dickson, of South
Carolina, and Doctors Fort and M’Gown, of Georgia.”
The contents of this the first volume of Dr. Fenner’s proposed
annual, in the form of Reports, are Reports from Louisiana,
Alabama, Georgia, Mississippi, Tennessee, South Carolina, and
Texas, together with Excerpta and Miscellanies, and notices of
Medical Colleges of the South and West, and of American Medi-
cal Journals. Some of these papers have appeared before, in the
Journals of the region to which the descriptions are confined.
Alluding to these periodicals, the editor says : “ He expects to
select from them whatever they may contain of importance, with-
out lessening their influence or checking their progress. Plaving
been four years connected with one of them, and thus become
familiar with their arduous labors, one can but wish them all man-
ner of success.”	»
These Reports manifest the characteristic traits of Southern
medical literature, in their being full of talent, written in a flow-
ing and exuberant style, and marked by plausible and ingenious
reasoning, but tinctured, withal, by a love of hypothetical disquisi-
tion, and straining after remote analogies; facts being too often
overlaid by speculative commentaries, and opinions replacing
actual history. The writers are not fully aware of the rich mate-
rials at their disposal, nor are they conscious of their powers to
interest and instruct by a methodical arrangement and exhibition
of these materials, to the eschewing of scrappy literature, and
attempts to harmonize their own views with those of their distant
cotemporaries and famed predecessors.
The reputation of Sydenham awaits him who shall describe
the successive epidemic and fixed diseases of New Orleans, with
the care and acumen evinced by that great man in his histories
of those of London during his own time. The fields of observation
turned to such admirable account by Cleghorn in the island of
Minorca, and by Hillary in that of Barbadoes, were more limited
than those which are within the ken of a physician of Alabama or
of Georgia; while the means of insuring more accurate details of
meteorology and medical topography can be enjoyed to a much
greater extent by an American writer at the present day, than
were accessible to the English authors whom we have named.
In offering this little piece of criticism and advice, we ought to
add, that the volume before us gives abundant proof, on the part of
our medical brethren of the South, not only of an earnest desire
to begin a course of careful observation and legitimate inquiry,
but, also, of their having made some progress in it. Let
us verify this assertion by a more distinct reference to the
“ Reports.”
The first are from Louisiana, and of these the initial article,
headed “ General Report of the Medical Topography and Meteor-
ology of New Orleans, with an Account of the Prevailing Diseases
during the year 1849,” is by the Editor. The distant reader will
have a good idea of the peculiarly low situation of New Orleans,
when he is told :—
“ The site being far below the annual elevation of the river, and
the back part below the occasional rising of the lake, the city has
to be protected from inundation by means of levees or dams—one
running its whole length in front, one above extending from near
the river to the swamp, and another covering the entire rear. The
levee in front is about seven feet in height—above and in the rear
it is not required to be so high. Lake Pontchartrain is situated
about five miles back of the city, and its level is about seven feet
below the base of the front levee. The intermediate space between
the lake and the city is a cypress swamp, presenting, about mid-
way, a considerable elevation called the Metairie Ridge”
The recession of the river from the city has been of late years
considerable, so as to leave a large surface of ground for wharves
and stores. The Mississippi rises in March and June.
“The streets of New Orleans run at right angles, and are generally
narrow in the older part of the city. Those more recently laid off
were allowed much greater width. These are principally above
Canal street, and in the rear. In the populated part of the city, at
the present time, there are three streets of extraordinary width ;
viz., Canal, Esplanade, and Rampart. The two former separate
the three Municipalities, and the latter intersects them in the rear.
These streets are about one hundred feet wide, allowing ample pass
way on their sides and handsome promenades in the centres, shaded
with trees. There are six public squares, appropriately situated and
answering the valuable purposes of recreation and ventilation. We
have no recollection of any blind alleys in the city. Situated, as
we are, at a convenient distance from the Gulf of Mexico, and
under the full influence of its balmy breezes, our city does not suffer
in the least from want of proper ventilation. According to Dr.
Barton, £ the prevailing winds are, during winter, E., N., and
N. W.; during spring, E., S., and S. E.; during summer, S. E.,
E., and S.; during autumn, N., E., and N. E. A perfectly calm
atmosphere is very rarely noted ; resulting, no doubt, from our alter-
nations of land and water, and the rapid current of the Mississippi
before so large a surface of the city.’ ”
About one half of the inhabited part of the city is paved, and the
proportion thus improved is increased every year.
“ The streets of New Orleans are proverbially muddy and filthy,
owing chiefly to the dampness of the climate and the inefficient
means resorted to for cleansing. The dependence for washing
them, is upon heavy rains, the wrater-works hydrants, placed at long
intervals, and the river when above the level of the city. By means
of culverts, the water of the river when high is conducted through
the levee into the cross streets, and runs in a rapid stream to the
rear of the city, whence it is removed by the Draining Company.
It will thus appear that, as yet, we have resorted to nothing but
surface draining ; but Dr. Barton has attempted to show that, not-
withstanding the low level of the locality, it is perfectly amenable
to effective underground drainage”
On the subject of the supply of water and underground moisture,
we are tempted to quote the following :
“ The Water Works Company was chartered in 1833, and com-
menced supplying the city in 1837. It consists of a reservoir three
hundred and twenty feet square, erected upon an artificial mound
twenty-five feet high, situated in the upper part of the city, two
squares from the river. The water is thrown from the river into
this reservoir by a powerful steam engine, and thence distributed
throughout the city by means of iron tubes placed under ground in
the middle of the streets. The extent of these tubes at this time is
about thirty-seven miles. From these main tubes are issued
branches of leaden tube, which convey the water into houses for all
domestic purposes. We were informed at the office of the com-
pany, that the extent of leaden tube at this time is about one million
feet. In our special report on Colic, the probable influence of these
leaden pipes on the water imbibed in the city is briefly examined.
The Water Works Company do not afford a supply of water nearly
adequate to the purposes of domestic use and washing the streets.
Within a few years past, a plan was submitted to the General
Council, by which continued streams were to be kept running at all
seasons along the cross streets from the river to the swamp ; but it
was not adopted. Such a measure might exercise a beneficial in-
fluence upon the health of the city. At present, the open gutters
often present the most disgusting aspect and are exceedingly offen-
sive to the olfactories. There is still a considerable number of
vacant lots in the city, many of which are lower than the level of
the streets, and, during wet weather, contain stagnant water, which
breeds myriads of musquitoes and evolves deleterious effluvia.
Stagnant water is also to be found under many houses.”
On the score of prison hygiene we learn, “that the inmates suf-
fer less from the prevailing diseases, such as yellow fever, cholera
and the like, than any other persons in the city. The prisons are
all situated on the outskirts of the city, which we would suppose
were the most unhealthy localities ; and the only striking differences
between the living of their inmates and the citizens at large, consist
in the regularity and temperance of their habits and their seclusion
from the direct rays of the sun.”
“ The privies of New Orleans are necessarily very shallow—ex-
tending only about four feet into the ground. According to muni-
cipal ordinance, at a late hour of the night their contents are re-
moved and emptied into the river, instead of being deposited in the
rear of the city, as formerly.
The greater part of the city is now lighted by gas, the works for
the preparation of which are situated in the back part of the city,
between Gravier and Perdido streets. Their pipes now extend
over a distance of more than thirty-four miles.”
Differing on this point from Dr. Barton, to whose labors the
editor gives frequent credit, the latter says that his own observations
have led him to the conclusion that there is a rainy season in New
Orleans as regularly as there is frost in winter, or there are swallows
in summer. This occurs in the months of June and July. There
has been a great increase of rain during the last four years.
Acclimation.—“Some do not become seasoned until they have suf-
fered the severest form of endemic fever belonging to the climate
and locality; others become gradually and thoroughly acclimated
without ever suffering an open or severe attack. There are persons
who have resided in New Orleans twenty years without ever having
had yellow fever, w’hilst others have had it two or three times.
Strong attacks of the severest forms of our remittent, bilious and
yellow fever seem to cause a modification of the system, which se-
cures to the individual a greater or less immunity from subsequent
attacks. Attacks of the milder forms, as ordinary intermittents,
effect no such immunity ; but, on the contrary, when frequent, lead
to permanent engorgement of the spleen, and cause an increased
liability to the complaint.”
Severe attacks of yellow fever, or even mild ones during
severe epidemic seasons, certainly give, in Dr. Fenner’s opinion,
immunity from subsequent attacks, especially if the parties continue to
dwell in the same locality. He admits, however, that some persons
may be attacked a second time; but, he adds : their system has
been so fortified by even a partial acclimation, that they more readily
survive the attack than the unacclimated.
Contrary to the common belief, Dr. Fenner shows that creoles or
natives of New’ Orleans have been attacked with yellow fever. We
give his conclusions:
“1. That persons coming from more northern latitudes to this,
have to undergo an acclimation or seasoning, before they become
secure in the enjoyment of good health.
2.	That this acclimation may be attained without sickness; but
that, most generally, it requires the endurance of one or more spells
of the customary endemic fevers.
3.	That an attack of the endemic yellow fever effects greater
security against subsequent attacks, than any form of fever seen in
the country ; but that the remark is applicable, in some degree, to
all of them, excepting the ordinary mild intermittents :
4.	That persons may have yellow fever more than once, though
it is evident that those who have had one plain attack, usually have
little or nothing to dread from subsequent attacks :
5.	That creoles, or natives of New Orleans, may have yellow
fever—though generally, they have it in a very mild form.”
So much for our present views of acclimation. The subject is
full of interest, and we shall probably recur to it, from year to year,
as our experience is enlarged.”
After referring to Dr. Barton’s annual Report of the Board of
Health of New Orleans, and the laborious investigation of the mor-
tality of the city, by Dr. J. C. Simonds, the editor makes the fol-
lowing remarks :
“ It will be seen from these reports, that the sanitary condition of
the city is still very bad, and the mortality very great. Let us not
deceive ourselves, nor £ lay the flattering unction to our hearts,’
that we are blest with as fair a portion of health and longevity as
falls to the lot of any other city of equal size ; but rather let us look
the facts sternly in the face, and endeavor to find a remedy for
every existing evil. We shall never commence the great business
of reform, until we have become fully aware of our real condition.
Little or nothing has ever yet been done directly and expressly with
the view to improving the sanitary condition of the city of New
Orleans. True, we have derived, incidentally, considerable benefit
from improvements established for the purpose of facilitating com-
merce ; but we trust the time is not far distant, when this intelligent
community, enlightened by the investigations of the medical pro-
fession, will adopt all necessary measures for rendering our city, as
it may be, both a pleasant and safe abode, at all seasons of the year.”
Yellow fever depending, as Dr. Fenner believes, on something
within the city corporation may, in his opinion, be finally eradicated.
Reference is made to the late inundation, of which a fuller account
is given in the following part of the article now under notice, also
still more in Mr. Farraday’s paper subjoined. The editor gives
next a monthly account of the general aspect of the weather, the
stage of the river, the condition of the streets, and the principal dis-
eases prevailing in the city of New Orleans, for the year 1849.
The nan'e acknowledgment of the editor, touching the fiscal view
of professional labor, is worth repeating.
“ The year (1849) has been a very unfavorable one to the phy-
sicians of New Orleans. During the first part, we had an immense
deal of labor and care, with but poor compensation ; and in the
middle and later parts, we had but little practice, and of course,
small remuneration.”
Articles II and III are on the Inundations of New Orleans in the
years 1816 and 1849, respectively. The latter, by Mr. G. C. Fara-
day, describes, also, the Hydrography of the Mississippi River.
The mean depth of the river at Carrolton, nine miles below New
Orleans, has been, for thirty years, on an average, 64.4 feet, supposing
the bottom to have remained unchanged.
Annual Report of The New Orleans Board of Health, constitutes
the fourth article of these Reports. As our extracts will neces-
sarily, owing to our small space for inserting them, convey but a
very imperfect idea of the scope and variety of topics embraced in
the Report, we deem it an act of simple justice to repeat here the
introductory remarks of the editor.
“ The following report, drawn up by the indefatigable Dr. Barton,
one of the committee to whom the task was assigned, will doubtless
be read with much interest. We venture to say that no other per-
son in the city would have gone to the trouble of supplying the
great amount of valuable statistics, to be found in the tables ap-
pended to this report, without the most liberal compensation. Yet
here it is—gotten up at immense labor, and without any pecuniary
remuneration whatever. We cannot expect a continuation of such
favors without pay : no man can afford to do it. Dr. Barton seems
to have a genius and fondness for those minute observations in
meteorology and hygiene, which are so necessary to enable us to
arrive at scientific truth. They require much time and care, but
cannot be dispensed with. We consider the medical profession and
the entire community, greatly indebted to Dr. Barton for the beau-
tiful charts and valuable tables accompanying this report, and sin-
cerely regret our inability to insert his large and beautiful chart, on
account of the heavy expense.”
Dr. Barton begins his report (for the year 1849) by an emphatic
declaration of the necessity, under various aspects, of correct and
full sanitary returns, which shall exhibit the diseases as modified
“by sex, color, length of residence, occupation and particular
locality, the actual climate, and the value of life, or expectation of
living.” “ With a reputation abroad for perennial pestilence, with a
boasting at home of unparalleled salubrity, it is high time the truth
should be known.” The ratio of mortality in New Orleans seems
to have been at length ascertained.
The mortality from the class of Fevers was 14.58 of the entire
mortality, of which more than the half (or 55.30 per cent.) is from
yellow fever.
Of deaths from pulmonary diseases among the fixed population of
New Orleans, the proportion is small. Dr. Barton says:
“ By the following table it will be seen, that notwithstanding the
addition made to our mortality by emigrants and visiters with these
diseases, yet we are more favored in these respects than any large
city in this hemisphere.
Death from Phthisis	Death from all Pulmonary
to Total Mortality.	diseases to Total Mortality.
Philadelphia,	14.84 pr. ct.	28.57 pr. ct.
New York,	17.50	“	28.08	“
Havana,	19.50	“	25.07	“
Boston,	15.13	“	23.97	“
Baltimore,	18.20	“	23.33	“
Charleston,	18.27	“	22.73	“
Mexico, (city,)	2.45	“	16.76	“
Norfolk,	11.01	“	.	12.78	“
New Orleans.	9.37	“	13.87	“
The aggregate mortality of New Orleans in 1849 was 9862,
of which 29 per cent, were from deaths in the various hospitals.
“ From this exhibit of the principal causes of mortality we pro-
ceed to refer you to the entire aggregate. It amounts to 9862 ; of
whom, about 29 per cent, died in the various hospitals. From this,
deducting 3176 for cholera, and 372 from causes of death other
than diseases, the nett mortality amounts to 6314 ; being at a ratio
of 1 in 16.67 or 5.99 per cent. The stationary population being
estimated at 105,347 ; being an increase of 5.32 per cent., annu-
ally, over the population of 1847, when the census was taken.”
The mortality in New Orleans in early life is very small, being
only 36.98 per cent, in those under 20 years of age. That is to
say, that for every 100 born, 63.02 reach their twentieth year. In
Massachusetts the mortality is 40 per. cent., and in England 47 per
cent., before the sixteenth year is reached.
The impression of the committee (Dr. Barton being the chairman
and reporter,) is, that the mortality of New Orleans “ is at least
double what it ought to be, were such improvements made as
science, observation and experience point out, and humanity and
interest demand.”
The second part of the report from which we have already made
some excerpts, is devoted to a consideration of the means of im-
proving the health of New Orleans, by a removal or mitigation of
the causes of disease. These present themselves under the heads
of “ great elevation of temperature, [deficient] ventilation, undue
moisture and filth.” Tables of mortality and of meteorology, and
classification of the deaths and diseases of New Orleans, for the
year 1849, accompany and give additional value to the report.
Article Fifth, by the Editor, is a “ Special Report on the Fevers
of New Orleans—particularly the Yellow Fever of 1849.” He
begins by telling of his opportunities for a practical acquaintance
with the fevers of the country prior to his going to New Orleans to
live, in 1841. Respecting the difference between these fevers and
the yellow fever, and their proportionate prevalence in the city, Dr.
Fenner thus discourses;
“ In New Orleans we have met with all the forms of endemic
fever which were familiar to us in the country, (West Tennessee,
Mississippi and Madison Parish, La.,) with the addition of yellow
fever and ship fever or genuine typhus. We have found those
common to the city and county to prevail at the same season and
in a similar manner, excepting that we meet with a more rapid and
malignant congestive fever in the country than in the city, and the
bilious remittents of the country retain their character throughout,
more than they do in the city. Here, in the summer and autumn,
they have a decided tendency to crisis by hemorrhage. This makes
yellow fever—it forms the true characteristic difference between the
high grades of summer and autumnal fever in the city and country,
and must depend on locality and dependent circumstances. We
have intermittent, remittent and continued fevers, alternating in
type and running into each other, just as they do in the country.
Intermittent fever prevails here throughout the year as it does in the
country. During the healthiest years it predominates over all other
types; but during the sicklier years, in the country, it runs into re-
mittent bilious and congestive, whilst in the city it runs into yellow
fever.
“ Dr. Harrison testifies that he had often observed malignant
intermittents immediately to precede the outbreaks of yellow fever
epidemics.
“ The New Orleans Charity Hospital is probably the most exten-
sive fever hospital in the world. Let us see how far the statistics
of disease at that institution will sustain our observations. It
appears from the records, that in a period of nine years, from the 1st
January, 1841, to 1st January, 1850, there were admitted into this
hospital 73,216 patients ; of which number there were admitted for
all the different forms of fever, 33,381, (and among these last,) for
intermittent fevers, 17,217.
“ It would thus appear that nearly one-half of all the patients
admitted into this hospital were for the different forms or types of
fevers—and that more than half of these ivere intermittents.”
“ The following statement will show the prevalence of intermit-
tent fevers at the different seasons of the year, for the time specified :
Int. Fever. Spring. Summer. Autumn. Winter. All Fevers. Yellow Fever.
1841	112	403	177	92	1991	severe.
1842	114	453	394	135	1758	little.
1843	85	208	413	137	2222	severe.
1844	117	469	732	231	2207	little.
1845	180	353	664	206	1763	none.
1846	236	569	1045	218	2603	little.
1847	391	508	691	602	6901	severe.
1848	282	689	874	535	6361	moderate.
1849	420	1701	3738	1275	7575 do.
Total	2443	5353	7728	2331	3381
“ It will thus appear that intermittent fever prevails here all the
year round; gradually increasing from the winter up to the au-
tumn, when it begins to decline. It will be seen, however, that
there is considerable variation in the amount, as well in the different
seasons as in the different years. The proportion is greater in the
healthy years; but intermittents are never entirely absent, even
when yellow fever is raging. During the nine years specified, on
selecting the month in which yellow fever was worst, we found the
following relative proportion of intermittent fever at the Charity
Hospital:
1841,	September—Yellow Fever 682 Intermittent 18
1842,	“	“	247	“	144
1843,	“	“	365	“	128
1844,	“	“	68	“	255
1845,	“	“	00	“	279
1846,	October,	“	83	“	376
1847,	August,	“	1611	“	74
1848,	September,	“	597	“	299
1849,	October,	“	520	“	720
4133	2293
Dr. Fenner says, “that, as all the forms of idiopathic fever met
with at this locality prevail together and are frequently seen to in-
terchange, or run into each other, we are led irresistibly to the con-
clusion that they are merely modifications of diseases springing from
one and essentially the same general remote cause. All authors
agree that the intermittent and remittent bilious fevers of the country,
in the summer and early autumn, spring from the same remote
cause, and consequently are but varieties and grades of the same
disease. Now, we contend that the yellow fever of New7 Orleans
holds the same relation to its intermittents, that the severe bilious
fever of the country does to the intermittents there—they are there-
fore in the same category.”
Difference in their mode of termination.—“ The fevers of the
country cause death by inflammation of the brain or of the gastro-
intestinal canal, or by that strange lesion of the nervous system
which is called congestion—the fevers of the city produce such an
alteration of the blood and the solids as leads to fatal hemorrhage
and jaundice.”
He warns us against continuing in the prevalent belief, that
yellow fever is a disease of cities and towns, while intermittent and
remittent fevers belong to the country. He has shown “that in
New Orleans, one of the favorite abodes of yellow fever, w7e have
all the forms of summer and autumnal fever met with anywhere—
and yellow fever has been seen in very small villages, sometimes
even in the country.”
In other parts of the Report, more especially devoted to a con-
sideration of yellow fever, Dr. Fenner states his having seen, during
his attendance at the Charity Hospital in the months of September,
October and November, cases of intermittent, mild remittent and
dysentery run into well marked yellow fever. Without our
engaging at this time in an examination of the questio vexata, the
solution of which, to a certain extent, Dr. F. thinks he has reached,
we would remark, that the appearance of diseases in a certain order
of succession or concurrence, does not, by any means, establish
their identity or even close affinity. The body may be rendered
susceptible to an attack of yellow fever, as it may also of cholera,
by morbid precursors and derangements of very various and even
dissimilar kinds—a fit of indigestion, strong mental emotion, or
even a fractured limb, for example.
Dr. Fenner claims somewhat of novelty for his views on the
pathology and treatment of yellow fever. We could wish that they
had been presented in a more definite and precise manner than we
find them in the Report. Is the following meant to be a new view
of the pathology of this disease? “In the early stage of yellow
fever the derangement of the system is entirely functional, and con-
sists chiefly in lesion of innervation. In the advanced stages it is
altogether a different affair—organic lesions have then taken ..place,
and the blood is altered.”* The indications to be fulfilled in its
treatment present nothing different from those of antecedent writers.
* The italics in the extracts are all by the authors themselves.
Touching the treatment, we want a larger addition of detailed
facts before we can yield our convictions to the general statements
of the editor. He had just been speaking of the circumstances
under which sanguineous depletion is of use in yellow fever. “We
merely wish to state that since 1847 we have learned from actual
observation that liberal doses of quinine and opium, given early in
the disease, and during the exacerbation, will subdue the fever and
permanently and safely cut it short of its natural course, in a great
many cases, without resorting to blood-letting in any manner.”
He quotes opinions, and iterates his own confidence in the free use of
quinine for 'the cure of yellow fever, “ mais mon cher ami, you
surely know that jusHhe same eulogies have been lavished on the
free use of the lancet, and on large doses of calomel, and on the
far niente practice of some French and Spanish physicians, and yet,
notwithstanding, people die in nearly the same proportion as before,
of yellow fever.” Were Dr. F. at our elbow, we would address
him in this fashion—Will he not allow’ us the privilege of doing so
at a distance ?
Dr. J. C. Simonds-furnishes Article VI., being “ Statistics of
Yellow Fever and of all Diseases in the Charity Hospital for thirty
years, from 1820 to 1849 inclusive.
“ The table shows for each year, and for each quinquenial
period, the discharges, the deaths and their sum, and the mor-
tality per cent, of yellow’ fever, the entire number of dis-
charges and deaths of all diseases, and the proportion per
cent, of yellow fever. The remarks are not based upon the
figures in the table, which speak for themselves, but for the
years 1820, 1822, 1824, have been obtained from a report of
the Board of Health, and for the years from 1832 to 1844 from a
paper by the late Dr. John Harrison, in which he states that ‘the
terms mild epidemic, epidemic, and violent epidemic, are intended
to express degrees, both as to the prevalency and malignity of the
disease.’ 1 In 1832 a violent epidemic of Asiatic Cholera raged at
the same time the fever prevailed. In 1833,1834 and 1835, there
also existed sporadic cases of Cholera.’ ”
The seventh article is by the indefatigable editor, Dr. Fenner.
It is a “ Report on Epidemic Cholera in the City of New Orleans,
1848-’49.” We read many interesting details in this paper, but
none w’hich would show that cholera derived any peculiar features
from its abode in New Orleans, different from its well known char-
acter elsewhere. The questions of importation and home origin are
taken up and illustrated by pertinent facts occurring in the field of
Dr. Fenner’s observations.
The almost entire exemption from the disease in the prisons and
orphan asylums of the city, is w’orthy of note and remembrance.
“ By reference to the reports of the orphan asylums and prisons
of New Orleans, obligingly furnished by the attending physicians,
it will be seen that cholera prevailed in only one asylum, (the
Poydras Female,) and there only after the epidemic had completely
subsided in the city, (see Dr. Rhodes’ report.) The exemption of
the inmates of prisons and asylums from epidemics of yellow fever,
is a remarkable, but well established fact.”
Period of Greatest Severity.—“ The epidemic raged most
severely from the 22d to the 30th of December, having reached
its zenith about the 28th, on which day the deaths by cholera
were ninety-two. From the 16th to the 22d, the weather was
oppressively warm, the thermometer rising as high as 84°. From
the 22d, it was cool, wet, gloomy, till the night of the 30th, when
there fell a white frost. On the morning of the 1st of January,
there was another white frost, and, from that time, the disease
declined steadily.”
Comparison with the Epidemic of 1S32.—“ The mortality from
cholera, at its late visitation, compares most favorably with that of
1832, when it first scourged our city. The number of deaths by
cholera, from the 12th of December, 1848, to the 20th January,
1849, as appears from the reports of the Board of Health, amounted
to near fourteen hundred—five hundred and ninety-six of which
occurred at the Charity Hospital. We learn from an interesting
memoir on the cholera of 1832, addressed to the Academy of Medi-
cine of Paris, by Dr. M. Halphen, a French practitioner of this city
at that time, that the disease made its appearance about the 25th of
October, in the midst of an epidemic of yellow fever; that, in a
few days, it raged severely, and that, in the short space of twenty
days, it killed about six thousand people. Dr. Halphen says, that
the mortality amounted, on some days, as high as five hundred a
day. He estimates the full population of the city then at fifty thou-
sand ; and, as cholera broke out during the prevalence of yellow
fever, ere yet the absent citizens had returned, and before the cus-
tomary visitors had dared to come in, he doesnot think the popula-
tion, at that time, exceeded thirty-five thousand ; thus showing the
frightful loss of nearly one-sixth of the population in about twenty
days. When we read over these sad details, we may wTell con-
gratulate ourselves upon our happy deliverance from the late pesti-
lence. True, we have lost about fourteen hundred people, and
amongst them a few valuable citizens ; but wrhat w’ould have been
our fate, if so malignant a disease as that of 1832 had broken out
in December last, when all of our own people were at home, and
the city was full of strangers ? In 1832, the living could not afford
decent burial to the dead. Dr. Halphen states, that, on some days,
upwards of one hundred corpses were accumulated at the cemete-
ries, awaiting interment. Large trenches were dug, into which
cart loads of uncoffined bodies were heaped indiscriminately ; and,
in the dead of night, a great many bodies, with bricks and stones
tied to their feet, were stealthily thrown into the river. The same
ratio of mortality, at the present time, would demand about twenty
thousand victims. Let us turn from the appalling calculation, and
thank God that we have been so mercifully spared I”
We pass over the subject of Treatment, as presenting us with
nothing new, although what is said is said plausibly.
On the subject of “ premedication” as a part of prophylaxis we
glean no encouragement from the trials, made at Dr. Fenner’s sug-
gestion.
Article eighth, also by Dr. Fenner, is a “Special Report on the
Epidemic Colic which prevailed in the city of New Orleans during
the summer of 1849.”
More justice would have been done to the subject and to the
author himself, if he had given precedence to a succinct account of
the disease in New Orleans, instead of literary references and specula-
tions as to its probable affinity with various forms of colic described
by preceding writers. This blending of description of actual and
recent phenomena with literary disquisitions only weakens the force
of the former, and diminishes its historical value by distracting the
attention of the reader.
“ The cholic prevailed at New Orleans during the months of
July, August and September; chiefly amongst the laboring class of
whites; but to some extent amongst negroes. It occurred during
a remarkably healthy season ; though, in the time above mentioned,
were to be seen cases of intermittent, remittent, typhoid and yellow
fever, dysentery and diarrhoea. But these also were confined pretty
much to the same classes, as shown by the records of the Charity
Hospital. During the three months specified, the number admitted
into this hospital was very great, whilst there was little doing in
private practice.”
No adequate cause of the colic is assigned. Hints are thrown
out that it may be lead poison, arising out of the great extent of
pipes made of this metal, by which the water is conveyed from the
iron mains to the houses for domestic use. The length of leaden
pipes now in use in New Orleans, is one million of feet, or more
than 189 miles.
Free blood letting, anodynes and laxatives, aided by the warm
bath andj’omentations, constituted the best treatment in this epide-
mic colic.
Some useful remarks conclude this paper, on the tests for lead
and copper in soda water; and also on lead poisoning, by Dr. Kit-
triedge of Cincinnati.
The ninth article of these Reports is “ On the Topography, Cli-
mate and Diseases of the Parish of St. Mary, La., by James B.
Duncan, M. D.” This is a short but instructive paper, true to its
title and promise.
The following is pertinent to an ethnographic question, now dis-
cussed with some animation by different writers:
“ And here I will remark (as this subject is at the present time
exciting much attention, that this class of people, including Terce-
roons, Quarteroons, Quinteroons, &c., in this vicinity, are as
healthy, as robust, and as prolific as any portion of the community.
Many of the men are fine specimens of manhood, have large fami-
lies of children, and among them are now existing (both male and
female) several remarkable instances of longevity. These remarks
I presume may be confirmed by the testimony of other physicians
practising among them.”
Notice is taken of a common disease among negroes on plan-
tations, the prominent symptom of which consists in dirt-eating.
The condition of the system in which it manifests itself is, Dr. Dun-
can thinks, often produced by a deficiency of suitable nutriment.
“ The diet of negroes on most plantations being salt pork, corn
bread and molasses—rarely eating fresh meat and vegetables—a
condition of the system is thus produced, closely allied to scurvy.
In addition to the symptoms above described, I have occasionally
seen a spongy state of the gums. There is generally present func-
tional, and sometimes organic disease of the heart.”
The treatment is well summed up in the following sentence :
“ Restore the healthy tone of the system, invigorate the subject, put
rich blood into his veins, clothe him well, feed him well, and do
not overtask him; arouse his feelings of pride, teach him to feel
that he is a reasonable and rational being, and, in a majority of
cases, success will attend our efforts, and we shall have the satis-
faction of rescuing a valuable servant from the grave.”
The next article is by Dr. Wm. A. Booth, “On the Cholera of
Lafourche Interior.” The editor expresses his opinion of its merits
in quite emphatic language, when he asserts that it “ contains the
greatest number and variety of facts relative to cholera that has ever
been published in America,” so far as his knowledge extends.
The various aspects of this awful scourge and its affinity to other
diseases, are well stated. The same may be said of pathological
phenomena exhibited in its course. But in all these, we find no
positive addition made to our prior knowledge of the subject; no-
thing assuredly depending on the manifestations of the epidemic in
Lafourche.
“ Reports on the Origin and Sanitary condition of the Orphan
Asylums of New Orleans and Lafayette.” By Drs. Rhodes, Carey
and Sunderland.
A case of yellow fever has never been seen or heard of among
the children in the “ Poydras Female Orphan Asylum.” The like
exemption from cholera was not enjoyed. Out of 150 little inmates
of the institution, “the whole number of cases of cholera could not
have amounted to less than fifty or sixty.” Why the precise num-
ber is not stated, we are at a loss to conjecture. Dr. Rhodes does
not favor us with the number of deaths of those who were attacked.
Their distribution in different directions, by the advice of Dr. R.,
need not have prevented him from procuring the requisite statistical
returns.
Of two hundred children in the New Orleans Female Orphan
Asylum, under the care of Dr. Carey, not a single case of cholera
occurred in the establishment. There was one death, and two
cases of children, with the disease on them when they were brought
to the asylum.
Respecting the “ Male Orphan Asylum of Lafayette,” under the
charge of Dr. Sunderland, we read :
“ The average time that the boys have remained in the Asylum
is two years, one month and twenty-three days. The average
number of boys in the Asylum each year is 71.5. The average
number of deaths each year 6.32, which is eight per cent. Of the
children under seven years of age 14 per cent, die ; while of those
over seven only 3 per cent, have died.
“If we take into account only those children who were healthy
when admitted, the mortality of those under seven years will be
about five per cent., while that for those over seven will be about
one per cent, per annum.”
We are obliged from want of room, to postpone our notice of
the remaining “ Reports” until the August number. Their intrin-
sic worth makes us desirous of presenting a full analysis of them to
our readers.