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THE
CAUSE AND PREVENTION
              OF
YELLOW   FEVEK,
CONTAINED IN THE REPORT
             OF THE

   SANITARY  COMMISSION
\
              OF
NEW ORLEANS.
           BY (

     E. H. JBARTON, A.M., M.D.,
CHAIRMAN OP THE SANITARY COTHMTSSfoX PRESIDENT OF THE LOUISIANA STATE
 MEDICAL SOCIETY, AND OF THE NEW ORLEANS ACADEMY OF SCIENCES, ETC.
     PHILADELPHIA:
LINDSAY AND BLAKISTON.
        1855. 
B 26*2)0
 1855
f<jUv\No- LfSoT   -wt--3 
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,
                                Mayoralhy 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 it,
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 jire
taken to insure it.   These are specially 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 tfois.   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
work's 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 bo 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 sucli  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,
                                     JOHN L. LEWIS, Mayor.

Extract from letters from Prof. Okas. 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  difficulties  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 tr}' and  explain how 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 
i
and most satisfactory sanitary document ever given to the world.  Such
is my deliberate conviction, after reading it twice over.  I ain 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
report—as  a  specimeu 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 dying 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. Hunt, 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, &c.
   " 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.   Tim 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.  And, 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''  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 Gen'l  Jno.  Henderson of New  Orleans
    *       *      *       *       *       *       *       *
   "I have read with an interest, surprising to myself,  your forthcoming
work, modestly styled a'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 ?"

       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
Bhorten 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
night—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 iniormation  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 energv, 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  Buffalo 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  sheai-3  of Atropos,  when
combined.
   " The principal arguments enumerated to show the  influence  of this
combination are briefly these :—In all the yellow fever zon3, 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  place, 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  JJ. 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 calls  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 DeBoufs 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 stupify 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 annals 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 hitman 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 1  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 II. 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 tp th§ 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:
   " 1st. 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 aud 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  bo 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
of 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 reporton 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 the ir
 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. Tfcomas, 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 manv important truths.                            <
    The opinion's 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, or fantoccini, are amusing  themselves with puerile
 fancies, 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 any work that  has
 issued from the press for many 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 individual  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. 
17
                           Office  of the Sanitary Commission, )
                                     Nov. 17th, 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 Neio 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. 
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              TABLE  OF   CONTENTS

                              TO


      PREFATORY  REMARKS.




                                                           FACE.
  Farther proofs of disturbing the original soil—
Production of disease at Natchez.................................     6
      Do.         do.     Baton Rouge........................     6
      Do.         do.     Donaldsonville.......................     6
      Do.         do.     Terre aux Beufs......................     7
      Do.         do.     Wilmington, Delaware................     7
      Do.         do.     Columbia, South Carolina.............     7
      Do.         do.     Savannah, Ga........................     7
      Do.         do.     Buffalo,  N. Y........................     8
      Do.         do.     Louisiana...........................     8
  It is only injurious in a certain contingency—
Effect of the establishment of principles...........................     8
How fires in houses, ships, <fec, preserve health.....................     9
  Aqueous vapor not alone influenced by state of dew-point—but
    all secretions—
Proofs___'.....................................................     9
The philosophy of the action of a high dew-point...................    10
Effete matter of a human being the worst poison to that being; why,
  law of being...................................................    10
Proofs, in chronic affections of insalubrious climates, of injurious effect
  of a high dew-point...........................................    11
Proofs, that moisture is indispensible  to fever......................    11
Mean dew-points in the United States, <fcc.........................    12
General rule in climatic comparisons..............................    12
Meteorological elements of yellow fever at Savannah...............    14

  Resume—principles established—
The impossibility of the existence of contagion in yellow fever, per se...    15
The controling influence of moisture..............................    16
Malaria,—what ?................................................   16 
I
0 
PREFATORY   REMARKS.
   The following Report has been re-issued, by the partial advice of some
friends, to supply a farther demand of the public here as well as abroad
—the first edition, printed  by the  City  Council,  and intended for
private  distribution, being  now exhausted.  The opportunity is em-
braced  to fortify the positions  taken   in  the   Report  itself;  to
extend its  illustrations ; and to give farther explanations  of portions
of it which have not been so fully understood as they might have been.
The most material portion of this is  embraced  in a paper  read before
the "Academy of Sciences," of this  city, defending  the opinions and
farther expanding the principles contained in the report.  This paper is
subjoined  as a supplement.   Therein is explained  the difference  be-
tween  common  mud  and  " original soil;" and the pathological and
etiological differences between  yellow and  bilious fevers is shown  to
arise in consequence of proceeding from causes diversified in amount and
expending  their  influence on different organs.  This is illustrated by
numerous analogies which the practical part of the profession furnishes us
in the administration of medicines in doses differing in quantity in pro-
portion to the effect we expect to derive from them, and that these medi-
cines do really affect different organs precisely in accordance with their
difference in dose or quantity.   As that was written rather as a reply to
an attack on the opinions set forth, the following views were not called
for, but both  are to be deemed supplemental and explanatory of the
original  report, and are placed before the scientific public for the reasons
above stated. 
VI.
Prefatory Remarks.
  The opinion is  expressed  in the  report, that so highly injurious  to
health is the disturbance of the "original soil" of the country, when the
meteorological condition required to give it activity is present—that it
was considered one of the most efficient causes of every epidemic which
has devastated the South-Western parts of the United States, at  least
during more than  half a century.  Since the publication  of that report,
public attention having been called to it, extensive corroborations  have
been given to it;  some  of which I will now proceed to record.

  Natchez.—The fever of  1825  was  satisfactorily  ascribed  "to the
large  deposits of fresh earth which were dug up and exposed to the sun,
with which a wharf was made.  The first cases of the fever occurred here.
They  were confined to  the immediate neighborhood.  By interdiction,
and finally removal, it was put an end  to."*  July and August unusual-
ly hot and rainy.
  "In 1837, streets were  cut down to the extent of four or five feet,
levelled, and the balance spread on the low lots in the  neighborhood;
soon after which, a most malignant fever  broke  out  in the vicinity, and
of a most fatal character.  These remarks are equally applicable to various
other  points in the city, where recent openings  had been  made in the
ground and fresh earth exposed to the  action of  the sun."f
  Again: "in 1839  Natchez was visited by yellow  fever, in an epi-
demic form, and as the Natchez and Jackson railroad had recently  gone
into operation, and much  fresh earth  exposed by the extensive excava-
tions  both in  and near the  city, the  effects were clearly manifested  by
the prevalence of  the disease along  the  line of  the  road, and the  town
of Washington,  through which  the road passed,J enjoying, heretofore,
the reputation of  remarkable salubrity.  The  summers  of both  these
years  hot and  rainy.
  In  Baton Rouge,  1827.—"The  epidemic yellow fever of this  year
appeared  at a time when several  streets were being  opened, and earth
disturbed and  spread on the  streets, and assigned as  the  cause of the
fever  at the time."§
  In  Donaldsonville in 1827, (I think,) "the epidemic  yellow  fever
* W. H. Pearce.                     t Ibid.
X Ibid.                            § Dr. French, Senr., and  Wm. Elam, Esq. 
Prefatory Remarks.
vii.
was ascribed to the erection and  enlargement of a new levee, extensive
digging of ditches, and spreading the materials on the streets."*
   "At Terre Aux Betjf, great  sickness and mortality produced at the
period of the excavating for the Mexican Gulf railroad, during which
there was extensive digging and exposure of swamp mud."f
   At Wilmington, Delaware,  the great epedemic  yellow fever which
devastated that place in 1802, was  ascribed "to the streets being cut
down and levelled, and the materials spread on them, in cellars dug and
filled  with  water—the weather  being very  stormy, torrents  of  rain
falling—much fog and  misty weather, and the  disease seemed  commu-
nicable as far as the fog extended,  but not beyond it !—disease aggra-
vated by any addition to moisture in the atmosphere.''^
   Columbia, South Carolina.—" The digging of the canal near  the
town  in 1819, is well known to have  greatly increased  the amount and
severity of the fevers of this usually very healthy locality."§
   Savannah, Ga,, in  18l7-'20.—The severe epidemic yellow fevers of
these years are thus accounted for  by Dr. Daniel :||—"Heavy rains, al-
ternated  by a hot  sun—soon  after  the commencement of this weather,
the City Council turned their attention to  the levelling of the streets, con-
trary to the express  objections of several medical gentlemen.   In  this
process the refuse and offals of our  yards  and kitchens, which, for years
had been permitted  to  accummulate  gradually in mounds (where they
were comparatively innoxious,) were, with a  prodigal hand, distributed
upon  the street* and subjected to the influence of heat and moisture of
the summer season.  In addition, earth was deposited in the depressions
of the streets and lanes, for the purpose of levelling them, which, ming-
ling with  the falling rains, produced numerous muddy  and offensive
places."
   Do., in  1854, Dr. John F. Posey  writes me, "That the earliest cases
occurred of the epedemic fever of this year, in the  neighborhood where
the streets, and a square in  front of them, had been filled up, to a level
above the lots, which are occupied by as many small  wooden houses  as
* A. S. Phelps, Esq.                    t Ibid.
X See account of this fever by Dr. John Vaughan.
§ Dr. N. "W. Gibbes.                    II In his work "on the Fevers of Savannah." 
viii.
Prefatory Remarks.
could be crowded on  them, and which, on  the commencement of the
epidemic, were occupied by an incredible number  of people—that the
small space or yard-room had been planked over, on account of the mire
caused by the  rain water  from the  houses  and streets, and that the
boards were rotting, that under the houses, which are all very  low, there
were  large collections of trash, chips, <fec, rotting, and kept wet by the
frequent rains, producing a stench which added to the effluvia from the
rooms, was very offensive.  From thence the disease extended over the
city."  How much like various parts of our city in 1853-'4 !
  In  Buffalo, N. Y., Professor Hamilton clearly  traced " the  produc-
tion of cholera, in 1852, to the influence derived  from upturning the
earth, with a stagnant, and, of course, humid  atmosphere."
  Louisiana.—Dr. Halphin, in his minute and graphic account of the
cholera in this city and adjoining parts of the State in 1832-3, ascribes
it, most especially, to the vast exposure of the original soil,  from digging
the canal of the bank (referred to in the report,) and gives  instances, as
occurring in the interior of the State, where a similar exposure on plan-
tations, was accompanied with a  frightful mortality, both among the
slaves and white people.
  This subject might very well  be  left   here,  not only  from  the
amount, but from the numbers, variety, and respectability of the authori-
ties, and  could  be  greatly enlarged, not   only from  the  experience
of  our own  country,  but from  various  foreign  countries.    Farther
testimony is deemed superfluous.   I wish  it to be  distinctly understood
that I have  never said or intended to convey  the impression, that this
alone would  produce disease; that, acting in  a manner equivalent to
filth, it only constituted one of  " the blades of  the shears of fate ;" that
the other (the meteorological) was indispensible to combine  with  it, in
order to produce the effect.   No instance has yet been mentioned, where
these two combined  their influences,  and  the results, as alledged by us,
did not ensue—provided there were susceptible subjects exposed !
   When a principle is  established, a key is found  to the explanation of
a vast variety of phenomena—it is both the  pilot and chart, which leads
us to and teaches us great truths.   By adopting the principle, that it is
only  during a certain range of the dew-point,  (which is  a mere measure
of  the  amount of moisture in the  atmosphere,)  that  certain diseases 
Prefatory Remarks.
ix.
occur, we understand how it  is, that in most insalubrious climates and
seasons,  a fire in a  room  protects the inmates  from the influence  of
undue moisture, by  lowering the dew-point, as is  often done in this
country.   In Sierra Leone  the natives have a practice, during the sickly
season, of keeping fires constantly burning in their huts at night, assign-
ing for it, that " fires keep  away  the evil spirits."   Captains Cook and
Peyrouse preserved the health of  their  crews, in their long and perilous
voyages, in the  most sickly regions, by drying and ventilating by fires,
between the decks of  their vessels ; and  the only successful voyage  to
the interior of Africa ever recorded, doubtless owed  the salubrity which
accompanied it, to the same cause.   Thus, too, the night air  is  more
dangerous than the atmosphere of the day.   In all these cases, heat ex-
pands, dilutes, and promotes the escape of deleterious gases, (when these
are limited and confined,)  lowers the  dew-point, and  enables  the  skin
to deplete the surcharged system of noxious ingredients.
   It  is an error to suppose that only the amount of aqueous vapor ema-
nating from the body  is influenced by the state of the dew-point.  All
secretions proceeding externally from the system are so influenced—as is
perfectly  obvious to  all, who attend to their condition, either  in their
own  bodies, or those of their patients, particularly  during  the seasons
when the causes  are sufficiently aggravated to  produce an epidemic.
The  effluvia from all (particularly from the sick) is most obvious, and
which no ablutions will  entirely remove,  but temporarily.  We shall
show, presently, that  the most  noxious  of all substances  to the human
body is its own  worn out materials.  A high dew-point, and a stagnant
atmosphere prevent the elimination and evaporation from the  body  of
these offensive excretions, and in  proportion as these  are retained, the
body  becomes protanto  to its own poisoner, besides being influenced by all
the conditions without.   The  most careless observer during  malignant
epidemics, cannot overlook these clearly demonstrative conditions.  They
are recorded in the  following pages, in every  exhibit  of the daily at-
mosphere  and  mortuary condition.   A  high  temperature,  a  high
dew-point, stagnant atmosphere, close rooms, and a patient reeking with
offensive perspiration, will  carry  conviction  to  any mind,  not closed
against it by prejudice, or insusceptible from incompetency.  So offen-
sive are  these odors  often  during the existence  of yellow fever, that 
x.                       Prefatory  Remarks.
many physicians are induced to believe  that they are diagnostic of the
disease external.
  In relation to the influences ab externa, a very striking instance occur-
red to me during the epidemic of 1854, which I  will  relate.   Being
called some distance up the river, while it was raging in  the city, on re-
turning, I had  to take a steamboat containing much live  stock, (hogs,
sheep, cows, &c.)  The boat was, from this cause, offensive beyond con-
ception, and  I remarked  to my companion,  a professional gentleman,
that there would, probably, ensue  considerable mortality from it, after
we  reached New Orleans.   In the course of a  few hours, a considerable
change in the weather, rather suddenly,  occurred ; a fall of temperature
ensued,  (and, of course, the dew-point,)  and all the offensive odors  afc
once  subsided.   Nor  could  they be  perceived in  any  part  of  the
boat.   Having accidentally  omitted to  bring my  hygrometer with
me,  in  vain,  sought  a  thermometer to  take  the dew-point.   In a
couple of hours we  reached the city, and I immediately proceeded  to
take the dew-point, and found  it about  60  degrees.  From this period
the epidemic retired.  It is to be remembered,  that this is about the de-
gree that the report states that the epidemic usually  retires.*
  As to the philosophy of it, or the mode of action of a high dew-point,
retaining  the  effete matters  in the  system,  we are  not  at  all  at
a loss.  It is  evidently a law  of being,  in  the constant  changes which
are ever occurring in all organized  matter, which designates it as differ-
ent from the inorganic, viz.: that materials once used, are no longer fit for
the purposes of life  of that being ; it must, then, pass on  through the
circle of  created  things, before  it can  become again  adapted to the
necessities of that individual; and it is now an excretion.  It has performed
the part allotted to it.  It is the effect of a high dew-point and imper-
fect decarbonization of the blood, by a subtraction of at least one-fifth of
the amount at a temperature  of 80  degrees, from what  there is at 60
degrees, besides what influences the  system, through the cutaneous en-
velope, to cause the retention of these now noxious materials.   Whether
this is done as  the result of excessive action, as stated  in the  text, it is
necessarily accompanied with  diminished power and tonicity, speedily
resulting from the condition, and  the consequent elimination does not
* Vide table in the Introduction. 
Prefatory Remarks.                      xi.
take place.  As a result of this state of things, the surface is kept hot-
ter with  sweat, evaporation does  not  take place;  there  is an offensive
atmosphere surrouding the  individual;  there  is  great  torpor  of the
capalaries, and the  system is  laboring  under a load  of effete  and
poisonous materials.  Such is  constantly  the case in  that atmosphere
surcharged with  an  amount of  impurity sufficient  to give origin to
epidemic  fevers.   In the chronic diseases of hot insalubrious climates
this influence  is displayed in  a very striking manner  in  the  " bombi-
cinous"  aspect—the pumpkin colored appearance of the skin of the
natives and long residents, in their enlarged spleens and  diseased livers
—the chronic  intestinal affections and general torpor of the body (and too
often of  mind;)  and a  very striking proof of  the  correctness of the
principle and  its explanation, is derived from the success of the  mode
of remedying it.  Health is known to  be best  sustained  in  these
climates by acting on this very surface;  by a free use  of the bath and
coarse friction, by cleanliness, a regular life, and early morning exercise,
when there is  known to be more ozone in the atmosphere.
  That a  large amount  of moisture  is essential to the production of
fever, and that none occurs without it,  whatever may be the temperature,
has been so fully impressed in the report,  that farther proof is  deemed
superfluous.   As illustrations  are, however, sometimes  more striking to
the  mind  than the most direct proof, I will furnish some.  It is well
known that the high temperature of sandy  deserts, never produces fever;
that  the  fiery blast of the Harmattan which desecates  the fluids, and
withers the whole aspect of nature, puts an immediate end to fever, and
that  on  the coast of Africa, after the rainy seasons, they welcome this
blast, as with  it the recovery of invalids commences.  It is clear that the
presence  of undue moisture was the prevailing obstacle.  There are
some valleys wherein the  foot of man  has never trod  and, returned from
alive, and which are whitened with the bones of the victims of temerity.
These are the true types of the " valley of the shadow of death."  Several
of these are known to exist in tropical regions.  They are evidently made
so by the condition referred to.   They  are deep ; ventilation cannot reach
them ; a stagnant and of course a damp air, forever hangs over them, and
hence, their fatality to human life.  The temperature of some deep val-
leys in Africa has been  actually  found as high as  118°.  It is  very 
xu.
Prefatory Remarks.
probable that the dew point must have been  about 90°—evidently in-
compatible with a lengthened continuance of existence.
  It is well  known that malignant fevers do not occur in elevated re-
gions, even  in  the tropics,  and  Baron Humboldt places  the limits at
2500 feet.   The reasons assigned are not very clear or definite.   It is
easily accounted for on the grounds set  forth-i-from the amount of hu-
midity essential for the prevalence of such fevers, being absent.   I found
the humidity at Jalappa (in  Mexico), whose elevation is a trifle less  than
that above stated, to be  in early Nov., at sunrise*  .606 )  Saturation
                                and at midday,   .566 \     \e™8

At  the City of Mexico, whose elevation is about 7500 ft.
  above the level  of  the  sea, I found  the humidity in
  November and December, to be at sunrise        .685
                            and at midday       .378

  It has been asserted by very respectable authority that " the mean dew-
point of the  summer in the United States is 15° above that of. autumn."
What  part  of the " United  States,"  is  not stated.   In  this part of the
United  States the  difference is less than 2 °,  on an average of near 10
years, and that difference is derived solely from comprehending in it our
very dryest month, viz.: October. But if we compare the dew-points of
the two months of June and July with  those of August and September,
the  difference is  only about one-tenth of a degree.  It is, however, a
general fact that  the highest dew point occurs in  the  sickliest month,
which  is  almost always August  in this country.  The  same occurs at
Rio Janiero, and it is believed wherever the yellow fever  occurs  as an
epidemic, and records have been made of it.
  We shall see in the report that the rule in relation to the amount of
temperature, necessary for the existence of yellow fever in  Philadelphia,
is at a lower rate than what exists in this climate—the same rule doubt-
less applies  to  the dew-point.    There  are  peculiar climatic conditions
applicable to every country, to constitute the seasons of each normal or
abnormal;  what  is normal to one  would  not  be normal  to  another
in different latitude and  condition, and the consequences  resulting to each
do.
* Am. Jour. Med. Sciences, 1846, p. 107. 
Prefatory  Remarks.
xiii.
of these  must be judged of mainly by its own standard,  although the
principles are  the same.  But where the climates, latitudes and condi-
tions are similar, the  same general rule should be the standard of com-
parison.   Thus, in relation  to Savannah, the only place from which I
have been able to procure the records in detail to apply the principle to,
(and  it is for the disastrous year 1854), it will be seen that by the an-
nexed table,  and by comparing  it with that in the " Introduction," in
which the meteorological elements  deemed essential  to the existence of
epidemic yellow fever  here  are  stated, that  not  only  a very great
similarity, but almost  identity exists between them, thus verifying the
principle referred to.
   I have used every  exertion +o procure the requisite records, from other
places for the purpose of a  more extensive comparison, so as  farther to
verify or refute the opinions expressed, but hitherto, unsuccessfully. 
                The  Meteorological  Elements  Prevailing at Savannah,  Ga.,

At each of the several epochs of Commencement, Acme, and Declinatien of Epidemic Yellow Fever there, during the autumn of 1854.
	TEMPERATURE.			TEMPERATURE IN SUN.			DEW-POINT.			BAROMETER.			WINDS.			HUMIDITY.			DRTING POWER.	
	General average at			Average at			Average		at	Average		at	Pre dominate at			Average		at	Average at	
1854. SAVANNAH, GA.	& c s-s a s ° 8	B <	«5 .3 "3 A	i w a i« a s o a	-05 a	® ft	» .	s <	"3 O	o a «> al ° s	1		a> a is	1 <	a ft	s> o a <o a^ a ° o a	a	.S ft	0) a §8	Acme. , Decline.
August 17—20, j Beginning, \ Sept. 10—14, j Maxim, or acme,\	79.44	84.14		No record taken— but said to be very high.			71.78	79.44		30.169	30.282		s. S.W.	8. S. E. S.W.	S. E.	.810	.790		7.79	4.70
October 27—31. J															N.					
Declination, j			69.60						64.91			30.123			N W.			.8bb		! 8.08
    During the worst month, September, 7,457 inches rain felL
    During the worst month, September, 790 was the mean humidity.
    The greatest storm that ever visited the;city since its settlement, occurred in the evening of the 7th, and accompanied with heavy rains, ending on the morn-
ing of the 9th, immediately after which, the fever went up to its maximum—during which, there was much thunder and lightning.
    Hurricanes are said to put an end to yellow fever in the West Indies, " as frost does in America"—or rather a depression of the dew-point to a certain
degree.  Here it seems the very reverse took place, and that the acme or maximum intensity of  the disease immediately followed.  It will be seen, hereafter,
that stormy weather has a very injurious influence on those affected with yellow fever.
    (For the statements from which this table has been compiled, I am  indebted, through a friend, to Dr. Jno. F.  Posey, of Savannah, to both of whom I
return my sincere thanks.)
^
& 
Prefatory Remarks.
xv.
   In bringing  these  observations  to a  close,  it  may be instructive
to make  a resume, to  see  what opinions and  principles are  entitled
to be deemed  established  or  sustained, and  to  offer them  to  the
fair and candid  investigation of my professional  brethren, to whose ex-
amination  they  are presented, with the hope that  they will apply the
same personal tests and trials that  I have bestowed upon them, before
they give their final judgment of their value.  Our  science is a  progres-
sive one ; its great principles are only to be reached  through the rugged
paths of experiment  and observation;  speculation is but another name
for guessing and conjecture.   Its path is paved with false facts, enlight-
ened  only by the occasional glare which genius and ingenuity cast upon
it, and will only tend, as it has ever tended,  to  throw doubts  and cast
clouds over a subject of the  dearest interest to the welfare of our kind.
Let us discourage these, and the great truths of the science will be vouch-
safed to us in time, if not now.
   1st. That the epidemic  yellow fever has never occurred  here (at its
commencement)  but during a  high  dew-point (the minimum being up-
wards of 74°).  In Savannah last year it  was almost 2° less, and con-
tinued for some  time.
   2d. That it has always ceased, as  an epidemic, before it descended as
low as 58 °,  In  Savannah  last year, it terminated when it was a fraction
less than  65°.   In 1848, here, it ceased at  about 1°  higher, although
the average of a  series of years was, when it reached  62 ° 12'.
   3d. That at temperatures  of the dew-point  below these,  sporadic or
endemic  yellow  fever may occur, but it is not known to have  existed
here,  with any certainty, as  an epidemic, when  the dew-point  differed
from that above  stated.
   4th. That what is miscalled the contagion of yellow fever, or its
liability to spread, exists only with the first condition.
   This, at once,  strikes at the root of all contagion in yellow fever, per
se.  No one pretends  that sporadic or endemic yellow fever is conta-
gious !  Do these differ from epidemic yellow fever in their natures t
No one has the hardihood to make any such  pretension.   A change of
lir which  suddenly  lowers  the dew-point to near 58  degrees, (here) if
 ontinued, puts an end to epidemic yellow fever ; a crowded population
nay  enter the  city, occupy the  houses,  rooms, nay, the very beds,
rhich lately reeked with  yellow fever, yet not an  instance, which can be 
xvi.
Prefatory  Remarks.
attributed to contagion occurs.  The filth, the miasm, and  all the " ter-
rene" matters, are just as before.  But one change has occurred, the con-
necting link, the combination, has  been broken—the  meteorological ele-
ment is wanting, and the effects are no longer present.   Can anything be
more conclusive ?  Where  is the contagion now ?   Does a few degrees
of temperature  less,  at  once, disarm the  giant that  has been mowing
down, but a day or two before,  his countless victims with his remorseless
scythe ?   The "contingency" exists no longer.   Such a misnomer is ap-
plied to no other  disease.  " Sober second thoughts," and sound judg-
ment, worthy to enlighten and  guide this people, will not apply it here
when its unsoundness is thus exposed.
   5th. That the main controling influence in all  unhealthy situations  is
moisture, whether in  cities, towns, countries, ships, or dwellings,  al-
though filth and heat are to be  deemed correlative.
   6th. That malaria is not any one specific thing, but that all  impur-
ties of the air, and  organic matter  in  decomposition, are liable to in-
fluence injuriously, the organism, and particularly the worn out excreta
of human beings may be so denominated, and is particularly incompati-
ble with  healthy action, and when in combination with the meteorologi-
cal condition, may produce yellow  fever.
   These,  if future  researches shall  confirm  our observations, are all
deemed of inestimable importance to society—and  the more so, if they
shall be found to apply to other climates and conditions.
   The views, principles, and opinions, embodied in  this  report, I am I
proud to say, and have the honor to acknowledge, have received the appro-
bation, sanction, and endorsement, of many of the most  distinguished
scientific inquirers of our country, and some of  these testimonials are,
by permission, placed in  the antecedent pages of the work. 
REPORT
                               OF THE

     SANITARY   COMMISSION
                                TO

            HIS   HONOR J.  L. LEWIS,
                MAYOR OF THE CITY OF NEW ORLEANS ;
                              AND THE

      HONORABLE THE MEMBERS OF THE BOARDS  OF ALDERMEN

                  rAND ASSISTANT ALDERMEN.


 Gentlemen :
   You  will be  pleasod to accept herewith a Report embodying the
 results of  the labors of  the Sanitary  Commission, upon the  special
 and various matters  committed  to their charge by the Council.  The
 delay in presenting it, is ascribable almost entirely  to  the  comprehen-
 siveness and thoroughness aimed  at,  in gathering  from  all sources of
 sanitary  intelligence, here and elsewhere, the facts and  phenomena
 deemed useful in tracing and attesting the origin and causes—the atmos-
 pheric and terrene conditions—the transmission—duration and expulsion
 of that formidable disease—the yellow fever.  No opportunity has been
 slighted—no toils have been spared to push our explorings and researches
 throughout the vast realms of the yellow fever zone, in both South and
 North America, and the West Indies, and the voluminous sanitary data
 prefixed to our Report, are our vouchers for the magnitude and extent
 of our labors.  Even since our Report has gone  to press—most valuable
 accessions, in response to our circulars, have been received from abroad;
 and we are still farther assured of valuable testimony on the way to us
from distant fever regions worthy of all consideration and respect,
           1* 
ii
dedication.
   Out of these data, together with the experience of many  years, have
grown the materials which form the opinions and principles put forth in
the Report, as to the origin and causes of yellow fever, of which no more
may be said  at present, than that two of  these  principles will be found
of inestimable value  after experiment and experience shall have fully
tested their soundness  and infallibility.
   The one is that yellow fever is and always has been, here and elsewhere
a preventable disease, and
   The other is, that the presence of two general  hygienic conditions are
absolutely indispensible to the origination and transmission of the disease
—the one of them, atmospheric—the other terrene.   These must meet
in combination, or there will be no result.   The absence of one, as to this
disease, is as  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 fol-
low that his power  extends to its prevention and expulsion.
   These two  principles constitute the bases of all the preventive and
remedial measures with which the Report closes, and which were specially
devised for  practical execution through  the minstrations  of the  city
authorities.
   Throughout the several Reports we have constantly endeavored to avoid
speculative opinions—to adapt all our principles and suggestions to prac-
tical ends, having the great  object of  our appointment—utility to our
stricken city—ever  before our eyes—as a polar star for our guidance.
   With the presentation of this Report, the authority of the commission
ceases.   Its labors and its functions end together,  yet its members cannot
part with the voluminous record of their  toils, without an expression of
their entire and unwavering confidence,  that, if the preventive and reme-
dial measures they  have recommended, shall be fully carried out, rigidly
enforced and perseveringly maintained by the city authorities—it would
be altogether impossible, for  the yellow fever to  originate here  or to be
disseminated as an  epidemic, if brought from abroad. 
THE
         JOINT AND SEVERAL FUNCTIONS
                        OF THE

SANITARY    COMMISSION
  During our late great epidemic, the subject of the  sanitary  condition
of our city became a theme of deep concern and anxious scrutiny.  The
great malignity of the fever—its unparalleled spread, visiting places here-
tofore exempt from its ravages, all  tended to  arouse public  attention,
and the conclusion was at an  early period arrived at, that the  subject
merited  the most  thorough  and careful  investigation..   Prior  to this
period the  sanitary condition of the city had not received the atten-
tion  its  great importance required.   We have had occasional Boards
of Health, whose existence  continued two or  three years, with large
intervals  intervening,  and being  mere   boards of  record with little
authority or  means, but partial benefits resulted from them.  Divers
opinions had been expressed in the city journals with regard to the salu-
brity  of the city.  The  public had been pretty steadily assured, by the
authorities and others, that " the city was one of the healthiest in  the
Union, although subject to occasional epidemics."  Confiding in these
assurances, the great mass of  the citizens took little part in the subject,
being quieted and lulled into  security  by these representations.  Our
reputation abroad,  however,  from occasional  exposures by Boards of
Health and  other sources, and above all, the great calamity of 1853, fully
aroused the public,  and induced the determination to look thoroughly
into  the subject, and  through  the urgent promptings of public senti-
ment, the Board of Health, (the only body then acting that had the power
—the City Council having  adjourned for the summer,) appointed the
Hon. A. D.  Crossman, Mayor of the city; Drs. E. H. Barton, A.  F. Axson, 
lv"                    SPECIAL  INiSJKlXTIONb Of

S. D. McNeil, J. C. Simonds, J. L. Riddell, to constitute a Sanitary Com-
mission.
   To this Commission were deputed special instructions  for inquiry and
investigation, viz:
   1st.—To  inquire into the origin and mode of transmission or propa-
gation 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 applica-
bility 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 inter-
course with  New Orleans.
   The Commission immediately organized and proceeded with due dili-
gence  to the fulfillment of  the important task confided to it.  It issued
circulars embracing all the points suggested for examination, and  distri-
buted  them among the medical faculty and citizens here and the adjoin-
ing States, and to every quarter of the yellow fever region, whence infor-
mation could be expected to enlighten its judgment on the  subjects  to
be considered.  It  sat as a Court of Inquiry in this city daily for about
three months, eliciting and  inviting information  from every accessible
source.
   When  this field had been sufficiently explored, it deputed its various
members to  visit different parts of this and the adjoining States  where
the epidemic had  existed,  to institute inquiries  upon like matters and
report upon them.  One member was sent to visit the various Eastern
cities,  to obtain  information of their sanitary condition, ordinances and
usages.  He was likewise instructed  to visit Washington, to apply to  the
Government of the United States for aid in obtaining through our Diplo-
matic and Consular agencies throughout the yellow fever zone, whatever
information  our circulars called for,  or that would advance the cause we
were engaged in.
   The readiness and courtesy shown by the Government of the  United 
SAN1TAK1"  COMMISSION.
V
States, the efficient  aid and co-operation of the medical profession, and
others here and elsewhere, the intelligence and readiness manifested by
those gentlemen  to whom  our  circulars were  addressed, are  sources of
gratification to the members of  the Commission, and it is  our desire to
state emphatically, that although much diversity of opinion existed, not
only in the profession, but  among others, whose evidence  we  have pro-
cured, from nearly every part of the yellow fever zone, as at present exist-
ing—we have conceived it our  duty to receive and promulge  them, and
let the public judge of the propriety of the deductions drawn from them.
The ample success which has followed our efforts to procure information is
attested in the evidence and documents accompanying this. The reports on
the subjects presented to our consideration,must speak for themselves, they
are all herewith presented to the Mayor, City Council and the public, and
we tender our kindest  acknowledgments to the Secretary of State, (Mr.
Marcy,) for the facilities he has furnished us in acquiring most valuable in-
formation from abroad  from the highest and most valuable  sources; and
  To Mr. R. G. Scott, U. S. Consul,  and Drs. Pennell, Lallement and
Candido, at Rio  Janeiro;  Mr.  W. Lilley, U. S. Consul, at Pernambuco;
Mr. J. Graham, U. S.  Consul, and Dr. H. W. Kennedy,  at Buenos Ayres;
Dr. W. Jamieson, at  Guayaquil; Mr. S. Grinalds and Dr. Lacomb,  at
Puerto  Cabello;  Mr. N. Towner, U. S. Consul, and Dr. J. W. Sinckler,
at Barbadoes; Drs. Amic and Chapuis,  at Martinique;  Mr.  J.  Helm,  U.
S, Consul, and Dr, Pretto, at St. Thomas; Dr. W. Humboldt, at Mexico;
Mr. J. W. Dirgan, U. S. Consul, and Dr. Lafon, at Matamoras; and Mr.
Pickett, U. S. Consul at Vera Cruz; and  J. W. Dana, U.  S. Consul  at
Lucre, Bolivia.
  The duty of investigating the various subjects referred to this commis-
sion under the instructions has been duly distributed among the different
members—to Drs. Axson and McNeil, the first; to Dr. Riddell, the second;
to Dr. Simonds, the third; and to Dr. Barton, the fourth. 
 
INTRODUCTION.
  The  Sanitary  Commission,  in  fulfillment of the important trust
confided to it, has deemed it one of its most urgent duties thoroughly
to examine into the past state of the health of the city, so far as records
could be procured to attest it.  These have extended beyond half a
century—although the  records of  many  of the years have been
sparse  and imperfect.  With occasional exceptions  the results have
proved very unfavorable to  its health in the  past;  yet, as sanitary
guides  and beacons, they are regarded as full of promise for the future.
  There  must exist some cause for the great insalubrity shown in the
mortuary returns.  It certainly does not arise from its cleanliness and
the absence of those sources productive of disease in every country.
Then it  must derive  its origin  from those conditions in which  it
differs  from other places that are healthy.  It must proceed from
those circumstances which  the uniform experience of mankind has
found to be the cause of insalubrity elsewhere.  Or shall we abandon
as useless, all the dear bought experience of our race, and remain as
we are despite our recent severe and bitter afflictions 1  Are we forever
to turn our face upon the past,  and to be made no wiser by its valuable
teachings 1  The problem thus presented to us to solve is not  a new
one; it has been solved a thousand times  before;  we give  it  again,
with the  special experience  derived  from  our locality  and circum-
stances,  and with the same uniform results.
   The value of general hygienic regulations has been extensively com-
mented upon in a subsequent report; that of personal hygiene  is
hardly less important; upon this  depends  mainly  not only  our per-
sonal comfort, but health ; and it is in many cases the only substiute for
sanitary  regulations  of a more general nature, affecting the entire
community ;  and is of special value to us here where the latter have
been so much neglected. That they are more appreciated than for-
merly, is shown by the remarkable  fact that about half a century 
Vlll                         IN'TRODl'dlON'.
 ago leprosy existed to such an extent in New Orleans,  that  it was
 deemed necessary to erect a hospital for its special treatment, (a quan-
 tity of land in the rear of the city having been appropriated for the pur-
 pose,) and there are still surviving among us those who have a lively
 recollection of that  loathsome malady.   It too, has yielded  to  the
 ameliorating hand of civilization and modern comfort,  or climatic
 changes, and is now confined to the inferior grades of society in Cuba
 and Mexico.   When the general principles of hygiene shall have been
 as  widely extended  over the city, our epidemic  and endemic  fevers
 will in like manner disappear, and we may again enjoy that salubrity
 which was once our wont.
  The causes of this insalubrity have been most carefully scrutinized,
 and it is our deliberate conviction that they are fairly ascribable to
 local conditions which are mainly removable.  A reference to some
 of them here, the principles applicable to them, and the recommenda-
 tion for their removal or abatement, will not be inapplicable in antci-
 pation of the Reports themselves.
  Throughout the vast  period  to which this investigation has  ex-
 tended, commencing when the population did  not exceed 8,756,  (in
 1796,) no epidemic has occurred that has not been preceded and accom-
 panied by a great disturbance of the original soil of  the country, (in
 digging and clearing out canals, basins, &c.,) although  other local
 causes doubtless had their influence.   This has been so unequivocal
 and so constant, and without exception, that  it seems  to the  Com-
mission to bear the relation of cause and  effect.  The proofs of it
 are furnished in the following pages, and might have been greatly ex-
tended in its  more local influences.   This disturbance seems to have
generally taken place with great recklessness, manifestly preferring
for the purpose the warm season, during which it is most dangerous.
  We have to make the same remark in relation to the clearing and
draining the neighboring swamps,  both  of vast public utility,  and
when done in a suitable season  and proper manner, under enlightened
advisement,  not injurious to the public health ; but most disastrous,
when these are not faithfully observed,  as  medical annals for hun-
dreds of years past fully attest.
  The numerous undrained, unfilled lots  and squares dotting  the 
INTRODUCTION.
IX
 surface of the city, becoming muddy  pools  in  the  rainy, which is
 always the  sickly  season,  and common receptacles for filth and
 garbage of all kinds, are exhibited in our sanitary map, and  should
 be early abated.
   The numerous low, crowded and filthy tenements, many of which
 are also indicated on the" map, are probably as disastrous in the pro-
 duction of yellow fever as any other; they are commpn " fever nests,"
 and are denominated "nuisances" of the deepest dye.   They con-
 stitute the ordinary hotbeds  of disease and death at every epidemic
 period, (yellow fever, cholera or what-not.)  They have been signalized
 by a most fearful mortality.   They conduce much to impair the repu-
 tation of the city for  salubrity and they demand therefore the firm
 cauterizing appliances of the city government.
   The extensive livery stables in the heart of the city, andvacheries
 near the thickly populated districts,  and the vicinage  of slaughter
 houses should be abated, as they strongly tend to impair the  purity
 of the city atmosphere.
   The present cemeteries within the city limits  should by all  means
 be closed against future use.
   The kitchen offal and back yard filth, including the bad system and
 neglect of the privies,  constitute some of the greatest sources of vi-
 tiated air, and require the most active agency and timely  surveillance
 of the Health Department.
   The system of  sewerage set forth in  the second repoit is confidently
 recommended as well for its  economy as its promised efficacy.
   The present mode of  cleansing the streets  is  most defective; the
 time is inappropriate.  It should be done,  at least during hot weather,
 whvn the sun is no longer present to distil the poison into the atmos-
 phere.   The  carts should in all cases immediately follow the scraper
 and remove the gathered garbage, in covered carts,  and that taken
 from under the bridges should never be spread upon the  streets.  It
 had better be left where it is, protected from the sun.
   None but the most superficial  disturbance of the soil,  or cleaning
 out of canals and basins, should  be permitted daring the hot season.
   The bank of the river, the levee, wh rves, rnd filth from the ship-
ping, require  a special police ; they constitue some of the most preg-
 nant sources  of disease.
           2* 
X
INTRODUCTION.
  The effect of tl^e various nuisances and others on the disastrous fever
of last year, is fully set forth on the sanitary map with its accompanying
exposition.
  After the ample detail of local causes for our summer and fall fevers
under a high temperature and the great humidity incidental to our posi-
tion, it is scarcely necessary to say that we have a sufficiency of them, with-
out looking abroad for the sources of our insalubrity.   Nevertheless, in
relation to the subject of Quarantine, although the Commission is unan-
imous in the belief that no system, however rigid or successfully carried
out, can ever be a substitute for the sanitary or preventive measures we
have  recommended,  and which if properly enforced, would be at once a
protection  against both the origination and  spread of yellow fever and
cholera among us, yet  in the imperfection that must attach  to  all such
measures, we  unite in recommending the establishment of a quarantine
station below the city,  under the surveillance and control of the " Health
Department," thereby  preventing all foul vessels from entering the port
with diseased passengers or creio, placing the restriction only where it is a
measure  of safety, and furnishing character  and security abroad to our
intercourse with other  nations.
  We are sensible there is great difference of opinion among the mem-
bers of the profession and in the community in relation  to the communi-
cability of yellow fever, and have investigated the subject with great care
in the following pages; and the conclusion we have come  to, is that yel-
low  fever is not a disease personally contagious, that its  infectious pro-
perties 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 Avhichlurnished
its nativity.  That although vitiated or infectious air may be conveyed in
goods and in various ways to distant places, ventilation speedily dissipates
it, and that if disease results, when it is much concentrated, or with very
susceptible individuals, it extends no farther, 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  estab-
lishment and corroboration of these important principles.
   But farther than this, the Commission has  not remained satisfied with
theoretical  presumptive  evidences.   Most  careful  scrutiny  into the 
fNTRODUCTION.
XI
 actual occurrences of the first eruption of the fever, its spread, the char-
 acter of its localizations, the persons most liable and suffering from what-
 ever class and country, have converted presumptive proof* into positive
 certainty, that the  fever originated with us, that its fatal malignity and
 spread  was justly attributable to a  very remarkable  concurrence  and
 combination of atmospheric and terrene causes, always peculiarly fatal to
 human health and life.   These have been most amply examined and fully
 pointed out, and the gratifying fact is  shown, that at least one of these
 causes is  entirely under our control, and that it is in our  power greatly
 to diminish the other, and hence by disseverance, the fatal union is pre-
 vented.
   The Commission has taken great pains to investigate the climatic con-
 dition,  to which our latitude and  position peculiarly expose us, so far
 back as meteorological records would permit.  It is impossible to over-
 look the fact  that the meteorology of  a place, is, in other words, its  cli-
 mate, and upon this mainly  depends the character of its diseases, for these
 special  liabilities are  dependant  upon conditions which  constitute  the
 difference between one climate and another. Were it otherwise all climates
 would have similar diseases, nor  would  varieties  of season  alter them.
 We have become impressed with the  conviction,  that much error has
 existed on the subject, and that the evils incident to our location can be
 greatly ameliorated.   It may be probably premature at this early day Of
 the practical application of meteorology to etiology, to venture into much
 very precise  detail,  with regard  to  the  elements essential  to the ex-
 istence  of the two great scourges of our city, (yellow fever and cholera.)
 But in the infancy of meteorological inquiry, as at all beginnings, there
 must be a starting point.   The testimony we offer to the scientific public,
 is submitted Avith great diffidence, but  as pioneers, we make our humble
 offering at the shrine of  science, to be corroborated or refuted by subse-
 quent observations.   If true, Ave cannot over  value their  importance, if
 not, the experiments to disprove them will lead to valuable results.
   We have essayed to show what are  the  precise meteorological or
climatic elements, necessary for the  existence  not only of epidemic
yellow fever,  but of  cholera;  that is, to show what are the  meteoro-
  * The undersigned members of the  Sanitary Commission,  dissent from this assertion, denying
the positive certtinry alledged.                               J. L. RIDDELL,
                                                     J. C. SIMONDS. 
xii
INTRODUCTION.
logical conditions under which they prevail, at each stage of their
commencement, progress, maximum intensity and declination.  The dif-
ference in the combination productive of yellow fever and  cholera
may be comparatively small, although the effects are so different, nor
is this very uncommon or  wanting in illustration in various depart-
ments of science  or  medicine.   A  change  of wind, with a differ-
ence  of five  or ten degrees of temperature may  produce the most
fatal pleurisy, pneumonia or laryngitis.  So, the same apparent con-
dition produces a great diversity of effects on individuals of different
physical susceptibilities, and a difference of one or  two grains of
moisture in a cubic foot of the air we breathe may,  and  often  does
result in the occurrence ot  the most fatal maladies.
  The results we have come to, after a careful analysis of the records
in this  climate,  at least, during the several  years  through which
these are reliable, (and they have been made with great.minuteness
during the last twenty-one years, and corroborated as far as they go
by  those of  every epidemic yellow fever and cholera that has ex-
isted in this country, of which there are any records; the more special
details embracing nine epidemics of yellow fever and six of cholera,)
are embraced in the following table. 
CLIMATIC OP. METEOROLOGICAL ELEMENTS OF EPIDEMIC CHOLERA AXD YELLOW FEVER AT NEW ORLEANS,
       AND COMPARISON OF THE METEOROLOGICAL CONDITIONS AVHICH HAVE PREVAILED, DURING THE THREE EPOCHS OF
COMMENCEMENT, ACME OR MAXIMUM, AND DECLINATION, OF THE EPIDEMICS OF CHOLEEA and YELLOW FEVER,
                      ON AN AVERAGE OF SIX OF THE FIRST, AND FIFTEEN OF THE SECOND.*
	T3 a) a	'3. S,	d O	TEMPERATURES IN THE SHADE.			TEMPERATURES IN THE SUN.			TEMPERATURES of the Dew Point.			BAROMETER;			AVINDS.			i HUMIDITY.			DRYING POWER.		
	5 a CO	.2 <S H« - « '- .S	o.S1-1 safe .2 7? «f 3 £> * c. SG Jr ►. : t > . % <J "x																					
				GENERAL AVER. AT			GENERAL AVER. AT			GENERAL AVER. AT			GENEI	1 i.I, AVER. AT		Pvfidom lit at			(i^neinl nvr. at			(Jeneral iivr. ar		
				i o a a> S c O G> o a	1	a _o .a u (U ft	& O 0 a) o g	a" pi a	a .2 "eS .5 13 a; ft	a> O a o a« S a O <D O S	a a a	a o H .3 13 0	i o a a; a^ as o o> oa	a a	a .2 Is .5 13 a; P	3 a a a o	a' a	S _o eS .2 13 CD ft	o S a o a	a pi a 'S	a i o eS ! •s i w i ft ;	■b a 3 a^ a a o a	a a a a	a .2 Oj ft
From \ Cholera, )	6 37. j? j 100		21.99	72.84	66.95	69.73	81.36	84.59	80.31	66.71	56.79	61.14	30.101?	30.060	30.075	s i<: x.i:>:,t *F,EStsW			.850	.796	.791	5.06	7.08	7.24
From ) Yellow V	15 58. 33		18.30	80.14	79.60	65.72	106.91	117.07	99.11	75.82	74.34	62.12	30.r.i8	30.021	30.074	N.| jNE. 'ne'e.ir N&-:			.888	.865	.755	3.79	4.53	8.02
Fever, ) | |		100														4ene.;e. j								
i Dhferojeo : i				7.30	12 65	4.01	25.55	32.48	18.80	9.11	17.55	0.98	.001	.036	.00!	!m ii;ut ™ I iTth-NK			.03f:	.069	.036	1.27	2.55	0.78
				more.	more.	less.	more.	more.	more.	more.	more.	more.	less.	less.	less.	iNEdif. &F<			^..rolMinr,.		k*s	less	less	more
in the Table, have extended ae far back as records have existed, reaching from 1817 to 1854, inclusive. During the earlier 
xiv
INTRODUCTION.
   This table shows what an examination of the  details of which  it
 is but the concentrated result would more than justify ; viz :
   1.—What are the several meteorological conditions of yellow fever
 and cholera at the commencement, maximum intensity and declination
 of these two diseases when existing in their epidemic grades.
   2.—In comparison, it shows that cholera exists in a  greater  range
 of temperature and humidity than yellow fever.
   3.—That these diversities constitute the pabulum for  its support,
 so far as the mere  climatic condition is concerned.
   4.—That a higher solar radiation  and  atmospheric pressure  exists
 during yellow fever periods than during  cholera.   Although the at-
 mospheric pressure under which these two diseases  prevail are shown
 by this average table to be about the same, the barometer continuing at
 a permanently higher grade, more regularly and constantly in yellow
 fever than in cholera, yet  in this latter the  fluctuations  are  much
 greater; indeed, it is so under all its climatic  relations,  as is  abun-
 dantly shown in the large detailed table too extensive  for this sum-
 mary, of which this is a very condensed abstract.
   5.—That for the existence of yellow fever a higher range of tem-
 perature and of dew point for its commencement and maximum inten-
 sity, and that a declension of the former (temp.) to  less than 70°, and
 the latter (dew point) to near 60° puts a speedy end to  its epidemic
 existence.
   6.—That a larger quantity of rain usually  falls, on  an average,
 during the existence of yellow fever  than during cholera.
   7.—The  " drying power" is  more variable during cholera than
 during yellow fever.
   S.—The  average duration of epidemic yellow fever has been  58.33
 days, and the period of its influence  decreasing,  while  the average
 duration of cholera has been 37.66 days,  and the period increasing.
   These experiments are fully borne out by what we see daily verified
of the ravages of these two very different diseases in the various cli-
mates that have been subject to them.
  If subsequent observations shall prove the correctness of  these
statements, the future occurrence and continuance of epidemic yellow
fever will be ascertained with great probability by referring to a well 
INTRODUCTION.
XV
kept meteorological register;  it will show what valuable information
is  to be derived from connecting accurate and extensive meteorolog-
ical experiments with the Health Department, recommended in a sub-
sequent report.
  There are but two practical remarks which we deem it necessary to
draw from this table, and from the reasoning in the reports:  the first is,
that although it is easier to keep free of yellow fever than of cholera,
we can exercise much influence on the causation of both, even in their
climatic relations; and secondly, the combination  of the terrene and
meteorological conditions which is absolutely essential to the existence
of either, we  certainly have  it in our power greatly  to control,  be-
cause, by  proper policeing and regard to other hygienic measures, that
condition is clearly under our influence.
   If then, we have demonstrated, as we trust we have, in  the  subse-
quent pages, these important  truths, and shown what are the meteor-
ological elements necessary for the existence  of epidemic yellow fever,
and even  of cholera,  and pointed out the conditions in  which they  de-
cline, its great value  will be appreciated,  not only  by the scientific
public, but far beyond this, its importance for the practical purposes
of life will be inestimable. The ability to make the announcement that an
epidemic  exists ;  and again,  that it suspends its ravages, and that all
danger is over;  in the first case warning the accessible population to
speed to a place of safety, and in the second enabling us to invite
back the  flying citizens to their deserted  homes;  to open  the  public
thoroughfares to the  resumption of business, and the ordinary purpo-
ses and pursuits of life,  will be of incalculable practical value to  the
community.   This principle is held forth for our guidance throughout
our  report; nay, it  is  the basis  on  which  is founded,  the object
sought—prevention, saving the community  from  the infliction of dis-
ease.
   We state these  as  the result of our experience in this climate,  and
let us be  understood  to mean that by the meteorological elements of
these  diseases,  (consisting  of a very high range of temperature  and
saturation, and great solar radiation,) we intend to express the limits
within which they have prevailed here epidemically, which are essential
to their existence as such, and beyond which  they soon cease.   Now
whether these views  will be borne out elsewhere, we believe there is, as 
XY1
INTRODUCTION.
yet, no recorded (certainly no published) statements to show. We are
perfectly sensible that climatic conditions and national susceptibilities
differ in  different  countries,4nd  produce often diversified  results,
and  that  cholera  has prevailed  in  great  apparent  diversity  of
climates,  and  that the meteorological elements would  seem  not
to  apply  to   it.  Statements  are  recorded  of  the  prevalence
of cholera when the exposed thermometer was near zero—this is not
at all incompatible  with an inside temperature of between 70° and 60°,
with filth, the peculiarly noxious effect of crowding and most defective
ventilation, (and of course, a high dew point,) all of which, we know,
exists in  Russian dwellings, where this disease prevailed.  The incon-
gruity then no  longer exists,  for it  is  the  condition to which  the in-
dividual is exposed that is to be  estimated.   Nevertheless, we acknowl-
edge that it will take time,  observation  and experiment  in different
climates to show  where and what may be  the variations,  if any, from
the views laid down.   There is little doubt, however, that if they  are
not precisely the same elementary or  atomic (if we  can use the  ex-
pression)  combination,  yet  the  principle is the  same; to-wit:—
a union of meteorological and terrene conditions  for  the production
of either of these epidemics.
  The principles set forth in the  reports, the facts commented  on, the
important and necessary combination of meteorological and terrene con-
ditions, the places and sources of infection pointed out in our map, with
their constant consequences, have been most  impressively and accurately
illustrated and  corroborated  by what  has occurred during the present
summer, (1854.)  Fever has again been manufactured in the depots point-
ed out, (under the combination alledged) the filthy wharves and river banks
have again cast their noisome odor to  poison the atmosphere, and the
additional aid from  corrupted bilge water and filthy vessels from abi <>;in,
the dirty back yards and unfilled lots and overflowing privies have added
their mite, the cleansing out of  canals and the disturbance of  the streets
for laying down water and gas pipes have continued throughout the sea-
son,  and  although  the streets have been better attended to than  hereto-
fore, they form  a very small portion  of  the necessary policeing of a great
city, and the result  has been that  yellow  fever has  again  swept  off its
numerous victims and will ever do so until we become wiser by  the les-
sons that have been so often furnished us. 
INTRODUCTION.
XVU
  But again, this position has been farther confirmed by what has occurred
in other cities during the present  year.   In  the  city of Savannah, the
epidemic  of this year is with great probability attributable to the exhu-
mation of a large  number of vessels sunk just below  the city during
the revolutionary war and that of 1812, to the filthy land and other debris
derived from the  city  and the  tide, which was thrown upon the bank
near the town and even spread upon the streets, over  which  the  wind
constantly blew, and to the excavation of the soil of the streets (at least
a mile) for the purpose of laying down water pipes.
   The epidemic at Augusta, was as fairly owing to the cleaning out of
filthy  canals in the  city,  and exposure of the offensive mud to the hot
summers sun, to the emptying the city filth  on  the bank of  the  river,
which  was unusually low, and to the disturbance of the soil of the city
for the purpose of laying down gas pipes.
   Since the special reports were written,  and even  gone to press, some,
indeed most of the foreign reports, highly valuable as they all are, have
been received through the State Department at Washington, and it is no
slight gratification  for the Commission to compare their experience and
observations in relation to the etiology and contagiousness of yellow fever
with their distinguished confreres in other regions  of this  zone, and to
see the remarkable harmony in our views; it furnishes a strong corrobora-
tion of the opinions and principles announced, and presents a new claim
on public confidence.
  For the purpose of carrying out in a full manner the views  herein  set
forth, we  earnestly  recommend the project of a Health Department in a
subjoined report.  Such an organization we deem indispensable  to the con-
dition and character of the city; special requisites  are demanded, with
experience, science and skill.  It should be constituted  a special Consul-
tative Department, to be advised with in all cases by the city government,
affecting the  health  of the city, and  it will be  seen, hereafter, they are
very numerous.  No enlightened large city is without one, and here it is
more  demanded than in any other.
  It is recommended to State, city and corporate authorities, that  when-
ever disease of an epidemic character exists to an unusual extent or ma-
lignancy,  that  special commissions be instituted to investigate their ori-
            3* 
JtTin
INTRODUCTION.
gin  and causes.   Such  action  i* in  consonance  with the philosophic
spirit of the age, and we are proud that the first Commission for this great
philanthropic purpose, shtuld have the honor of having been originated in
X«w Orleans, 
ERRATA.
e  V!, rea.l  Condition for Commission, in
      heudin '
   3, rend ciiiuvii for affluvia, in line 11th.
   4, 14 lines irom top for "passee"'  read
      pnssil.
   3  C, liiui from top—on margin, for "pos-
      tulata" read probata.
   5, 13 lines lrou'  bottom  for  ''reasona-
      bly" read seasonably.
   C>, 17 lines from bottom for " members"
      read numbers.
  12. C> lines ffiin top—insert not  between
      ''I " and  "think."
  23, in 4th lnii; from bottom for "thermo-
      infter " read barometer.
  25, 11 lines from  too—attach note  after
      50.3* "on the 23d after epidemic had
      declined,  and at   the  very  period
      marked for  its declination, evidently
      producing it.''
  25, 17th line from  bottom, forhygrometic
    read "liyiirometric."
  9^5 lines" from   bottom  for  " produc-
      imis '* read production.
 10G, in note at bottom  for "same"  read
      / am.
 107, 18 lines from bottom after " offensive "
      insert "and the cutting down the  bank
      of the  river, and spreading the mate-
      rials on the streets."
ge 109, 9 lines from top for "causing "  read
       producing.
'   182, 16 lines frombottomfor "lethal" read
       lethale.
'   200, 19  lines from  bottom for "nature"
       read influence.
'   200, 2 lines from bottom for "fellow " rend
       fever.
'   207, 15 lines from top for "renewal " read
       removal.
'   211, 12 lines from top after " amount, " in-
       sert of moisture..
'   221, 4 lines from bottom for  "secured"
       read sewered
'   228, line at top for " gradual" read gradu-
       ally.
'   239, in 8th line  from top for  " monaxysi-
       nal" read monoxysmal.
'   241, in 7th line from top  after "fifty"  in
       sett of.
'   241, omit two lines  beginning  at  " 16th, "
       13th line from bottom.
'   247, in 2d line from top for  "men"  read
       even
'   247, 14  lines from bottom for "200,000"
       read 2,000,000
'   248, in  11th line  from top for "onthe"
       read as a.
'   249, in 9th line from top after  "burthens"
       insert respectively
       For table " H, " read table G.
Pa 
 
ADDITION
TO  ERRATA.
Page  79, first line, top—for " succession" read accession.
    169, 11  lines from top—"distinguish" read distinguishes.
    205, 15th line from top—put a period after moisture, and a capi-
           tal " P " to " probably," next word.
    220, 14  lines from bottom—for "ills" insert benefits.
I 
I 
INDEX.
                SUBJECT.__________

Awakening of the public mind to the value
  and importance of sanitary reform,.......
Where lies the difficulty?.............----
Not in the subject, but in prejudices and igno
  ranee of it...............................


SECTION II.—Medical Constitution of
             the  Year — Prediction of  the
             Fever—Interpretation of Phys-
             ical Phenomena—Climatic Pe-
             culiarities—Parallel of Cholera
             and Yellow Fever .1..........
Medical constitution—What*......-..;......
Do of J<m«ary,wtthits meteorology andmor
  tality....................................
Do of February, with its meteorology  and
  mortality,...............................
Do. of March, with its meteorology and mor-
  tality,...................................
Do. of April, with  its meteorology and mor
  tality,..................................■
Do. of May, with its meteorology and mortal-
  ity,................  .................
Moisture mistaken for dryness,.........
Reasons for the prediction for  the epidemic
  in May,.................................
Early cases,.....................-.........
In June— meteorology and mortality,.......
Tropical character of the season............
High  barometer,..........................
Antecedence of scarlatina.................
Predominance of Nervous affections,.......
In July—duty of Physicians.................
No evil permitted without a remedy,........
Interpretation of physical phenomena,......
Prodrome of the epidemic,................
No precursory influence on man,...........
Oreat moisture—Great stagnation of air,---
Filthy gutters,.............................
During August—mortality,.................
High  temperature, and almost average satu-
  ration,...............V""."...........
High radiation—unprecedented,............
-aturation—unparalled stagnation  of air,---
In September,..............................
Great climatic change,....................■
Epidemic retiring..........................
The mode  of interpreting  the  influence ol
  meteorology on  mortality................
[n October,............-...................
Climatic change continued.............-----
Epidemic, as such,  ceased ---•-..............
In November—unusual East Wind,..........
In December,..............................
Great barometric  variations,..............
Air becomes comparatively dry.............
Parallel of cholera  and yellow tever, climat-
  ically and physiologically—Dew point-
  Wind— pathologically,.............-.'..-
Mortality of the month,................- - - -
Great results often  proceed from apparently
  insignificant causes.......................
Climatic peculiarities of the year, - - -.......
High radiation and sickness  concomitant,...
SECTION  I.—General  Pbogramme—Im
             portance of Sanitary Laws—-Our
             general condition—What  other
             Cities lave done,  and their re-
             sults, ifC.,.....................
Division of duties,.........................
Importance of the subject,.................
Causes of yellow fever assignable..........
Not atmospherical alone,...................
Not filth alone.............................
These controllable,........................
Neither alone suliicient.....................
The remarkable culminating points of each,..
Proof,..,.,................................
Combination anJjr fatal,....................
Probata—Corollary,........................
Yellow  fever preventable................
Duty, responsibility, and toil of the Corfimis'
  sion,...........................-........
Fair examination and immediate trial,......
Laws of health established—a mark ol  civil
  izarion,.................................
No ills without a remedy,..................
Value of the  lesson,.......................
New Orleans requires sanitary reform more
  than any other city—risk in speaking the
  truth,...................................
Causes of our neglect and apathy,..........
Ignorance of our condition,................
Highest proof of  patriotism,................
Filth and disease cause and effect,..........
Proof of our gullability,---...............
Value of knowing the truth,................
Coat of ignorance,........................
No attempt to alter it,.....................
The real mortality for half a century,......
Average mortality for half a century,.......
The true wealth  of a city,..................
The  real cause  of the high price of every-
  thing, ..................................■
Insalubrity and immorality have a similar pa-
  ternity, .................................
Average mortality of the State..............
    "      "     ot England and the United
  States,...............................
Stigma of insalubrity,...................
Sites of cities not selected on account of their
  salubrity,................................
Bad locality for health (New  Orleans) if not
  improved,...............................
Petersburg, Va., once very fatal in its climate,
Do. Bristol, Pa.—in extent, both corrected,..
Do. of Louisville, Kentucky—corrected,---
On what has depended the improved health
  of Northern cities,.......................
Experience abroad,........................
Man's situation and elevation dependent upon
  his industry and intelligence,..........
As shown in England anpT Turkey,.......
Contrasted—and with, othqr countries,...
Condition in Egypt,.....................
Mortality with the natives,..............
Salutary effect of sanitary measures,.....
Consequences of their neglect........... 
ii       Index to Report on the Sanitary Condition of Necn Orleans.
SUBJECT.
M
SUBJECT.
Difference between  moisture, at high and at
  lew temperatures,....................
Peculiarities of the season...............
Creoles exempt—Carbuncles,---.......
Influence of color and sex—Eruptions....
Law of compensation—Buboes,..........
In May most contagious maladies,........
In August most nervous diseases,........
Reverse of the pulmonary,..............
Intemperance most fatal in summer,.....
Thunder storms and lightning during  epi
  demies,......................•.......
Gas in the gutters soon after a rain,.....
Earthquakes during the summer,........
SECTION III.—Cost of Acclimation to each
             Hativity  in  the United States
             and Foreign Countries, with
             the probable  causes of their re
             markable diversities..........
Social position,  as represented by the ceme
  teries,..........................-........
Mode of constructing the table,---........
Table H.—Showing cost of acclimation,.....
Cost in New Orleans,......................
  "  in extreme Southern States,...........
  "  in Northern slave States,..............
  "  in Northern States,...................
  "  in Northwestern States,...............
Probable cause of the difference,...........
Cost in British America,...................
  "  from South America, M exico, and West
  Indies,..................................
Total, 12J per cent, for all America,.........
Mortality of the colored,...................
    "    of those from France, and do. Eng-
  land,....................................
Mortality of those from Ireland—Cause,___
    "       «    "    North of Europe,...
    "       "    Middl* Hurope,..........
    "    from Holland and Belgium—Prob-
  able causes,.............................
Mortality of those from Switzerland and Aus-
  tria,...................................
Accounted for,...........................
From Spain and Italy—Probable reasons...

SECTION IV. — Population — Mortality-
             Ratios of Cases and Deaths-
             Comparisons with other Cities
             and Countries,...............
Total population in 1853,...................
Difference in the population in 1847 and 1853,
Total unacclimated population,.............
Number supposed to have left the city.......
Number in the city during the epidemic,....
Mortality by yellow fever...................
Ratios to the different populations,..........
Cases, mortality and ratios in different pub-
  lic institutions,........---..............
Ratios—Number of cases in private practice,
Total ratios................................
Tribute to the Faculty—Our associations and
  friends abroad,..........................
Why compare with other cities,............
Mortality from epidemic yellow fever in Phil-
  adelphia,  in 1793,*'97-'38,.................
Average hospital mortality there,...........
When most fatal,..........................
In Kew York, Baltimore, and Charleston,___
In Mobile—In New Orleans,................
In Spain—In th« West Indies,..............
At Vera Cruz,..........................
Ratio of mortality in the different classes at
   Rio,....................................
Mortality in the interior,..................
Great mortality from yellow fever abroad,.

SECTION V.—Epidemic Constitution—
             Its two  Constituents — Differ-
             ence between an Epidemic and
             an Endemic,.............■
Division of the  subject,.................
Epidemics formed of certain constituents,...
If epidemic, not contagious,................
Proof of an epidemic atmosphere...........
Further proof            "      ..........
Epidemic atmosphere—what,...............
Its great value,............................
Contagion independent of external  circum
   stances,.................................
On vegetable and animal life formerly,......
Birds driven away and killed,..............
Its influence on vegetable and animal  life
  in the neighborhood,.....................
Epidemic influence on fish on coast of Texas,
At Bolixi,  Bay of St. Louis, Bayou Sara,..
Do. at Centreville, Clinton, Baton Rouge,
  Lake Providence, Port Gibson, Natchez, at
  Washington, at Gainesville,..............
Information of epidemic influence from Smith-
  sonian Institute,.........................
Rainy season depresses the midday tempera-
  ture, ...................................
Elevates the morning and evening,.........
Tropical weather in New Orleans in 1853,..
Do. extended throughout the stations.......
Equal to a remove 10 deg. farther South,...
Frequency of rains, next to  amount, evince
  tropical season,..........................
Rains and fevers cotemporaneous in Texas
  and Mobile,.............................
Simultaneous occurrence  of the fever with
  high saturation,..........................
Do. do. always  present...................
Why impossible to be contagious,..........
To what extent infectious—not personal.....
What is contagion,.........................
Yellow fever not contagious,................
How apparently so, explained,.............
No exhalation from the human body of per-
  manent suspension in the atmosphere,___
Consequence on human intercourse, if per-
  manent, .................................
Forbid human intercourse,.................
Physical in harmony with social constitution.
No two opposite facts in nature,.............
Difference between an epidemic and an  en-
  demic,..................................
Practical deduction,........................
Proof from Humboldt,.....................
Nowhere apparently, even, contagious, but
  where epidemic principle present,........
As at Memphis, Clinton, Bladen Springs, at
  Cahawba, Black River, Point Clair, Holly-
  wood.Gainesville, Trinity, La, Portersville,
  Rio, Puerto Cabello, Guayaquil............
Fever the same as in former years,.........
Each have their types,.....................
Although an epidemic atmosphere may pre-^
  vail, disease only developed where locali-
  sing condition of filth, &c,............
63 
Index to Report on the Sanitary Condition of New Orleans.     iii
SUBJECT.
V-
SECTION VI.—The two Agents required to
             produce an Epidemic—Atmos-
             pheric and Terrene—Yellow  Fe-
             ver Zone—Limits of the Epi-
             demic of 1853—Geographical
             limits of Fever—Meteorological
             Elements—In detail.....
Ancient opinion of pestilence—Must be causes
  and under laws,.........................
Epidemics—the "shears of fate"............
The danger is in the combination,..........
The meteorology is the climate of a country
High temperature of certain duration essen-
  tial—in Philadelphia—and how apply here
Temperature producing an epidemic in New
  Orleans, and during it,..............
Do. in Spain—at Kio .................
Above 90 deg too high to favor its production,
Hence it does not  exist in  Atrica and  the
  East Indies,............................
Temperature required for the plague,......
      "          "   for typhus gravior,..
Temperature alone not sufficient,.........
Yellow fever commences far South, and pro-
  ceeds  regularly North,...................
Limits of epidemic in 1853,................
Periods  of its occurrence in different coun-
  tries,....................................
On what yellow fever zone depends, mainly,
What has changed it,......................
Yellow fever blending with the ordinary dis
  eases of the country......................
Occurs in the rural districts of Mexico, South
  America, and  West Indies,..........
Precursors of the yellow fever at Rio,.
Simultaneous climatic changes,........
Diseases change with the climatein Demarara,
Modifies and influences treatment,..---
Vital laws influenced by meteorological,,
 First yellow fever South of the equator,
 And at the unusual height of 3,028 feet—in
  rural districts,......................
 Do in rural districts and with natives,.
 Do. in   "      "    in  Barbadoes,.....
 Deductions from its blending with the ordi-
  nary fevers, not only here, but in Charles-
  ton, .....................................
 This occurs through man's agency..........
 Occurrence of fever dependent on tempera-
   ture, .....................................
 Its geographical limits,.....................
 Humidity affects health differently at differ-
   ent temperatures,.......................•-
 Its amount in the atmosphere but recently
  understood,.............................•
 Fevers not in proportion to the  amount of
   moisture, but a great amount  always re
  quired,......................- -.-----; y" ■
 Different effect of humidity at high and low
   temperatures,......................
 Pro fs,.............................--•
 Quantity of rain not an exact proot ot tne
   ameunt of moisture,...............
 Rainy season the sickly season........
 Proofs at Puerto Cabello, Bermuda, New Or-
  leans, .....................-.--.-.....
 Denied,  but no proof to sustain it,.....
 Unfounded statement of Darby,.......
 Positive proof of its erroneousness....
 Moisture indispensable,.............
 Proof in Flanders.....................
 Srror in mipposing great moisture at sea,..
SUBJECT.
It is only so near shore,............
Effect of swampy districts on health,
Effect of drainage of towns on moisture and
  on health,................................
Amount of moisture depends upon tempera-
  ture, .....................................
How great humidity acts,................- - •
Dew point of yellow fever, plague,  typhus
  gravior and cholera,
Sources of it here,......
Kadiation as a  source of disease now first
  noticed............................
Yellow fever weather described,......
Shown elsewhere—At St. John Baptist,
At Gainesville, at Hollywood, at New Orleans,
Probably the "fiery something" of Chalmers
  and Lining,.....
Terrestrial radiation,
Whence  the principal danger of night air,..
Proofs,.....................................
Influence of  elevation upon it................
Illustrations,...........................
Proofs in its  influence on the vegetable  king-
  dom,
Radiation worthy of farther investigation
Influence of winds,......................
Amount of moisture in each here—Direction,
Unwholesome nature of land wind, in sum-
    mer, .................................
   System of balances,.....................
   Apology if records imperfect,...........
   Exact amount of materials for an epidemic
    unknown.......................•-.......■
   Duration required, for disease to be developed
   Advantage of foresigth—to epidemics,----

   SECTION VII.—The Second Constituent
                The Terrene—^Exposure of the
                Soil—Sine quanon for our Ep-
                idemics—Proofs bach for  sixty
                Years,  in nearly  every large
                Southern town—How first no-
77              ticed— Grade of Fevers—Know
77              as much of the cause of Yellow
 •7              Fever as of aay Fever—Paral-
                lel with the Plague—Extension
                of  Epidemics due to  inunda-
77              tions— When Swamps most dan.
7(3              gerous—How and when to drain
                Land....................•
78 The other blade of the shear,...........
78 From whence varieties of fever,........
   To  apply the same principle  in examining
79   into the causes of yellow fever as of other
     fevers,.........................;■•*■••"•
79 1st proposition—Cause of every  epidemic,..
   2d       "      Cause of our endemics,---
   3d       <<      Cause of our periodic  or
80   bilious fevers,.......................
   Of the 1st proposition—Proof.........- -
80 Brief history of all our epidemics—of  1796,
81 Of 1811, '17, '19, *22, '32, '33, '46,  '48, of
     '49, and its consequences,......;-•--•
81 The special causes for  the epidemic of  1853,
81 Cholera and yellow {ever—Highest grades of
     zymotic diseases,........................
82 Exposure of earth with heat and moisture—
83   worst combination,..................
83 How these facts first made known to me,
83 No effect without an adequate cause,---
84 JToo invariable for a mere coincidence,.
84 Proofs of each of the epidemics of Natchez.
85 Do. of Memphis—Do. of St. FrancisviUe and
P.
87
 98
 99
 99

100
100
100

101
101
102
102
102
103
104
105 
iv      Index  to Report on the Sanitary Condition of New Orleans.
SUBJECT.
SUBJECT.
  Bayou Sara—Lake  Providence—Fort Ad
  ams, lentreville, Clinton, Trenton,......105
Do. on the Lafourche, Natchitoches, Algiers 106
Do. at Mobile, and at Selma,..............  106
Do at Montgomery, Hollywood, Gainesville,
  in Charleston,............................106
Value of a sanitary survey,.................107
At the Chesapeake and Delaware  Canals,.. lUr
And in other countries—In Africa,.......... Ll'9
At Martinique, at Fort de France........... 109
Same results on first cultivating a country.. 109
Disturbing original soil cause of'our epidemics 109
The special cause of every epidemic  yellow
  fever in the Southwest of the United States, 110
Testimony of Hippocrates and Sydenham,.. 111
Too many coincidences to  be other  than
  cause and effect,........................Ill
Ampleproofs,..............................Ill
Cause of our endemics,....................ill
Cause of our bilious and periodic fevers.....Hi!
Proofs that the yellow,  bilious,  and periodic
  fevers are convertible  and the same,......112
Importance of this in a sanitary p^int of view, 113
Identity of yellow and bilious levers—Proofs, 114
Of endemic origin,........................!ll5
Why yellow fever not always  break out with1
  apparent presence of the causes,..........115
Two conditions  necessary for an epidemic
 /ever,...................................115
The  presence of an acclimated population1
  prevents effects proportionally to cause,... ;116
Every climate has its peculiarity of morbid
                                        ' 116
                                         11
                                         117
  action,
Don't know the real cause of any disease,...
How diseases have been changed,...........
Know as much of the cause of yellow fever
  as of any known disease..................
Parallel ot plague and yellow fever,........
Similarity—Black vomit—Liability but once,
Marshes—Humidity,..................____
Latitudes—neither contagious,___
Dissimilitudes,...................
Acclimation period of occurrence,
Temperatures required lor each,.___
Influence of its climate on consumption, and
  why,.........'...........____
Effects of  our half dried swamps,___
Inundation cause of cholera and other sick-
 Why the epidemic should commence in New
  Orleans,
 Late inundatians promoting the spread of the
  epidemic,................................
 Dangerous in proportion to desiccation—short
  of complete dry?tcss,.............
 Inundation of  the Tiber,...........
 ^t Strasburg—In France and Italy,,
 At Ly n Keg is—At Brassora as an act of venge-
  ance,.................................__
 In Kgypt— At Laguayra—Its first yellow lever,
Inundations  here do not produce disease first
  year,...----.............................
Always the second year.....................
Different stages of draining produce different
  diseases,................................
Northwestern li nits of the epidemic,
                                          122

                                          123
                                          123
                                          123

                                          124
                                          L25

                                          125
                                          125

                                          126
                                          lie,
Effect of inundation late in the spring,......1j7i
Effect of exposure after inundation,........."""
At Demarara—Near Philadelphia...........
Near Calcutta—In Holland—Near Rome,___
Precautions necessary,.....................
Mouf land evolves more humidity than water,
V.alup of woods,...................;.-,.- '■
The baneful effects of our half dried swamps,
Result of its improper exposure since 1846,
The two conditions illustrated in Demarara,
And in different years,...................
And in Rio de Janeiro ..................
130
131
131
132
132
     SECTION  VIII —Localising Conditions
                 Specified  more in  detail — How
                 much Air spoiled each day—What
                 does it—Imjluenceof Cemeteries—
                 Priries— Streets,  tfC —Filth —
                 Low  Houses — Miasmatic Theo-
                 ries— Cause  of   Yellow  Fever
                 known— Deductions practical—
                 Duty of Civil A vXhority - Penalty
     Attention to sanitary measures a test of civ-
       ilization and refinement,.................
     Providence influences man through second-
       ary causes....................____
     Illustrations.........................,
     Filth the great enemy of man,........
     What is it ?..........................
     Indispensable nature of pure air,.....
     Peculiar air of cities,.................
     It spreads everywhere................
     Parts of cities most filthy, and therefore most
       sickly,............................
     Test of a city's insalubrity when it  departs
       from that of its neighborhood, and shows
       it to be artificial,.....................
     Amount of air required for respiration,
     Size of rooms,.........................
     Amount of air vitiated in a crowded city per
       day,...............................
     Absolute necessity of ventilation,......
     How promote this....................
     Necessity of drainage,...............
     Disorders nof from defective food and clothing
       among the poor but from crowding and filth
     Cost of removing filth buf; a small part ■ f the
       annual cost to relieve,..............
     Resulting demoralization,............
     The poison from crowding is organic matter,
       as well as carbonic acid gas,..............
     Comparison  of air with food,..............
     Necessity of ventilation,....................
     Organic matter always in ajr, notwithstand
          rains,...............................
     Water absorbs whatever air contains,.......
     Absorptiye power of water,................
     Value of rain water if kept pure,___,......
     Moral and physical copdition dependent upon
       imilar circumstances,...........T.......
     How food injured,..........................
     Injuries resulting from cemeteries,.,.........
     How toon bodies decay,....................
     Number of bodies  to the acre annually,,....
     Regulations  in London,....................
     Intra-mural interments adopted by rural cem.
      eteries,...................................
     The greatest difficulties in cities,.............
     Amount of filth exposed to constantly and to
      be ditposed of,...................___...
    The area of the city—temperature and moist-
      ure, .....................................
    Amount of this gas to poison a bird—a dog—
      a man..................................
1271 Streets  as a  source  of  disease—what good
128|   andbad..............................
129, Houses—How to be constructed,............
129j Empty lots as a source of disease...........
129 The true miasma  is whatever  impairs the
130   purity of the air.........................148
 133

 133

 134
 134
 134
 134
 135
 135
 136
  6
13
 138
 137
 137

 137
 138
 138
 138

 138

 138
 139

 139
 140
 140

 141
142
142
 143

143
143
144
144
141
145

145
145

146

146

146

 147
148
 148 
Index to Report on the  Sanitary  Condition of New  Orleans.        v
SUBJECT.
SUBJECT.
I*
 Supposed cause of fevers—No proof,........14''
 Explanation of IT. Ferguson's hypothesis,.. 150
 Solution required,  for  absorption into the
   system,.................................150
 Why it can't be the " drying power,"'........150
 Is from a physiological cause or hygrometric, 150
 Always moisture in the atmosphere,........151
 Absorbent soils only apparently cleanly—Con-
   ceals, not destroys filth,..................
 Healthy as long as dry,...................,
 A two-fold condition requisite,..............
 No effect can arise but from an adequate cause,
 Ditference of curative and preventive science,
 Cause and consequence,..............
 Must be a cause of every disease......
 And as much of that of yellow fever as of any
   other,...................................
  Because we can trace its origin to the causes
   producing it,......................
 Seats of these causes in all large cities,
• Why limited—and how extended,___
I Statements to be of future value t-hould  be
   made up at once,..................
 Gibraltar very filthy within the houses, and
   very crowded......................
 Bay of Havana,......................
 Cause of the insalubrity of the city,..
  Description of Vera Cruz—Cause of its insa-
   lubrity............................
  Prescription to produce yellow fever—(in a
    note,).............................
  Cause  of yellow fever,...............
  Great value of the spontaneous cases—settles
   the subject,  ............................
  Do. at Hollywood, at Gainesville,............
  Do. in  Washington, Lake Providence, Tren
    ton,.  .................................,
  Do. in Franklin, t'ie Black Warrior, at Mobile,
  Do.at rielm >, Demopolis, Saluria,PortGibson,
  Do. at Baton Rouge, Centreville, Natchitoches,
  Do. at Washington, La., Martinique, Bermuda,
  Do. at Barbadoes, Kio de Janeiro,.........
  Local—Spontaneous origin from filth,.___
  Spontaneous occuri ence at sea,...........
      Do.         do.     on arrival in port,
  Change of type of fever from change of cli-
    mate,....................................
  Opinions of InspectorsGeneral of Hospitals,
  Dr Rush's recantation about contagion and
    local origin,..............................
  In ships at sea from Northern ports..........
  Cause of yellow fever known,..............
  And is controllable,........................
  Conclusions of General Board of Health of
    England on yellow fever,.................
  No room for skepticism,....................
  Demonstration,............................
  Its vast practical value,....................
  The importance of knowing the cause of dis
    ease,.....................................
  Prevention better than cure,................
  Fatal consequences of a mistake,............
  Disease not essential to dense population,___
  Localised filth the cause of disease,.........
  Typhus independent of climate,............
  All depends on removing filth and moisture,
  The rich sufl'er as well as the poor,___
  The cost of preventable disease equal to the
    whole public revenue,.............,
  When  penalty on the public authorities to
    be exacted,..............................172
  Proportion of preventable mortality........'72
  Origin of disease,..........................172
Of cholera,..........................
Evidence of civilization,.............
Originators of sanitary laws,.........
Legal claim  on the civil power to protect
  health,............................
Original opinion of Dr. Rush,.........
First legislative action upon it,........
As much the duty of civil authority to keepoff
  yellow fever as it is to  protect life in any
  other way,..............................
Reform—the great question now—Its sacred-
  ness,..............................
A shameful and disgraceful neglect...
Vet  may prove a blessing, if "sanitary laws
  established........................
173
173
173

174
174
174
174
175
175
m
SECTION IX.—Recapitulation —Meteoro-
          logical—Special Terrene causes—
           Greater carerequired infastgrow-
          ing Cities—Tracing the Progress
          of the Disease by Earth exposure—
          Inundations—Sanitary Map of
          the City—Application of Principles
           —Locations of Filth and Disease
          the same— The one resulting from
          the other—In each Ward, with the
          ratios to Population—Fever Nests
           and Plague Spots—The mode oj
          spread of the Fever,.........
Not of foreign importation.............
Meteorological or climatic causes.......
Special terrene causes—Earth exposure,
Streets—Irnfilled  lots—Open drains,.__
Manufactories—City  interments,............
Slaughter-houses, &c.—Damp, crowded filthy
  houses,..................................
Public kept in ignorance....................
In all fast growing cities a large proportion of
  immigrants,.............................
Greatest mortality where no pavements,....
Mortality not from want of acclimation____
No acclimation to filth—To what extent ac-
  climation,...............................
To what extent acclimatable,...............
The true test of the salubrity of a country,..
The true meaning of acclimation—The  real
  need,.............................
All remediable.......................
Tracing the progress  of the fever from the city
Into the country,....................
Effect of inundations,................
Why rural districts in  other States not suffer
  so much,..........................
Why the fever occurred late in some places,
Sanitary Map of the city—Application oi
  our reasoning,.......................
Difficulties in computing the population,.
City returns not reliable,...............
Map too small,.........................
Total cases of the fever,................
Cases from private practice,............
 iNote—Names of physicians and others  who
  reported cases of the fever,........
 Cases from public  sources—From Charity
  Hospital,...........!..................
Table K—Population by districts and wards
  Cases and ratios,)......................
 Balance how distributed,.................
 Explanation of Table R.,.................
 ■Sources of information...................
 Propositions and results!'..................
 Population  and number of cases in the 4th
  District,.........................
1*6
176
177
177
178
179

179
179

179
180
180
180
180
181
181

182
183

183
184

184
184

185
186
186
186
186
187

187

187

187
187
188
188
189

190 
VI
Index to Report on the Sanitary  Condition of New Orleans.
SUBJECT.
Ratios per 1000—Causes................
Want of pavements—Lower lots or ponds,
Three Cemeteries—Earth exposure,......
Gormley's Basin and canal and manufactories
Crowding low houses—Slaughter-houses,---
1st Ward—Causes and proportions...
3d   "
5th  "
4th  "        "            "
2d   «
Malignity of the disease in proportion to the
  concentration of the causes,..............
1st District—Population and cases.........
1st Ward — Lynch's Row —Whitney's Pick
  ery„..............- • - -..................
Blocks in Pacanier and other streets.........
7th Ward—Nuisances in....................
2d Ward—Causes,.........................
4th Ward—Causes.........................
3d Ward—Fever nests......................
6th Ward—Fever neets.....................
Causes—5th Ward—Causes.................
2d District,..............................■
Population and < ases..Ward 2d—Causes,...
5th Ward—Causes,...........-............
Fever neste in front of the 2d District de-
  scribed, .................................
The  reason why yellow fever not all the
  year,.....................- -.............
And why limited to 60 or 90 days...........
The 3d  Di-trict, ........................
Population and ratios—Cause...............
Consequences  on the community............
Cause of insalubrity,.......................
The  number of acclimated population dimin
  ishes the ratio,...........................
Algier >—Population, ratio and cause,......
Origin of the fever—How the fever spreads
  from locality to locality,.................
Difference in Northern cities, and cause,...
No resisting plain facts,....................
Why all interested,.......................
The  occurrences  around us more  apt  to be
  impressive...............................
Proportion of natives and those born else
  where in New Orleans...................
SECTION X.—Remediate, or Preventive
          Mkans—How far Man can control
          Temperature, Moisture, (fc.—Influ-
          ence of wooden Houses—Winds—
          Tlieir qualities—Best Pavements—
          Streets—When and  how cleaned—
          Empty Lots as a source of Disease.
          Privies the great difficulty—Reme-
          dy— Drainage— City  Cemeteries
          closed—Best water, what—Plenty of
          water—Kind of Houses best—Influ-
          ence of Intemperance..........___203
Man's influence on temperature,............203
Do. on a large scale,.......................204
Actual proof here,  ........................204
Test—How it ought to be...................205
Moisture,..................................205
How removed and remedied,..............205
Italian custom—In the East during plague,.. 206
Why wooden houses  bad—Experience else-
  where,..................................206
Thorough drainage and paving necessary,.,. 207
What constitutes a perfect pavement,.......207
The city may be made darter cite the country, 208
Proofs of the value of pavements, .........208
Influence on the amount of precipitation,... 208
Influence of winds,.....................
Their properties,.......................
Our influence on the North wind,........
Small revenue devoted to preserving health,
To forbid turning up the soil in hot weather,
Back yards—Fountains of tilth............
Filth removed before decomposition,.....
And before sunrise - Custom elsewhere,..
Bank of river kept clean,.................
Low lots filled up,.......................
Vacheries and manufactories removed to a
  certain distance.......................
Gormley s Basin filled up and planted,...
Running water in the streets—How efficient,
Production of stagnant waters,..........
Effect of light,..........................
Night soil one of the greatest difficulties,.
How remedied,.........................
If not water closets,....................
riemove gas through kitchen chimneys,..
Effect of running water in the streets,...
Swamps to be drained,..................
Cemeteries in the city to be closed,......
Plenty of water of the best kind,........
Water how impaired,...................
How purified,..........................
Town water is town air,.................
Surveillance on buildings,...............
Direction of houses,....................
Only a certain amount of ground to be built
SUBJECT.
IP-
How dampness of stores to be removed,.
Why certain buildings not to be permitted in
  the thickly built parts of cities,........
Influence of social habits................
Effect of intemperance,.................
Proportionate mortality,................
209
209
211
211
211
212
212
212
213
213

213
213
 13
214
214
214
215
215
215
 1«
216
216
217
217
217
218
218
219

219
220

220
 20
220
221
SECTION XL —Comparison of  New Or-
         leans with other Cities—Pea-
         alty of congregating in Cities —
         highest class of disease in different
         climates produced by it—Proofs of
         high civilization. Effect of Sanitary
         Measures in Louisville —Norfolk-
          Williamsburg — Charleston — Sa-
         vannah—Mobile, tyc. — Climatural
         Parallel with Southern Cities— Val-
         ue of the Mississippi as a Scavenger
         —Delusive cleanliness of Cities on
         a sandy foundation— Vera Cruz—
         Its mortality under Mexican and
         American Regime contrasted—Tri-
         umph of Sanitary Measures......
Foundation of all sanitary laws,............
Penalty of congregating in cities,...........
It is wisdom from past experience..........
Proofs.....................................
The filthy parts of cities alone subject to yel-
  low fever,.........................
In Louisville—effect of paving and draining,
In Norfolk effect of paving and draining,
Wilmington—Delusion ot sandy soil,...
Effect of drainage and clearing,........
Charleston—Effect of draining and filling up,
No earth disturbance allowed in summer,.
Savannah—Clearing and draining,.......
Why a rainy season not always required for
  sickness where a sandy soil.........
Parallel of New Orleans with other Southern
  cities,..............................
All  our>filth can be removed,........
Attributes of the Mississippi river,....
222
222
223
223
223

224
225
226
226
227
227
227
228

229
229
230 
Index to Report on the Sanitary Condition of New Orleans.     vii
SUBJECT.
SUBJECT.
Causes of the salubrity of the rural districts.
Mobile—probable humidity,................
  "     only apparently clean,.............
In Flanders,..............................
Vera Cruz—Triumph of sanitary measures
Description of the city and its neighborhood
Civil and military authorities during Mexican
  regime,.................................
Do. of each during American regime........
The mortality of the civil about one-half,___
Of the military, about one-fourth............
SECTION XII.—Resume —Propositions
         and Corollaries,..............234
1st—New Orleans not sickly per se,.........235
2d—Mortality not owing to want of acclima-
  tion.....................................
Can't acclimate to filth, anywhere,..........
3d—Epidemic  constituents,................
4th—The efficient cause of all our epidemics,
5th—Epidemic not importable or contagious,
6th—Requirements for an endemic,.___
7th—A lesser amount required for periodic
  fevers...................................
8th—Local causes and local effects,.........
9th—Causes  of epidemic cholera...........
Corollary—1st—Epidemics controllable,___
2d—do. of endemics,......................
3d—do. of the causes of periodic fever,.....
4th—do. New Orleans may be made healthy
5th—do. claims for legal enforcement.......
Her prosperity alone depends upon health
Intelligence synonymous with health,.......
The real causes of our fevers,.............
All cities improved by sanitary measures ex-
  cept New Orleans,.................
The certain  result  if proper measures
  adopted here.......................
SECTION XIU.—Recommendations..
Sewerage—Drainage,..................
Forest growth—Paving.................
Water works—Shed on the river bank,.
Trees planted—Gormley's Basin,.......
Covered drains—Slaughter-houses...........
Vacheries—Livery stables,.................
Privies—Cemeteries........................
Disturbing soil—Health department,........
Quarantine—Sanitary survey—Record book,
SECTION XIV
Health department ordinance—Composition
  of.
Duties of President,.......................
      of the department,.................
Penalty for obstructing inspectors...........
Office records—And books of do,...........
Number of inspectors or wardens,..........
To license undertakers. Vidangeries, Sextons,
Permit from Health Department to author-
  ize burial,...............................
Penalty tor infraction,.....................
Duty of inspectors—Removal of nuisances,..
Empty or low lots filled—Cemeteries disused,
Duty of vidangeries—Cemetery certificate,..
District physicians—Duties—Qualifications,..
Health Department—To •■amine quarantine
  station,................^...........
Duty and report of its ptlyWcian,___
To publish advice durkij epidemics,..
Meteorological and cemetery reports pub-
  lished weekly,......._............
Annual report.........._...........
Compensation,.........—..........

SECTION XV...........*-..........
Approximate cost of recommendations for
  each...............................
SECTION XVI.........................
Estimate of a mode of raising the means to
  defray the cost of the Recommendations,..
No additional tax required..................
 ale of swamp lands.......................
Public land from Government U. S..........
McDonogh's bequest,......................
Tonnage duty,...........................
Loan from McDonogh's estate,.............
241
241
241
241
241

242

242
242
242
242
242
243
243

243
243
243
244
244
244

245
245
245

245
245
245

246

246

246

246
246
247
247
248
248
248
*» 
INDEX
CHARTS,  TABLES,  MAP,   <fcc.
CHARTS, TABLES, &C
ill
CHARTS, TABLES, &C.
CHART A.--Represents  the mortality of
            the city foTthe near fifty years,
            With its causes—and the aver
            age monthly mortality.....-
CHART B.—Represents the average monthly
            radiation, temperature in shade,
            dew  point,  moisture,  drying
            power, and mortality, special
            and general..................
TABLES C,D, E.—Contain the daily meteor-
            ological condition in detail, and
            the daily mortality, during the
            three epidemic months........
TABLE F.—Contains the classified mortal
            ity of the year, with the nativ-
            ities, age, sex and color........
TABLE G.—Has the returns of each of the
            Cemeteries, monthly, during
            the year......................
TABLE H.—Shows the  cofct of acclima
            :tjqn to each porfton of our pop-
            ulation, according to nativity.
TABLE I.—Comparisons of 1853 where the
            yellow fever prevailed, and do,
            of 1852, where not............
TABLE K—Weather at vtrious stations du
           ring the yellow fever months of
           1853.......................
100
97
250
36
58
58
TABLE L.—Amount of rain where prevailed
            yellow fever  of 1853, in com
            parison with a mean of several
            years....................--
TABLE M —Humidity, and monthly mean of
            stations where the yellow fever
            prevailed,  summer of 1853...  53
TABLES N. and Q.—Complete meteorologi
            cal tables for the year,,,,......250
TABLES P, Q —Tables of hygrometry of the
            winds,  and winds by seasons
            and months, on an average of
            several years.................132
TABLE R.—Localization of cases of epidemic
            yellow fever, population of dis
           tricts and wards, and ratios of
            cpses to each..................188
MAP. S.—Sanitary map of New Orleans, with
           nuisances,  &c,  injurious  to
           health, indicated in  each ward
           and district of the city, at title page
TABLE—Showiqg periods  of occurrence of
           each epidemic  yellow fever and
           cholera  that has  occurred in
           this city, with the  amount of
           mortality and  ratios to popula-
           tion,  and   relative  rank  in
           amounts, &c,.................
To follow the "Introduction,"..........XVIII 
   The following table was prepared for the purpose of aiding to fill up the
 three first  columns in the table in the Introduction, so as to extend the
 averages over as large a number of epidemics as possible, with no inten-
 tion whatever of publishing  it.  It is furnished now at the unanimous
 request of the Sanitary Commission,  as embracing important views of
 our comparative condition but little known, and  upon which most  erro-
 neous opinions are entertained.
   The climatology of the year has also been most carefully compared
 with that of the preceding epidemic years and found entirely to corres-
 pond.  It  has also  been comprehended with the averages in the other
 columns, and adds its important mite in then verification.
   This table  farther shows,  that with the exception of  the remarkable
 year 1853,  produced by the most  unusual  concurrence of causes—
 that it is certainly in our power to say shall never occur again—that the
 yellow fever is not increasing among us; that the present year stands in
 comparison with others but as  the  tenth, and still does not forbid us to
 entertertain the sanguine hope, expressed elsewhere, that if the suggestions
•as to its prevention  are fully carried out, we  may be enabled  to drive it
 entirely from among us.
    Since the  " Report on the sanitary condition of New Orleans" was
 put to press, important corroboration of its views in relation to the causes
 of our  epidemics has been  obtained—besides  those mentioned in our
 " Introduction," in relation to this year.  If necessary, they can be com-
 prehended in a supplemental  report—wherein, with other documents
 intended for our report, but necessarily excluded—I propose to state the
 meteorological  elements of epidemic yellow fever in other climates and
 places, in corroboration and  illustration of what has been found here.
                                                          e. n. b. 
 
                        COMPARATIVE  TABLE.
Estimate of the Salubrity of New Orleans, as affected by her Epidemics.

                         1st—of Yellow Fever.
1617.
1819..
1820..
1822..
1829..
1832..
1833.
1837.
1839.,
1841.,
1847.,
1848
1849..
1853.,
l«o4..
Totals,.........................80,577
Averages,....................... 5,371
   2
,138
,766
,734
,520
099
,976
,807
,9.34
,549*
,043
,026
,862
,787
,564t
  6(KJ
  425
  400
  808
  900
  400
1,000
1,300
  800
1,325
2,318
  872
  769
8,101
2,484
21,624
 1,441.60$
 24,196
 26,133
 27,176
 31,706
 47,561
 55,084
 57,713
 68,229
 73,48
 78,745
108,609
115,503
122,511
154,132
160,823
Mues-	iYllles-
emal.	vnai.
	
	
o2~ £o.2	"32 =
°«a	o"- g
	
ftf-SS.	-5.2 &

 T6±i
 81.65
 64.98
 86.86
 52.98
147.02
 86.21
 70.45
 53.53
 57.16
 83.11
 69.48
 80.49
102.42
 65.69
76,777 73.30 18.30
24.79
16.23
14.71
25.48
18.92
 7.26
17.70
19.05
10.88
16.82
21.34
 7.54
 6.27
52.55
15.44
 3d.
 9th.
11th.
 2d.
 6th.
14th.
 7th.
 5th.
12th.
 8th.
 4th.
13th.
15th.
 1st.
10th.
The same as  affected, Idly, by Epidemic Cholera.

                              I From Cholera I
1832.
1833.
1848-'9................(of '48)
1849............................
1652..........................
1853..........................
Totals,...
Averages,
 8,099
 4,976
 8,026
 9,8(52
 8,670
15,787
55,420
 9,236
4,340
1,000
  924
2,081
1,080
  554
9,979
1,666.K
 55,084
 57,713
115,503
122,511
147,441
154,132
89.7^
78.78
17.32
 7.99
16.98
 7.32
 3.59
21.99
1st.
3d.
4th.
2d.
5th.
6th.
  To complete this table to the present period, and render it more satisfactory, it
was necessary to estimate many of the past months, as well as some future tetums
for 1854; for, there being no authorized Board of Health, or of record, to enforce
returns from the cemeteries, several have reported in  the early part of the year
irregularly, and sometimes omitted  it altogether.   I  have been able to procure a
reliable return for January; for parts only of February, March, April, and May,
and have had to estimate the balance;  for the rest of the  year to the 18th of No-
vember, the  returns  are about  the  same as  usual.  That in relation  to  yellow
fever  is, no doubt, as reliable  as  at other times.   The balance of the year has
been estimated.
' lucln.linsr Lafayette hereafter.   t Partly estimated   +The mortality from yellow fever in
\hnU- years, thus lorma 26.64 per cent, of the whole mortality.    || The  murtulily from
i.l.-ni in epidemicycHTb, thus form* 18u:', per cent, of the whole muitulity. 
 
REPORT
                       UPON THE

SANITARY   CONDITION
                          OF
             NEW  ORLEANS,
                          BY
        EDWARD H. BARTON, A. M., M. D.
                           SECTION I.
               SYNOPSIS  OF ITS CONTENTS.
 Preliminary remarks—General programme of grounds assumed
   and positions to be proved:—The Science of Hygiene—Igno-
   rance of the Truth and assumptions of Facts, leading sources
   of error, as to our past and existing condition—Filth  and
   Disease—Their relations to one  another—The  effects of
   imputed perennial insalubrity upon the thrift and growth of
   a city— What  the healthy and natural standard of mortality
   of the Rural Districts of a country is— What the like stan-
   dard in the Urban  Districts.   Sites of cities never  selected
   wholly on account of salubrity—Sanitary measures and their
   results in this country and elsewhere—The sine qua non of
   their efficacy everywhere, must be skill in devising them—sea-
   sonableness  in applying them, and promptitude and perseve-
   rance in enforcing them, dec.  &c.
   The Sanitary Commission at an early day after its  organiza-
tion, deemed  it advisable to assign to each of the members,
severally, one  of the  prominent  topics, into which the subjectDivisionot
(with which it  was charged specially by the city authorities) dutles"
naturally and conveniently divided itself.  To  my share  was
             A 
2            Report  of Dr. Edivard  H. Barton on the

         allotted the special and arduous duty, of making "a thorough
         EXAMINATION INTO THE SANITARY CONDITION OF NEW ORLEANS,
         AND OF ALL  AGENTS AND  CAUSES INFLUENCING  IT DURING THE
         PRESENT  AND  PREVIOUS YEARS, AND TO SUGGEST WHATEVER IN
         OUR WISDOM WILL TEND TO IMPROVE AND PRESERVE THE HEALTH
         of this Metropolis. "  This  opens a vast field of research, with
         corresponding responsibility, and on a theatre where the making
         and preservation of records  are the last things to be thought
         of; however, those archives, the fruit of the garnering and toils
         of years  here, will now show  their  value, as well as foresight, in
         collecting them,  and it only remains to set forth for public con-
         sideration and judgment—the facts—reasonings and conclusions,
         which have  resulted from our investigations;  and which I pro-
         ceed now to do.
                               re Fort.
            That this particular and  voluminous branch of the subject,
         as well as those branches of it, devolving upon my learned asso-
         ciates, is full of importance to our  immediate constituency, and
         eventually may become so to  the age we live in, we confidingly
Importaneeof believe, because we are fully  hopeful of the results which must
         follow the adoption of the preventives  and remedials we have
         suggested, at  the close  of our labors.  But, will the city au-
         thorities, adopt and carry out, such as we have  suggested and
         advised ?  That  is more than  we can say:  But,  this  we know:
         That  if the causes we have assigned for the late devastating
         pestilence, as  well as  those  which have preceded it in past
         years, be clearly and inevitably  deducible  from the facts we
         have  presented, and are truly assigned;—then must it follow as
        *" does night the day, that  the preventives and remedials we have
veralienable              ,-              ..  .     .  ,  .    „         ...
         recommended, if seasonably applied and rigidly enforced,—will
         not only forestall and prevent yellow fever from originating here,
         but from propagating here,  should it be brought from abroad.
            Let me be understood.  I  do not pretend to  say that all the
         causes, to which we assign the production of yellow fever, can
         be forestalled  in their coming, or  expelled when they do come,
         by any human agency, whatever ; for, the meteorological condi- 
On the Sanitary  Commission of New  Orleans.           3
 tions of  elevated temperature, excessive saturation, great solar Not atmea-
 radiation, large precepitation and prevalence of particular winds, phsnc aiene.
 or  the absenee of all winds, may not be entirely preventable
 or remediable, by the art or the power of man.   But, (as will
 be  seen, throughout the report,) great as  is the  influence we
 attribute to the presence of these most deleterious and  alarm-
 ing agencies,  we  have  no  where  attributed, nor  wish to
 attribute, to these agencies alone, a capacity for originating or
 propagating that disease.  It  is only when they are in combi-
 nation with those morbific influences, which we have denominated
 terrene,  (which  embrace  every  species  of noxious affluvia,
 which filth of  every description, and disturbances  of the origi-
 nal soil, generates and transmits,) that the etiological conditions
 exist, for the production  and spread of the pestilence.  More-Not<*haloae
 over, it is a doctrine of  the Report, as it is a corollary from
 the premises—that  the terrene condition  alone, is without  the
 power to originate the disease, in the absenee of the meteorologi-
 cal conditions referred to :—otherwise our goodly  city would
 be apt to furnish the pabulum  for the  disease, not only for  the
 summer  and  fall  months, but expose us to the  pestilence
 throughout the year!
  Now, it is a  further doctrine of the Report, that  these terrene
 causes or conditions, are  entirely, and always, within  the reach
 and control of  man, and  remediable and removable, therefore,
 at  mans'  option  and pleasure.  The terrene  causes  then of
 great filth, <fec, being removed and extinct, the meteorological The'e cc*"
 would be powerless to originate the disease here, and if imported
 here, it would be quite as powerless for propagation, be the
 meteorological conditions even  as ominous and menacing as
 they were during the late epidemic, and whatever might be
their  injurious influences  upon diseases not needing,  for their
existence  or duration, the presence or potency of the terrene
conditions ; although, most assuredly, we think, that the meteor- Ne,t!lfT aicne
ological conditions never  have reached, and never can reach,'8*
any thing like the  insalubrious  and  blighting  excesses  of
the  past  year, in the absence of the terrene conditions, whatever 
4-             Report of Dr.  Edward H. Barton on the

         may be the affiliation  or sources of causation and dependance
         between them.
            These remarks are most fully borne out by a brief reference
         (in advance of what will be more particularly  detailed here-
         after,) to circumstances attendant upon the largest mortality,
         the subsidence and cessation of the late epidemic.  The subsi-
         dence was gradual, it  was true.  It always is so.  But it wa8
         marked, and  full of sio-nificance.   Solar radiation reached its
The: re«::.rka-       '              °                 ,     • -,   •      t  ,
         loftiest elevation on the 19th of August; the  epidemic reached
bl e culmma-                                  °         x
tinff point* ofits culminating point on the  22d; down, but  gradually, sub-
eac'.      sided the combination  of high temperature and great humidity,
         and although  the latter, was occasionally very high afterwards,
         the combination of high temperature was  wanting to  give it
         virulence;  the epidemic, also,  gradually  declined, pari  passee,
         with  these important changes in  the  atmospheric  element,
         which hung over our  doomed  city like  a funeral  pall,  and as
         they  gradually  passed away,  the refreshing blasts returned,
         until  the health point  (the equilibrium)  was reached, and  the
froof.     epidemic  had ceased,  weeks before the great  queller, (as is
         thought,) frost, made its appearance,  and fully  one  month
         earlier than all prior  epidemics.   The  chart B, and tables D,
         and E, accompanying  this Report, are absolutely conclusive of
         all this.
            Well, in all this time, and up to the final cessation and  dis-
         appearance of the epidemic, what  became  of the  terrene con-
         dition.   They remained wholly  and  absolutely  unchanged!
         Indeed, all knew (or seemed to know) that it would have been
         madness to have disturbed  them, while the fever lasted, and of
         course, they were let  alone, or not materially altered, (except
         the cleaning  of the streets, which is a very  small part of the
Combination cleaning of a city—probably not constituting a twentieth por-
oniy, fatal,  tion.)  What better  proof could one  have than this  of  the
         total  seperability  of  the  two conditions?   And  what better
        * proof could there  be that  as  the separation  progresses,  the
         disease subsides, and  that when the seperation was complete
         the disease was extinct!  And what can follow—but that if 
Sanitary Condition of New  Orleans.
5
THE COMBINATION HAD BEEN PREVENTED, SO WOULD HAVE BEEN
THE DISEASE!
   To sum  up—the leading and controling  principle that has
guided us in all our sanitary  conclusions is  that  the following
postulata have reached the importance of demonstrated truths,
through the facts and reasonings set forth in the Report, viz:
   1st. That a  close junction  and  combination of the  meteor-
ological and terrene conditions  (referred to) is absolutely indis-
pensable to the origination, transmission and duration of yellow
fever every where.
   2d. That all the terrene conditions referred to, are control-Postulata-
able  and removable by human agency;  and consequently, are
seperable from the  meteorological conditions, at  man's option,
and at man's pleasure.
   3d. That the  atmospherical  element can  be much modified
and ameliorated by man's influence.
   4th.  That the irresistible corollary from the probata are, that CoAiary.
yellow fever is an evil, remediable and extinguishable by human
agency.
   The great practical principle of the Report, therefore is, that
the yellow fever, although among the greatest of physical evils,
is demonstrably, a  remediable evil, and it will be the function of Yellow  fever
a future section to  set forth, in detail, the remediable appliances, preventable.
which reasonably  employed  and scrupulously enforced, will, I
feel confident, extirpate that disease in any locality.
  All this we maintain confidently and boldly, for our conclusions
have been neither overstrained nor far-fetched, but  are the legiti-
mate progeny from the relations subsisting  between cause and
effect. If others may disallow or  distrust them, most assuredly the
Commission could not.  How  could  we, when we know, that
in the fullness and  accuracy of the facts we have gathered, no
toils have  been spared; that in  collating them one with another Duty, respon-
and assigning the  appropriate  weight to each, every care has sibiiity,  and
been taken, with searching  and  impartial scrutinies for ourtoilof the
guidance, to commit no mistake, and as to the facts and anal-commisslon'
ogies we have brought from  afar, we  have  presented the most
               B 
0            Report of Dr. Edward II. Barton  on the
         eminent and reliable medical authorities of the living and the
         dead, as  our vouchers for  the facts they have recorded  and
         the deductions they warrant, when applied either to them or
         to our own special testimonies.   It is these deductions which
         constitute and authorize the results we have  proclaimed;  and
         these results constitute the bases of the principles we have pro-
         mulged and maintain in relation to the origin and causes of
         and the preventives and remedies for  the  extirpation and ex-
         tinction of yellow fever.
            Looking then, to the momentous interest we represent in this
         first  great sanitary movement in the South—inviting the utmost
         scrutiny into our facts, principles, authorities, and the corollaries
         we have deduced—we only  expect that confidence to which, we
         humbly deem, all are fairly  entitled.  If, upon  such investiga-
         tion, the recommendations are found reasonable; if  they are in
Fairexamina- accordance with the science and the well attested experience of
Hon and im- the present enlightened age; then we hope there will be no hes-
mediate trial. Nation in putting them upon immediate trial.   The  " let-alone
         system " has been tried long enough; it has filled and darkened
         with a deeper gloom the domicils of the dead—cast adrift mem-
         bers of our cherished population—restrained  and  still restrains
         large and valuable accessions,  and has checked and impaired
         our  advancement  and thrift in every branch of industry.  The
         trial has been full and unsatisfactory. All unite in saying there
         must be  sanitary reform ; it is written  in indelible characters on
         the  age.
            Health is the greatest of earthly blessings  ; the  rules appli-
         cable to it are reduced to a science; it is denominated Hygiene;
         it is governed by principles and regulated by  laws, almost as
Laws o precise an(j exact as those attached to  any other department of
         science.   It is the true science of life; it  teaches men  how to
lished a mark
       .  live, and how to prolong life, and when properly applied, it has
         increased its average duration for terms averaging from ten to
         twenty years, and surely, this is worth striving for.   It is now
         fully understood,  and the  most enlightened communities and
         nations are adopting its principles, and applying them to prac- 
Sanitary  Condition of New Orleans.
1
 tice.   In our country it has diffused its blessings  in  proportion
 to the extent of its application.  The adoption of its principles,
 as well general as personal, is a mark of civilization, and char-
 acteristic of  refinement.  Indeed, sanitary reform is the talis-
 manic indicium and distinguishing amelioration of modern  re-
 formation.
   From the  afflictive dispensation with which it has pleased an
 all-wise Providence to visit our city during; the last summer and
         .                      ,                             No ilk with-
 autumn, it becomes us to draw lessons as well of wariness as
                                                            out a remedy.
 of humility.   There  are no physical ills inflicted upon man
 without their uses and their recompense.   If the  mortuary ca-
 lamities of the year will drive our people (so long deluded on
 the subject of their sanitary condition) to  open their eyes to the
 actual truth; if it can  be demonstrated,  to  their satisfaction,
 that we have labored and suffered under remediable ills; that
 there is yet hope for  us, then the fearful lesson  we have been
 taught will not have been in vain, and we  shall be able to date
 from 1853 a new era of prosperity and progress, in all that may
 be  compassed through  numbers and commerce—health  and
 thrift.
   In no part of the world is a thorough sanitary reform so much
 needed as in New Orleans.   In no country on earth has a place
 been so much injured through a want of insight into her sanitary
 condition by her municipal officials.  In none have more pains
                                                <• •          ^ew Orleans
 been taken to keep from the people a knowledge ot it; the very
                 x             x                            requires sani-
 attempt to enlighten the public in relation to this important in-     reform
 terest has been steadily repulsed with denial, if not with incre- morethanany
 dulity, and the authors have been pointed  to  as inimical to the other city.
 city!  The obvious effect of all this has been the almost entire
 neglect of sanitary measures.  There is another party who  as-
 cribe all the ills said to affect us to a foreign source;  and again,
 there is another who despair of the power of man to alter our
 condition.  This fixed incredulity as to the existence of facts on Biskinspeak.
the one hand, and of the exotic sources of importation of the ing ^ ^^
malady on the other, with an utter inadequacy of  means of pre-
venting its introduction, or expelling it when it came, is plainly 
8            Report of Dr. Edward H.  Barton on the
Causes of our the cause of our apathy at the results, and restraint upon all
neglect  and trials at amelioration.   Either opinion  is  adverse to a change,
apathy.    an(j from t^e statu qU0 m  wnich the city has been kept  for so
         many years, it might be  supposed  these  were the prevalent
         opinions.   They may be all resolvable into an ignorance  of our
         actual condition—of what has produced  it, and of  those  vast
         influences that have effected the wonderful changes in the  san-
         itary condition of cities all over the globe.  A belief in them has
         heretofore been a barrier to all improvement, has palsied the hand
         of enterprise, and has driven from  our city valuable  citizens,
ignorance  of an^ prevented the immigration of labor, of wealth,  and of in-
cur condition. teuect#  That these views are sincere there is no doubt;  that
         they  are erroneous I trust to demonstrate in the course of  this
         investigation;  that they are entirely un-American, so entirely
         opposed as they are to the progressive advancement of the age
         we live in—so  outrageously at  variance  with what has been
         clearly  demonstrated as the result of the application of sanitary
Highest proof jaws and usages elsewhere, I think there is  no  doubt.  I trust
of patriotism. to show that they will not bear the touchstone  of examination,
         and that it  is the highest aim of patriotism to make an attempt
         to alter them.
            New Orleans is one of the dirtiest, and with other  conjoint
         causes,  is  consequently the  sickliest city in the Union,  and
         scarcely anything has been done  to remedy it.  That the one re-
         sults from the other, is in exact accordance  with the common
         sense, the common experience and common feelings of mankind,
Filth and dis- anc[ yg^ to use  the  language of a  distinguished investigator,
ease,  cause«tke city lies quiet, with an open keg of powder with a lighted
         torch only a foot above it."   Like causes produce like  effects,
         under the same circumstances, forever.  If then,  the city  is to
         be restored to salubrity, there must be a radical change.   It is
         the duty of medical men,  who, from their studies and  province,
         ought to know the value of sanitary measures, to urge upon the
          community their great importance, to show the critical condi-
          tion on which rests  the foundation of public  prosperity; and
          if any  change is to be wrought, " it is best to be  done quickly." 
Sanitary Condition of New  Orleans.
9
No city can bear many inflictions of such a calamity as that of
last year without serious deterioration.   Concealment and boast-
ing will not help us much.   Public confidence is plainly on the
wane; the disparaging truth that almost every official as well
as unofficial means have been used to conceal, deny, explain away,
has been resorted to, and now it stands forth in all its unabashed
effrontery, in the very face of well attested and repeated proofs
afforded by our Board of Health and our Medical Faculty, that
the evil exists, and is remediable.
   When, a couple of  years ago, an enterprising fellow-citizen
(James Robb, Esq.) informed the public that" he would sink or
swim with New Orleans," in a great railroad scheme, that was D  F ,
                             o                    '          Proof of our
deemed essential to our prosperity, little did  he—little  did the gullibility.
general public think that anything else  was  wanting to insure
that prosperity but railroads! so successful had been the as-
sertion that " New Orleans was one of the healthiest cities in
America," in spite of the most unequivocal proofs before the
public to the contrary, evincing a self-love, that a public, gullible
always, upon that point, is so prone to swallow.
   It required a great calamity, like that of 1853, to open our
eyes to the actual truth.   A conviction of an error must pre-Value  of
cede its correction.  A knowledge of causation must  precede knowing  the
the application of the means of  prevention.  On the important truth.
subject influencing the health of the community, "ignorance is
not bliss."  The cost to our city, to reach this conviction is to
be estimated  by millions, and to her commercial prosperity—to
the value of her real estate—to the reputation for perennial in- c   f.  no_
salubrity—figures cannot calculate it.   But how shall  we esti- rance_
mate it in the orphanage—the widowhood—the loss  in valuable
citizens—in the products of labor !  Shall we say then, that all
this could have been prevented ?    Have  any preventive means
been tried ?  Have there been any organized sanitary measures?
                               J                            No attempt to
Is not all the world benefited by them ?   Does not the common u  .
                             J                               alter it.
sense and common experience of mankind here coincide ?  Are
we to take advantage of what this teaches us, or are  we to be an
exception to  the  balance  of  the  world?  Does here  flourish 
10           Report of Dr. Edward II. Barton on the
The real mor- perennial health, and have we found out the perpetual elixir 1
tality for half The record in chart A contains what has been the memoria, the
acentury.   terrible memoria of the past, and it belongs to the present peo-
         ple to say what that record  shall exhibit in future.   I invite atten-
         tion to this chart now merely to show what has  been the  mor-
         tality of the city for half a century, (I shall direct attention to it
         hereafter for other purposes.)   There  may be errors in it, but
         where records of the past  are so difficult to be obtained as they
         are here, it was impossible to  do better.
            This record then exhibits an annual average mortality during
Average mor-^^ iong period, including the disastrous year 1853, 59.63 per
tality for half ^000  of ttie p0pUiati0n—more than double  what it would doubt-
         less have been, had proper sanitary measures been adopted and
         efficiently enforced at an early period.   To what  this large mor-
         tality  is to  be  properly ascribed, will  be pointed  out in its
         proper place,  and  we shall then see if our situation will admit
         of corrective measures or not.
            The wealth of a city depends mainly upon the number of its
         inhabitants—labor is  wealth—population and labor are its most
         productive elements;—a system of measures that is irrespective
       a e of the poor,—of the immigrant,—of that  class that has raised
wealth of a ....   „      .              7    ,..,..     ..
         this city from  the swamp and made it what it is:—that has
         cleared the land and drained it,—made the streets—constructed
         the dwellings, and done so much to develop its destiny, is void
         of justice to the laborers who are  worthy of their hire, and is a
         reflection upon the proprietors who profit  by  it.   The value of
         real estate rises with competition  where there is no overplus in
         market—the quantity of merchandise sold, depends upon the
Therealcanse number  of consumers  and purchasers.  If there is  increased
       lg risk and jeopardy of life, an enhanced price  is put upon every
         article sold.   High food,  (when we ought to have the cheap-
         est market in  America)—clothing—merchandise of eveiy de-
         scription,—high  rents,—low  real estate,—high  wages for
         mechanical labor of all kinds—high price for professional talent;
         —these are the real reasons, as I am informed  by  intelligent
         merchants at home and abroad, why we have the  dearest market 
Sanitary  Condition of New  Orleans.              11
 in the United States; for comparatively few will risk their lives
 or trust their capital,  without additional compensation, for the
 additional risk run!   Hence the inevitable result, a retardation,
 if not a blasting check upon commercial prosperity and advance-
 ment, and finally, a recklessness of life, and corruption of public Insalubrity
 and private morals.  Disease and crime have a similar paternity.and imffi0rali"
 mi         ,  .    .            .                                ty have a sim-
 iney are  twin sisters; as exists the one so flourishes the other,.,
   , .    .       -i  -i  •                                      "ar Paternity.
 and there is not a doubt in my mind, that the most effective means
 of advancing the cause of morals and religion among us, would
 be  the establishment  of  sanitary measures!   "Cleanliness  is
 next to godliness."
   It is assumed by statisticians after a very thorough examina-
 tion  into  the  subject, that a mortality of two per cent, or one
 in fifty, may be fixed  upon as a healthy and natural standard ofAveragemor"
     i l'i     A j.±  1  1    11                                ta"ty °f l^le
 mortality.  Attached to the late  census returns for 1850.  the^
                                                        '     state.
 average mortality for the Eastern  District  of Louisiana  was
 20.68 in a  1,000, and in the Western District 21.25 to 1,000,
 and the average of the entire State 20.92.   This was  a large
 average for Louisiana, admitting the correctness of the returns
 —for 25 per cent,  of  the mortality of  that year was ascribed to
 an exotic to our climate (Asiatic Cholera.)  The whole of Ene--
 l  j          ~-  ™         ,.  i   i   ,                       Of England.
 land averages 21.80,  one of the healthiest  countries in  the
 world.  Throughout the  United  States the average is 22.47.
 The average age  of death in England is 29  years, while inoftheUnit«i
 America  it is but  20.  The annual average mortality  of the States"
 six  or eight principal American cities, is a little upwards of 2£
 per  cent.  In the three principal cities of England, it is some-
 thing more.   Is  it  possible then  that  5 JUL  per  cent.,   and
 for the last six years in this city preceding '53, it has averaged
 61  per cent.!  and  this  from  official published sources, is
 the  natural  mortality?  Is  it possible, I say, that this  is  aStigmaofin"
 necessary  and  inevitable  state of mortality ?   Will the worstsalubrity-
 enemy of New Orleans allege for a moment that this cannot be
 remedied?  Is our local position—climate—are  the pursuits
 character and habits of our people so utterly irreconcilable, or
unamenable to all sanitary influences, that this  enormous  mor- 
12           Report of Dr. Edward II. Barton on the
          tality is  to continue,  and that  we are to bear the stigma of
          being not only the sickliest city in  the United States, but  in
          America,—nay,  even in the civilized world ?   It is not only a
          stain upon the climate and position—but upon the character of
          the population, and the generally admitted influence of intelli-
          gence every where.   Did I think so—I should not pen theselines.
            The primary object in the location of sites for cities, has never
          been, as it should be,—for the enjoyment of health,—the lead-
Sites of cities                             ,          .     „
          ins: idea  has always been,—its convenience tor commerce,—
not selected on  ~               J
 account of business, or political purposes.   The consequence has almost al-
their saiubri- ways been a great penalty in the sacrifice of life, to subserve these
ty.        subsidiary purposes; and the most expensive  means have been
          resorted to, to correct it, and  usually with  success.  These  re-
          marks apply in a remarkable manner to our city—robbed from
          the swamps—with large bodies of water all around, us—a hot
          climate—a rich earth teeming with organic remains,  we have
          aggregated together precisely the materials with only the addi-
          tion of a large and crowded population, for boundless insalubri-
          ty, although  second to no city in  the world for commercial
          purposes,  that this result should ensue is not only not astonish-
          ing—but  it would be the operation of  a constant miracle were
          it otherwise, we have synthetically the very  materials for  its
          theoretical  existence.   Under such circumstances, what does
Bad locality common  sense dictate?  The answer  at once will be—correct
of New  Or-jt—do, as all other cities have done and not lie  idle and  indo-
leans, if  not \Qn^ resting satisfied in boasting that it was one of the " health-
          iest places" in former times (when there was no city at all!)—
          but put your shoulders to the wheel, rectify the  disadvantages
          of  your position  in this respect, and  take courage in viewing
          the stupendous works that have been  made  to improve the
          sanitary condition of ancient cities—that yet in their mighty
          relics, are still standing monuments  of the  great value  those
          people  placed  on health,  and  their „ confidence  in  sanitary
          measures  to preserve it.    It has been said  on high  author-
          ity,* that  the  climate of  Petersburg, in Virginia,  during
* Dr. Jackson. 
Sanitary  Condition of New Orleans.
13
our revolutionary war, was so fatal that no native of the place sur-  Petersburg
vived his 20th year. It is now a healthy locality.  It has been more once very fa-
recently known that at Bristol in Penn., so great has been the mor-tal •  extent s
tality from the influence of neighboring swamps,  that from its firstaBd do* of
settlement, not above  two  or three children, born there, have
arrived at maturity—and this continued until the swamps were
drained.   Wilmington, Norfolk, Savannah and Louisville, were
annual sufferers under the most disastrous fevers, an investigation
into and a removal of the causes have restored them to salubrity.
The same remark applies to all the northern cities—Philadel-And do- of
phia particularly, (as will be shown by-and-bye) has  suffered as others"
much  by yellow fever as New Orleans—nay\ it has been more
fatal there, than here, (even  including our last sad year.)  Now
she suffers only  an occasional  out-break, when  her sanitary
measures  have been neglected.   The recent occurrence will be
found hereafter only a confirmation of this remark.   The same
remarks are applicable to Baltimore, New York and Boston; °n what de_
they each of them for the time being have had their filthy orpends theim"
infected localities, when their sanitary measures were not pro-prm
             ,  i    n  •               -i              i    oftheNorth-
perly enforced; but all intelligent  practical  men  among them
                                                            cm cities*
admit, that the great improvement in their public health, and
particularly their freedom from yellow fever, is owing mainly
to the strictness of their police regulations.   What insurmount-
able obstacle exists in  the position  of New Orleans, that pre-
vents her being benefited by the same means ?
   Much light can  be thrown on this subject,  by reference to the
history of other nations (of the old world) as to what has been
effected by sanitary measures.  In their true interpretation they
are but the application of the arts, purposes, comforts and science
           rx                                     .          Experience
of civilization to the promotion of  health.  That this has been
extended in proportion to the attention paid  to them and that
when this has been withdrawn and a relapse into comparative
barbarism has resulted, the mortality has increased.   It should
be  gratifying to the pride as it is flattering to  the industry and
intellect of man, that through their constant  efforts only,  the
salubrity  of  any spot (not  salubrious from position) is main- 
14           Report of Dr.  Edward  H. Barton on the
Man's  «itna- tained; when these are relaxed, or when prosperity and civiliza-
tion depen*-tion decline, the seed of disease,  are,  as it  were, immediately
ent on *""*" deposited  in  the earth.   There is scarcely a civilized nation of
dnstry and m- an^ no^Q menti0I1ed }n history, whose progress and decline are
 «lgence,   ^ illustrative of this truth.  In  the flourishing condition of
          empires, disease has  been kept at bay—industry and cultiva-
          tion has kept pace with population, the arts and sciences  have
          flourished,  and man  has fulfilled  the great end of his being.
          With the decay of the arts and  enervation  of a people,  culti-
          vation has been abandoned—negligence has supplied the place
          of industry, and the mouldering columns and dilapidated palaces
          are the sure forerunners of the pestilence that sweeps its desola-
          ting besom over  the land, and  finishes that which man has
          commenced.  The sombre aspect of the Ottoman Empire, and
          the flourishing condition  of Great Britain,  furnish  impressive
          pictures of the truth of  these  remarks—the former being in
          the most neglected and sickly state—the latter  the  best  culti-
          vated and  healthiest  country in Europe.   It is thus that fate,
          foredoomed by negligence and ignorance of invariable physical
As shown man^ m0TSix laws>  advances to destroy  the cherished  pride  of
England and many ages.  Rome once the queen of  cities, is following the
Turkey, con- fate of Babylon, and from the same cause, is daily diminishing
trasted,  and in population.   Pestilence advances from street  to  street, and
with  other ]jas aiready become the sole tenant of some of its finest palaces,
conntrws.    tempies and churches.  Rome, indeed,  might be singled out, as
          affording in itself and as a warning to us, a history of most
          that is interesting  in the police  of health.   When  still the
          capital of the world, in spite of her liabilities,  she  overflowed
          with population,  and the disadvantages of her position were
          counteracted by the activity and moral excitement of her inhab-
          itants, the  drainage of marshes, the width and durability of her
          paved streets and the abundant supply of pure water, from her
          numerous  acqueducts for baths and other  domestic purposes.*
          England, in the  17th century, was  desolated  by  a constant
  * From an Introductory Lecture, by the author, to his class in the Medical College
of Louisiana, December, 1835. 
Sanitary  Condition  of New Orleans.             15
 repetition of plagues, they  have disappeared under the ame-
 liorating influence of sanitary  measures.  Such  too has been
 the case in  the greater  part of Europe ravaged by repeated
 plagues  of leprosy.    In several  portions  of it, the  average
 duration of life,  up  to the  present period, has nearly doubled Condition of
 from the  same cause.  But a stronger case is presented  inEsypt-
 Egypt?  9- country in so many  respects similar to our own;—
 in  latitude,  climate,  and  liability  to  inundation  from  the
 great rivers.   The plague,  (which  is  in  that  country what
 the yellow fever is in this)  exists in  a sporadic form,  every
 year, and the epidemic  form about  every  two  years and
 where during a recent outbreak (1835) it  was fatal to up-
 wards of  38 per cent,  of its  inhabitants!—nay, I may say
 natives, consisting of  Negroes, Malays and Arabs, a description Mortalitr
 of  the filthy, crowded, unaired, holes (hardly houses) they live™"1 the "R"
 in—the  stagnant water and garbage  around and a deprivation
 of  eveiy comfort, will readily account for this enormous mor-
 tality.  An accurate examination into the condition of the
 classes and circumstances of the various races upon which this
 carnage  ,fell demonstrated, most clearly, that it existed in exact
 proportion to the neglect of sanitary measures.   It  was leastSa,ntary ef"
 among those Europeans, who lived in  airy well ventilated houses
 and severest on those who dwelt in the most crowded and filthy
 manner.   A  reference to the history  of the same unfortunate
 country,  a successive prey to almost every invader for centuries,
 will exhibit infliction or suspension of the plague just as proper
 measures have been adopted  or neglected to preserve the health
 of the people; health, like liberty, requiring  eternal  vigilance.
 "During the reign of the last of the Pharaohs, during the 194
 years of the  occupation  of  Egypt by the Persians—the 301
 during the dominion of Alexander—the dynasty of the Ptole-
 mies and a great portion  of  that  of  Rome,  Egypt was  free
 from plague !*   The absence of any  epidemic, for this long
 space of  time, was entirely owing to a good administration of
government and sanitary police, conquering the producing causes
* Report of the general Board of Health, of England. 
16            Report of Dr. Edward H. Barton  on the
consequence of this most formidable malady, in a  climate very similar to
of their ne-our  own*   The fatalism of Turkish administration, opposes a
elect.      barrier to all improvement and one of the finest climates in the
         world, is left a prey to controlable calamities.   The sanitary his-
         tory of Rome affords  us  a  hardly less valuable lesson.  The
         position is a sickly one—and the average mortality even among
         her highest class was at one period as high as 5  per  cent.   To
         correct this she has left some of the noblest monuments which
         the hand of  time could not entirely destroy—in her vast under-
         ground drainage and sewerage, with her neighboring marshes
         dried, and other sanitary measures.   With a neglect of  these
         in her successive revolutions of  government—disease again
         became ascendant, and one of the oldest and most lovely countries
         in Europe, at certain  seasons, is  scarcely habitable.   The  ex-
         amples might be greatly extended, to show, that  by the effect of
         sanitary measures and extending the comforts of life throughout
         all classes, and these are but  sanitary measures, the  average
         duration of life has been in many instances doubled, and in all,
         greatly extended.
  Awakening   One word more, preliminary to proceeding  in medias res :
 of the public The appointment of the Sanitary Commission has resulted
 mind to thefrom a convicti0n on the part of the public that the sanitary
 value and im- con(j^on 0f tne cjty demanded the most serious investigation;
          that there had evidently been vast errors in the public mind
 sanitary re-                                               .
          in relation  to  it;  and, apart from all that misfit have been
 form.                              x                     ^
          the  condition of New  Orleans  at an antecedent period,  and
          which can  be readily credited from what we know of the
          rural districts now, still common sense required us to look  it
          full in the  face at what it is at this time.  The subject itself
          is not a difficult one.  The difficulty alone subsists in recon-
 W here lies the
          ciling conflicting opinions.   It exists in dispelling the cloud
          of errors that conceal the truth.  It exists in  getting men to
          belive what is against their ( apparent)  interest, rather than
            *  Among these was specially noted was the neglect in draining the marshes after
          the  inundation—leaving so many stagnant pools to exhale their poisons to the at-
          mosphere.  This was rigidly enforced during the Pharaonic and Ptolemaic times.
          Gliddon 
Sanitary  Condition  of New Orleans.              1*7
anything intrinsic in itself; here it is all clear enough, it only
requires the plainest reasoning  from  effects  to  causes, andNot in the
vice versa, it only has to show what has been done a thousandsu Je°'
      i  c      • 1  7          • /.        i     t  .          prejudices and
times betore,  with but one  uniform result !   It is not the
                                                           ignorance of
object or intention of the Commission to flatter  themselves,.
the people  or the place;  our object  is to deal with facts,
not to form hypotheses; to show, if we can, if our situation
is a  remediable one;  if  from  the apposition  of the  facts,
theoretical views  shall be  entertained or result,  we  plead
beforehand, avoidance of  speculative  intentions,  and trust
that  the facts themselves will  be  estimated at their sole
value, no more.   We earnestly entreat  a patient and un-
prejudiced hearing.
                       SECTION II.
Medical Constitution—what of each month—influence of meteor-
  ological conditions  upon  mortality—Prediction of the epi-
  demic in May—its commencement—interpretation of physical
  phenomena—peculiar  climatic conditions—when they ceased,
  and the epidemic—the cholera epidemic of  November and
  December, parallel  between cholera and yellow fever weather
  and liabilities, and differences—climatic peculiarities of the
  year—peculiarities of the epidemic influence on man.
             medical  constitution.
  The Medical Constitution is derived from such a combination „ ^ ,
                                                           Medical  con-
of climatic and terrestrial conditions as influence the constitu- stitution.
tion of man.   What that constitution has consisted in  (in the
present case)—we shall show in another section,—constituting
the most remarkable year, known in our annals.  We propose
now to consider, briefly, what has been the meteorological con-
dition and its special influence on the salubrity  of the city (of
course in connexion  with the  other  condition) in a succinct
summary for each month.
  During the month of January 1853—the maximum temper- Do. 0fjanua-
ature  was 71—the minimum 33^—the average  41  and thery. 
18           Report  of Dr. Edward H.  Barton on the
         range Zl\—the average dew point was 44.93—barometric aver-
         age 30.113—average humidity .882.  The highest solar radiation
         47° (a most remarkable difference between the sun and shade
         for the month of January.)  Amount of rain 3.190 inches; winds
         mostly from the North, and weather pleasant.
           The mortality amounted  to 679.   The largest number being
         from consumption and amounting to 92, and  a very uncommon
         feature was the occurrence of two cases of yellow fever.   The
         whole zymotic class amounted to 133.
Do.ofFebm-   During  February the maximum of the  thermometer was
ary.       77—minimum 36£, average 56 and range 40.50—the average
         dew point 50.48—average of the barometor 30.238—average
         humidity  .845—average amount of vapor  to each cubic foot
         4,5*79—the highest solar radiation 37—winds very variable—
         and more from the South and Southeast, with increase of force
         —amount of rain 4.600 inches.  The amount of the mortality
         was 441;  of consumption 83, of the zymotic class 65—another
         case of yellow fever being returned.
of March.     During March, maximum of the thermometer was 78,  mini-
         mum 43,  average 62.63, and range 35—the average dew point
         56.17—average  of the barometer 30.262—average  humidity
         .832—average  amount of  vapor in each  cubic foot 5.381, the
         highest solar radiation 40— winds mostly North, and amount
         of rain 6.870 inches.  The amount of mortality was 463; of
         consumption 90, of the zymotic class 54.—of pernicious fever
         2—of scarlet fever 14.
of a  a      During April, maximum of the thermometer was 85—-the
         minimum 50, the average 70.37 and range  35—-the average
         dew point 66.60—average  of the barometer 30.260—average
         humidity  .833—average amount of vapor in each cubic foot
         6.804—the highest solar radiation 29^-winds mostly from the
         South, and amount of rain 1.848 inches.  The mortality was
         532; consumption still being the largest and  amounting to 80
         —the zymotic  class being 89—scarlet fever 19—measles 20—
         pernicious fever 5—and diseases of the nervous system  75—a
         very large increase over any preceding month, more than double 
Sanitary Condition of New Orleans.              19
that of March, and first showing the impress of what Was to
come.
  During May, the maximum of the thermometer was 88—the of May.
minimum 60—the average 73.82,  range 28—the average dew
point 67.11—average Of the  barometer  30.237—average
humidity .842—average amount of moisture in a cubic foot
7.601—the highest solar  radiation 39—winds Southerly and
Easterly, amount of rain  3.840—a largely increased combina-
tion of injurious influences.  The moisture had greatly increased
with the high range of temperature, although the precipitation
had been small, below the average of the month—as  the pre-
ceding had  been,  eminently  showing how erroneous it is to
calculate the amount of moisture from the quantity of  rain that
falls, and the cause of the mistake that some of the communi-
cants to the Commission have fallen into in describing the con- Moisture m"-
dition precedent and accompanying the existence of the epi- * en or ry~
demic, while on the same page, a few lines  off, the evidences
and  effects  of this moisture are pointed out—in the extensive
prevalence of mould; and a vegetable life that alone  predomi-
nates in Very  humid weather,  and the  existence of a stag-
nant  atmosphere,  or such winds as are known to be solvent of
a large amount of moisture.
   The high combination then of heat and moisture, with so
small a precipitation, together with a most remarkable eleva-
tion of solar radiation, greater than I had ever seen it, so early
even as January, (see chart,) assured me that the climatic in-
fluences were very remarkable, and when  I  saw the filthy
condition in which the city was—the  great extent  of expo-
                              #                           Grounds for
sure of the original soil of the city—for gas, water, and other ,    ,. .
              °                       °                  the prediction
purposes, the digging of the Carondelet  Basin, the cleaning oftheepidem.
out of canals, and the embankments and excavations for rail- ic in Mar#
road purposes, and the reflection on the  fatal consequences
that these had heretofore always brought on our city, with
the chart A before me;  this early connection of the  atmos-
pheric element with the  physical showed, in the combination,
a foreshadow of what was to come, and enabled me to give 
20          Report of Dr. Edward H. Barton on the
         a warning as early as the middle of May, in the Academy of
         Sciences, in this city, of the disastrous consequences that were
         to follow, and to some scientific  correspondents.  How that
         prediction was verified I now proceed to point out.
            The mortality now reached 671, of which the zymotic as-
         cended to 143, consumption now declined, diseases of  the
         nervous system reached 145.  There were only two cases of
         yellow fever formally reported on the mortuary record, though
         the investigations  of  the Sanitary Commission have dis-
         covered several others, and there were several recoveries
         during the  month  from the disease, occurring in  different
         parts of the  city, without any intercommunication in private
         practice, in the upper part of the city.
           During June the maximum temperature was 91° on  three
         several days, the minimum 73, the average outside as before)
         80.73, and inside 81.46, and the range 21.  The avetpge dew
         point had now reached 73.20, its maximum having been up-
         wards of 80, and its minimum 66.3.   The average humidity
         was .815; the average amount of moisture in a cubic foot
         had reached the large amount of 9.136 grs., nearly three times
         the amount in January.  The maximum solar radiation was
         35. It now became greatest at our nine o'clock  observation,
         which,  with  the almost daily showers,  showed the tropical
acter of the
         character of the climate we were now experiencing:.  The
season.                                            x       °
         rains in May were about weekly; on the 9th of June the rains
         set in, and fell almost daily the rest of the month.  The ba-
         rometer continued unusually  high, as it had done, and which
         continued during the existence of the epidemic, not finally
         falling until December, coinciding with an observation of Mr.
High barom- Prout, preceding and accompanying the outbreak of the first
eter.      great epidemic of cholera in London, this rise being cotem-
         poraneous  with  the occurrence of Easterly winds; accord-
         ingly the NE., E., and SE. winds now predominated greatly,
         with that influence on the system they are always known to
         produce, the first, especially, during  our epidemics.  The rise
         was ascribed to the diffusion of some gaseous body through 
Sanitary Condition of New  Orleans.
21
the air of the city considerably heavier than the air it displaced,
—The mortality had  now reached, during the  month, six
hundred and fifty-six; consumption, which had  formed  a
prominent feature in the weekly mortality, was now greatly Antecedence
reduced, near to its normal standard ; and scarlatina, which
seems to be a prodrome of the epidemic yellow fever here, as it
is in various other countries, was now reduced to half its mor-
tality during  the  preceding month, and thence gave way to
the epidemic, and scarcely made  its appearance again, until
December.  Precisely opposite was  the influence of  the
season on the class of nervous affections; almost keeping pacePredomin"
with  the epidemic, it reached its acme  at the same time
   ,                                  11  i           i    vous affec-
and then declined. The class was unusually large throughout .
the year.
   The zymotic class began now rapidly to augment.  Bilious
remittent, pernicious,  typhoid,  and malignant fevers greatly
increased,  and more  than twenty  deaths  by  yellow fever
were reported.
   We are  now approaching the limits of that great epidemic in July.
influence, which so severely afflicted our city,  and extended
its ravages in an unprecedented  degree, nearly throughout
the Southwestern  states;  in  many instances  even desola-
ting portions  of the rural districts, for  the first time.   The
period of its  commencement may  be  fairly dated from the
second week in July.  By that  time  physical agents  had
sufficiently matured their power  to show their influence on
man.   Let us not exclaim, at this late day, as of old, " visDnty of phy.
est notissima, causa latet.   It  is  the duty of the profession, sicians.
standing as sentinels  upon the great watch-tower of public
safety, (as to  health,) to find out the causes of effects so dis-
astrous.  Providence  permits  no  evils, without there being
                    .      ,  ,          ,.          ,i  Noevilwith-
correspondine;  remedies:  and these remedies  can only be
      tr     o          >                            -'    out a remedy.
properly understood or applied, but from a previous knowl-
edge of their causes.
   To the meteorologist, to the observer of causes and effects,
and the influence of physical agents, the phenomena precur-
           D 
22           Report of Dr. Edward  H. Barton on the
        sory to, and during  the existence of an epidemic, are not at
        all obscure.  The alarm, the agitation of mind, the anxiety
        for the sick, which usually exist at this period, is not very
        favorable to exact observation.   The difficulty then exists to
        curtail the  exuberance of  the imagination,  and  record
        the  nakedness of truth.   A  distinguished French traveler,
        (Chateauvieux.) in describing an epidemic, says :  " No visi-
        ble signs mark the existence  or approach of this pestiferous
        air,   The sky is as pure, the verdure  as fresh, the air as
        tranquil,  as in the most  healthy region.  The aspect of the
         elements is such  as  should  inspire the most perfect confi-
         dence ; and it  is impossible to express the horror which one
         experiences, on  discovering  that all this is deception; that
        he is in the midst of dangers, of which no indication exists,
         and that, with the  soft air he is breathing,  he may be inha-
interpretation ling a poison which is destructive  to  life."   Now this vivid
of physical description,  although generally  credited, is  mostly  a fancy
phenomena,  sketch; and the  philosophic observer  should interpret the
         facts as they really exist; the " pure sky" is evidence of ex-
         cess of radiation, and  the " tranquil  air"  is but stagnant,
         suffocating saturation, or  the wind blowing from unusual
         quarters, laden  with moisture,  or  deprived  of it, ( as  the
         simoon,)  is destructive to the vital principle.  The filth and
         the stinks around him, warn the observer that the elements
         are at war with  his being;  that his constant skill must be
         exercised in the application  of corrective measures, and that
         the equilibrium of his constitution must be constantly main-
         tained.   Elemental disturbances did exist, both precedent to,
         and during the epidemic;  and a long experience, of near
         thirty years, has shown me that they have always  existed;
         if they have not been always  properly interpreted, it was
         because the precision of science was not so rigidly applied to
         the laws of causation, nor were her votaries then required  to
         explain everything, as now.
the epidemic.   ^ disruption of the ordinary catenation of seasons was early
         apparent.  The winter was unusually mild ; great and unusual 
Sanitary Condition  of Nciv  Orleans.
23
radiation evinced an elemental derangement.   Spring came
" before its time;" summer leaped into her lap; and  this
brought, before  the system was prepared  for  it, blighting
autumn with  its associate diseases—the full force of radiant
power,  great heat and intense saturation.   Here was  one
branch of the " shears" prepared for its influence; the other
was supplied in a most unusual  disturbance of the  earth,
and the presence of excessive filth.
   On man this great epidemic was not heralded (as is often Noprecnrsorr
experienced) ty the severity of its avant couriers;  no precur- influence on
sory violence announced  the approach of the disease;  it was man-
mainly in the atmosphere that that portion could  be  predi-
cated from (radiation); on earth all was quiet and calm, but,
as it often happens with cholera, it was the " torrent's stillness
ere it dash below," with a few cases of yellow fever as early
as May, as a kind of warning to the authorities, which in-
creased to twenty in  June, still unheeded;  during July it
rapidly, but regularly augmented, at a geometrical ratio,  each
successive week, and when it reached upwards of one hundred
victims a day, our drowsy Councils established  a Board of
 Health!
   During July the maximum temperature was 89°, minimum
 71, average  outside 79.88 and inside 81.68, (our table in the
 appendix is  limited to outside temperature); the outside had
 been lowered by frequent rains, as is  usual in tropical coun-
 tries;  range 18.  The average dew point 72.13, the highest Great  moigt.
 being 80.9, and lowest 66.5, (the  day after!)   The averagew.
 daily humidity .825, the average at sunrise being  .930.  The
 average amount of moisture in a cubic foot being 8.798 grs.,
the average at sunrise being 9.600!  The maximum solar ra-
 diation was 32°.  The rains were now truly tropical, not only
 in number but amount, having rained on eighteen days and
 four nights during the month.   The thermometer continued
 very high, and averaged 30.265, its maximum this (as during
 last month) being 30.37.  The predominant winds were now
 mostly from our rainy quarters, SW. and W., blowing over 
24           Report of Dr.  Edward II.  Barton on the
Great stagna-
         an extensive region of swamps, and the bed and banks of the
         river for upwards of eighty miles.  But what most distinguishes
         the month in this respect was the unusual number of calms
         noted in my  register, amounting to twenty-six during the
         month, showing, nearly one-fourth of the month, the atmos-
         phere to be in a  stagnant condition, hot, saturated, filthy. The
Filthy gut- gutters were, twelve hours after a rain, reeking and bubbling
ter8,      up with gaseous products, all highly inimical to animal life.
         (I am indebted to my friend. Dr. Benedict, for keeping my
         meteorological journal this month.)  The consequence of all
         which was a total mortality of 2,216, and the epidemic being
         fully established, those from yellow fever amounted to 1,524,
         and the whole zymotic class 1,734.
in August.    During August all the  meteorological and mortuary con-
         ditions reached  their culminating point, and about the same
         period,  as  will be  seen by reference to the chart B, and the
         tables C, D, E,  in all which this is shown in great detail; the
         influence and the inference are both clear and indisputable.
High temper-The maximum thermometer  was 91°, minimum 72°, average
ature.and ai- 81.25, the maximum dew point 79.4, minimum 66.2, and aver-
most average age 73. average temperature of evaporation 76,13, average
saturation.   Darometer 30,194, average humidity .873, average at sunrise
         .950,  only requiring one-twentieth more for complete satu-
         ration every morning ! this being actually noted at fourteen ob-
         servations, the number of grs.  per cubic foot, on an average for
         the month, being 9.737 grs., and at 9 P. M., being 10.045. more
High radia- than three times the amount  in  January,  and at the  highest
tion'      temperature, the highest solar radiation having attained the al-
 nprece ent- mogj. unprecedented height of 61° ! although there was but one
         ' day during the month that was marked entirely clear the whole
         day, (the 30th,) raining nearly every other day, some days two or
         three times in succession, and the amount during the month reach-
         ing 7.016 inches.  The winds were mostly E.  and NE., and the
Unparalleled number of "calm" days, without a parallel  here, amounted to sev-
stagnation of enteen i or> at sixty-eight observations, evidence of a close, suf-
         focating, inelastic atmosphere, which, with the antecedents and 
Sanitary  Condition of New  Orleans.
25
terrene accompaniments, most satisfactorily accounts for the un-
precedented mortality.   This amounted to 6,201, and the mor- Mortah>-
tality by yellow fever to 5,269, the whole zymotic class, depend-
ent upon the same general conditions, being 5.338, besides the
"unknown," and diseases of the nervous system 209.
  The month  of September has been usually the  most fatal in Septembv.
month, on an average of more than half a century here.   This
year, however, it was  something less than one-fourth that of
August.   The meteorological condition had materially changed,
the  maximum temperature  being  86°,  minimum 60, average
76.23.  The maximum dew point 78°, the minimum 50.3, and Great climatic
average 70.93, average temperature of evaporation 72.44, aver-change.
age barometer 30.191, average humidity .857, the highest solar
radiation (in the early part of the month, the 4th,) being 45°, winds
mostly N., E., and NE..  The rains continued until the  13th,
amounting during the month to 5.045 inches,  a large precipita-
tion for September. After this there were but two light showers,
and the disease rapidly declined with the change in the meteor-
ological condition, which was considerable  in  every  particular.
This is a uniform fact, and especially in reference to the hygro-
metic, as shown by reference to my records of former epidemics.
  The  whole zymotic mortality  was  1121.   The yellow Epidemic re-
fever being 1066, and the epidemic, with the climatic change tiring.
in  the  second  week, evidently declining—the whole  mor-
tality for the month amounting to  1627.   Attention is invited
to tables C, D, E, which contain  the daily meteorological
and mortuary condition  in great  detail during the  three
epidemic months, and I would gladly add the whole year of
both, could the  latter be obtained, for  the gratification of
scientific men, to show how much  climatic  conditions influ-
ence our health, and especially during this remarkable  year. The mode of
In interpreting the connexion of meteorology with mortality, interpreting
two  circumstances are to be taken into consideration:  First,the  influenoe
the amount of vital resistance  to be overcome previous toof meteorol°"
the attack (for it is  never at once.)  Second, the period to
elapse before resulting in death.   These,  as yet, are undeter- 
26           Report of Dr. Edward H.  Barton on the

         mined and irregular, dependant  upon individual susceptibility
         and constitutional  power.   The second is easier estimated
         than the  first—for the  average duration of the  disease is
         known to be  from three  to five days.  The period of incu-
         bation is  less known.  We sometimes find, in the advanced
         period of the season, that a sudden great fall in temperature
         produces a frightful mortality;  cutting off at once all who
         are very  sick, unless  carefully protected; and  here a little
         foresight  of a coming  change  can  often  be put to most
         valuable use.   In this case  it is almost equally apt to prevent
         the farther continuance of the disease, provided  the change is
         a permanent one.
in October    During October the maximum temperature was 81° ; min-
         imum 48°, and the average 66, 81; the maximum dew point
         74° 5; minimum 31° 9;  average  59°  31.  The average
         temperature  of evaporation 62.30;  average barometer 30
         231 ; average humidity .804;  maximum solar radiation 41°.
Climatic
         Winds mostlv from East and North but two days, on which
change con-             *                                ^
tinued     *'  rained  until  the latter part of  the  month, one  night
         preceding the frost  of  the 25th, and  having rains two
         days after, amounting in the whole to 5.175 inches, which
         exceeds  the amount of precipitation  for any October during
         the last  ten  years, excepting  that  of  1849.   Range of
Epidemic, as" drying  power*  during the  month, 30.  Here  is a  great
such, ceased, reduction in the destructive  elements in every particular,
         and the mortality greatly  declined.   Indeed, this  has con-
         tinued pretty regularly ever since the 10th or 13th of Septem-
         ber, about which period the climatic changes occurred.  These
         are often more obvious to  one's feelings than by our instru-
         ments, and the time is not distant when these can be stated
         more precisely.   The mortality from yellow  fever during
         the month was 147; of the whole zymotic class 243, showing
         that the epidemic feature had almost entirely departed.  The
         entire mortality was 674.
inNovember.   During November  the maximum  temperature was 75°;
         minimum  45°;  and   average 66.92.  The  maximum dew 
Sanitarg Condition of New  Orleans.              27
point 69.5; minimum 36.1; average 59,46;  average tem-
perature of evaporation  61°.85; maximum solar  radiation
46°.  Winds mostly East  and  Northeast.   This  direction Unusual East
of the winds has been very remarkable and particularly from winds-
the East for the last four months, exceeding the average of the
last five years at least 200 per cent.  The maximum barometer
occurred on the 18th,and was 30.46—a very unusual heighth
here—soon after which the cholera broke out.   The average
for the  month  was 30.329 ; average  humidity .846.  There
were but three days of rain until the 26th, '7th '8th, '9th, when
they were  heavy,  and the amount, of precipitation for the
month reached 7.032 inches; range of " drying power " 20.
   The  average for the month was 30.329; average humidity
.846.   There were but three days of rain until the 26th, 27th
28th and 29th, when  they were heavy; and  the  precipita-
tion for the month reached 7.032 inches.   Range of "drying
 power  20.
   The  mortality  for  cholera  was 177.   The  yellow fever
 mortality was but 28; and the whole  mortality 987; and the
 zymotic class 318.
   The  condition precedent to and accommpanying a disrup-
 tion of the cholera here, is irregularity of climatic move-
 ments—a high and low barometer, and  mostly the latter—
 and a high and low drying power, mostly the former.
   During December, the maximum temperature was 68 on the in December.
 8th, and the minimum 34 on the 20th—the maximum dew point
 65, minimum 24.2 on the 31st—average temperature of evapo-
 ration 50.67, maximum solar radiation 25°, winds continued from
 East, North, Northeast, the maximum barometer 30.48 on the 2d, Great barom.
 when the cholera was  at its height, and declined to its minimum etric varia_
 29.5 7 on the 30th, much the lowest point it had reached during the tions.
 year.  Average humidity .823, and the average number of grains
 of moisture in  the atmosphere was 4.167 to each cubic foot,
 less than there had been since January.   There was but one „.
                                    *                    Air compara-
 slight shower of rain to the 13th, and this occurred on the 7th; tively ^^
 the amount was only 200th of an inch—the total for the month 
28            Report of Dr.  Edward H.  Barton on the
          was  4.560,  and under the  average  for  any  December.  The
          cholera ceased soon after the middle of the month.  New Or-
          leans was in no condition  to localise it, as at this  period  there
Parallel  of  had been some attempt, during our long scourge of yellow fever,
cholera and  to cieanse the city!   This epidemic, so different from its prede-
veiiow fever.  cessor  an(j  incompatible  with  it,  is doubtless influenced by
          meteorological conditions  that differ also.   They have never
          existed here as epidemics together, they consequently depend
          upon somewhat different elements for their existence, as such.
          The latter requires exalted temperature and high saturation, and
          is essentially a disease of the hot season—the  former exists in
          a lower temperature, with much less  and very variable humidi-
          ty  and great variation of the drying power, often very exalted,
climatically  (such at least, has been the case in this climate,) irritating, by
and  physio-  rapid evaporation, the mucous surfaces, producing in them an
logicaUy.    erethism, always a prodrome of the disease—such is just the
          condition attendant on epidemic influenza—the almost universal
          precursor of cholera.  The dew point is also essentially differ-
          ent in cholera from*  what it is in yellow fever.  While in the
Their dew-  former it varies from 48° to 70°, in the latter  it rarely descends
points.      below  60°  and ascends to 80°—these are very remarkable dif-
          ferences.  I speak  of that state of the  atmosphere sufficiently
          aggravated to produce an epidemic of these diseases respectively.
          I do not here allude to incidental, sporadic or endemic cases;
          they may occur under circumstances somewhat different  from
          these, and are dependant upon local circumstances that have not
          been subject to analysis.   And be it remembered that I speak
          of the climate of New Orleans, with the records before me. The
Do. of wmds. predominant winds are also different—while in cholera they are
          the East and  Southeast, in  yellow fever they are the East and
          Northeast.f  The individual liabilities are also different; while
           * Or lower.
           t How deeply it is to be regretted that there is no meteorological record of that re-
          markable occurrence of cholera here in the fall (Oct.,) of 1832, when the  yellow
          fever existed to a great extent in this city. A few days after its outbreak, the yel-
          low fever entirely disappeared, and was thoroughly supplanted by the worst cholera
          epidemic ever witnessed in this city.  Being on a visit to the cholera districts in the
          North, I did not reach here until it subsided, which was as rapid as Its advent, from
          a sudden fall of temperature with North winds.  In the  epidemic cholera  of the 
                  Sanitary  Condition of New  Orleans.               29

with the former, a full habit—sanguineous  temperament and
high living, predispose to the disease, it  is a  protection to  the
latter.   The one attacks the cerebral and sanguiferous system
and mucous surfaces—with the  local developments  dependant
much on the  habits and condition of the individual, the  other
attacks the  great system of  organic life, giving increased activi- Pathological
ty to one secretion, whilst paralysing all others, leaving cerebral differences-
life, with all its integrity, to the last moments of existence.  The
one occurs with a high atmospheric pressure,  the other under
a low one,  or this predominates.   Both belong to  the zymotic
class,  they are invited and localised by filth—want  of ventila-
tion, &c.   The difference in the climatic elements may  greatly
aid  in explaining their different effects  on the system.   Such
certainly is the result  of our  experience here in the  several
epidemics   of cholera which have occurred  in this city during
the last twenty years, and the very fact that they never prevail
together, but successively here, is a proof of  the correctness of
the remark that it arises from the difference in the meteorologi-
cal elements, that constitutes  the sole or principal dissimilarity
in the remote causes, and that, still, if the localising  condition,
(filth, the hot bed of corruption  and vitiation) be  not present,
immunity is enjoyed.
   The mortality from cholera, during the month  was 332—of Mortaiity 0f
yellow fever but 4—of the whole zymotic  class 429, and  the the month.
total mortality for the month 844.  The  table  F, prepared by
Dr. Macgibbon, for the  Sanitary Commission, embraces  the  de-
tailed mortality for the whole year, classified, with the months,
ages, nativities, colors, sexes, &c, and made as correct as it was
possible, under the difficulties of procuring the materials.
   After this detailed application of the meteorological condition
and its special consequences, in  this most remarkable year, it

succeeding year, I  find no record of the dew point in my meteorological journal,
(hygrometric observations were only commenced by me in 1834, and have been
kept up ever since.) But I find in my journal of the period of the  epidemic " a
great fall in the thermometer on the 8th June, (and of course the hygrometry) a heavy
fall of rain on the 9th. over five inches, and severe thunder and lightning ; a change
of wind from the Southeast which had predominated, to the Western  quartern, and
the disease gradually declinod,  it reached, its acme on the eighth .'" and terminated
about the 25rh.
E 
30            Report of Dr. Edward II. Barton  on the
         will be instructive to review the two conditions productive, in
         combination, of such disastrous results, and see how they differ
         from  those of other years.   If in the  appreciation of those at
         the command of science—the causes pointed out do not seem
Great results commensurate ^fa the results, it is to be recollected, that it is
         but " yesterday " (as it were) these definitive  causes have been
from appa-
  ,  .  .  . developed by scientific investigations and applied  to human
rently insigni-      l     J                 o            i j.      ^
ficant causes, maladies, that in the great store house  of nature, the mightiest
         results have been caused by apparently the most  insignificant
         means, and that in no human infirmity can we yet measure the
         precise amount of causation.
            The annual average temperature in 1853 has been less by about
Climatic pe- two degrees, and this has occured during the rains, it has been ac-
cuiiarities  of counted for by Prof. Blodget by the tropical  character of  the
the year.   season, the  daily  curve of temperature being much less sharp
         during the  rainy season, hence the daily mean of temperature
         is less than  usual, this has been specially verified here.  More
         rain has fallen than any year during the last thirty excepting a
         fraction more in 1839.*  The barometer has been much higher
         than any year I have ever noted it, and continued so until some
         time  after the occurrence  of the cholera  in December.  The
         winds have  been nearly one-third more  Easterly  than during
         the last five years, and especially during the epidemic; more
         Northerly—not half the usual Southerly winds, about one-third
         more of  Westerly winds—in this respect,  what  has  eminently
         distinguished the season has  been the unusual occurrence of
         calms, or stagnant state of the atmosphere, for the whole year;
         it has been about four times as  many as usual, and for August
         more  than  eight  times as many calms  as the average of  the
         last five years.  The " drying power " has been greater for  the
         whole year than usual and especially for December.  The radia-
         tion was materially different, as is usual, in yellow fever  years,
         the highest amount existed during the yellow fever, (and this is
         commonly in September,)—this year the  largest mortality  oc-

            * I was not here in 1847, being absent in Vera Cruz—more rain is alleged to hav«
         fallen then. 
Sanitary Condition of New  Orleans.
31
curved during August, accordingly the highest radiation occurred High radia-
then.   In a series of non-yellow  fever years,  the culminating tion and sick-
point  existed in  Hay—vegetation probably  then requires itnessconcomi-
most.                                                     tant
   So great  is this  " drying power"  in a climate where Effectof great
moisture is deemed the  " only sinner," that at times  it be-"drying pow-
comes very embarrassing  in the treatment of disease,  and iter-"
is of great importance to remdy it.   It occurs  not only in
cholera, but in cramp,  in rheumatism, in pneumonia, in scarla-
tina,  and sometimes  even  in  yellow fever; it  makes the
 meteorology of  the sick room a  part of the proper armory
 of the profession.   Covering the body  with blankets and bed
 clothes does not prevent the rapid evaporation that ensues, in
 a dry period, not only from the surface of the body, but from the
 lungs.   In the more elevated sierras of Mexico, where the per-
 spiration passes off with such celerity, from diminished  atmos-
 pheric pressure, that  sensible perspiration ( or sweat) is not
 often or long seen, there is worn a kind of close woven ( or
 Canton flannel)  under garment, that resists  this rapid  de-
 siccation, and is very  comfortable.   I  am in the  habit, at
 times here, of changing the hygrometry of  the sick room by
 having water poured on a heated iron.   Too much dryness,
 then, may be a cause of disease as well as too much moisture.
    England, enveloped  in her fogs a large  part of the year,
       °            *            °      °   r          J   > Difference be-
 is, with her low temperature, one of the healthiest  countries tween moist._
 in the world;  while  New Orleans, with her great moisture ure and high
 and  high temperature, complicated as  it is, with other power- and low tem-
 ful  agencies, is one  of the sickliest.  The  exact  amount perature.
 required for health is a subject for future investigation.  The
 Sanitary Commission has tried, in vain, to procure such an
 array of facts during our last memorable  year, as to justify
 some generalization on the subject.   It is not abandoned ;  it
 is too valuable, if  such a record can be procured of the exact
 period of occurrence of the principal classes of disease of a
 year so distinguished, as well  for its meteorological as mortu-
 ary  condition,  it  should be done.   The meteorology of  it 
32           Report of Dr.  Edward  II. Barton on  the

         we have.  But three professional gentlemen, Drs. Benedict
         Kovaleski and Copes, answered our circular, furnishing dates
         of the occurrence of cases of disease during the whole year-
         loo few for important deductions*  It does not require that
         statement to  show whether meteorology has any influence on
         man, there is not a day or month of this, or any other year,
         in which this is not shown to the satisfaction of every mind
         capable  of observing, and  not  closed  against conviction.
         The contrary supposition  embraces the belief,  neither  more
         nor less, that man  is independent of climate—nay, of exter-
         nal agents—is so  absurd  that I  dismiss it with  no further
         notice  than  this  bare reference  to the hypothesis  that  has
         nothing reasonable to support it.
            Inclosing this imperfect analysis of the  "epidemic constitu-
         tion, "  it is  proper to refer  to those specialities for which this
peculiarities epidemic is entitled  to the paternity.  Hereafter it will be shown
of the season, that the fever of this  year has been the same in all its essential
         features with those  of preceding years, with  the usual variation
         for season, and that all the stories of its African, Rio Janeiro
         or West India nativity, are as equally groundless as the impor-
         tation of the epidemic itself.   It is doubtless true that its  ma-
          lignity  was  hardly ever  equalled with us and that there were
          sections of the city where many cases terminated  within twenty-
          four hours from the commencement.  It was remarked that an
Creole ex-  unusual  number  of children were attacked, even those born
empt.      here, unless both parents were themselves Creoles—a much larger
          proportion of the colored population than common; the remark-
          able number  of forty-four are reported (although much less than
          in the country)—females also suffered more, and especially those
          pregnant, than in any year since  1835—a fine miliary eruption
 influence of wag usuaiiy seen  on the skin within twenty-four hours from the
          attack—it was the  harbinger of safety as long as it kept out—

            * Since the above was  written 1 have obtained, with the assistance of the Sanitary
          Commission, near 10,000 cases of certain classes of disease, supposed to be mo.st
          under the influence of meteorological conditions, at the dates of their occurrence,
          during this interesting year (1853), which I intend digesting with their correspond-
          ing meteorology at as early a period as practicable. 
Sanitary  Condition  of New Orleans.            33
its repulsion the signal of great danger if not of fatality;  this
was followed during  convalesence, with  troublesome furunculi,
throughout the body, it even occurred in many  who had not
the fever;  this same eruption characterised the great epidemic
yellow fever of Philadelphia, of  '93, many were  affected with Ernption'car-
carbuncles, and in several instances buboes during the fever.
TL        •            rr.                                    buboes.
lhe  perspiration was offensive even with those who were  care-
ful enough to  bathe twice a day, the same was noticed of the
above Philadelphia epidemic.  The appetite for strong food and
drink was materially lessened with those who had extensive
and exhausting professional  labor to perform, and its indul-
gence increased the exhalation from the body above  spoken of.
These, however, I have repeatedly observed in former epidemics,
a large proportion of the telegraph operatives fell  victims to
the fever.
  The stimulus of the generative power, which the distinguished
historian of the great Philadelphia epidemic of '93,  Dr. Rush,
mentions, and the facility of and liability to conception,  even ,
                                     J          x    '      Law of com-
with those who for ten or twenty years had ceased bearing, also pensation.
existed;  (noticed here by me, and published in my account of
the yellow fever of 1833 ;) it seemed a kind of law of compen-
sation like that which attaches to the poor in sickly countries;
of multiplying their births in proportion to the mortality.  The
rise and decline of the mortality in the zymotic class (or prevent-
ive mortality) has been  traced in its successive monthly stages,
its culminating point this year being August instead of Septem-
ber as heretofore, uniformly, unless when epidemic cholera shall
have been the principal  disease; this being essentially a winter
disease with us, or at least, occurring  at any other season than
the summer, it makes the angle  in that part of the chart A des-
ignating the monthly liabilities, much less sharp for  September
than it otherwise would be.
  Class III, of monoxysmal or  contagious maladies,  had its in May most
greatest prevalence in May, and was at its minimum in September, c on t a g i o us
  The class  of "nervous diseases"  had also its culminating malady.
point with the highest temperature in August.   That of pulmo- 
34           Report of Dr. Edward II. Barton on  the
Nervous  dis- nary affections again reverses the figure.   Intemperance reaches
eases in  Au- its highest amount as the fears of the fever increase, and doubt-
ed-       less added an immense amount to the whole zymotic class.  This
Reverses  of  taD^e shows here, as  every such table  shows, that the "unpre-
the puimona-ventible diseases" are a constant quantity, and that  our enlight-
ry.        ened efforts are mostly  to be directed to the variable classes
          (mainly the ''zymotic") which  man  has (most fortunately), so
Intemperance v     J       J
     ■  ■   much power  to control.   There exists a  popular  error ot  the
most injurious      z                                 •»•
in summer.   " purifying " influence of storms accompanied with thunder and
          lio-htning; it is something similar to that denominating a heavy
          atmosphere (high barometer) " light"—because with a low tem-
          perature it is bracing, and a light atmosphere  (low barometer)
storms andr                  °             1  i. ,   •    -r 1        •
,. ,  .   j  "heavv."   Storms of thunder and  lightning, I have  noticed
lightning du-      J                              o     o
ring epidemic, for  thirty  years in this country, to exist during epidemics, and
          instead of " purifying the atmosphere," to injure the sick; they
          existed  throughout the epidemic here and elsewhere last year,
          They have been noticed  during the  epidemics at Rio and
          Demarara and  other places.   It  is  the opinion of many phy-
          sicians  in tropical  climates, (Belot  at  Havana, and others at
          Rio, &c) that this  development of electricity increases  the
Unless a  hur- cases of yellow fever;  that in proportion to the violence of the
ricane.      storms the disease augments in violence and that it aggravates
          existing cases, (and so in  cholera.) unless a hurricane occurs,
          when (so great is the change) there at once occurs  a great
          temporary abatement  of the disease.  The frequency of the
Gas in the  rains are shown and their amounts during the epidemic months,
gutters soon  exhibited in the meteorological tables for those months, in detail.
after a rain.  j^. wag remarked also as frequent as the gutters were thus cleansed
          when stagnant water still remained,  that  discolored  slimy
          pellicles covered its  surface, bubbles would issue, within twelve
          hours after these ablutions ; I called the attention of my chem-
          ical friends to it and advised its annalization.  It is to be greatly
          regretted  that  the  arduous nature of our professional  duties
          during a severe and exhausting  epidemic curtails greatly our
          ability  to make  that  extended sphere  of experiments  which
          science and humanity both demand, for these arc twin sisters, 
Sanitary Condition of Nevj  Orleans.              35
and the measure of the utility of  the  one depends upon the
extent it can advance the other.  This is our apology for not
accomplishing more  in the most memorable  year for both that
our country has yet known, and we feel humbled at the  small
offerings we have been able to make at the altar.
  It is  as well to mention, without knowing  that there exists
any connexion between them, that  there  was a slight shock of
earthquake at Biloxi about the period of the occurrence of the
fever there ; that simultaneous with  the outbreak of the  fever
here  in May, there  were earthquakes in Georgia, and that at
the precise period when it was most fatal viz :  the 20th and
21st of August; there were earthquakes in Ohio and Thebes,
all of these were attended with thunder and lightning.*
Earthquakes
during  the
                       SECTION III.
Estimate of the life cost of acclimation in New  Orleans from na-
  tivity—to the natives of Louisiana—to those of the Southern
  and Western States—to the Northern States—to the  North-
   Western States—to the British population—to those from the
   West Indies, South America and Mexico—to  those of Great
  Britain and Ireland—the North of Europe—of Middle Eu-
  rope—of Western Europe—of the mountainous parts of Eu-
  rope, and  the  South of Europe, together with the probable
  causes of the remarkable differences.
  The classes of  our population, with regard to  their social po- _ dal  os!_
sition on whom  this epidemic has borne most heavily, connot tion M repre_
be shown by any recorded proofs; and must be left to be in- sented by the
ferred from the exhibits from the  several  cemeteries, in which cemeteries.
they were  interred, and they are  to be seen in Table H.   The
poor are the greatest sufferers always,  and especially in insalu-
brious  places, and  during  epidemics;   they  live in  more
crowded, filthy, and uncomfortable dwellings.   They are  igno-
rant mostly of sanitary laws, are unable, or find it inconvenient
to apply them, and hence,  require the strict surveillance and
kindest concern  of a paternal government.  The most  of those
*Meriam. 
36
Report of Dr. Edward  H.  Barton on  the
Cost of accli-
who constitute this class,  are the  hands, the  machinery, that

make the  wealth of a  community,  and give it its power;  and

hence,  are the rightful claimants of  its fostering care.

   Table II, has been constructed  from  the materials of which

our mortuary table of general mortality has been formed, to

show the liabilities of our heterogeneous population  to the epi-

demic yellow fever from nativity.  For this Mr. De Bow (our

fellow townsman) has kindly responded to my request, and fur-
                               TA13LE H.

                    COST  OF ACCLIMATION,
SHOWING THE LIFE COST OF ACCLIMATION; OR LIABILITIES TO YELLOW FEVER
  FROM NATIVITY, AS EXHIBITED BY THE EPIDEMIC OF 1853, IN NEW ORLEaNS.
NATIVITIES—State and Country.
 Southern
  States.
 Northern
Slave States

 Northern
  States.
N. Western
  States.
S New Orleans,.......................
) State of Louisiana....................
<; Arkansas, Mississippi, Alabama......
( Georgia,  South Carolina,............
5 North Carolina, Virginia, Maryland,.
 Tennessee, Kentucky,.
( New York, Vermont, Massachusetts,..
< Maine, Rhode Island, Connecticut,---
(New Jersey, Pennsylvania, Delaware,.
C Ohio, Indiana, Illinois,..............■
I Missouri,...........................•
 9

10

11

12

13
14

15
1 a  Southern
  '   Europe
British America,
f West Indies.....
< South America,
(Mexico,.......
5 Great Britain,..
 Northern
  Europe.

  Middle
  Europe.
L'wWestern
  Europe.
Mountan'ous
  Europe.
J Ireland,.....
C Denmark,__
} Sweden,.....
( Russia,.....
c Prussia,.....
\ Germany,...
c Holland,___
I Belgium,___
f Austria,.....
\ Switzerland,

5 France,.....

C Spain.......
\ Italy........
38,337

 2,655
 4,160

 8,898

 1,693

   318

 1,693

 3,832
22,093

   491

14,765

   127
   663

  8,306

  1,848
S2£§

a S  >
46,004 \

 3,176
 4,984

10,751

 2,030
   381
  "66,945
 1,790

 4,598
26,611

   588

17,718
   152
   797

 9,967

 2,217
140
 25

 42

153

353

 92

 20
.826
 11
  240
3,569

   96

2,339
   50
  176
  480

   61
 3.58

13.22
30.69

32.83

44.23
50.24
   12.32
  6.14

 52.19

204.97

163.26

132.01

328.94

220.08

 48.13
 22.06
109,679[62,648|7,011 111.91
  * These were not all the States represented by population in New Orleans; but they are all
that were debited by deaths from yellow fever, and all that could be estimated from ; although
there were26,590 that were necessarily unrepresented in these calculations, moat of whom, wore
colored, however. 
                 Sanitary Condition  of  New Orleans.              37

nished me, from the U. S. Census Bureau, of which  he is  the
honored and intelligent head, the aggregate and nativities of the
population of the city for 1850. That furnishes the first column;
upon that I have calculated the population for 1853 for each
country respectively, by  adding a fractional  increase per cent.
over that from  1847 to 1850, (the most recent fixed periods;)
that supplies the second column.  The third is derived from the
Cemetery Reports during the prevalence of the epidemic, but as
there was a large number that was classed as " unknown," it was
deemed the nearest approximation to the truth,  as  in  all  our
records it is little better than approximations, to add a large per
cent, of these, for such is the negligence herein relation to such M0(ieof con-
records, where there is neither law, responsibility or appreciation, 8tructing the
that the statist can only be expected to approach the truth, however table.
desirous he may be to be exact.  These, then, I have divided among
the known in the proportion they bore to them respectively.  Ac-
cordingly, this column was thus constructed, and it is believed not
to vary greatly from the truth.  It carries, at least, strong probabil-
ity in its favor.   The fourth  column  results from this, and  fur-
nishes the ratio of mortality per thousand of the population. Upon
this foundation we arrive at  the following remarkable results,
which, if  correct, furnishes the cost of acclimation to every de-
scription of our population.
   The estimate for New  Orleans is very  imperfect.   In  the cast in New-
census  with which I have been kindly furnished, the nativities Orleans
of the city have not been seperated from those of the State, and
hence are aggregated together.   The mortalities of  the natives
of New  Orleans from  yellow fever have almost entirely been
confined to those under ten,  with very few exceptions, and  still
only amount to 3.58 in a  1000.
   While  the proportion is shown to be  pretty much the same
in the range of States along the Gulf and South Atlantic (none Do. in the ex-
being recorded for Texas and  Florida,) the  average  shows  but treme  South-
13.22  in  a  1000, or about 1-J- per cent., which is small for the em states.
population, and is very small  even  for bilious  fever,  and  will
             F 
38           Report of Dr. Edward H. Barton on the

         fully sustain some views in relation to the identity of the origin
         and nature of these fevers, in a future part of this Report.
            The next range of States  farther North, being the Northern
         slave States, or middle States of the Union, are subjected  to a
Do. from the cQgt of aca[jmation  which  is  more  than  double that of the
Northern ^^ Southem gtates . it amounts to 30.63 in a 1000, or a frac-
         tion over 3 per cent.   This was to  be expected;  the winter cli-
         mates  are as different in their temperatures, as the summers in
         their hygrometric properties.
            The next group embraces the  Northern States, which still
Do. from the fart}ier increases this difference, being 32.83 in a 1000, or nearly
Northern ^ ^ ce^ Jt .g probable tbat tbe habits of life between  these
         two sections are more influential in the production of this dif-
         ference than the climates.
            But what shall we say of the Northwestern States, having an
Do. from the mcrease  over the Northern  States  of more than  one-third, ov
Northwestern ^^ ^^ ^qq ^^ ^.^ ^ ^ Gujf g^^ being 4423
         in a 1000, or nearly 4-|- per cent.   This is a large increase, and
         is not accidental; it is regular.  The States of Tennessee and
         Kentucky, which  form  the Western part of the group of  our
         Northern  slave States, is considerably  larger than the Eastern.
            The great  difference in the  life-cost of acclimation  be-
 Probabie  tween tbe Northeastern and Northwestern States, and  those
          from  their  brethren  farther South, probably, in  great part,
 difference.     .          i •  1  i •   1 •  -i 1       •      •
          arises from their habitual indulgence in  animal  food and
          general  gross living at every meal, more than in any part of
          our  country, or probably  the civilized world.  This habit is
          not readily dropped ; when they immigrate South the process
          of animalization is accompanied  with  the evolvement of great
          heat  or combustion,  and is incitive  to, and apt to produce
          fever.  This calorific process is  but  slowly  adapted  to the
          requirements  of the  climate, and the habit and its conse-
          quences are productive mainly, in our opinion, of the forego-
          ing  results.   It  is at  least suggestive of valuable hints, and
          should  not be lost sight of.   Man can adapt  himeelf to  any
          climate, but it is mainly through  his  living.   This is proved 
Sanitary  Condition of New Orleans.             39
 by the  valuable  and interesting experience  of  Northern
 voyageurs, who find their crews resist the rigors of a North-
 ern winter in proportion as they adopt the mode of living of
 the natives.  It is perfectly reasonable.  Where man resists it,
 and carries  the habits of one climate into another, he pays
 for it by abbreviation of life.
   British America still rises in the scale, and illustrates its value Do.fromBrit-
 and correctness.   It amounts to 50.24.                       ish America.
   It is equally proved by looking at the small influence from
 change of climate on those from Mexico, South America and the Do fromS,th
 West Indies, where the great contrast is shown by the exhibit America,
 of only 6.14 in a thousand, and  doubtless,  these derived their Mexico, and
 liability from coming from  districts where  the yellow  fever is West indies.
 unknown, for the opinion is entertained, by the reporter, that the
 acclimation to the disease in one climate  affords immunity
 throughout the zone.
   So much for the natives of this continent, showing an aver- Totalj i2 i_3
 age influence of this change of climate on them of about 12.32 per cent, for
 per 1000 in order to acquire perfect acclimation here.  Of  the all America.
 colored population there are no records but that of death,  and
 the remarkable number of  forty-three is given in our  mortuary
 table for last year, a number utterly unprecedented in our  an-
 nals, although it has been much greater in  the country.   The Mortality of
 nativity  of the slave population is not given.   I do not remem- the colored.
 ber ever  to have met with a case of death in the  black popula-
 tion during the prevalence  of  this disease in the West Indies,
 except during the recent outbreak.
   The table exhibits, as we proceed down the  columns, a  still D
more serious  result from change of climate, while the mortality prancei
of the natives of  France, with their temperate living and habit
of adaptation, have now reached 48.13 per 1000; those from
England, generally a rather choice population, with fine consti-
tutions, but with national obstinacy in relation  to diet, have as-
cended to  52.19, probably  from a much fuller  habit of living,
not readily adapting itself to the requirements of a waf m climate,
and at least this difference, if not more, exists wherever these two 
40            Report of Dr.  Edward H. Barton on the
         nations are exposed to similar influences in a hot climate, and
         most probably from the cause stated.
Do. from ir«-   Those from  Ireland reach the enormous amount of  204.97
land-      in 1,000, showing the consequences of an entire revolution in
         everything, climate, diet, drink, social habits, all that elevates
Ca058.     man to the dignity of his being, from moral, political and phy-
         sical degradation and subserviency, with propensities and dispo-
         sitions the most reckless.
From North    Those from the North of Europe  are also very large, 163.26.
of Europe.   rpbe difference of climate i.s  very great, and men will not, until
         after much suffering, adapt their habits to altered condition.
From Mi-uiie   Those from Middle Europe, it'will be seen, are  much less,
Europe.    132.01  in 1000, although still very large, and the same remarks
         apply here as in those of Ireland, although the social changers
         not so great, and there exists among  them greater constitutional
         prudeuce.   With  these,  and indeed, all European immigrants,
         aud particularly, among  the Irish, a  propensity  to  crowd  their
         families into a small space, with the inevitable result of accumu-
         lation  of filth,  and deficient ventilation,  is eminently conducive
         to a greatly enhanced mortality.
            But  still, the largest  mortality in our table is found to exist
         among the immigrants from  the low regions of Western Europe,
         reaching the highest elevation of 328.94 in 1000.   Holland and
and Belgium.        &      &
         Belgium are low, flat countries, with much moisture, which, at
         a low temperature—with proper comforts of  life, is not incom-
         patible with great salubrity, but when these are exchanged for a
         climate of  high temperature and great  saturation—and  these
         will be shown hereafter to be a material part of the conditions
         most inimical to health—together with  a total  disruption of his
         social  habits, the influence on the constitution is most deeply felt,
         as recorded.
            But the climatic change from the high, mountainous  regions
From Switz- 0f Europe, (Switzerland and Austria,) with their low tempera-
         ture, dry, elastic air, and plain food, to the heat, moisture and
Austria.     .
         different social condition which they soon reach  here, is pro-
          ductive of consequences, although great, scarcely sufficient to ao- 
Sanitary  Condition of New  Orleans.
41
count for the large mortality  of 220.08  in  1,000.  Elevation Accounted
then, in a temperate  climate, in its proclivity to develop the for.
sanguine or blood-making  and heat-producing system or tem-
perament, so different from that of warm climates,  where the
bilious temperament predominates, and which is so much better From Spam
adapted to it, must aid in accounting for  this  large mortality. and Italy.
This is eminently illustrated in seeing how small is the mortality
in the natives of Spain and Italy, about one-tenth of those just
mentioned, or 22.06 in 1,000. and who are almost uniformly  of
                                                      /   Probable rea-
the bilious  temperament, living on a milder vegetable  regimen
and great temperance, which this temperament instinctively calls
for.
                      SECTION IV.
Total population of the city during the year ; estimate of the
  unacclimated ; number of cases of yellow fever in public and
  private  practice ; ratios of mortality in each ;  comparative
  mortality in other countries ; mortality in our rural districts,
  S)V.,  fyc.
  The total population of the city of New Orleans, by
the United States census, in 1850, was............129,747.
  By adding the ratio of increase from 1850, and care-       Total popuia-
fully and laboriously calculating, from  the varied and       tionini853.
imperfect returns of the city census of 1851,-'52,  for
each ward and class of the population, so far as it was
possible to procure them, I have arrived at the conclu-
sion that  the augmentation, in  our aggregate perma-
nent population  in 1853, amounted  to.............154,132.
  It is well know the increase has been much greater,
especially of the floating population.
  The difference between the population during  the       Difference of
last preceding epidemic,  in 1847,  and that of  1853,       population in
is 45,433; to which add 5000,  a very small estimate       1847 and 1853.
of the floating population, and of that large class of
denizens, who have their actual homes here, but are a 
42           Report of Dr. Edward H. Barton on tlte
          large part of their time absent, and which are embraced
          in the  enumeration of the population of other large
          commercial cities (more particular in this respect) all
          of whom are unknown to our census returns, and who
          generally form the first victims of an  epidemic;  and
          we have an unacclimated population of 50,433.   But
          as no  epidemic  so thoroughly influences  the whole
          population, as to leave none still  susceptible to attack,
          and we well know even the last did not, and that was
          the most thorough and wide pervading we ever had:
          whole families escaping, and of course, the disease did
 Totalunaccii-110t stoP *or 'ne want °f subjects.  In fact no epidemic
 mated  popu- so thoroughly influences the entire unacclimated pop-
 lation.      ulation,in any city, so that none escape; may be from
          some transient or accidental cause, although they may
          be subject to it  afterwards, as we now well know.
          During the existence of the plague in Marseilles, in
          1720, when near half the population fell victims to it,
          amounting to 40,000—thousands did not suffer at  all,
          out of a total population of 90,000.  It is probable that
          more than double the number was left untouched  in
          1847 than were taken sick; it is deemed fair to estimate
         the total susceptible population, in 1853, at.........60,000.
         And the entire city population, at................158,699.
            This  will be considered moderate, when I add that
         our foreign immigrant population, arriving in the city,
         to the month of June, '53, reached near 24,000, many
         of whom doubtless remained.
Number sup-   On this as a basis, I have supposed there left the
posed to have city, before or through the epidemic, arid thus reducing
left the city.  our population to that extent,....................  36,283:
         being something less than one-fourth.  I have come to
         this conclusion,  after a very minute examination into
         all the records and  sources through which this exten-
         sive emigration could take place, viz : by  the river,
         and through the lake; by public and private records; 
Sanitary Condition of New Orleans.              43
and  deducting the ingress  from the  egress.   To be        Numbering
more  sure,  I have consulted the judgments of those        city during the
who have been here, like myself, during the epidemics        epidemic.
of the last twenty or thirty years, and there is a pretty
general concurrence in the  belief that the population,
during the summer, amounted to at least...........125,000.
   The total mortality, from yellow fever, during the        Mortality  by
year, not only those certified to be such, but  a large        yellow fever.
proportion of the " unknown," supposed to be such,
from a want of proper records; it is estimated, upon
all grounds  of probability,  to be.................   8,101.
   The ratio of mortality from yellow fever, to the en-        Ratio3 t0 the
tire  permanent  city population, being the calculated [per cent] different pop-
natural increase over the census returns,is 1 in 19.02,or   5-25. uiations,
   The ratio of mortality, to the population supposed
remaining in the city, or  exposed, is  1  in 15.43, or.....   6-48.
   The ratio of mortality to the population  estimated
susceptible, or unacclimated,  (60,000,) is 1 in 7.40, or..  13.49.
   And the  total  mortality of the  year,  to the  total
known permanent population, after deducting all other
causes of mortality than disease* was 1 in 10.19,  or..   9-80.
   And including all causes of mortality,  1 in 9.76, or 10.23.
   To arrive at the number of cases of yellow fever which oc-
curred during the year, the details are more precise than have
ever been  attained here before, but stiil far from perfect,
owing to the backwardness  in  the  faculty  reporting  their
cases.
   The  reliable  returns   are  derived  from  the  following
sources,  viz :
                                     [Cases.]    [Deaths.] [percent.]
There occurred at the Charity Hospital,..........3312, of which, 1890,  being 58-84
The Howard Association had, besides 429 in the }
  Touro Infirmary, and about half of those in >  9353,    "    2252,  "  24-09.
  the four Board of Health Infirmaries........)
  * Deduct from the aggregate, Table F, the following causes of deaths, not
from disease, viz : "non viable," 13; "still born," 346; casualties, 61; drowned, 105;
burns and scalds, 18; hydrophobia, 6; poisoned, 4;  wounds, 47;  suicide, 14; old
age, 5; treatment, 3; (to which ought rightly to be added, intemperance, 123; al-
though I refrain,) amounting to 670, or about 41/t per cent, of the whole mortality
and reduces tliis to 15,117;  and the ratio of mortality will be as above.
  I  have not made this correction in Chart A, for previous years, because I had not
the materials.  The deduction would have, doubtless, been much larger. 
44              Report of Dr.  Edward  II. Barton  on  tlu
                                                        [Cases]      [Deaths ]  [per cent
Cases .mortal- The Touro Infirmary, of Howard 429; others, 94,.. 523,  of which  213, being 40-72.
ity, and ratios The Maison de Sante............................. 333     "       97,   "   28-69.
            The Luzenburg Hospital,........................ 150     "       79,   "   52-66.
in various
            The Board of Health and Howard Infirmary, No. 1, 343     "      155,   "   45-18.
public institu-   .<     „      .,     „        ..     No 2..... 338     .,      170)   „   5Ug
tions.          "     "      "     "        "     No. 3,___1500     "      500,   "   33-33.
                                                No. 4..... 432     "      207,   "   47-91.
            The City Workhouse, 1st District,................  89     "       14,   "   15-73.
            The City Prison, 2d District,.....................  30     "       5,   "   16-16.
            The Lunatic Asylum.............................   9     "       0,   "   oO-OO.
            The Boys' Orphan Asylum, 4th District,..........  60     "       2,   "    3-33.
            The Boys' House of Refuge,.....................   21     "       6,   "   28-57.
            The Girls'House of Refuge,.....................   21     "       ],   "    4-76.
            The Catholic Female Orphan Asylum, Camp St. --   81,     "       4,   "    4-93.
            The Poydras Female Orphan Asylum,............   50     "       9,   "   16-20.
            The Circus Street Infirmary, no returns, but estima-
              ted about.......................................300     "      100,   "   33-33.
            To which  add, of cases reported to me,  and]
              called " outside cases,"  by  members of the j
              Howard Association, and other philanthropic ? 2929     "      705,   "   22-02.
              individuals, and supposed same rate of mor- I
              tality as the Howard's public practice,*......j                        equal to
            Making the  total of elemosynary cases, or at.....19479     "     6409       32.90
              per cent, or 1 in 3.03.
            From various members of the faculty, in the city,
Number of     whose names are mentioned hereafter, I have
cases in pri-   had reported to me, localised,................ 7624.
            From the best estimates the Sanitary Commission
vate practice.                                J
              is able to form of the location, practice, and
              number  of those who have  not  reported, it
              believes  they do not exceed.................. 1917.
            The total, then, in private practice, to which must
              be debited the balance  of  the mortality from
              yellow fever, amounts to....................... 9541     "     1691       17-72
Total ratios.    per cent., or 1 in 5 89.   •
            Making the  total number of cases in the city,
              during 1853,................................. 29,020     "     8101      27.91
              per cent., or 1 in 3.58,                                     *
               This is the largest number of cases,  and the greatest  mor-
            tality from  yellow fever that ever  afflicted  our city.   But it
            is the least   mortality to  the  number of  cases that  has  ever
            occurred  in  a great  and malignant  epidemic  yellow  fever,

              * These were  all attended  by physicians of this  city, almost entirely  without
            remuneration, and it is but bare justice to them to say, that they were ever, at the
            call of duty and  humanity, making every sacrifice  at the noble shrine; and that,
            when the epidemic slackened in its virulence here.they generously voluntered to pur-
            sue the scattering pestilence into the interior, in aid of their less experienced brethren
            and suffering fellow citizens.  It is with pride we record that no one  proved recre-
            ant and deserted his post, and that many (fourteen) fell victims to their high profes-
            sional honor and devotien.  Nor was the  other  branch of the profession les«
            distinguished in the call of duty, and suffered  still more in obeying it; more than
            thirty apothecaries having sunk under it. 
abroad.
                  Sanitary Condition  of Nev)  Orleans;.              45

such as this was,  and  it  is but fair to claim  for our faculty
and philanthropic associations, unequalled skill and kindness, Tribute to the
in the treatment of the greatest scourge of our country, as I faculty; our
shall presently show.  It is but a faint tribute of praise, dueassooiation><
to  the  warm hearts and  open purses of our countrymen, in and
other sections  of our happy union, to  acknowledge that much
of  this proceeded  from their kind aid, in the deepest hours of
our travail we  saw that our calamity was  felt with electric
speed every where, and that relief,  accompanied with warm
sympathy,  came, even beyond  our wants; which was then as
liberally distributed to our suffering fellow-citizens elsewhere.
   Now, thoroughly to understand our relative status to other
places, and it can only be done by comparison, let us en pas-
sant, cast a glance at the  sufferings from this disease in other
 ...        .             .                             pare with oth-
cities and  countries, not  that it makes our misfortunes any
                                                             J er cities.
the less, but it is consolatory to know, that other cities have
suffered as  much or more than  we have, and are  now enjoying
the blessings of health.  It will be  made  probable  that  we
might, by similar means, do so also, and it is for that purpose,
mainly, that I make this comparison.
In Philadelphia, in 1793, the ratio of mortality to those exposed or         Mortality of
               remained, was...................................    1 in 10 epidemic;
               and the ratio to the entire population..............    1 in 13 „ ..   f
do.     do.      in 1797, the ratio of mortality to those thatremained,  1 in 16.6
               and to the entire population......................    1 in 50   '
do.     do,      in 17'J»-, the mortality to the  entire population was 1 in 15.50 m '93-'97-'98.
               and to the number exposed.......................    1 in 6
The three epidemics of the same city, for 1793,  1797 and 1798, gave an
               average mortality of the entire population of...... 1 in 14.24
               and of those that remained in the city. of.......... 1 in 10.13
And the mortality to the cases attacked in the epidemic years, from 1793
               downwards varied from 1 in 1.2, in 1819 to lin 3.86
               in 1805, giving an average for all these epidemics of  1 in 2.12 Average hos-
  The loss at the  Hospital alone  during the epidemics  of pitai mortaii-
1793, 1797, 1798, 1799, and lS02-'3, the only years in which t-
the admissions were recorded,  varied  from 1 in  1.68 (1799)
to   1  in 2 (1803,) with an  average for the six seasons of 1 in
1.867.
  In  these  several attacks of epidemic yellow fever in Fhila-
            G 
4G           Report of Dr.  Edward II.  Barton on the
where  most delphia, it was remarked, that it was much more fatal in the
fatal.      ]ow  filthy malignant atmosphere  of some districts, than in
         those where they were  more elevated and airy—in  those in
         wooden houses than in those of brick.  This is found to be
         the case every where.
in New York    -^ne genera^ mortality to cases in New York, was about
Baitimoreand 1 in  2;  in Baltimore,  1 in 2.87; in Charleston, about  1 in
Charleston.  4 of the cases fatal, on  an average of the several authorities.
         In Savannah the number of persons dying  of autumnal dis-
         eases to the whole white population was in 1817, 1 in 9|, and
         in 1820 1  in 5.1-10.  In Natchez, on an average of a  num-
         ber of years, the mortality to cases was 1 in 2.13 and 1 in 16
         of the population.  In Mobile, 1839, and 1847  the average
         mortality to cases, was  estimated at 1 in  7.   The  mortality
         to the cases in the epidemic here of 1820, was 1 in 6 in adult
Mortality in whites, in various description of persons ; as women, children,
New Orleans, blacks,  1 in 10.  The average  in New Orleans in a series of
         years to 1849, the mortality was 1 in 4, this, however is taken
         mostly from the Hospitals, in private practice  about  1 in 8 or
         9, and the proportion to general  population as 1 in 55. From
         an estimate I made some years  ago, from the results in pri-
         vate  practice,  there  is some  difference  from those above,
         which are obtained with the preceding interesting  historical
         statement, from the reliable authority of Dr. R. La  Roche, in
         Philadelphia, mine made the mortality in private practice  to
         vary from 1 in 10 to 1 in 20, while those in Hospital did not
         vary greatly from those in our public  institutions last  year,
         with the exception of being from about 10  to 15  per cent.
         less.   During  the  late epidemic,  the  statements,  as usual,
         were conflicting and imperfect—no estimate that is  entirely
         reliable can be formed  of it, in private practice; I have aver-
         aged it  at 1 in  5.89, it is impossible from obvious circumstan-
         ces,  to arrive at the exact truth, it no doubt varied  from 4 to
         50 per cent.
            During  1804, not less than twenty-five cities and towns were
         visited by  the fever, in Spain; the population amounted to four 
Sanitary  Condition of New  Orleans.
47
hundred and  twenty-seven thousand two hundred and twenty- in Spain.
eight, of which  fifty-two thousand  five hundred and fifty-nine,
or 1 in 8.12, perished.   In fourteen of these places, at different
periods, the mortality, in proportion to the population, was 1 in
6.42 ;  the extreme being  1 in 2.25, and 1 in 13.3.  In seven
places,  the proportion of persons affected, amounted to 1 in 278
of the population; the extreme being 1 in 1.18, and 1 in 5.   In
twenty-one, the  average  proportion  of  deaths, to  the number
affected, was 1 in 3.087;  the extreme being 1 in 1.3, and 1 in
6.42.   While two hospitals gave a  mortality of 1 in 2.15 of the
number admitted, with extremes of 1 in 11, and 1 in 282.*
   In the  West Indies it is often difficult, as it is here, to obtain in the West
exact records; the public and private  practice being so different.Indies-
In the  government  military hospitals, in  Cuba, the mortality
from yellow fever is very  small, not exceeding  often,  (if the
statistics,  as published, can be relied on,) two to five per cent.-
while in the hospital  for the reception  of the poor, it  is very
large, as  large  as any where.
   In Vera Cruz, the mortality in private practice is very small; AtVeraCmz
the treatment being very mild and simple.    While  in  the
military hospitals, with the Mexican  soldiers coming from  the
tierras templados ifrias, (upper country,) it is frightful; some-
times nearly the whole dying, and the whole per centage is that
of escape, which is very small!   The filth of the hospital, and
intemperance of the men,  being very great.  The  details will
be given hereafter, when we come to  show the influence of sani-
tary measures upon  it, and the  comparison of other Southern
cities with New Orleans.
  In Rio Janiero, from the highly  valuable information  the Ratio of mor-
Sanitary Commission has  received direct  through  the United tality of dif-
States   Consul,  Robert Gr. Scott,  Esq., (who  has sent manyferent classes
valuable documents; see proceedings,) exhibiting a remarkable at Rio-
proof of the protection, and assimilative influence of climates,
on these diversities, all exposed for  the first time to this (then)
new malady—affecting them respectively as follows :
'Dr. La Roche. 
 48           Report of Dr. Edward II.  Barton on  the

                                                               per cent.
          On native Brazilians,  about..'....................      '■'
          On negroes of recent and former importation, from.....I5 to 2
          On acclimated, (to that country,) Europeans,.........5 to 6
          On the unacclimated and sailors, a mortality of about......30
 Mortality in    Jn the interior  towns of this and the adjoining states,  the
 the interior,  mortality to the cases, as also to the population, was, last season,
          much larger than  in this city, many villages  being more than
          decimated of their population ; of the mortality to cases, proba-
          bly nearly  half dying, in many places.    This can  only be
          accounted for by a want of familiarity with  the disease, and not
          having  proper  nurses.   In  this  city, where  these exist, it is
          probably as successful,  in the same description of subjects, as it
          is any where.   In  Havana and Vera Cruz, with a Spanish and
          Mexican population, and  from the South of Europe  generally,
          whose inhabitants are not given to intemperance, the mortality
          is very small.   Indeed, with  them, it is not  considered the most
          dangerous form of fever, nor can it hardly be deemed so here, in
          good subjects, with proper care and attention.
Great mortal-   Professor Dickson, says ; '' Yellow fever  must be viewed as
ity from yei- one of the most destructive forms  of  pestilence, exceeding even
low fever    t}ie piagUe  perhaps,  in proportion  to mortality.  In 1804, in
          Gibraltar, out of a population of  nine thousand  civilians, but
          twenty-eight persons escaped an attack, and the deaths amoun-
          ted to more  than one  in three.  Musgrave  gives a scarcely less
          terrible account of  it  in Antigua, in 1806.   In Jamaica, under
          the care of  Dr. Hume, three out of four  died of it.   In the
          city of Philadelphia, in  1820, there died eighty-three out of one
         hundred and twenty five, about two out of three."  During the
         late outbreak of the yellow fever, in  Philadelphia, there occur-
         red one hundred  and twenty-eight deaths,  out of one hundred
         and seventy  cases, in public and  private  practice,  making a
         mortality of 1 in every  1.48, or seventy-five per cent.
            It will be apparent from these  statements, that yellow  fever
         is  a much more fatal disease in  Northern than in Southern 
                 Sanitary Condition of New Orleans.              49

climates.  The subjects differ as much as the treatment and
the climates.
                        SECTION V.
 Epidemic  Constitution—Its Constituents—Proof—Influence on
      Vegetable and Animal  Life—Meteorological Elements—
      Terrene do.—Difference of an epidemic from an Endemic—
      An Epidemic cannot be Imported—Epidemic requires local-
      ising causes for its development.
   Having thus shown the special medical constitution and of its
 disastrous  influence on man—and contrasted  its effects here
 with what it has displayed, not only in various parts of our  own
 country, but throughout the  yellow fever zone; we  now pro-
 ceed to approach it a little nearer and ascend to its causes.
 Let  us scrutinize  these, as well general as local, that we may
 thoroughly understand our  status—the principle upon which it
 depends for  existence, and  by a  practical application draw
 useful lessons from it,
   I proceed then  to exhibit  the evidence, which proves, first, Division cf
 that a great epidemic  constitution, or what has been denomi- the subject.
 nated '' epidemic meteoration,"  existed; and  secondly, what,
 were the probable causes or constituents of it.
   We have evidence of the  existence of a great  epidemic yellow
 fever in 1853, not only over the city of New Orleans, but over
 a large portion of the Southwestern part of the United States; Epidemics
 from its effects on nearly all the forms of life, animal, as well formed of cer-
 as vegetable;  that there were some vast  influences let loose or tain constitu-
 developed,  or  some  apparent  irregularity  in the  ordinaryents-
 elements  of existence, that was at war with its being, that  is
 essential to be understood,  in order to derive the necessary aid
 to counteract or  control them.  It is of vast  practical  value
 then to know the constituents which composed it, if they be
 susceptible  of analysis, for  it may be  considered  a settled
 opinion with all intelligent men, that epidemics derive their
poicer and spread themselves from certain unusual circumstances 
50           Report of Dr. Edward H. Barton on the
         and conditions, that these are required to  give  them activity,
         and the important fact is clearly inferable  that being the sine
         qua non,  they  form  them.   This, in the nature of  things,
         from its wide pervading, direct and almost immediate influence
         over an extensively spread population, must be  atmospherical,
         and we state  them, en passant now, to be more  specially men-
         tioned hereafter, that the admission of  this  principle—the
         admission  of a wide-spread atmospherical element as a necessary
         constituent, draws  after it an important, if not inevitable in-
         ference, in its being a conclusive  answer to  all averments of its
         contagious qualities!—not that a contagious disease  cannot
if  e idemic Decome epidemic (although it is very rare), but the difference
not conta-   xS> tna* a contagious disease never looses that quality, and epi-
gious.     demic disease does, directly it is removed  out of the sphere of
         the epidemic atmosphere, which  always has bounds and limits,
         however extensive it may be, and beyond the  influence of the
         localising  conditions which will be pointed out  hereafter.   The
         testimony in support  of  this, which the Sanitary Commission
         has obtained, has been most ample and conclusive.   We make
         it  as our offering to the vast proofs with which medical record
         abound on this important subject.
Proof of an   An epidemic disease is  known  to  prevail when a large
epidemic.   number of cases of disease, of the same type and character,
atmosphere,  break out, either  simultaneously,  or  within  a brief period,
         over a considerable extent of a city or country, wearing one
         general livery, and evincing and maintaining a sway over all pre-
         vailing diseases.   The statement of this proposition, is to carry
         conviction of its truth to all those who witnessed the charac-
         teristics of the  disease last summer, when forms of morbid
         action, that were  not suspected  to  be yellow fever, from
         wanting its prominent symptoms, were suddenly terminated by
         black vomit.  Indeed, so fatal was its influence in many cases,
         that nearly, and in some cases all its stages, were merged in
         the last and unequivocal  one—the fatal  black vomit, as  a
         child in the nurses arms, in others, in a vain attempt at vital
         re-action,  the system sinking in  the effort within twelve  hours'; 
                 Sanitary Condition of New Orleans.              51

so virulent the poison, so  futile  the  recuperative  principle.
The general uniformity of its type, its speedy prevalence over Far*erProof-
the entire city, breaking out in distant and disconnected parts
at the same time, and by-and-bye, extending over  its entire
area, and  thence,  as we shall see, to different parts of the
country, not immediately, even in those having  hourly com-
munication  with  the city, but many weeks afterwards, as the
combined principle (meteorological and terrene) became ma-
tured and extended, with a greater  or less prevalence and
intensity of the localising causes,  to be mentioned  hereafter.
   It is  farther proved from its reaching insulated  places, as Do
jails, penitentiaries  and lock-ups, heretofore exempt.   Even
insulation on a plantation did not always exempt the inmates ;
in the  tardiness and  great  length of  convalescence  (taking
about double the usual period,) the great liability to relapse,
from the deficiency of re-action in those that continued in the
epidemic  atmosphere, and the rapidity  of restoration on a
removal from it.
  'Hence then the atmosphere constituted wings for the  pro-
pagation of the general  epidemic and localising  conditions
gave it  a habitation in various places.
   What is meant by  an  epidemic atmosphere  then,  is  the
presence of certain elementary  constituents or their combi-
nation different from  the habitual or normal condition.  We
shall essay  hereafter to state,  in what these consist.  We
have  no  proof of anything specific,  beyond this combina-
tion, and this is  two-fold,  the meteorological part probably Epidemic at-
forming the predisponent, is innocuous without  the other, itmosPhere-
is but one blade of the "shears," the second is the localWhat"
circumstances and  influence — the true localising  or fixing
power.  It is what has been denominated by high  authority
*"the test  and  touchstone  of  poison"—that  produces its
development whether acting on  individuals or communities,
filth in every kind, degree and sense, represents our meaning.
For an  atmosphere to prove epidemic pre-supposes the pre-
*Mr. Simon. 
52           R<port of Dr.  Edward. II. Barton on  the

         sence  of both.  If there is  only one of them present, (and
its great   either one of them is the same) the effects do not take place.
         If a case is carried from an infected  locality to  one  that is
         pure, it does not spread; but if conveyed to a place where
         there exists an impure, kindred or  infected atmosphere,  the
         disease is propagated, and it seems, to the surperficial observ-
         er, "contagious," and hence  arises the establishment of one
         of the great "false facts" in physic, and  the foundation for
Contagion in- endless, but ridiculous controversies to the disgrace of science
dependent ofan(j ^ injury of humanity.   Instances corroborative of each
 xema Clr~ Qf tnese  conditions,  are  furnished in another  page.  The
         special  characteristic attribute of contagion is that it  is irre-
         spective of external conditions ; it pays no respect to climates,
         zones or seasons; it requires no special atmosphere—it yields
         to none;  it is selt-propagative and progressive,  and  depen-
         dant upon its own creative and self-sustaining powers.  To
         none of these has  yellow fever any similitude.
On vegetable   Certain atmospheric appearances have been often observed
and animal  here> during the cholera epidemics of 1832 and 1833.  The
llfe'formerly'dark murky "cholera cloud," as it was then denominated,
         hung over our  devoted city, like a funeral  pall, as long as
         the epidemic continued, and struck every heart with dismay-
         The experiment with meat, has been often tried during a
         cholera epidemic,  and it usually became  putrid, if  some-
Soon tainted
    .  ,   what elevated in the atmosphere, and filled with  animalcules.
butcher s                           x     '
lueat#      This, however, is believed not to be remarkable, as it would
         take place at any  season.  It was  observed here  last year
         that butcher's meat became  earlier tainted in the  stall than
         usual.   Birds  and beasts have been driven from their usual
         haunts,  into the  deepest recesses of the  forest, showing by
Birds driven  ....      A,      ,               ., -     „          ..
         their  instincts  that   they  were sensible  ot some malign
away,
  ,...,    properties existing in the bosom of that atmosphere whence
         they derive their main vital influence.  At Lake Providence
         Judge  Selby noticed that the feathered tribe almost entirely
         disappeared during  the prevalence of the epidemic.  In a
         former outbreak  of cholera, on the  " coast," it was  observed 
Sanitary Condition of New Orleans.              53
that  the carrion crows  ceased to  make their  appearance,
although there were plenty of dead cattle  exposed  in the
fields.  An unusual  influence  on animal life has been often
remarked during the existence of  cholera here.  In Spain,
so malign has the air been sometimes found during the exist-
ence of yellow fever, that birds confined in their cages have
died.   The older records in our profession, of  periods when
epidemics raged with  one hundred-fold  more  violence than
they have done in later times, almost every species of animal
life suffered—nor do I know of any reason for the compara-
tively lesser  influence of epidemics of latest, over ancient
times,  than  the extension  of the comforts of life,  and the
refinements  which "civilization has  wrought, which, really,
are nothing else but  sanitary measures.
   Nor are we without  evidences of the  extension of suchft3 innuenc*
influence to the vegetable  creation.  During the late visita- on animal
tion, Mr. Lawrence, who is engaged largely in horticulture, and vegetable
in the lower  part of the city, informs  me that his  gardenlife in the
seed would often  fail to germinate, but  still  more  often,neighborhood
when they would sprout up a few  inches from the  soil, a
sudden blight  would seize  them, and  in  a few  days they
would wilt and die.   This was  eminently the case with the
cauliflower, the celery, the  cabbage, raddish and other veg-
etables.  To keep  up his stock,  he, in vain, applied to his
neighbors, to those  on the  opposite side of the  river,  and
down the coast.  The same influence had been extended to
them.   Many  of his  fowls  died,  old   and young, withoutEpideraic i,l~
previously  appearing  sick.   These  effects  only continued
 ...     . ,   .    T    ,          «  .            ...  on the coast of
during the  epidemic.  In other parts or the country similar
effects were produced in the destruction of the various kinds
of poultry, in|the  tainting and  destruction of orchard fruit,
and a blighting influence of  various forms of vegetable life ;
and on  the coast of Texas  the fish were found dead  in  im-
mense quantities, as reported to the Sanitary Commission, viz:
   At Biloxi, the peaches rotted on the trees; great mortality Biioii.
existed among the fowls; flies and musquitoes remarkably mi- 
•"> I            Report of Dr. Edward  II. Barton  on the
         merous; mould on  the trees;  heat unusually great; ther-
         mometer 94°; two earthquakes during  the season; many
         cases of yellow  fever, without  personal intercourse, with
         any sick of the disease.*
Bay of St.    j^ -gay gt. Louis, there was an epidemic among fowls.
           At Bayou  Sara, the China trees had a sickly appearance
Bayou Sara                            .
         and their leaves covered  with a crustaceous larvae.j
Centreviile.    ^ Centreville, musquetoes and  flies more numerous than
         ever  observed before; and mould of a drab color, and very
         abundant,- season unusually wet, and heat of sun very great. J
Clinton.      At Clinton, musquetoes uncommonly numerous night and
         day.
BatonRouge.  j^t Baton Rouge,  " fruit of the peach full of worms, and po-
         tatoes rotted in the ground."
Lake Provi-  At Lake Providence, " fowls very sickly and many of them
dence.     died ; animals and  plants sickly—many had bumps upon
         them; musquetoes tenfold more numerous than ever  known
         before; never saw one-twentieth part of the  mould; toad-
         stools vastty  more plentiful than heretofore;  a peculiar smell
         pervaded the atmosphere of the place." §
PortGibso».   j^t port Qibsori) dark ^n(j unhealthy spots on the peaches;
         bright and bluish mould very common  on  the  grain.  Dr.
         McAlister writes that during eighteen years of close obser-
         vation,  he had never seen such repeated floods, attended with
         such an excess of thunder and lightning, succeeded  by such
         hot sultry  days, during the latter part of the summer.  The
         city  occupies a level locality on a rich alluvial soil, and pre-
         sented  during this time, the appearance  of a marsh.
 N*t0        At Natchez, epidemic among poultry  (fowls) ; musquetoes
          very numerous,  and the epidemic  particularly severe with
         • pregnant women.||
            At Washington, Miss., epidemic among poultry (turkeys)
 At Warning-                                               "
 t«"i-       taking  off entire stocks, without apparent cause ; their livers
          found greatly enlarged and diseased.^}
* Drs Byrenheidt & Cochrane     t Brown.     J Dr. Wood.
§ Judge Selby.      || Dr. Davis.        If Prof. Wailes. 
Sanitary  Condition  of New Orleans.              55
  At Gainesville, fruit rotting prematurely  and  extensively ;AtGaiMviUe-
native cows dying in great numbers, without obvious  cause.
  But fortunately fur the int-rest of truth, the recent progress
of science  has not even left this hitherto dark corner, without
other rays of light, with which to illuminate it.  The Smith-
sonian In-titution, in the noble language of its founder, estab-
lishes  "to extend knowledge  among men,"  is spreading the
en'ightening rays of science over every region of  our country.
I am  indebted  to the kindness  of Professor Blodget of that
valuable institution, who has  most obligingly  answered the
queries I havj addressed him upon the subject, for the subjoined
information, containing direct and conclusive  proof of an epi-
demic atmosphere, showing,  most  satisfactorily,  that wherever
the epidemic influence was felt  by man,  there was  exhibited
proofs through meteorology, of the existence of that atmosphere,
that this prevailed to a most remarkable extent, that,  notwith-
standing the advanced period of the season and the presence of
a remarkable elevation of temperature—that  is  proved not  to
have been a sufficient meteorological ingredient to constitute the
epidemic constitution, and that the disease did not become de-
veloped  until there was  superadded to this, high  saturation,
affording demonstrations upon the subject, it is believed,  never
exhibited before.
        LETTER  FROM  PROFESSOR  BLODGET.
              " The Temperature Comparisons.
   " The comparison of mean temperature, at various stations  information
embraced in the district over which the yellow fever extended of  epidemic
at sometime during  the summer, with the mean for a series 0finflnencefrom
years, or for  1852, shows, on the whole, a greater number of
                      ,.,v.         tr . ,1  •  n               Institution.
negative than  positive  differences.  Yet the inferences, suppor-
ted by the first view, of a colder or less tropical summer tempera-
ture, are the reverse of truth, as may readily be  shown.  The
daily curve of the temperature is much less sharp in the rainy
summer of the tropics, than in the latitude of New Orleans, in
usual  seasons.   When,  therefore,  a temporary  institution  of
(Lis rainy and humid tropical summer occurs  in these latitudes,
the mean temperature deduced from the usual observations k  too 
5G            Report of Dr.  Edward H. Barton  on the
Rainy season\ow^ anc| tjje true mearj)  also, lower than usual.   Thus, in the
depress the ramy geason of centrai America,  the  mean for  July descends
       m"to 77°, deduced from  the  usual hours; while in Texas, it rises
peratnre,                                     -.-..  r*    -,   -r i    n .1
         to 85°.   At Fort  Brown, on the llio Grande, July, of  the
and  elevates
ihe  moming Present veai'>  was dry an(* Wealthy.    In August the tropical
and evening, rains set in, and, with the same morning  and evening tempera-
         ture, the midday mean  fell from  92° to  88.7°.   The  same
         result occurred at  New  Orleans, in the  contrast of  June and
Tropical wea-July, m a still more decided manner, the morning mean rising,
ther  in New m juiVj 2.5°  above that for the same hour in June, and the
Orleans, in midday  mean  Mmg  2.5° below that of  June.   The daily
         curve, from minimum to maximum, was thus diminished during
         the  rainy month of  July 5°, and  was actually but 4.4°, an un-
         precedented low, and peculiarly tropical curve.
            " Comparison of  all the stations here  given, in  this manner,
And extended wouj(j prove the apparent low temperatures  they exhibit, to
thTonehoutha.ve been the institution of conditions approaching the  tropi-
         cal climate more nearly than in  any year of which we  have
         precise record.
            " In further proof of this position, the great and general heats of
          the summer on this continent may be cited.   A change of ten
Equaltoare" degrees of latitude, Southward,  would give about the precise
mova 1 eg. measures 0f temperature and humidity actually  experienced on
         ' the continent.   With this general accession of temperature, the
          humidity, and sanitary consequences, follow inevitably.
                          Rains  as shown by the  Table.
            u The amount of rain, as a rude measure of humidity, is given
          at several stations, in comparison, also, with the means of a
          series of years.
 Frequency of   " Frequency of rains is next to amount;  and in the  pres-
 rains, next to ent case is particularly  important.   The stations are thus dis-
 amount,  tinguished in  connection with the tables of amount.
 evince tropi-    « To group the results:  South Florida only was profusely
 calcondition.. r&iny jn Junej except for t^G ]ast half Qf the month,  when
          New Orleans became remarkable for frequency of rains.  In
          July Texas was very dry ; New Orleans the reverse, with tro 
Sanitary Condition of New Orleans.
51
pical frequency of rains.   In Northern Florida and South Rains and fe"
Carolina the rains were heavy, though not unusually frequent.verscotempo"
In August the tropical rains of New Orleans continued, andrane0U9'
began  at the  close of the month in lower Texas.  In Sep-
tember they spread over the Gulf coast East  and West of
New Orleans,  and diminished at that point.  In October they
were continued on the  Rio  Grande, and  at Bermuda, and
other islands, and over most of the Gulf coast also.
   " The yellow fever began on the Rio Grande with these rains
          /                                               In Texas and
in August, and continued till they ceased in October !   It be-
     °                       J                          Mobile, fever
gan in other parts of  Texas with the same  conditions, and so and raing .
at Mobile, continuing  with  their unusual continuance.        uitaneous.
                        Humidity.
   " The mean humidity or  per centage of saturation, is given
for the observed hours, and for the mean of the whole month
at several stations in  the South and West.   June is seen to
have a low fraction  of saturation in all parts  of the United
States, except at New Orleans, where, with a temperature 3° Simultaneous
above  the mean, the saturation was unusually high.  In July occurrence of
the fraction of saturation at  New Orleans largely exceededthefeverwith
that at any other locality observed, Savannah, Ga., approach-
                                            .              tion and ele-
ing it  most nearly.   In August it was largely increased at all
stations;  in Texas and at Savannah becoming nearly as great perature<
as at New Orleans in June.   In September it was slightly
less at New  Orleans,  and greater in  Texas, and Eastward
from New Orleans, at Mobile,  &c.  October  had mainly  a
high temperature and high fraction of saturation."
   For proof and illustration of these positions, reference is made
to the tables J, K, L, and  M, subjoined, containing records
of temperature, rain  and humidity, throughout  arid  beyond
the epidemic  region  of last year, and the  averages  of other
years, with which to compare it.  The whole is most conclu-
 sive. 
5*
Report of Dr. Edward  H. Barton on the
TEMPERATURE, RAIN, AND HUMIDITY, OF SAVANNAH, PENSACOLA, AND JACK-
                         SONVILLE, 1853—53.
	Jan. | Feb. |Mar.|April|May. I.Tunn.l July.							Aug.	Sept.	Oct.	Nov.	Dec,
	MEAN TEMPKRATUKE.											
" 1853....	17.88	54.40	59.50	68.11 71.86 69 67	73 04 74.00 77.29 75.67 74.2.-)	75.44179.9*-79.00 81.50 78.89|81.74 78 00		77 .Ml 74 17 79.33 75 M 82 50' 77.55		04 50 68.92	1)0.4(1 64.2,-	48.40 53 45;
	51.33	57.04	63 58					81 00 78 00				
" 1853....						80 22	82 08 82 3H		78-42	69 56	[i5.67|54 94	
	AMOUNT OF					RAIN.						
" 1853....	1.147	1.142	2.479	0.444 0.465	8.721 3.959 1.530 4.862 0.200	9 310 0 787 3.240 0 833 0 937	5 324 6.464 7.400 2.531	5 040 8.168 2.700 14.000 1 562	4 673 9.427 9.675 0 500 14.781	2.888 9.350	3.096 6.882 2.275 3.618	
												
	3 250	4 062	2 562	0.500						5 500	1.000	1.969
	MEAN PER CENT				AGE OF HUMIDITY.							
	.658	.677	.690	.617	.74CI .752i .7871 .80r				| .8'8 .793 | .871			
" " 1853.... Jacksonville, 1853...					.690	.707 1 .826	.773 | .864	1 .840		.737	770	.710
TABLE J.—Mean Temperatures for 1853 in Districts in which  Yellow
  Fever at same time prevailed—And  a Comparison with a mean of
  years, or with the year 1852.
               __________________________I june. I jui.y. |  aug!  | sept. I  oct.
Charleston,—Ft.  Moultrie.

Savannah,...............

Whitemarsh Is'd,........

Jacksonville,.............

Key "West,..............

Ft." Brooke, Fla,..........

Ft. Meade, Fla,..........

Cedar  Keys,............

Pensacola,..............

New Orleans,...........

Austin,................

New Wied,.............

Fort Brown,............
,1852
1852

1852
78.48	82.85	80.08	76.83
-l-o.i	-1-1.5	—0.2	-|-0.7
79.00	81.50	79.33	75.83
—0.4	—1—0.2	—1.0	—1.1
77.40	80.92	78.65	74.85
-|-1.1	-1-1.8	—0.4	-|-1.0
78.89	81.74	82.56	77.55
80.00	82.92	82.37	76.47
80.50	83.42	83.97	—
—1.4	—0.2	—0.6	— .
78.56	82.15	82.23	80.20
—0.8	—1.7	-|-2.0	-|-2.7
75.53	79.00	78.20	79.93
—3.7	—0.8	—2.6	-|-2.0
80.11	83.18	81.98	79.37
-1-1.5	-|-2.7	-1-1.3	-|-0.6
80.22	82.08	82.38	78.42
—0.4	—2.8	—1.1	—0.5
80.38	80.24	79.60	75.89
-|-2.2	—0.1	-|-0.0	—1.2
80.81	82.00	81.01	76.77
79.37	—	83.83	75.71
80.80	82.00	81.00	76.80
79.25	82.75	83.75	75.75
82.08	84.18	82.88	78.41
-j-0.4	-1-0.8	—1.8	—2.0
65.69
—1.5
64.50
—2.7
63.74
—2.2
68.92
71.59
80.27
-|—2.0
75.00
—0.9
73.01
-|-0.0
71.94
—1.2
69.56
—1.5
66.65
69.43

68.75
71.88
—2.1 
Sanitary  Condition of New  Orleans.
                                TABLE K.
Weather at various Stations  during the  Yellow Fever  months of 1853
Charleston,___
Fort Moultrie,
Savannah,...
Jacksonville,.
Bermuda,....
Key West,...
Fort Meade,.
Fort Brooke,..
Cedar Keys,..
Pensacola,___
New Orleans,.
Austin,........
San Antonio,..
Fort Graham,.
Fort Brown,..
J Dry.....
Very dry.
Dry.......
Very wet..
Showery..
Wet.......
Dry..
Dry..
C Last half..
I 6howry...
Usual.
Usual.
Dry.
< La6t half..
) showery.
Showery.....
Very showery.
Showery.....
Very showery.
Very showery.
Very showery.
Usual or dry..
Very wet____
C Dry ex. last
\ five days___
Dry..........
Very dry.
SEPTEMBER.
Very showery.
Very wet.....
Usual.........
Showery.....
Showery.....
Showery.....
Showery.....
Usual or dry..
Very showery.
C Humid, few
) showers___
Usual.
1st half dry,
2d  " wet
He'vy sho'ers.
( 1st half very
{ wet........
Very wet___
Showery.....
C First half.
I showery...
<i 1st half very
1st half very
wet........
1st half very
wet........
C 1st half wet,
( 2d do humid
Usual........
£ Constantly
I showery ...
Dry..........
( Frequnt....
( showers___
Few showers.
( Constantly
) showry___
TABLE L.—Amount of Rain at Stations at which  Yellow Fever prevailed,
  for theSummer months of 1853, and in comparison with a mean of several
  years.
Charleston, Ft. Moultrie--
Savannah...............
Whitemarsh Island, Ga...
Cedar  Keys.............
Key West...............
Ft. Brooke, Fla..........
Bermuda................1853
                         1852
Ft. Meade, Fla...........
Pensacola...............
Now Orleans............
Ft. Brown, Matonioras...
June.	July. |	Aug.	Sept.	Oct.	Nov.
1.550	10.880	2.200	8.100	4.050	
—2.8	-1-4.4	—5.0	-1-2.5	-1-1.5	
0.787	6.464	8.168	9.427	2.888	
—7.2	—3.2	—1.2	-|-4.9	—0.3	
1.280	5.280	5.580	13.200	3.240	
—3.0	-1-1.2	—0.2	-1-10.4	-1-2.1	
3.262	11.437	3.625	15.437	4.600	
—1.9	-1-2.0	—4.0	-1-9.1	-1-1.2	
18.110	2.330	5.020		1.690	
-1-14.6	-|-0.0	-1-1.7		—1.5	
9.090	4.120	4.670	4.360	1.700	
-1-2.4	—7.0	—5.8	—3.9	—0.8	
		3.510		6.690	11.630
		7.000		4.260	2.400
3.540	4.520	3.390	2.120	0.310	
0.937	2.531	1.562	14.781	5.500	
	—6.1	—7.1	-1-12.1	-1-2.0	
1.712	11.508	6.280	4.948		
—3.7	-1-5.0	-|-0.8	-1-1.0		
1.700	0.000	3.100	8.000	7.750	
—1.0	—1.8	-1-1.2	-1-3.3	-1-2.8	
11.340
 2.980 
00
Htport  of Dr.  Edward  II. Barton  on
the
  In comparison with 1852, and with previons years generally, the difiei-ence of hours  must be
taken into account.  Sunrise and 6 a. m. always give a higher fraction of saturation than 7 a. m. ;
and the mean deducted from 6, 2, 10; and from sunrise and 3 p. m. it is always greater than that
from 7, 2, 9.  The precise measure of this correction has not been determined.
  June, of 1853, was everywhere less humid than 1852, except at New Orleans ; there its fractioB
of ^duration was greater in 1853, distinguishing this point as reversing the condition common to
most other parts  of the country for that month.
  July, of 1853, has a higher saturation at Austin, New Orleans, and  Savannah ; elsewhere lea.
then in 1852.
  In Ausrust, 1853, is everywhere of higher saturation than in previous yews ; aad the difference
is greatest at New Orleans.
  September, 1853, presents thesame conditions prevailing inAugugt.
  October is not sufficiently observed. 
Sanitary Condition of New Orleans.              61
  Such then, are some of the direct proofs furnished by me-
teorology, of the limits and extension of the great epidemic.
It is only to be regretted that every village and hamlet in the
country does not supply data of a similar character, to make
the application still more precise.   On a  critical analysis of
these highly valuable observations, it will be seen with what
exact accordance they correspond with the variable outbreak
of the epidemic in every  part of this  extended  region.  In
        r              J  r                      °        Great  heat
every instance where the facts are known great heat and high  ... hsatu.
saturation were the predominant conditions for the  preva- ration aiwavs
lence of the disease, and it  was often remarked that "thepresent
return of these  conditions re-produced the fever two or three
times."  Can proof be made stronger ?   It will  be thus seen
how truthfully and philosophically this explanation comes in
to substitute itself for that most unsatisfactory  and  barba-
rous one of contagion, sundering, so far  as it extends its
creed, every tie that binds man  to man, as we have unfortu-
nately found to be the case in many instances during the last
season in the interior, not in this city, where the doctrine is en-
tirely new.  The inhumanity of that attribution is only equaled
bv its folly.  If yellow fever is contagious, it is  a law of the
                          •                  -i    -i     -n  •  Whyimpossi-
disease, this it must carry into all places, and under  all cir-
                                                        . ble to be con-
cumstances (like  small pox.)  A " contingent contagion'  is   .
a medical misnomer, is void of a precedent, and has no par-
allel in the annals of the  science.  Every  device  has been
resorted to in the way of experiment to show the contagious
quality of yellow fever, if any existed, but have all signally
failed.  That it may be infectious under certain circumstan- To what *%-
ces, is admitting nothing more than that it is caused by im- tent infection
pure air, and that this air can be carried  in  the hold of a
vessel, or any similar mode, by  which the  air of one place is
conveyed to another, or even through clothing, (in some spe-
cial cases  and to a very  limited extent,)  is not  denied.
Where the above conditions are present in a sickly season or
district, it  sometimes requires but a slight  addition  for the
 development of the disease, and this is apparently furnished
 occasionally, by  the  arrival of cases, or  vessels,  or  goods,
            i 
G2           Report of Dr. Edward II.  Barton on the
         with the poisonous or infectious air ;  but it is not a result of
         secretory action, as all the  contagions unquestionably are.
         This susceptibility of conveyance or transportability, exists,
         to a very limited extent, and only when  the causes giving
         origin to the  disease are  more  than  usually malignant,
         and are only 2^'opagated  in a kindred or congenial atmos-
         phere.   These views have thousands of times been proved by
         our constant experience here for more than half a century, and
         such, I deem it, is the general result of the experience of
         the profession South, during that  long period, with  a very
         few exceptions, and those mostly of the last year.
            Infection is not a personal quality—it  applies to vitiated
infection not air from whatever cause proceeding.   It is the product, not
personal.   the producer.   It is the rem.   How is it when we approach
         so near as  to causation—to the thing—the principle—in any
         of the  generally  acknowledged contagious diseases?   In
         small pox the smallest appreciable amount of secreted matter
         inserted into the body, at once and always produces the dis-
         ease,  and all these contagions have a peculiar secretion as a
         product of the disease, which by its specific action on the sys-
tagion.
         tern, re-produces itself and thus propagates the malady.  Is
         that the case in yellow fever? All the secretions and products
Yeiiow  fever of the disease have been over and over again inoculated into
not coma- susceptible  bodies.  Even black vomit itself has been tried
gious.     jn every way, and all with impunity.   They have been slept
         with,  clothes used, all with the same result, and this would
         ever be the case, unless  there  should happen  to  be present
         an epidemic, or foul, or kindred atmosphere !  Without then,
         this localising condition, the  congenial materials, the  disease
         does not spread.   If it is not contagious,  and it  has-never
         been found apparently so in this country before, then there are
         existing independent circumstances that account even for the
         seemingly contagious quality, and this proves the existence of
rently so, ex- ,.     . ,   .    .     ,         . -,   .                  -,  ,
         the epidemic  atmosphere or epidemic meteoration, and the
plained.                                  l
         extensive prevalence of yellow fever out of its usual bounds
         is proof positive of the existence of that epidemic atmosphere,
         and its prevalence and limits are bounded by it.
           Such high authorities as Drs. Haygarth,  Percival,  Ferrier 
Sanitary  Condition of New Orleans.
63
 Carmichael Smith, Currie, Russell, Roberts, Arnott, Christison,
 and others in England,  deny  that exhalations from the living
 body  are  capable of permanent suspension in the atmosphere,
 or that they can be conveyed,  unchanged, through pure air  to
 great distances.  They regard it as established by an indubita-
 ble  body of evidence, that the moment these  exhalations come No exhalation
 in contact  with the  external  atmosphere,  they  are  diffused from human
 through it; that by such diffusion, their infectious properties are bodies of per-
 destroved, and that, though when pent up in close unventilated manent  sns_
 rooms  or filthy ships they may acquire some  degree of perma-pension in the
 nence, much concentration and virulence, yet,  when  they once atmosPher*-
 pass into the ocean  of air,  they disappear as a drop of rain in
 the ocean of water.  These authorities, view the property thus
 possessed by air to neutralize and destroy these exhalations, as a
 provision of nature for our well-being.
   It was further  observed  that if the  emanations  thrown off
 from the living body  formed permanent  and powerful  poisons,
 and if this were capable of being conveved, unchanged, to great
 j- j.            i    n ,    n     i.      ,  .    ,.   ,          ,  onhnmanin-
 distances, we should be able to live only in solitude; we could
                                                             terconrse, if
 not meet in society, for we should poison each other; the first
              ,                  r                 '          permanent.
 symptom of illness would be  the signal for the abandonment of
 the sick, and we should be compelled by a due regard  to selfForbid  hu-
 preservation, to withhold from persons  afflicted with disease,man inter"
 every degree of assistance that required personal attendance.    course•
   But our physical is in harmony with our social  constitution,
 and  not in contradiction  to it. The  necessity of intercourse
 between all the members  of the human family is one of the
 moral exigences of our race.   The policy of encouraging, facil-
 itating and fostering that intercourse among all the nations  of „,
 ,i.        „       .      .      ...                Physical in
 the  earth is one  of  the  impressive distinctions  of our age.,
                            1                             o harmony with
 " But if it be true that plague and pestilence are capable   ofsocial   sU_
 being imported from  country to country, carrying devastation tntion
in  their course, and that this calamity  may  be prevented and
can only be prevented by placing periodical barriers between
one nation and another, so as effectually to obstruct that inter-
course, then there is a contradiction between the necessities and
obligations of the human family, and the physical laws of their
being.* "
■ Report on Quarantine—General Board of Health. 
64           Report of Dr.  Edward H. Barton on  the
            It is as true in physic as in other sciences, that " there are
          more false facts than false theories,'''' and the alarm in the pub-
          lic mind, last year, was sufficient and  did clothe  this disease
          with qualities susceptible of  explanation, much more  satisfacto-
Xotwo°ppo_iv, of universal application, and in exact accordance with reason,
site facts inscience an(j philanthropy.   There can be no two opposite facts
          in nature, although it may be very difficult sometimes to  ascer-
          tain and establish the true one.   Whenever this difficulty occurs
          we must apply to general principles for explanation,  and  have
          recourse to the ordinary and well known causes, circumstances,
          condition, and analogies, existing or applicable.
Difference be-   Another ground  of  error existed in confounding an  epidemic
tween an epi- with an endemic.   The  difference does  not exist  merely in a
demic and an greater prevalence over a wider space of the former, but in  a
endemic.    greater intensity of the  materies morbi.  An  epidemic is  a
          wide pervading disease, one of whose constituents being atmos-
what is anPneric> an<* therefore diffusive, influences the type of  prevailing
epidemic    febrile maladies, and furnishes to them  a uniformity of livery,
          and  this will doubtless  aid in the explanation  why  so  many
          Creoles have been affected with a fever,  having so many of the
          characteristics of the yellow fever last year, and especially with
          children, who are so much more susceptible to  prevailing mala-
          dies than  adults.   During the existence of an endemic fever,
          this  does not take place; although equally and similarly exposed.
          The very  idea  of  transporting an epidemic, which  is mainly
          atmospherical, from one  country or  locality to another,  is an
          absurdity upon its faee.   The very statement of the proposition,
          is its own refutation with intelligent and thinking  men.   It  is
          little less than arrogating an attribute of omnipotence.
            The important practical deduction resulting from this, is, that
Practical de- an epidemic cannot be imported.  The principle is very clear.
auction.     The facts are in exact  accordance.   Humboldt  has  long since
          shown, that, although yellow fever prevailed among the  newly
Proof from an"ived ^very year&t Vera Cruz, it never prevailed epidemically
Humboldt,   there  between  1776  and 1794, although the  intercourse with
          Havana and other places, where  the disease continued to pre- 
Sanitary  Condition of New  Orleans.              65
vail, was quite free.  If a ease of yellow fever proceeding from
a locality where the epidemic prevails is  conveyed to another,
where it does not, it must terminate with the case, as has been
eminently illustrated this last year, on  the various marginal
limits of the epidemic.   This  proof  of  epidemic influence  is
shown by pointing out these limits, and here it is known mainly
1  •      •    i       • 1         •    •        i»i           even  appa-
by its wanting those evidences of its existence which proved its
          ,                                                  rently  conta-
presence in others.  Professor Blodget's  interesting communi-  ioug  b
cation has shown, that the principal atmospherical constituents where the ep_
consisted in a high saturation, with elevated temperature. Now, idemic princi-
in these places where this epidemic showed itself, and not having pie was pre-
the power of spreading, there is no evidence to show that thesesent
existed, or only one existed.  For instance, at Memphis, about Ag at Mem.
two hundred  miles above  Napoleon, Arkansas, many cases, pms.
 (upwards of sixty,) were  carried, but with the freest intercourse,
public as well as private, the disease did not spread.   The place
was far from clean, but there is no proof either of high satura-
tion or elevated temperature.
  At Bladon Springs, Ala., where the sick were taken in con-
siderable numbers, and there existed the most unlimited commu- As at j^^^
nication with all, yet it did  not spread, and there was exhibited springs.
no evidence of  the two conditions required, or either of them.
  At Clinton, near Vicksburg, the same thing happened; there At Clinton.
was the most uninterrupted intercourse with ''infected spots,"
persons, and goods,  but there was no evidence of an epidemic
atmosphere, and consequently the disease did not spread.
  At Cahawba, Ala., about ten miles from Selma, where itAtCahawba.
prevailed in an eminent degree, and between which places there
was constant uninterrupted intercourse,  the disease, although
freely brought  there, did not spread, but terminated with the
individual cases.   There existed nothing unusual in the seasons.
  At Black River, Concordia Parish, many  cases of yellow fe- AtBiackRiv-
ver were carried, but it did  not spread.  Precisely the same oc- er, Pt. ciair,
curred  at Waterproof,  Tensas Parish, where many  cases were Hoiiy Wood,
brought and terminated without extending the disease.  A likeand  Gaines-
result was noted at Point Clair, at Holly  Wood and at Gaines-vUle- 
66            Report of Dr. Edward H.  Barton on the
          ville, and many other places, including our watering places, until
          an advanced  period of the season, when, from  the occurrence
          of the  precedingly  mentioned  conditions, the disease  became
          developed.
Proof at Trin-   At Trinity, La., a rather remarkable instance was furnished
ity, La.     °f 00^h conditions being required for effect, for saw-dust was used
          to fill up  low  places in the streets, and even the earth dug from a
          foundation for a warehouse, was spread upon the streets;  but
          there was no  evidence  of the existence of the other condition,
          extreme heat, direct (radiation) or indirect, or proof of unusual
          moisture by hygrometric tests.   On the contrary, no epidemic
          influence noted on  the fruit, ''which were  fine  and healthy;
          musquetoes not so troublesome  as  usual;  mould less than com-
          mon,"  (proof of dry air;) no disease or fatality observed among
          animals."  "  Many cases of fever brought  here, and ended
          without propagation, and no precaution used."*
At Porters-    At Portersville, where several hundred people were  assem-
vuie, cases not bled, and about one hundred and fifty in one inclosure, no cases
extend.     occurred, although five  imported cases were brought in, nursed
          by different persons, and two died with black vomit.  The dis-
          ease did not extend.|
            During the existence of the  epidemic yellow  fever at Rio,
          many persons were  carried to  towns at some leagues distance,
Puerto Cabei- but in no case did it spread.   The  same thing  occurred in  the
io.        neighborhood  of Puerto Cabello, and Guayaquil.    The epidemic
          atmosphere did not  extend to them, and consequently the other
          condition was wanting.
            This description of cases, circumstances, and results, could be
          indefinitely multiplied,  not only this year, but  every year of  the
          existence of yellow fever, either here or in foreign countries.
            The explanation is so obvious, on the principles to be presently
          laid down in  this Report, that  it is scarcely necessary to antici-
non-commu-                                                    J
          pate  them here.   One  of the  conditions  deemed essential
mcationorex- x
tension     ^or *ne existence of an epidemic disease is wanting ;  either the
          terrene or meteorological.  The cases above  given, show that
* From our intelligent communicant, Dr. Kilpatrick.     t Dr. Moore. 
Sanitary  Condition of New  Orleans.             67
the epidemic  atmosphere was not present, and  the disease did
not spread.   Again, a sudden change in the weather occurs, the
yellow fever is arrested ; multitudes of  fresh unacclimated
people (as we  have  often  witnessed) rush into the city, and
become exposed to the very foci where it was lately so malignant,
yet not a case occurs.   The meteorological condition is wanting.
But, if the weather again  becomes hot and  moist, with high
radiation, the disease is certain to become resuscitated.  Again,
the cause why cholera passes over  one town or plantation and
seizes on the next, is evidently owing, according to the most sat-
isfactory experience  in  England, and what has been known to
follow the disease here since 1832, in the difference in the ter-
rene or localising conditions, (filth,  disturbance of soil, &c.,)
and the atmospherical being, or not, in unison.
   It  was also alleged  that the fever of 18/53 was  different
from  any fever with which this city had been inflicted here-
tofore, and  therefore  must have been " imported "  from  the
West Indies, Rio Janeiro, Africa,  " Nova Zembla," or God
knows where.  This  has proceeded from a patriotic,  but
mistaken  impulse, which is pretty  universal, as well among Fever the
savages, as  those more civilized, viz: never to acknowledgesameasinfor-
the paternity  of a pestilence!    Nevertheless,  the  soberraeryeare-
dictates  of  truth, still  more unyielding and  inflexible than
those  feelings, compels the  acknowledgement, painful as it
is, that the late epidemic first commenced  in this city.   I
have  shown the folly of ascribing  its  origin to  any foreign
 source, and that the appearance and  symptoms of the fever,  did
not run precisely parallel with  the yellow  fever  of  every
 year, is just what might have been expected.  No practical
 man  will say  he ever  met  with them,  pi-ecisely similar in
 type  and symptoms, at  every point, in any series of consecu-
tive years.   There has been left some chasm in the similitude,
 some inequality  in the morbid excitement.  At  one season,
 the head  will  be the   more  prominent  point  of attack, or
onus  of the disease ;  at another, the  stomach ;  at another
the spinal system, &c, &c, giving rise to different theories 
68           Report of Dr.  Edward H.  Barton on the
         as to the pathology of the disease, requiring a  modification
 Each have 0f treatment;  now blood-letting, to a great extent, general
 th«ir  types. flg wejj ag  \oc^t as  jn t^g epidemic of  1833, requiring only
         local in  that of 1839, bearing neither in  that of  1841; not
         admitting the  general, and requiring much discrimination in
         the local  detraction of  blood, last  year, (in my judgment,)
         and  in all  very  little medicine.   These   peculiarities are
         probably produced  by variations  in the remote  cause, and
         the different conditions of the  individual.   Such  is just the
         experience in  other American cities.  I think it is less so  in
         the West Indies, from the greater uniformity of climate and
         condition there.  Such, too, is the result of the experience
         in other diseases.
           All epidemics, as all other diseases, must have a beginning,
         a starting point.   That  point will be in whatever part of a
         city  or country, in  which the localising causes shall exist  in
  t oug  an^g greatest excesS) (as win be hereafter pointed out.)   This
         has  been clearly demonstrated, by an examination  into this
mospheremay
    ., ..  subject in England, where  it has  been made  evident that
 prevail, dis-    "           °
ease only de- wbile  an epidemic  state of the atmosphere exists  over the
veiopedwhere whole country, the disease will only be developed where there
localising exists also, in more or less intensity, the localising conditions
conditions of 0f filth, moisture, stagnant air,  &c, (to  constitute the perfect
filth, &c.    combination.)   The result of the investigations of the Sani-
         tary   Commission  has,  most strongly  corroborated   these
         valuable facts, and in almost every place, which they were
         enabled to examine personally, the causes for the localization
         were made apparent enough, and will  be  mentioned  here-
         after.  Could  this  Commission have  been enabled to  carry
         out the examinations they intended, the public would have
         been  put in possession of a still larger body of most  valu-
         able  facts, to form the basis of future legislation, in this most
         important sanitary movement. 
Sanitary Condition of New  Orleans.              69
                       SECTION  VI.
Two agents essential to produce an epidemic—Atmospheric and
   Terrene—Climate what ?  How far heat is productive of yel-
   low fever—Regular progress of from the South—Yellow fever
   zone—Limits of the epidemic of 1853—On what dependent-
   Geographical limits of fever—Humidity important element in
   climate—Quantity of rain not sufficient evidence of it—Error
   of Darby in relation  to the dryness of this climate—Moisture
   essential to  yellow fever—The great causes of our moisture—
   Radiation—"Yellow fever weather"—Radiation of different
   climates—Winds—Amount  of moisture  in each  at  New
   Orleans.
   Having already shown proofs of the general fact of the exist-
ence of the epidemic, of its influencing the animal and  vegeta-
ble'kingdoms, of its extension by atmospheric and other condi-
tions, and of the practical fact of the impossibility  of its im-
portation, I now proceed in more detail to specify,  if not the
precise  elements of which it was composed, what will answer
just as well for all practical purposes, the conditions necessary
for its existence, and, fortunately for us, they can be measurably,
if not entirely controlled.
   Pestilences have, even to this day, been considered one of the
mysteries of nature ; and viewing a disease as an epidemic was
deemed a sufficient answer to all inquiries in relation to its cause
or nature.  This does not satisfy the exactions of modern science
any more than it does  of the causes of  tempests,  storms, earth-
                                                            Ancient
quakes, famine, and other instruments  of destruction to  man-   .  .
*    '       '                                             opinion <
kind.  As  men  were unacquainted with their causes or  laws, pestilences
they were  denominated " accidental," although,  all  intelligent
men now know that there can be no such thing as " chance " in
the government of the world,  but that there must  be causes
and laws of action, if  we could only find  them out, which is
both our duty and interest.  In  the  following pages we  have
attempted to analyze the meteorological constituents, asfar ascauseg ar
our means extended;  and  as it was clearly evident  that  these under iaws.
alone were not sufficient, other causes were sought out, and it
was soon clearly apparent, from the facts  before  us,  from long
            K 
70            Report of Dr.  Edward H. Barton on the
          experience, from analogy, and from the records of history, that
          filth, impurities of all kinds, disturbances of the soil, all com-
          bined in what I have denominated terrene, formed an essential
          and indispensable link in constituting a pestilential or epidemic
          atmosphere.
            Epidemics have been denominated the " shears of fate," the
Epidemics .            .                                  .
          singular propriety of which I will demonstrate  by interpreting
f  ,,      one blade to consist of the meteorological condition and the other
          the terrene, or local vitiations to give it  life, impart intensity,
          and produce development. Both are indispensable for efficiency.
          Hence then, the very natural division into
              1st. Meteorological; and
              2d. Terrene;
          neither  of which alone is competent to the  production of
          yellow fever; the first is not a simple but compound condition,
          as we shall see hereafter.  The  second may be also.  I do not
          propose to examine into it in this Report.
            It is the combination of these necessary ingredients that con-
in their com-st^utes tnB danger, that forms the poison and produces the ele-
Wnation.    ment of destruction.   Let us consider these separately,  analyze
          them, see what power we have over them, so as to prevent that
          union which is so fatal.
            First, of the meteorological : the meteorology of a city, dis-
          trict or country, may, without  any great violence to truth, be
Themeteorol. denominated the climate of that city,  &c.   Its  climate deter-
ogy is the cii-mmes the  character of its diseases, from its  influence on  the
mate  of a  great law of causation,  and  with reference to the great principle
country.    of prevention, that is,  sanitary measures, it  is almost equally
          important.  The  very  idea of attempting  to  influence these
          without a knowledge of its great principles to pilot and to guide
          us, is but groping like  the blind  Cyclops in the dark.   This
          is so well understood by every scientific as  well as unscientific
          man, that  there is no  description  of any epidemic fever on
          record,  of  any  note, in which there is not  constant reference
          to the condition and  changes of the weather  as  producing or
          influencing  the disease.  The testimony is overwhelming;  in 
Sanitary  Condition of New Orleans.              71
 no postulate in medicine is there less dispute;  all practical men
 yield it their  prompt  credence.
   Temperature has been very properly supposed to have much to High t*mper"
 do in the production of yellow fever, and that the yellow fever zone
                  ,    ...    ,     ,                        tain duration
 proper, is restricted to  limits where the temperature at midday,
 during the months of June and July is not less than 79°, and that
 the extent and malignancy of the disease is often in proportion to
 the  extent in which it shall exceed that height where the other in  Phiiadei-
 causes concur in a similar degree.  That has been applied to the pWa.
 region as far North as Philadelphia very successfully, even during
 the last summer.  It will not apply here with the same exactitude,
 because our temperature at midday is always above  that point at
 that hour from the month of May to the month of September, Tem erature
 nor is the  malignancy of the disease in the proportion  that it preceding  an
 shall exceed that  height here.   The average temperature  at epidemic at
 midday of May and June preceding our epidemics  has rarely New Orleans,
 been 81°88, and during the three epidemic months at the same and during it.
 period 83°75.  The average temperature of the whole day for
 the three months has been 79°51.   It rarely reaches as high aIn Spain"
 degree as 90° during the hottest parts of the day.  M. Arejula, a
 Spanish physician and writer of eminence, says that under 23o
 Reaumur (82 Fahrenheit)  it does not appear in Spain (I think.)
 In Rio de Janeiro it appears  when the thermometer is at  77°. At Rio.
 It is not a  disease requiring the highest temperature for its de-Ab  w.
 velopment; indeed, I conceive  this (or above 90°) rather unfa-t^y^t,,^
 vorable  to its origination. The  accompaniment of  great hu- vor  its  pro-
 midity being essential, and with precipitation  the temperature duction.
 at once  falls.  The average tropical temperature of  80° of con- „   .  ,
                       °    r       r                      Hence it does
 siderable duration, with great humidity, is doubtless essential tonot exist in
 its elimination here and South of us.  In Africa and the East In- Africa  and
 dies, a much higher temperature and higher combination may East indies.
 be the cause of  its non-existence among them.   So,  on the con- m
                                    °                        Temperature
 trary, a temperature above 80° is fatal  to the plague!   And^^  fM
 thus, also, a temperature from 30° to 50° develops  (with other the p]agne>
circumstances, as in the  other instances) the typhus gravior. Be- Do. fortyphiw
low this fever does not occur at all.  Such are the meteorolog- gravior. 
72            Report of Dr. Edward H. Barton on  the
Temperature
          ical limits  of these  great types of disease;  the  distinguishing
          characteristics of different climates and  distant countries; the
          avenue through which one-sixth (it is computed) of those who
          annually fall victims to disease reach the shores of time.
            From these remarks on the influence of temperature in the
          production of yellow fever, it is not at all attempted to support
          an opinion, which, no one who has investigated  the subject,
 alone not suf-                                                     .
          believes, that elevated temperature alone produces  it,  tor  were
          that  the  case, it would appear annually in regions far  North of
          us, where it is for long lapses of time an  entire stranger; for
          we know, that extremes  of  summer temperature, so far  from
          declining in proportion to increase of latitude, is just the reverse
          (for a certain time)  and  that our extreme heat here, is rarely
          equal to what it is very far North  of  us.  Temperature,  then,
          is only one of the elementary agents to aid in giving birth and
 commences
   ,  , „   activity to our formidable foe.  The same may be said in  rela-
regnlarly from      •>                                     ^
South  and ^ou ^° *ts decline or extinction.  As it commences usually South
proceeds reg- of us, (in the West Indies, South America and Mexico,) on an
uiariy North, average (one year with another) at least two months in advance
          or about May, so it retires that much earlier, and being a fever
          whose ordinary  duration  is from  sixty to ninety days, usually
          terminates,  when with us, it is at its maximum intensity.   The
          same principle will  apply with more or less accuracy, to the
          regions North of us.  Temperature then, although a certain
         range and duration, is absolutely necessary for its origin, is not
         indispensable (or has little to  do) for its continuance, far South
         of us it becomes extinct while this high range continues—ceases
         here usually before frost, (the supposed great extinguisher,) or
         continues sometime  after  its  occurrence, and particularly has
         this been  the case last year and more especially in several parts
         of the Southwestern  States.
           The farthest North the  epidemic atmosphere  extended the
Limits of ePi-1 agfc seas0Il has been at Napoleon, Arkansas, about 3 3 ° 5 0' North,
demicini853. and from Tampa m Florida, to Brownsville in Texas, in latitude
         25.50.  The yellow  fever zone, so often varying, now extends
         from Rio Janeiro to Charleston, and from Barbadoes to  Vera 
Sanitary  Condition  of New Orleans.              73
 Cruz.  Commencing at Rio, in January, it proceeds after reach-
 ing its acme, gradually North, reaching the Northern coast 0fPeriods ofits
 South America, in April and  May, and the West Indies andappearanoe in
 Vera Cruz, in  May and June, it arrives here usually the latter dlfferent
 part  of July, and  does not usually  reach  its Northern limit
 until some time in August and September.  In this mere his-
 torical statement, of course, it is  not intended to be  implied
 that  the yellow fever is imported from the South to the North,
 in this regular gradation, but merely that the physical changes
 inviting and producing its development becomes evolved as the
 season advances.
   Among these changes it  is not intended to be understood
 that its prevalence  is in proportion to the temperature existing;
 there are other circumstances that influence its production,
 among the most prominent of which, in the  deadly combina-
 tion,  is the presence of high  saturation.  This is amply and
 beautifully illustrated in Prof. Blodget's interesting communi- Another di*
 cation in  another  page—where  high temperature long existed Proof of con-
 with entire salubrity, but as  soon as great humidity was super-tagion'
 added, the fever was  at once developed.  It is difficult to say,
 why this  two-fold  combination  should be essential, but  in all
 climatural and  endemic fevers,  and this is essentially one, this
 double constituency is a svne qua non.  This then is another
 proof that removes it from the category of contagious maladies,
 which are  entirely independent of such contingencies.
  The zone, as now existing, is different from what it was for-
 merly, although the temperature is ab^out the same,  the local-
        ,. .                              „                   yellow fever
 ising conditions so much under the control ot sanitary measures,
   °                                             J          ' zone depends,
 have, no doubt, influenced it much.   Climate (that is,  its power mainl
 of affecting our race) is very much under the influence of cir-
 cumstances, heat, moisture, dryness, its main ingredients, can be
 much altered (as we shall see by-and-bye,) our mode of living
 also influences it.   If then, we can influence healthy actions, I
know no  reason why morbid actions should not also be influ-
enced.  In fact, we know that they may be, for I myself have re-
marked it, in the various  changes this  country has undergone, 
74           Report of Dr. Edward II.  Barton on tfte
          during my long residence in it.   It is as important as interesting
          to us, to know why the yellow fever should prevail in Brazil for
          the first time in 1849-50.  It has heretofore been the healthiest
          tropical city in  the world, and now we hear of its first advent
          in Chili and Peru, (March, 1854,) and in Guayaquil  in  1853;
          nor has cholera  in  all its destructive diffusiveness ever been
          known to have overstepped the equator.
            The limits within which yellow fever may occur spontaneously,
          (the yellow fever zone proper) is a  subject  of deep interest to
          us, and the more so, if this can be influenced, and averted as I
          believe it can, by the power of man.   In the latter period of
          the last century, and the earlier decades of this,  it was common,
          almost annually,  in some cities, as far  North as latitude 40°.
          The ground  is now assumed, and will be  hereafter supported in
          this report, that the immunity now enjoyed by them, has resulted
 What  has from no change of climate, or in the constitution of the inhabi-
 changedit.   t nts,  (technically considered,) but has arisen from the  applica-
          tion and enforcement of sanitary laws and regulations.   My own
          opinion has been long since given,* that yellow fever is gradually
          blending itself here with the ordinary diseases of the climate and
          season.  Even during last year, many cases (at least a dozen) in
          my own practice, during the raging of the epidemic, where the dis-
          tinction and unequivocal symptoms of yellow fever could not be
          mistaken, and where this exact type occurred in the same individ-
 Yeiiow fever uals in a former year, during the prevalence of yellow fever.  The
 Wending with bilious autumnal  fevers of this country not unfrequently put
 the ordinary Qn ^Q yellow fever type ^haemorrhage, yellowness, black vomit)
        e when  the causes  productive  of  these are much concentrated,
country.
          that is, when the two conditions exist in a high degree;  the same
Occurs in the occurs in the tierras calientes (the low level region) of Mexico
marshy dis-  an(^ some  0f faQ rural  districts of  South America—as near
       ex~ Guayaquil, and in the West Indias,  as at Barbadoes, where they
icoB
          suffered nearly as much, as in  the towns, and where the negroes
Sooth Ameri-             J         »               »                 &
ca and West sun?ere<^> wr tne  ^^ ^me  fr°m ^» aim epidemics of yellow
indie*.      fever, occasionally sweep  through those countries, as it has
'Report to State Medical Society. 
                 Sanitary Condition of New Orleans.               75

through this,  last year,  showing most conclusively, that when
the causes which give rise to yellow fever, exist in an exaggera-
ted degree, an epidemic is the result, whether in town or coun-
try, and that a sufficient  amount can be accumulated to produce
an endemic fever in a locality far removed from the ordinary yel-
low fever region, we well know,  from what has occurred at
Gallipolis, in  Ohio, in 1796, and at  Fort Smith, Arkansas, in
1823, if not in Louisville, in  1822.
   These changes of the types of disease, is no more remarkable
 -,     .    ..jy           .   tit                          Precursors of
than that different countries should be subject to different mala-
                                        "                    the yellow fe-
dies.  For three or  four years preceding the first  occurrence v   Rio
of an epidemic  yellow fever in Rio, in the winter of 1849-50,
there had been a gradual change in the types of fever of that
country, with an occasional case of unequivocal yellow fever (as
recognized  by those  who had been  familiar with it,) until its
final development into a disastrous epidemic.   Coincident and
cotemporaneous  with this great change in the  diseases of the
country, were proofs " that the broad features of the climate of
Brazil had  altered strangely, old  residents declaring that the
seasons were no longer such as they remember  them  to have Simultaneon,
been,"* all  acknowledged an unusual state of the  atmosphere  climatic
existed,  a remarkable absence of the  usual thunder storms, changes.
which were daily, at a certain hour, during the summer season, a
prevalence of winds from an unusual  quarter, (the Northeast)
besides other unknown but acknowledged changes.   These less
tangible variations have  not been noted, or observed, nor do we
yet know  of the presence there of a faithful notary of science,
to record those important conditions that instrumental observa-
tion can alone render valuable.
   Another  impressive instance of the effects of climatic changes
in the production of disease  is furnished by  Dr. Blair in his
recent valuable work on the yellow fever of Demarara.   Here,
as  in Brazil, it was noted that whenever the diseases varied or Diseases
changed, they were  usually preceded  by some variation in the change with
climatic condition.   Thus in  Demarara  preceding the  long *•»» climate.
*Dr. Pennell. 
76           Report of Dr.  Edward H. Barton on the
D o.  modifies
and influences
treatment.
          continued epidemic beginning in 1837, it was noted and even
          the " planters observed that the climate had changed.  The date
Demarara.   0f foe commencement and termination of the two rainy seasons
          cannot now be  ascertained or prognosticated with the  same
          precision as formerly.   Land winds prevail  in the rainy season,
          during night and morning only," &c*   Such, too, is the result
          of experience in all countries—such is reasonable where meteor-
          ology  is well understood, and  records  are made; and  every
          where, of the variations in  the climatic condition; there the
          results arising from them (disease) can be anticipated and if we
          shall be unable to prevent, provision will be made for them, and
          their influence modified and curtailed.
            Dr.  Blair notices that "extreme  seasons not  only always
          modify the  type of disease, but the effects of treatment; during
          the  depths  of the  rainy season, adynamic and congestive types
          are prevalent and marked;  purgatives  now do harm; mercury
          too  easily salivates;  thirst is  diminished.   There is  increased
          action of the kidneys,  there  are local  congestions, headaches,
          drowsiness,  sopor coma,  watery stools." These effects I have
          constantly noticed  in this climate for many years.
            That the  laws of  vital action are influenced by meteorological
          conditions,  surely we are not now to learn for the first time.
          Man learned it when he was first exposed to an inclement and
 fluenced by                              .....
          variable skv, and  has  ever since  used protectives against it.
 meteorologi-             J 7                          x            °
 cal       The foes of our  race, it is very true, are not confined to these,
          but  in the hasty generalizations of  later periods these have been
          almost entirely overlooked, and the morbific materials have been
          almost solely attributed to  agents  that allow a more extensive
          speculation, and that furnish the data for a more prurient imag
          ination.   It is the duty of  philosophy to  curb  this danger-
          ous  propensity, to confine ourselves, as much as possible, within
          strict limits, and allow due justice to all
            From Guayaquil, lat. 2°  15' S., the Sanitary  Commission
 First yellow         %    J  a                 /            J
    „  , „has received the  first recorded evidence known, of the vellow
 fever South of                 J
 the equator.  fever having appeared South  of the Equator, (previous to 1849,
*Dr. Blair. 
                  Sanitary  Condition of New Orleans.              *77

 -50.)   Dr. Win. Jamison  writes  us,  through the  American
 Consul, of its having occurred there in 1740, and again in 1842. And at nn-
 In the latter year it was fatal to twelve per cent, of the popula-U9uaI  height
 tion.   At Augas, 3,028 feet above the  level of the sea,  many °f 3,°18 feet*
 died of the fever contra 't-sd on  the banks of the  river Gu-iya- '"
   ....                                                 •    tricts.
 quil, but in no case was it communicated to the inhabitants.
   Dr.  Lacomb  writes  us from Puerto Cahcllo,  through  the
 United States Consul: " We have  instance, of black  vomit oc-'^ in runU
 curriug constantly in different parts  of  the  interior of  thisdls,xiets "^
          l x  i    x x- .  •        ,                  .  ,        .   w'Ui natives.
 country ; lately, at i\ utrias,  nearly  sixty per cent, ol the popula-
 tion died of it.   Also, at the Aragua  Valley, in Valencia, the
 capital of the province, situated nine  leagues from  this  place,
 many cases occurred among the creole population;  especially
 young people.   In ("araccas, five leagues from Laguavra.  many
 cases were fatal among the  creole population."'
   In Barbadoes, although clearly and palpably originating there Do.inBarb*-
 from local causes, it soon  spread over the entire island, and was does.
 just as bad in the rural districts as in the town.*
   Many instances were  mentioned  and will be found in  our
 record, of repetition of attack,  and  the  liability of those bom
 here, (and not of creole parents,  and some that were, and grown,),, ,  .
      x                L                          ■>    -,     ?/ Deductions
 were very numerous, more so than has ever been noticed before, lrora jubien-
 even reaching the limits of  adult life, and the dread of yellow ding with the
 fever began to be brought home, and even experienced, bv  the ordinary fe-
 fully developed natives.   This has been  attributed, during  the vers, not only
 fever, to the uncommon malignity of the diseas.-.   Mav be the,,ere' but in
opinion I  have heret >.'oiv advauc-l is the true one, and I repeat, c'hwIe'lon•
 although in vivid recollection of the scenes of last year, that the
 clear and unequivocal type i.s not so distinctly manifested in the
 mans of c".'.v»-'.'.', as it was twenty or thirty years ago.  A hope is
entertained in Charleston, that from the liability to attack of the
 more advanced adult's, and in proportion to this retardation  ot
age,  there "exists the strongest  possible  proof that our circum-
stances are undergoing a change of a nature calculated to sustain
the opinion, that yellow fever is gradually  ceasing  to be an en-
  * From Dr. Sinclair, through the U. S. Consul, to the Sanitary Commission,
            L 
78            Il'.port of Dr. Edward H. Barton on tkz
         domic or climatic disease among us."  If this is  true, I know
         no  reason  why  it may not apply, also, here.  The hypothesis
         is an interesting and important one.   It is very certain, that
         the  liability to  attack a second or third time, or even oftener,
         occurred in Philadelphia and other Northern  *  es frequently,
         and was the forerunner of its entire departure from  among
        »them ; whether as the consequence of this change, we shall not
         undertake to determine.  I am of  opinion, that in former years,
Thi- occurs
 ,  ,    , this was not the case with us; that  in latter years  it has become
thro  mans ■                         '              J
agency.    more common,  and that the  fever is becoming more and more
         indistinguishable from the  ordinary fevers of the  reason and
         country.   If with  this we  can lodge the hope of its departing
         from among us, or that the yellow  fever zone is being removed
         further South, then, I am very willing  to  entertain it;  but, I
         wish it distinctly understood as my conviction, that this change
         of zone, when once established, (and man must have created it
         by making the localising conditions,)  is determined  from the
         exercise of man's intelligence in controlling the specific conditions
         upon which yellow fever depends,  (upon  which we shall dwell
         hereafter,) and not upon any spontaneous climatic  change,  or
         evidence of cycles  occurring,  without some efficient cause.—
         These views are not at a.l incompatible with preceding observa-
         tions, in which climatic changes in Brazil  and Demarara pre-
         ceded the outbreak of yellow  fever there.   Climatic conditions
         are the predisponent, but without the localising circumstances,
         (the second blade or "terrene,") as we shall see when we come
         to state them,  yellow fever  can no  more occur than it can in  a
         country without subjects.
            Without some  considerable  elevation  of  atmospheric
Occurrence of jeraperatuve,  periodical or  autumnal fever does not  occur
     epen- ,,t aj^  ^7hen  it  occurs in  cold  and  even  in  temperate
dentontem-   ,.        .. .    ,   ,   .     ,   ,        ,             ,  „
         climates,  it is only  during  the hot weathr, or towards the
         middle  of summer;  that  a summer temperature of 60g  is
         necessary for the production  of the diseas?, and that it will
         not  prevail as  an  epidemic,  where the temperature of the
         season falls below sixty-five degrees, and disappears on the 
                 Sanitary Condition of New Orleans.               79

succession  of frost.*  Dr.  ]>■,;]::•,  in his great work'upon
the Diseases  of   the  Mississippi Valley,  remarks  that  the Its Eeosraph_
geographical limits  of  fever  in this country,  are East  thelcal Umitf*
Apalacian  Mountains,  below  the  83d°   of  North latitude,
beyond which these mountains  do  not extend.  Below that
parallel  it  has  no  Eastern  limit but the  Atlantic  Ocean.
Southwest of the Cordilleras of Mexico, and  the Southern
Rocky Mountains,  constitute its boundaries.  I have found  in
the City of Mexico, (situated near eight thousand  feet above
the level of the sea,) continued and intermittent fevers to con-
stitute more than a sixth part  of the annual mortality.   In
higher latitudes, it ceases in the  great plains  of our Western
desert, long  before we reach the mountains.   It  is almost
unknown, says he, at the distance of  three hundred miles from
the Western  boundary  of the  States  of  Missouri and  Iowa,
above  the latitude of 37° North.  In the South  it does  not
prevail as an epidemic beyond the parallel of 44°, and ceases
to  occur  periodically  about  47°.    The actual temperature
here, last year, is shown with  great  particularity in tables B,
C, D, T, and K.   I trust there is no room for skepticism, then,
to doubt the power of temperature in the production of  fever,
and there is as little doubt it is as much influenced by  the  hy-
grometer  as the thermometer.
   Humidity  is certainly the  greatest when connected with a
high  temperature, and is most  influential in  the  production n>,™-;;ty af-
of fever.  This is exhibited in table H—showing the differentlects hea,th
mortalities of the same people, in  the  healthy  country of" erenty in
                                              .            different tem-
Holland and 'Belgium,  where the average annual temperature
                0                                         perature3.
is less  than 50°, and here, where it is upwards of 67°,  with an
average dewT point of less than  43°,  and  here where it is near
62°, and with an  average  "temperature of evaporation" of
less than 47°, and  here where  it is 64°.
  The  mode of determining  the  amount  of  humidity is <heXt* amount in
most important, as it is the most recent point gained in the1
                                               .      .     phere recently
cultivation of meteorology,  and the study of climate  mflu-^^
■ La Roche. 
  80           Rcpi.trI  of  Dr. Edward II.  Barton  on ihc

           ences on  our  race.  One most interesting  fact has been de-
           veloped, which  may be considered  the  key-stone of the great
           value of  this  mode  of  investigatior.,  viz: Under the same
           temperature  two  sections  of country will  enjoy  a  different
           climate and  salubrity,  from  different, hygrometric condition*.
           One  will  exhibit  a  high  saturation,  producing  a  relaxed
           vital  system, with energies more  or less  crippled, and ex-
           tremely destructive to health and  life.   The other, where  the
           hygrometer is lower, presenting a drier atmosphere, producing
           a  greater elasticity  of body  and  mind,  with  a  power of
           endurance to which the other is a stranger,  and with a con-
           tinued enjoyment of Health.  In corroboration of this, the tes-
           timony is very  ample   .Humboldt mentions  that "Cumana
          is  the hottest,  driest,  and  healthiest among  the  equinoctial
          towns of South  America."    In various parts of our own coun-
          trv, and even in  this  city, the  fact of the coincidence of a
          great degree of dryness and health is abundantly shown, and
          so it is in  various parts of Africa and the West  Indies, and  it is
          not until the rains occur that fevers  break oat.
             Let it  be  distinctly  understood,  also, that fevers do not
Feven not in prevail in  proportion to  the  height of  the   dew point, or
proportion to amount of moisture alone, but that  they do  not prevail with-
amouut  of  out a high dew point—that is, that a large amount of moisture
mofc,ure> 0»l with a high degree of heat, is  essential  to  the  evolution  or
a large  pro- development of  the high  grades  of fever.  Our  second con-
portion al-   ..  .             •  ,     ,,          „       ,      •        •,
          dition  to  constitute   " the  shears  complete,  is  equally
waye required     .               .               .
          required ior destructive  efieet.   Moisture, no doubt, is the con-
          trolling sanitary  condition  at all high temperatures.   The  dis-
          tinction is very important.  In a preceding section, on the "cost
          of  acclimation for different nativities," the different effects are
Different «f- beautifully and satisfactorily shown on the same  people emi-
        u" grating from a country of great humidity  and  low tempera-
midityathigh      fTr n   t    i  -r^ x • ""  \  ,        ",■  x ■  x        •       ,'
          ture  (.Holland, and  Belgium)  to  one  ot  high saturation and
and low tern-      V                       .          ,
          elevated temperature.   These important facts  were eminently
peratureo.                l                  r                           J
          illustrated  last year.   With an  extreme  of  temperature  in
          parts  of the Southwest, there continued general health,  un- 
Sanitary Condition of New  Orleans.
81
til humidity was added to it.  Thus the devastation  was ex-
treme.  The invaluable testimony upon this  subject given by
Professor  Blodget,  through the vast means, the net  work ofPro°6'
scientific  climatology  which  the  Smithsonian  Institute is
spreading over our own  coum ■,  is incalculable.   Ihe exces-
sive  heats of Lower Texas, the Jiio  Grande valley, and other
districts where the thermometer rises to 112°,  115°, have a
temperature  of  ivaporation not above  that of  New  Orleans,
with  the air at  87°.   At Austin, Texas, with the air at 98°,
several  titm-.s  in June  the temperature  of evaporation  never
rose  above  78°,  and at the highest air temperature was at
74°,  76°, or  nearly  ten  degrees  below  the temperature of
evaporation  at New  York, where the air thermometer did not
exceed 95°.   The heats of these districts are therefore endu-
rable, and even pleasant, at  a degree which  would seem fatal
to life, from the great evaporating power and elasticity of the
atmosphere, Avhieh  uniformly prevails.*
   Nor is the quantitv of rain that falls in  a country  the best     .    ,
             1     •                              *          Quantity  of
evidence of this condition.  A  retentive  soil,  flat   country,rain not ex_
extensive marshes, and large  bodies  of water  will furnish the act!y a proof
facilities, with a  high temperature,  for a great and dangerous of amount of
humiditv; while  a rocky, clayey,  sandy or absorbent  soil, and moisture.
considerable declivity, will rapidly accelerate with winus  from
drying quarters, the, removal of  the rain that talis.   Hence, the
annual precipitation is  not the best  test of the humidity of a
country.
  The sickly  season  of nearly all  countries,  is the rainy
season, and where there is an  exception to it,  it  almost Rainy 8ea9on
surely exhibits a marshy, that is, a partially dried  swamp, thesicMyiM-
which is  more favorable to the accumulation of moisture in «»•
the atmosphere  than when enfindy inundated.   This is very
clearly exemplified by  the occurrences at Tampico, in 1836.
The rains usually commence there in July, and are  followed
by intense heat.   This is the period  of  the yellow fever.
* Uttsr from frol. Blodget to mu. 
82           Import of Dr. Edward II.  Barton on the

         In the above-mentioned year the  rainy season commenced
         twomonths iaror than usual, and there was a corresponding
         delay in the appearance of the  disease. *
           At Puerto  Cabedo, Dr.  Lacomb  state.-?  that  " it is a
Proo,atPner" constant and general rule  that  the place  becomes entirely
         free  from  disease,  and  the healthiest in the  world when
         strong heat, combined with total absence of rain and dampness
         prevails, the atmosphere, then being entirely dry."   On the
         contrary, " during the two last  years, 1852-53, the weatner
         was very hot, and very  damp,  with  frequent  small rains;
         during all this period yellow fever prevailed."
          In the Island oi Bermuda, a proverbially healthy place, there
         has occurred during the last summer, that precise combination
       er"of " unusually heavy rains, and  scorching hot weather, with
         out anything like a breeze  for day?;,  and filth from  an  old
         stranded vessel now exposed," followed by a mortality of one
         in every seven, t
           Probably no  condition is so  eminently injurious  to  the
At sew or-saiubrity of New Orleans, as this great humidity, not merely
leans.     of itself, but it furnishes  the agency,  either by solvency,
         combination, or otherwise, with temperature, for those  in-
         fluences that are so  destructive to health  and  life here.
         The  actual amount is shown in  the tables, (and  I wish I had
         room to snow the comparison with other countries.)   A very
         partial examination of these tables will clearly demonstrate,
         when contrasted with the monthly mortality, how destruc-
         tive to health is a nearly  (and indeed  often) saturated atmos-
         phere, accompanied with high temperature.  We have w.ver had
         an epidemic yellow fever in this country, without this combination!
         most of these ?:: c>'Is  are before me,  besides a  personal recol-
         lection which extends back upwards of  thirty years.  I am aware
Dan«>.-'.     that there have been counter statements, but they are enlirely
         unsustained by records or experiments.  The temerity has even
         gone so far as to refer to years, to corroborate it. My meteorolog-
         ical journal for those years show them to be void of accurate data.
Goupillian, from La Roche.   t Communication through Prof. Blodget. 
                 Sanitary Condition of Nexo  Orleans.             83

Two  yea.™ have been  specified,  viz:  1837  and  1841, as
being very dry, and at the same time epidemic years.  MyBut reoorded
Meteorological Journal  states for  the first, that although forpi0°
the whole yea , the total amount of rain is  small, yet  there
fell during the  month  of September,  (the  very month  in
which the mortality was more than double that of any  oth  r
month,)  more rain fell  than the average of the ten preceding
Septembers!  That there fell  during  the  preceding  three
months more than ten  inches of rain, and that in October,
which was the next most fatal month,  there fell more  than
double the average of five preceding Octobers! and that of
the litter, (or 1841,) more than 50 per cent, of rain fell that
y< i'. than the average of the preceding ten!   So much then
for facts and records, vs. memory and speculation!
   Mr. Darby, who  has written a work on this country,  of  quite
considerable authority, about half a century ago, is represented
            ,    ,, P "  .  .       ,             ■  „            statement of
to say in it that ''for eight months  m the year, after the season
     J                  ,                J   i J             Darby.
of inundation, lower Louisiana is drier than  any woodland  in
America."  He does not pretend to sustain this hazardous asser-
tion by any records of precipitation, or other eviccn ,:s.   It is
not  probable, with the  great removal of forest growth, which
tends to dry a country more than anything else, which has taken
place since this was written, that it has. tended to make it more
humid!   From a hydrographic survey, one-eighth of the  State
is constantly underwater; two-fifths of it subject to inundation!
In Louisiana, we  have two rainy seasons: that for New Orleans^ ..
                             J                             Positive proof
culminates in February and July,  which differs but little from of itg errona
that of other parts of the State, excepting, probably, West Fe-OUsness.
liciana, which in  a period of thirteen years, terminating in 13-33,
had then three rainy seasons, (April, July and December,) with
an ainual average of 61.344 inches!  The annual precipitation
on Red river, near Alexandria,  was 67.400 inches; of Plaque-
mine parish, below New  Orleans, 67.080 inches, and in this city
a fraction over 52 inches.  From these causes, her extensive mo-
rasses, impermeable soil  and flat country, Louisiana is unques-
tionably now, and no doubt, has ever been the most humid Siato 
84            Report of Dr.  Edward  II. Barton on tht

         in North America.   These circumstances give rise to our con-
         stant fogs that are so injurious to health.  Were  the  swamps
         in our neighborhood drained, and forest growth removed, these
         would in a great measure subside, and their morbific influences
         abate.
            We do not pretend to say that the yellow fever  is rife in pro-
         portion to the amount of moisture existing in  the  air; but we
         do not doubt  that  a  large amount of it is indispensable for it.
         When satisfactory scientific investigations on this  subject shall
         be extended to all the places of its occurrence, .veil that amount
         may be determined.  Whether it is a mere vehicle for the poi-
         son, or prepares the system for its influence, or  it is the  combi-
         nation, a large amount is e.-rtainly required for the existence of
         the disease.  Hence then, the discrepancies upon  the  subject,
         r.oidher alone being  sufficient, but with both and a high temper-
         ature the disease is not often  absent.
            Dr. Home made some experiments to show the connection of
n  ,. „,  humidity and disease in a campaign in Flanders.   He carefully
Proof in Hun-        J                     l  '
dew.      measured daily with the hygrometer the degree of  moisture and
         dryness of the air, and upon comparing his tables with the regis-
         ter kept of the sick, he found that the  progress of the  disease
         kept pace, as far, he savs, as anything of the kind can do with
         the humidity* of the air.   The whole  meteorological condi-
         tion has been kept by me here for many years, including the
         hygrometrv, and it has always appeared to me  that the direct
         influence on the health of individuals,  with its varying condi-
         tions, not only in yellow fever, but with large classes of disease,
         has.always been clear and unequivocal.   Its influence last year
         I  have shown to have- been  very  conspicuous.   The  special
         details for the epidemic months are  given in the tables, as taken
         five times daily, with the  cotemporaneotis mortality; the dates
         of the occurrence of the  disease would  have been more exact,
         but could not be procured.
            It is supposed  there is necessarily great moisture at sea, and
         that where there is a foul vessel  much  disease  should  exist in
           * La Roche. 
Sanitary  Condition of New  Orleans.              85
posing  great
moisture at
  warm weather.   There is a great mistake upon this subject;  it
  is now well known that the main means to keep a vessel healthy
  at sea, is not merely to keep her clean but dry—by stoves, dry
  rubbing and  other means.  The evaporation from the sea has
  been greatly overrated.  The calorific rays mostly pass beyond Error in sup"
  the  transparent  surface and  are lost below; in proof that the
  temperature of the sea, when deep, is not influenced by the
  sun;  but  when  we  arrive " off soundings" the thermometer
  gives us the earliest warnings of it by its depression, the dew
  point  is not as high far out at sea as near the shore, and but
  little dew falls; hence the little  injury  sustained from sleeping
  exposed to the air at sea.   But when we approach a coast it  is
  very different, and especially the estuaries and mouths of rivers,
  as I have  ascertained by  actual experiment.   On  the deadly
  coast of Africa, a few miles from land there is entire protection
                ,                                             It is only so
  from the maladies of that sickly region, but near shore, and
                                J   °   '                '     near shore.
  particularly near the mouths of  the rivers, it is very moist and
 very sickly.   That keen observer, Dr. Rush, attributed the dif-
 ference in  salubrity of the two,  to "a mixture of land and sea
 air."    Our more accurate means  of research, that science now
 furnishes in the hygrometer, enables us to explain it with  more
 precision.
   Of the direct effect of swampy districts upon the health, even
 of those accustomed  to them,  reference is most confidently „ _
 made to the sanitary condition of the four Southwestern States gwarapy djg.
 as exhibited in sanitary maps prepared  expressly to  exhibit it, tricts   on
 made from  the returns to the census bureau for 1850,  showing health.
 the condition of each one of the counties of those States by the
 author, and published  in the 5th volume of the Transactions of
 the American Medical Association.
  The examination into the effect of the imperfect drainage of towns E ffect  0 f
 under the authority of the English Government, is still more direct drainage  of
 and applicable to the subject under consideration. I quote briefly towns  on
from various parts of these valuable reports, to show the influ- moisture and
ence  of it  in the high latitude of 53 deg.  How much moreonbealth-
injurious must it be here.  "When a street is wholly  without
            M 
86
Report of Dr. Edward  II. Barton on the
drainage fever instantly breaks out in  it."   " Particular houses
were  pointed out, from which entire families were swept away,
and from several of the streets fever is never absent."   We find
a very striking account of a " fever constantly breaking out in a
General  Lying-in  Hospital, clearly traced  to  the influence of
above fifteen hundred yards of open ditches, full of the stagnant
filth of the neighborhood, (like Gormley's and others,) and to the
backing up of the main drain of the premises, whereby the whole
basement was flooded with every description of decomposingimpu-
rities. On the removal of these nuisances, together with a new
method of ventilation, the fever disappeared. Another instance i3
given of  a "village in a slight hollow, and badly drained, with a
wide, stagnant  ditch passing through it."   "  Here the deaths
by epidemic disease were thrice as many as in  a  village in  the
neighborhood, and the scarlet fever was so malignant  as to  be
fatal in a few hours."  Sometimes, in the best ventilated squares,
" the  neighborhood of the cess pools, and a number of untrapped
openings produce the most malignant fevers."   Liverpool, which
is situated in one of the best natural sites, is the most unhealthy
city in England, because a large number of her population live
and sleep under ground, and she has thousands  of houses  and
hundreds of courts without  a single drain of any  description.
" A table is given of  districts in Leicester, being divided into
three classes; fir^t, culverted; second, partly  culverted; third,
not culverted.  The  proportion of persons dying of epidemic
diseases  are, in the first one-twelfth, and in the second only one-
eighth of those who died in the third!"  In some of the towns
the description would fail to convey any conception, says a tal-
ented physician, of the disgusting and poisonous  condition,  and
he exclaims " can such a state of things exist in a country which
has made any progress in civilization ?"  Yet, such a description
would well apply  to  many parts of this city during the  last
summer!
   It  is a matter of record that the intermittent fever in the rear
of this city has greatly increased since the exposure of the swamp
in that neighborhood, probably twenty to  one of what it was
before. 
Sanitary  Condition of New Orleans.              87
Amount of
moistnre de-
pendent on
temperature.
   The amount of moisture depends upon the dissolving power
of temperature; the  question  is then, not exactly what that
amount is, so far as mere saturation is concerned, for the effect
of saturation  at different temperatures  is very  different, (as
shown how comparatively innocent  it is in the cool, moist
climatesof London and Holland, compared with intertropical
regions, with  their elevated temperature,) but it is the influ-
ence of the combination  at this high temperature, and to such
an extent as to co-operate with all the powers co-existing, that
are more or less incompatible with health, and  especially,
with those unaccustomed to or unacclimated to them.
  Of the fact  of a high degree of moisture in an elevated tem-
perature, being injurious to health, we trust the above evidences
                                                           xiow gr63.t
are sufficiently satisfactory.   The explanation,  or  modus ope-
randi may be more  difficult.  That it  relaxes and prostrates actg#
the system is  a matter of common experience; that it prevents
the elimination of effete and worn out excretions, that it debili-
tates, by excess of  action,  the healthy functions of the skin and
lungs, every  one  wiil  acknowledge who has experienced it—
diminishing the decarbonizing power of the atmosphere which
is always lessened as the temperature is high, air exp^ided and
saturated with humidity.  When the hygrometry changes to a
dry air a sensation of elasticity is at once experienced;  when it
becomes high, languor and prostration has to be endured; that
our health is influenced in a corresponding degree, is fortunate-
ly, now fully established.  High temperature  may produce  the
physical susceptibility—moisture may be  the medium of agents
from our second condition, and when they are all in excess, the
malignancy of the disease, will be proportionate.   Such  has
been the precise condition of things here  last summer.
  That there is dew point peculiar to  each of the higher classesThe dew
of fever (in their aggravated or epidemic grade,) is doubtless point Umit3 of
true  from what we know of the temperatures essential to theirrellow fever"
existence, and how greatly they are all  injured  by  humidity.
The dew point of yellow fever is from 70 to 80, it rarely exists Piaetw.
long,  when it is  under 60°.   The plague has probably a dew 
88            Rejtort  of Dr. Edward II. Barton on the
Typhus sra- pomt 0f 10° less.  The typhus gravior at from 35° to 45°-, and the
vior.andchoi- cnoiera m tuis cljmate, varies from 48  and sometimes much less
          to 74, and is probably less controled by its fall than yellow fever.
            The sources of this great excess of  humidity are mainly the
Bources of it swamps, lagoons, lakes around us and which are also the principle
here-       causes of our fogs, imperfect drainage and want of pavements.
            Radiation, *  as  a source  of  disease, has not heretofore, as
          I am aware,  attracted  the  attention  of professional  men;
          yet,  no  observant  practical  man  who  has  passed  through
Radiation as many epidemic yellow  fever seasons,  could have  failed to
acanseofdis-notice, the  peculiar weather  that  usually exists during the
ease now first ciear  days of those seasons.  In  fact, old  experienced  men
noticed.     Qut Q£ ^q profession have been in the habit of denominating it
          " yellow fever weather,'''' without analysing the conditions which
          constituted it.  It is characterized by  being very hot in the sun
          and cool in the shade  at the same  time—on one side of the
          street a broiling temperature, and on  the  other so  cool  as to
          urge to buttoning up  the coat.   This  uncomfortable alterna-
          tion of chilliness and heat, is productive  not only of uncomforta-
          ble feelings, but when exaggerated, passes into disease—consti-
          tutes the first stage of yellow fever.   It may be here  only the
•Yellow fever exciting cause, developing dormant disease, from the predisposi-
weat  er  e- ^.Qn jjemg a]rea(jy present.  The difference of the  temperatures
          between sun and shade, is at these times, very great, and essen-
          tially constitutes, with  other circumstances,  a sickly season.
          My attention has been  called to it for many years, and it has
          been carefully noted by me not only here, but in other countries.
          I have not remarked it to influence materially other diseases, be-
          yond the class oi fevers, except coup de soliel, of which  doubtless
          it is the principal cause.   During last year it occurred unusually
          early, in January, and furnished one of the grounds of the pre-
          diction of the great epidemic. This principle is illustrated in the
          accompanying  Chart No.  2, and Tables D, E, N, 0, to which
          reference is invited.  A more thorough proof could  be  made
 * Solar radiation, derived from the difference between the temperatures of the eun
and shade. 
Sanitary Condition of New Orleans.              89
 by a comparative exhibit of other years.  It is too minute for
 this paper, but the opinion expressed is  fully borne out.   The
 unusual  amount of solar radiation last summer, has been fully
 proved in several parts of the yellow fever region.  It has been
 particularly noticed at St. John Baptist, by Dr. Delery of this Showa eb&"
 city, where he remarked that "the planters found the sun'swhere*at St<
 rays so intense, that they were compelled to use umbrellas for Joh" Baptut'
 the first time as a protection against it," the yellow fever  pre-
 vailed here very extensively.  It was also noticed at Hollywood
 and at Gainesville*
   At  Gainesville, Mr. Fulsom had found the heat in the sun
 so great that he  frequently rode under a tree, to avoid its
 intolerable  influence, and for  fear of taking  a chill, he was AtGainesviiie
 presently compelled  to quit the  shade!   The  same facts
 were  observable  at  Hollywood, and in Wilkinson  county,
 in the unusual  and  uncomfortable difference between  the At Hoiiy-
 temperatures of sun  and shade.   Dr. Benedict observed the wood.
 same  thing in New  Orleans, as early as July, when  " in
 riding in a  gig in the streets, with the top up, it was found In New 0r_
 so cold as to compel him to lower it, to procure  the warm- leaM
 ing  influence of the   suns  rays.  This was   soon found so
 scorching as to induce him again  to put the top up !  and
 this was several times alternated from  the great difference
 in the extremes of each.t
   These remarkable  conditions would  doubtless have been
 recorded at other places,  had  the attention of observers
 been called to them.   It is probably the " fiery something,"
 to which yellow fever has been formerly attributed by those Probab)y ^
 distinguished and experienced observers, Drs.  Chalmers and "fiery wmK_
 Lining,  of  Charleston.  The profession  may  be assured thing"  of
 that it plays a much  more important part in influencing  the Chalmers and
 production  of morbid action, than is yet known.   Its precise Linin&-
 modus operandi I forbear to speculate on.  Is it  by  decom-
posing ozone, the great  purifying  principle?  The  direct
causes of  the varying  radiations of  different  climates,
* See testimony,  t Refer to Dr. Benedict's interesting paper. 
90           Report  of Dr. Edward II. Barton  on the
          elevations  and periods of the day, are quite obscure.  In
          experimenting on this subject, I have often noticed a varia-
          tion of from 5 to 10° occur in a few minutes, (from 5 to 20,)
          without any apparent difference in the clearness or transpa-
          rency of the atmosphere or change, of the winds.*
            Terrestrial radiation (or that proceeding from  bodies on
          the earth,)  is the true interpretation of the danger of expo-
          sure to the night air.  This exists in excess in sickly climates
       ra"and seasons.   It constitutes what is  so  much  admired in
          the  dangerous, but " beautiful blue sky of Italy,"  the air
          so  clear and transparent, (upward radiation,) rapidly cools
          the  body, chills it, and  often preludes the first stage of
          fever.  It is as tempting as hazardous in hot weather.  An
          umbrella, portico, tree, musqueto net,  any object intervening
where  the ketween the body and clear  sky,  protects one from it.  In
       '"'"the thickly built parts of cities, this radiation is very small.
          The  best radiators are cotton, silk, wool,  (rotatively,)  and
          consequently we are  least protected  by  clothing made of
          those materials,  in the order mentioned.   We thus interpret
          the  alledged injurious  effects of  sleeping exposed  to  the
          direct influence  of the moon.  It is always greatest on
         bright and brilliant nights.
           For the proper appreciation of the chart and  tables, it
         may not be  out of place to state, not only that  this is  not
increase  of merely a most unusual amount of  radiation for this climate,
          but that the popular estimate  upon the subject is a gross
          error, so far as it supposes that the intensity of direct solar
         heat increases as we approach the equator ; in fact, it is just
         the reverse !  Baron Humboldt found "the difference between
         the temperature in the sun and shade at Cumana, one  of the
         hottest, driest, and healthiest in the lower regions of equinoctial
         America, never exceeded 6° 6', sometimes not more than 1° or
         2*.   Captain Sabine found the maximum at Sierra Leone 18°;
         at Bahia, on the coast of Brazil, 9?.  I have rarely seen it exceed
         20° in Cuba or Vera Cruz, and have often remarked how sel-
radiation
proportion  to
increase   of
latitude.
Proofs.
   * The reason why persons insulated, or confined to the house, are rarely subject
g 0 yellow fever, may be that they are not exposed to solar radiation. 
Sanitary Condition of New Orleans.             91
dom umbrellas are used in tropical countries, and how rare it is
to have many trees immediately around their houses to protect
them from " the ardors of a tropical sun !"  There are some
grounds for the belief that it either increases with elevation,
or we become more sensible of it, from diminished pressure
of the atmosphere, for such seems to be the case on ascend-
ing mountains.   De  Saussure states it as the result of his
experience on his ascent of the Alps, and it was of  mine in
Mexico ; so dangerous is it esteemed in the elevated regions
       ,                                             °    elevation up-
of Mexico that  the  natives always  carefully protect the
loins  of their  horses  (their weakest part) with an  extra
covering of skin, when in use, and  often their  heads.  In
Jamaica, while on a level with the sea, the difference between
two thermometers, (or radiation, the one in the sun and the
other in the shade ) was at the maximum 12° ;  on the moun-
tains it was nearly double.  In  England, it is usually found
about 50°, and sometimes as high as 69°; while it has been
found at Mellville Island, latitude 65° North, 55° in March,
and sometimes as high  as  90° !  Captain Scoresby, in lat-
itude 80*? 19, found it as high as 80°.   Sir John Richardson, IllnstratioM<
in his late expedition to the Arctic climate, found the power
of the direct rays of the sun so great, in a cloudless sky, that
he  had to " take shelter in the water while the crews were
engaged on the portages!" and Captain Scoresby found that
the pitch in the seams on  the side of his vessel, occasionally
becomes fluid, ( which it never did on  the  coast of Africa), a
temperature of almost 130°, while ice was rapidly generated
on the other, in the shade !
  Let us apply these remarks, for a moment, to the economy
of nature, and see if we  cannot draw some illustrations  in
proof of the correctness of the statement.  It is thus that we
can account  for  the productions  of the rapid  Springs  in Proofs, in its
the Northern climates, where vegetation leaps, as it were, at influence  on
once into being, while, if otherwise, its  productions wouldthe vegetable
not have  time to mature  and  ripen for the  sustenance  0fkingdom'
man.  The cereal crops are known to be so much dependant 
92             Report of Dr. Edward H. Barton on the

         upon its amount, that it has become a matter even of calcu-
         lation in England, and it is so well  known that without the
         direct rays of the sun (whatever may be the temperature of
         the air) that fruits seldom come to perfection.   So great is
         this radiation in England, that many tropical plants cannot
         bear the direct rays of the sun there, and require protection
         in order to reach  maturity!   That the indirect (or shade)
         temperature is not solely dependant upon the direct, is proved
         from the fact that they reach their culminating  point almost
         always at  different periods, and  the exceptions  here are
         during the occurrence of epidemics!   In  non-epidemic years
         the highest point is probably in  May.   So, in England, it
         occurs about two months in advance of their highest temper-
         ature.
           These  views,  now  so well established  among scientific
         men, in their influence  on the vegetable, and even the animal
         kingdom, extends beyond their bearing, on our profession, but
         I forbear its introduction, tempting as it  is.
           Should I not have been entirely successful in establishing
         the connection of radiation as one of the efficient agents in
         the production of yellow fever, I have, at least, pointed out
Radiation a new fold for philosophical investigation,  that has hitherto
worthy of far-egcape(j t^e scnitiny of pathological induction.  It is cer-
 er  mvesti- tajn|y silown to be within the laws  of the  dynamic forces,
         and highly worthy the notice of the etiological inquirer.
           Pardon is asked for this digression from a subject as novel
         as it is interesting and important.  It is clearly apparent that
         it is entitled to more thorough investigation than it has yet
         received.   What is due to each climate is not known. I have
         long since requested the Smithsonian Institution to add it to
         the requirements from its meteorological correspondents,
         throughout the country.   It would  not depart far  from the
         rules of probability to say that whatever  influences the  phy-
         siology of the vegetable and  animal creation must also influ-
         ence their diseases.  In this  climate, I do not consider ten
         years of observation sufficient to determine what is the nor- 
                 Sandary Condition of New Orleans.              93

 mal amount, but believe that beyond 30° or 40° maxima, is
 productive of injurious influences.
   Winds.—All experience has  shown that free  ventilation
 and strong, unimpeded currents of wind are inimical to the
 elimination and concentration of malarial exhalations, conse- influence  of
 quently, to the production of fever;  that where the  winds winds.
 blow strongly and freely,  and find no obstacle from surround-
 ing objects, or  intervening forests, localities which otherwise,
 might be expected to be  fruitful sources of fever,  may be
 visited or  inhabited with impunity, while similar places be-
 come insalubrious, if the  air  is  stagnant *  Calms,  says Dr,
 Drake, permit  the exhalations from foul localities  to accu-
 mulate in  the atmosphere, which rests  over  them, but  all
 winds operate to disperse and dilute them with purer air.
   By reference lo  the table P and Q, it will be  seen that on
 an average of  years  our  most prevalent winds during the Amount of
 summer are the East, South,  SW. and  SE., and by referring moisturein
 to the table of the hygrometry  of the winds  here,  (or  the each"
 amount of moisture each of these conveys wilh them, table P,)
 it will be found that these are the very winds which  are usu-
 ally loaded with the largest quantity.  Thattable also shows
 that when the air becomes calm (or stagnant) it becomes still
 nearer the point of saturation.   During the worst period of Direction.
 our epidemic the  most  frequent wind was from  the  East.
 That is a pretty constant feature, not only in our epidemics,
 but most others.   Still  more remarkable was the frequency
 and long duration  of  onr calms, with all their injurious satu-
 rations and depression of the vital principle.
  Nearly all laud  winds are  unpleasant, if not deleterious  to
 health, in most climates, producing a sensation of chilliness and
 discomfort far beyond  their mere  thermal  influence.  It is the
"simoon," of most  countries;  in Havana and  Georgetown, Unwhoie-
Demarara,  it is  a South wind; here, and in Texas, where it is80me  nature
felt so severely,  it is  a North wind.  These winds produce aof Iand wind9
rapid evaporation from the surface  of the body, causing  extreme'
dryness, while the sun is unclouded and hot, (during the warm
months,)  and is  excedingly uncomfortable.   Fevers of a bad
, in summer.
* La Roche. 
94           Re2)ort  of Dr. Edward  II. Barton on  the

         character are  then known to  prevail.   It was upon this ground,
         mainly, that I have advanced the opinion of the protective influ-
         ence of Lake Pontchartrain.
            No one can doubt that there is a great system of balances in
         the natural, as in  the moral world.  In the animal and vegeta-
         ble kingdoms a great predominance of either, is unfavorable to
         the  other;  where they  are  equalised, health  results.   Great
         heat and moisture promotes an excess in vegetable life.  It is
         injurious to man.   All excess tends to disease, while moderate
         changes are conducive to health, " all natures' difference, is all
         natures' peace."  This has been often remarked in hot and other
         climates.  During the late epidemic yellow fever, at Bermuda,
         it was remarked that "an extraordinary state of atmosphere
         prevails here now, very favorable to vegetable life, but dangerous
         to animal life  and health."
            We think sufficient has been said to show in what this epi-
         demic  consisted.   We would not  be understood to mean, that
         the exact amount of heat, moisture and decomposed materials,
         were  ascertained to have produced it, and that there were no
         other materials than those we have enumerated.  For the more
         exact application and showing of these influences, the meteoro-
         logical  journal of the three  epidemic  months is annexed, in
         detail,  as noted four  or five times daily, made up during the
         intervals of the exacting demand for our time during that labori-
         ous period,  (the month of July was  kindty kept for me by my
         friend, Dr. Benedict, and the balance by myself.)  Every record
         was made that was in our power, conscious as we felt,  that we
         were  in the midst of the most important, and  therefore, the
         most   interesting,  pathological  year,  that  ever  occurred  in
         America, and that we should be held responsible, by the scientific
         part of the  profession, and the public, to make every observa-
records imper- #
         tion that could have any bearing or influence upon it,  and
         therefore our, future;  and  have  essayed to make  a  faithful
         statement of that  gloomy period.  How it will apply or aid us
         in influencing that future, time alone can tell.   No such exact
         or extensive record is known to us as having been made before 
Sanitary Condition of New  Orleans.             05
Exact amount
with which to compare it.   But we trust many such, and better,
will be made hereafter, should  it be the misfortune of this, or
any part of our country, to be afflicted with a similar calamity.
  The exact amount of the meteorological and terrene causes
to produce fever, and especially, a malignant epidemic yellow
c          A .        .         J       &      r      J      of the raate-
tever, is not known;  it may be  hereafter.   A distinguished • , *
                          *                         °       rials for an ep-
authority informs us that  "since the beginning of the world,i(lemic not
the temperature and humidity  of the  atmosphere have, per-known.
haps, not been twice in identically the  same  circumstances
for eight conscutive days."*
  However this maybe, and as duration is an important element
in everything relating to health, there isnodoubtof the fact that „  .
                                                          Duration re-
all the agents productive of yellow fever, whether climatural or qniredfordill.
terrene, are in the nature of things more or less fluctuating. ease to be de-
So  is  the physiological  condition of the  individual;  but I veioped.
have as little doubt that it is an approximative duration around
a very narrow circle that is required to produce the impression
resulting in a yellow fever season; that  is,  that  an  elevated
temperature, high saturation, excessive radiation, with terrene
causes in large amount, shall coincidently exist, although they
may slightly fluctuate, for a period, which,  according to my
observation, to overcome the physiological or vital resistance,
shall be rarely less than about two or three weeks,  depend-
ent upon the susceptibility of the individuals exposed.   It is
under such circumstances that yellow fever  rarely fails  to
follow.   During  my  long residence  in  this 'climate I  have
rarely seen such a prolonged continuance (the above duration)
of identical weather, if in excess, whether  of heat or  cold,
dryness or moisture, but was productive of disease of some
kind.  Variable  weather  and  seasons are usually  healthy,
though this is opposed to  popular belief.  Such is the play of
the organism, and such are the variations required to give it tone
and impart to it vigor.  Professor Schonbein has given many
reasons for the belief that fever arises from a deficiency  of
*Arago and Schubler. 
96            Report of Dr. Edward II. Barton on the
           ozone.   No experiments were made to test it here. ■- If ozone
           is developed, as is alleged, by the approach  of two clouds  of
           different electricities, that often takes place during the exist-
           ence of our yellow fever epidemics, with, as before remarked,
           injurious effects, its evolvement may be at too great an eleva-
           tion above our immediate  atmosphere  to benefit us.   If we
           possessed the certain power of foretelling, long beforehand,
           and always, the  advent of a great epidemic, thousands of lives
           would be saved.   I  do not know that  we  could do as much
           by fillinc: the atmosphere with ozone, which would  be  very
Advantage of  J      °           x
foresight and costly.  A writer in one of the prints during the summer ad-
remedies,     vises its being " drowned out," which I thought  highly plau-
           sible, if possible, the Mississippi river at such periods having
          usually  descended  so low as, if introduced,  could only influ-
          ence the low back streets.  But the  cheapest,  best and most
          rational mode, after all, will be found in the practical applica-
          tion of the means of prevention, by the  introduction of those
          sanitary measures that experience, fully tested, has shown to
          have saved other communities from pestilence, and  restored
          them to salubrity.  They will be fully  detailed hereafter.*
            In this early application of  meteorology to disease, I ask
          the indulgence  of  the  profession  for  the  paucity  of my
Notruthsvai- records.  Enough has been given to show that the connection
ueiess.      is most intimate  between them, sufficient to assure us of vast
          hidden truths, far beyond our  present means  of investigation;
          these truths  are  of value  to science and humanity ; indeed,
          there are no useless or disconnected truths in the great labo-
  * Tables C, D, E contain the daily meteorological and mortuary condition during
the three epidemic months.  I would gladly add the whole year of both were the
latter practicable, for the gratification of scientific men, to show how much climatic
conditions influence our weather, and especially, during this remarkable year.
  In interpreting the connection of meteorology with  mortality, two circumstances
are to be taken into consideration :  first, the amount of vital resistance to be over
come previous to the attack, (for it cannot be at  once,) and second, the period to
elapse before resulting in death.  These, as yet, are indeterminate and irregular pe-
riods, dependent upon individual susceptibility and constitutional power.  The second
is easier estimated than the first, for the  average duration of the disease is from
three to five days.  We sometimes find in the advanced period of the season that
a sudden great &11 in temperature produces a frightful mortality, cutting orl'all who
are very sick, unless carefully protected; and  here a little foresight of a coining
change can often be put to most valuable use. In this case it is almost  equally apt
to prevent the further continuance of the disease, provided the change is apcrmanent
one. 
(  IIAUT  I! ill usfraf/wj the Mf/m/re of Si)LA\{ and TKIMtKNTIAL llVI)IATIO.X^/>I()ISrn  KK /// the production olWAXM Kl-VKK/// XW (II! LEANS
                                                                                   it fit i .va  ts.;:l

       I're/xn-al lor the lie port  of the  Sam Wry  Com mission   BY   E.H.BARTOIN      A.M.IVI.D.
.IdiiiKiri/   ''  Febriittri/     March      Ajiril         M'".L       _Jjtiie         'I" hi        Anijiisl     Sej)/e//iber\   October       .Vol ember  j  Decembei
:■"'"''' "/'!.•,„„ II , /.' \l„l .') Sim !> ■ ll Mul, 'I 'Sim  "  , .'  Vii/ !> -Smi. !>  /.' Mul  II ,tiin 9 It Mul 'I >i,u. II 1.1 .M„l !) \Siui  II I! .Mid
l:,„l„il„„k,i>r .1.1/ M. U.ireM'ris, AM,M Iliir/'M.'.ci..,  IW 'I /1,,-WItm.IJ/ .« Ikiv /'Mr,..,- IV ■ W /Jnv-eM.ri.;-.IM. 1/ Mm /' V ■/•(.., .1.1/.. J/ Jl.iv I'M ,"'-, .1 \l Mllii
11/' .'/ . /W/'V/v,.- .IV .1/ /k,,i I'M;.,... .i ■/ 1/ Mm /'i; :,-,.„. | 1/ 1/ //,„/'!/ .//.,
          .  ..  .*




/,  :      ;   i  :
>;.U'/..i v		vims
TIi		- -hue.
""'	i.il.lli	r r, ,„,,.■ IlicXun
Tin		----tlml
in	1. :■'.	ulrlmlt
Inr	liwr.i	l,l,IV
TIi	■*,,,	III,III--..
ll„	fnilii	inicr
	,i,-i,i,. i:,„	
Th	•ii"""	,„/„„„.
II,	n ii,,-	Illll,II, ■ III. i
 
\\V'          (/  iu\e.oXau*umvu     Mm\At\\     U\V    >N
uv
\L/'A.U.UYU.
LU   L
%i
cHuVvoAV
3 the Enrth    5 feet.
...........    15 feet.
in sen......  lift J41
ASPECT 01' SKY.
N.K.J   N.K.I
W.I


   (II
 S. 2 S. W. 1
W. 3| S. W. 1
V E	y	S. K. K.	c .«. K. 1
	H	S. K.	! S. 1
	n	S. \V.	! S.2
	i	s. w.	AV. 1
W	i	■\v.	\Y. J
s \V	i	s. W.	S. 1
w	2	s. w.	; s. w. a
s \V	o	X.	i k."!
S W	:;	S.N	11 S.W. 4j
\ \v	2	X. \v.	> x. k. -'|
s.W	1	X. w. s. ]•:.	s. -2; S.E.I
S. \V. 1
   v..-2
S.W. 1
X.:i=lil,N'.K.r>=l|t E..1=l] S.E.Itli ) :  Totals...
                     lealmaOJii >S  Averagei
    :;:;S.W.-Jl^i:.\V.!)=-2i!XVV.(ir-H )£  Total Ay
 N.2.33N. K. 1.2 I K. I.e. ,  S. K. 1.(1(1 } f  Drving
 S. I.II'.IS. W. 1.-3W. 1.33N. W. ].(>(! \-l  Average
 ---------------,------------------'     Average
            1 .IS
Ten,,.,
:;.|,r	■sen: s	-l.jj, ubi.ii	l.m.ln,. ilearce repr- -„	ol Lh,ariie^.i, nixl	1 WIN'll.-o on, until ^	—0 Si;i rn	iij T „|. "V	ill! i.lm, [ :l « Iriwh liiv,-I. .■nil., I.reezc, 1 n stroiis win hrcczc, | :,ii vitv iln. ,1
lain	,• of	•a.,,,	f	A Hew l>..Mir.	Radiant 'J'in:i(MciMi:rr.it Ix Si v			IOMETER.—Rai.v
in-.:.		%						
I						i		i 7. ^
l"?7	Til.i,
-,.	7.1.3
	70.1 70.' 73.i;
	71.1
Td	7.1.1'.
	
?7.o 2.0,-on -

71.31 o.i .!i:;;i
73.2; -.'.-.'.HT
    2.1 on l
     II-11
i.!i.-:s.i.-=   :  :   :
•_'.i .!i:s'i z   :  :   \
•2.1 .ss3:I  i  -;  i

:f!i;'.!iiM:'.l
, P.M.  3.20 P.M.
ivcrs before day.
~, ( 11.35 a.m. H .4(1 a.m.
M \ 8.3!) A.M.  AII) A.M.

    f 9.3s A.M.  1I.13.V.M.
-..  I 1H.3.-) A.M. 11.(1.1 A.M.
om) 12.2.1 p.m. 12.38 P.M.
    L 1.52 P.M.  3.5(1 P.M.
10.32 A.M. ID.ISA.M.
 5.38 P.M.  6.00 p.m.
Gentle Simwere.
.12.M.  12.31) P.M.
\   '
 =th.-12

llll
P.M. 12.32 P.M..
12.23 p.m. 12.35 p.m.
 2.0(1 P.M.  3.3!l P.M.
 3.II0A.M.  3.31) A.M.
2.0.112!
l.l|91

I2th.

i:ith!

iiih.
3.15 p.m.  3.50 p.m..
ill-|i  llll)I  is 17
                    REMARKS.

The record this month lias been kindly kept for mc by Dr. X. 15. Benedict.
Much thunder and lightning during the  month.
Heavy rains, alternated with hut .-mi.  .Much damp weather    r
Thunder and lightning noted particularly on the 5th, lath, 13th, and 29th.
of Evaporation.... '...........'.


   R E 0 A ]> I T TT I, A TION.
11.12
 n.21
70.1,;
< 2.52 P.M.   4.3 I P.M.
\ 4.00 a.m.   5,1.1a.m.
22d .. 8.00 a.m.  8.30 a.m.

25th.. 0.10 p.m.  0.50 p.m.
',   .023

____081
.. .302


 1.3.14


.. .33.1


 l .3(1(1
TlierniO«v»-ter.  Dew- V,
Kiingo
tin- Thermome-
, Scale'.____

"or sat. 5 ob J
1  5.25 a.m.  G.OOa.m,
'  2.25 p.m.  4.(10 p.m.
(  7.00 p.m.  0.3D p.m.
 2ilth .. 3.15 P.M. 4.48 P.M..

131st.. 1.35 p.m. 2.15 p.m..

u Total,....................
u
From 1st
to 8th,
18s .1.10 on 10th,
lo2litii,
     29
 Daily,
1.55-1! G.-'0,l224l>
   ASPECT OF
'At Sun Rise.......
     !>. A. M......
QUANTITY OF RAIN
inches and fractions,     11
. of davs on  which Rain fell, JS;Xo. of days ealn
 __nights___"____J'___'I   41             ,\
		WINDS		
f d	vs	blowi	,g	
lie	X X	E.	1 > 04	
	s.	E.		i.'i
 11YGHOMETR1C CAI.cri.ATI(IN>

-iiniis,, j.Vl Midday. At 9, P. M.   A vera
VIOl-NT  OI-' MOIST! Ki;.

   .703 j     ,-'42

■TICITV OK THE VAPOR.
.7'.';;
tt-KUIMT ()

   9.0I0
  .-211

.CMS--. 
<:?."
tJu\u\Ax)Lmavl    ^W\u\Y\\    \oA    ^V\v     \l\u.u\\;>.   \uA\\    I. \\    (v.    Aj,.   ^'U\a\o\\\
AUGLST, K
LVTITIDE,
LOXGI'ITDE,  90°,
ASPECT OF SK
WINDS-O.-L
BAROMETER AT
Month.  Risk
. M.  p. M. p. M.
 THERMOMETER
Itside, in open air, in shnde,
Rise a. m. p. m. p. m.
.13
"	in in	d.	;;	.. X.E.I . W. 1	SV, , j		
11				ii, ::::::i:			W. 1
11	III		3	10 W. 1	X. 2 W. 2i		X. 1
-	III 3	",	1	0 X.W.I 10 E. 1	\. W. 3 X. K.2 K.2 K.2		K.2
II	III		8	10 E. 1	K. 11 K.2'		11
12	lil		II	10 1 1 9 E. I	K. 2| K. 1 K.2 K.2		||
(i	it	n	II	4 1	X. 11 X. K. 1		8. I
1)	3	i	1	0 1 10 X. E. 2|	K. 2| K. 1 N. K.2 K.3		B.S
9	S	'	1'	10 1	K. 1! F..-4		(1
7	-	i	1		W. I II		K. 1
s	II	i	1	s (	\Y. 1 ! W. 1		1)
in	III	r.	r	8 W. 2	\Y.2l W.I \v. 1 w. 1		X. W. 1 II
13	III	H	k	8 W. 1	W. 2lX. W.2		W. 2
13	111	-	i;	S W. 2	W. 2 X. 2		X. 1
13	111		n	10 X. K.2	W. 1	X. I	S. 2
12	3	;•	i	0| W. 1 in y i	V K.2 N. E. 1	X. 1 X. K.2	X. 2 K.3
13	n	-	n	0 S. ]-',. 1	X. E. 1	X. I'., a	S. E. 3
			i	s s. E. ll	S. K. 1 S. K. 1		8. 1
7	9	f-	2	III I	1 l; 1 21		K. 2
H 11	!l 1 n	<	l -H	III K.I 10 1 X. K. 31 III, K.2	X. K.2. K.2 1 1| 1- 2 K. :ii x. !•:.:•:		]■".. 2 K. 1 K. 2
II	m	n	0	10' X. K.3	K.3| K.3		!•:. 2
11	n	it	^	II) IN. K.3	X. E.2j X. K.3		K. 2
 -7503 S4023 SI.I'IS -7.V27 131

1:30.194 :!'I.222 3'I.1-I 3I.1SI 4.08

...........30.194
212 2327 2347 22-4
20.1  -iiii  |.12
-USK. 17-I\ K. 3(1-11
.K.OnU ,1 -  Totals,...
3.1] S.W.If.W.20-1  X.W. 4-1  X- T„
. I.3.3X. K.2.  ! K. I.s-  S. K. 1,11  I ■_ 111'
. 1.33 S. W. 0.0 \V. 1.21 X. W. 1.7.1  \ I Av

          1.33
1 freeh breeze, j 6 n violei
i ftronc wind.
1 very do. do
of Evaporation A. DewPoint.|
Radiant Thermometer ||  I'll YIuMKTK
     In Sin, at       I!        Rain.
                         R K M A R K .8 .

    Much thunder and lightning throughout the month :  during the  interv
,.f the heavy rains, a burning sun, cold in shade;  hot, damp, suffocating a
more " calms " than ever observed before : the average "force" of the wind v

small, 1.33 by the scale,  (stli,)  Wind to-day occasionally from North.
    The gutters, where any stagnant  water left twelve hours after a ruin.  I
gas bubbling up from below, turbid, discolored. (12th,) Rains partial, ill differ

parts of city. (20th,) Rain to-day, accompanied with sharp  blow from East.
    Fogs in  the neighborhood have been heavy every  morning. The " clcarnei

of the sky, has greatly predominated during the "sunrise,'' and 9, p. M. no-
vation, over those of 9 and 3 o'clock
 9, j  12,

l.M.1  M.
: J ? :  High Wnter

' * ~" >, which is ueunlly

'■"   Z\ Fifteen Feet
111   70 12.30 p.m. 1.20 p.
127   114;  80!
  72,-   74j 09.7


 21010 21.If 2 lli:
 74.0170.1),  71.0

I "]".<»!;....  Vl:
7.i 3.2	- 1.1
7.1 2.4	-1 1
i- >.\ ->.'■	-..1
O'i Yl	-1 1
Kl 3.1	-21 7-2 1
1.0 8,1	743
 1.2(1 p.m. 2.20p.m.;
12.  m.   1.30 p.M.|
 2.20 p.m. 3.15 P.M.'
M  3.45 P.M.  4,
-I
15! 1 7.  a.m.  8.:
,'lj;l2.  M.  12.1
19-   .((I 23-
173,   III  204
llll   31 I 222
22H2 2111
7.1:i3 I I".
70.20-4..1
I 1:1.0:1 11.1,13 7-11
.13 34.27  29.311   .63
			l; I! (		A 1' I T	r l..\	T I 1
	Barometer.			The	rmometc	13.	IV I'l
		1st. 11, 17th,	', ill 0 III'."'		1 2Mb, 1 17th,		on 1
							
trie Seal...
 |S.3on2:th/
 ll. or sat., 14 obi
	ASPECT OF SKV. f At Sun Rise...............7,1.1 9, A. M..............5.02 Mi.ldav................3,15 IHWXTITY OF RAIX nches and fractions.......7.010 of davs on which Rain fell, 11 nights___'•____!'._1_0.	No. Km Xo A	of 1 ,1 tii nf ,1	W 1 X i.vs blowii - X. X. E. K. >. v.. s! w. \v. x. w. vs calm,	l.i l.l 1 1 17	1IYGKOMKTRIC CAI.Cri.ATK IXS. ¥mr |At Sunrise At.Midday. At 9, P. M. Average. KS8 .DM | .7.10 I .!)!.", 1 ,-73
						j ;;;;! KI.ASTUTrv Ol' Till; VAPOII.
						','vj -S97 | .8117 J .034 1 .909
111 Xo						1.1111 WEIlillT OF VAPOR IN A CUBIC FOOT IN GRAINS. TTil 9051 | 9.515 | 10.045 | 9.737
 
0
&,tdco\aW\vuv\D    vAv^uAcV.    aoas   vytu\    OAWvU.   AicW)   ini)   (°.   Ap.   [&.{\\\d\v
SEPTEMBER. 1S53.   LVTITIDE, 30°.  LONMJITl'DK.
) Altitude ot'Tlirrmoiii.-n
i    do  ,1' U"ill Gunec,
SPECT OF SKY —II )t(
BAROMETER  AT
RlSE.I A. M. P. M.
3II.1U 30.121 30.11
.14	.12
.21	.20
.29	.21
.20	.18
.19	.14
.21	.10
.20	.22
 THERMOMETER  ! Aspect of  Sky
itside, in open air, in -imde, tit j      AT
   ANEMOMETER,
Course and Force of Wind at
)78	0
	3
ii,;	4
170	Ii
17-	9
-70	II
IS.)	II
1.81)1	9
l-;l	10
IS1)	III
77-	4
.23,   .23  07
.22
III
71   64J65I  111  11)
in
111 I   X. 2
 «■ X.E. 2
ION   E. 2
i   Hi|,  E. 1
2  III! X.E. 2|
0.  0|      I,
X.E. 2   E.
X.E. 3 X.E
X.E. 2 S.E.
K. 2
K.  I
K.  I
K.  I
r,  i
Hi  X.E. 1
III
\
on
9H.150 DOfiol! 90519 90577; 159;2169 2328 2408/210-
Averages, ],30.18.1'30.217 30.173 30.192 .05*
171 109


1.70.1.03
       1"   X. 4
       10 X.E. 2
       10j X.E. I
    7  I"   E. 3
    o!  10j X.E. 2
    :i:  10 X.E. 1
10  Id  10'i     0
       0, X.E. 1
X.4|
II-
227
       W. I
 E. 2i S.K. 2
 E. 2j   E. 2
 W. 2|  W. 2
:.W. II  W. 1
:.W. l|   E. 2i
'.K. II S.E. 2
 K. I   K.2
 W. ll   K.2
 X. 3: X.E. 3,
 X.:    X.3
 X. s!   X. 3
 E. •* X.E. :ij
 K. 2| X.E. 2:
X.3

V,. ::
K.2
K.3
V.. 3
E' 3
K. 2
S.W. 2
X.W. 2
  K. I
 X. 3
W. 1
 X. 1
 E. I
 K. 1
 K. I
 P.. I
 E. I
 K. 2
Total do.............30.191
 X.E. .1  K. 12.',  S.E. 2.) )
              calm, 3 ■
SYV. Oftl  YV. 13;X.\Y. Oi ) =
lX 2 32 X.E. 2.0.1 E. 1.50's.K. 1.00 ,
   S. OS.W. 1.33W. 1.28 X.W. 2 ;
ill Averages.............


,rage. temp, of Evaporatii
I) a fresh breeze ] G t
7-1.0	77	7-1.1	7-	77.:'i 2.9: 8.17
7li.il				70.3 0.81.871;
7.111		74.4	77	70.3 1.91-70
71-	7.1	7:1,1	7.-.	74.2: 1.31.9011'
72.(1	07	iii.o	lis	07.1 | 11.(1.797
03,-	07	02.1	02	17.5j 0.3 8S||
12.1	01	1.1.1	III	50.9| 4.5:.70.1
511.3	.10	50.3	112	OO.Oi 10.:t!.liS()
.17.1	0.1	59.:.	0.1	1)4.4: 7.1..8:111
01.7	(if	03.:	07	0.1,1 3.7.7-2
0 17,	7-1	71.4	7,	09.11 10.9i.803
lili.l	73	lili.l	71	70.1 4.1.815
00.1	71	00,'		09.]| 7.1 .8(14
Oli 1	71	00.1	7'	0.1.4 1.111.7551
07.1	7"	72.2	71	73.2| 5.8.847-
21054	22.H	21227	21-7	2150(1 1134L..^Totals,...
70.1-				71.801 3.7sl... : Avr. expos
2.12		9,11 '--72.4		--1' !.....|-"- Difference ...........j or radiatio
ji Radiant Tiir.u.MD^iKTEK
       Ix Six, at
 3,    9,
p. m. ;r.M.
PLUVIOMETER ;—Rain.	
Date. P.eoan.	a" p
1-. 4. A.M. .A 5. A.M. \ 10.30 A.M.	5. A.M... .250 8. a.m. ) .025 2.3(1 P.M. J' .100
.30 a.m.—sin
111   114   114
100   111   112
114   llji  113
 \ 12.311 P.M. 12,10

6..Showers at 11 & 3-.
. S 3.30 J'.M.  4.  P.M.
'.Showers...........
„< In night...........
 I   showers to 2 p.m.
A In
■in.
     ( Showers to 1 P.M....

T!» i 10 S Showers to 12 M___
ij:i'  (    do.  to 5 p.m....
70' II.. Occasional showers.
09.|w< 12.30 pm.  3.29 p.m.
07 \\'~\  4.   P.M.—showers,
!:4.jji3.. .1,1  p.m.  .1.5.1 p.m
   .,,,11 Showers light in
  '   I   »igl>t........
    1.. 7.   A.M.  9.  A.M
)  .060
>  .100
.081)


.100
1921  15081 185
IS   47|]o ft. .-
1-1	171	2(1
11	2-1	3.1
9,	7	III
11	20	39
101 ill	(iil8 1694 i'	
                        REM AEKS.

The occurrence of thunder and lightning continued as long as the rains.
The North winds, and cool dry weather, occurred soon after the middle of the.
  month, greatly abating the epidemic.
»f daily
;".:;:;,,
.10.112 0
10.191
,2lllli,
lOlli,
RECAPITUI, ATI OX.


    armonicter.  Dew Point.
1.....1',	■ of (Irvnhss	1 Degree of Moislim
,11 llll	Thermome-	on tin, Hvgronietri.
lie 8,	ale.	| Scale.KlOilbeingsat
2.) 7	in 23d.	0. or sat. 14 obs
11. ,,,-	sat, 14 obs.	,102 „„ 23,1.
4.,84		
20.7		,19-
f„rAt!
ASPECT OF SKY'.
 an Rise,...........
 9. A. M...........
Jliddav.............
 9. P.'M...........
             ■WINDS

'-'".No. of days blowing,
Y03|        '        „
' 03: From the X.
           X. E.
goof total,.
    QUANTITY OF RAIN

In inches and fractions.......:
No. of days on which Rain fe]
  ______  nights___________"   "
HYOROMETRIC CAI.CKKATIONS
-AtMiddny.;.U9, P.M.I

~AMOl NT OFMOlsTtTtl
Average
        X. W.
Xo. of days calm,
  Average total, ~
 1.33
 1.2-
 2.00

dd>
> | .732 |	.908 | .>
KLAS'l'HITV OF TIIIl VAI'OU.	
WEIGHT OF VAPOR IN .
    .816

IUBICFOOTIN 
Sanitary  Condition of New  Orleans.            97
ratory of nature;  if they are hidden from us to-day, their ap-
plication maybe made by our successors to-morrow. We can
no longer plead ignorance of their practical bearing and  im-
portance ; but, we are, as yet, upon the mere shores of meteor-
ological  science, "picking up the few pebbles" of truth that
have been yielded to perseverance  and industry, while  the
boundless ocean lies open before us, for exploration  and dis-
covery.
                      SECTION VII.
THE SECOND  CONSTITUENT  OF AN EPIDEMIC.--ME TERRENE.
Proposition—The Upturning of  the  Original  Soil,  together
   with Filth of  all Kinds—The  sine qua non of all our Epi-
   demics—Proofs as far bach as  Sixty  Years, to the  Present
   Period—How  first  noticed by me—Causes of Epidemics at
   Natchez, Memphis, St. FrancisviUe, Mobile, Selma,  Algiers,
   dec, dec.—For  an  Endemic less  necessary—For  Bilious and
   Periodic Fevers still less, but all the same !— Why Yellow
   Fever does not always extend— We Enow as much of the
   Origin of  Yellow Fever as we  do of any  other Fever—All
   Countries have their Peculiar Diseases—Parallel of Yellow
   Fever and  Plague—Extension  of  the Epidemic  due to late
   Inundations in Part—At what Stage, Swamps most Danger-
   ous—Proofs from Foreign  Countries  and here—Different
   Stages of Draining Produce Different Diseases—How  and
   When to Drain Land, &c.
   Our other  constituent  to produce the yellow fever epidemic,
the other  blade of. the " shears," is the terrene.  This is very
comprehensive, and  embraces all foul, filthy, organic matter
passing through  its decomposition,  whether terrene,  miasm,
malaria, or what  not.  Every thing terrene that is  injurious  to tt
health  may be so denominated.  I wish to be distinctly under-
stood here, that neither meteorological nor terrene causes alone,
is  sufficient to produce the effects  alluded to, and  hence the
great difficulty and  stumbling  block, when one of these  is 
98            Report of Dr. Edward H. Barton on  the
          found present, even in an aggravated degree, and not the other,
          and the effects do not ensue.*
            Epidemic yellow fever then depends upon two circumstances:
          first, a meteorological, and  secondly  a terrene  cause.   The pre-
          cise amount, or constituents, of which each of these consists in
          their original or proximate elements, the present  state of  science
          has not  yet  informed us of.  Of  the  first, I have shown the
          main ingredients; of the  second, it is probably composed of
From whence all decomposed or decomposable matter.  The varieties of fever,
varieties   ofmost probably, depend upon variable amounts of these constitu-
fever.      ents, influenced by the physiological condition of the individual,
          which only slightly varies the  extreme force  of the causes pro-
          ducing an epidemic.   I have expressed the opinion that an epi-
          demic yellow fever proceeds from a genera? distemperature of the
          air with local influences, and particularly with an undue disturb-
          ance of the original soil.  I shall show presently  that an endemic
          yellow fever depends upon a more local distemperature, with
          the same local influences, but  in a minor degree, and  that the
          type or  malignancy  depends upon the more or less  extent of
          these causes,  and finally, that  bilious or periodic fevers depend
          for their existence upon the same  causes, but in a much dimin-
          ished degree.
            In examining  into the  cause or origin of  our  epidemic yel-
          low  fevers, there is  no reason  why  we should  not  apply the
To apply the same principles, as  in initiating the cause or  origin of  other
same princi- fevers, or other  diseases.   If we cannot say that we have the
pies in exam- verv precise  and exact  meteorological data,  or the  precise
inmginto the amount of decomposable matter, we are just as near  the truth
causes of yei- as we are fa  i00]c[ng fafo  the  causation of any  other  disease.
lowfeverasof Overpowered  by  the magnitude  of the disease, and  bending
other fevers.  kefore £he authority of great na,mes, we suffer  ourselves  to be
          blinded  to the plainest facts.   It is  considered by some, as an
          act of temerity or folly, to dare to  think of preventing it; that
            *This, it Beems  to me, will explain  most of the difficulties that have set them by
          the ears in  Charleston, in relation to the occurrencces ot last year, and why they did
          not have the fever there,  " the meteorological cause " was said to be present, the other
          was not: the "Jacksonism " of the Mayor did  not consist "in removing the two
          cases " that occurred, but in his praiseworthy energy in keeping the city thoroughly
          clean, in preventing the concurrence of the  second, and equally essential cause,
          (now, the causa sine qua non.)  It is a great pity some more Southern cities had not
          been blessed with a little of that wholesome "Jackson " energy, and common sense
          of duty, instead of being contented in  boasting of the  existence of " cleanliness "
          and "health!"                     '• 
Sanitary Condition of New  Orleans.
99
 such ordinary things as heat, moisture, filth,  and such  like
 trifles, however combined, could give rise to this great monarch
 of  disease, (y. f.) is  but playing with human  credulity!  They
 forget,  all  the while, that  a sudden  change  of temperature
 alone, has often deprived human beings of life, in a few hours;
 that vitiated air has, still oftener, killed in much less time, and
 that  nearly all disease to which man is  subject, is caused by
 conditions not widely  different, or so  minute as to defy the
 utmost power of detection.   It is time  to put aside and be done
 with all this stultifying  and misleading mystery and awe, and
 boldly facing,  and  defying,  all  carping misgivings, push  our
 scrutinies as far into the causes as our facts and reasonings will
 legitimately carry us.
   Proposition  1st; now, if we  can prove that  the epidemic 1st  proposi-
 yellow fever has never occurred  here but in a certain condi- tion.
 tion of things in so long a  period  as sixty years, that it has
 always occurred here when this condition was present, and that
 it has occurred in at least three other places under similar con-
 ditions, so far as can be ascertained,  of between twenty  and
 thirty years each—then there is a. fair presumption, if not more
 that we have arrived at one source of its causation.
  Proposition 2d;  if we  can prove that our ordinary endemic
 yellow fever,  occurs here and elsewhere, under certain contin-2ddo-
 gencies of a high temperature, for  a certain time, with a com-
 bination of much moisture and filth, that these are never known Cause of our
 to he absent when it does occur, that it  has occurred under cir endemics.
 cumstances, where no foreign origin could possibly be imputed
 to it, that if there should be apparent  exceptions, viz: that it
 does not always occur where  these are all apparently present, is
 it not fair to presume this to happen, rather from some defect in
 our observations, (and we well know how imperfectly and under
 what prejudices and defective knowledge these are often made)
 than from any deficiency in the constituents themselves, or than
 an  occult cause ?   Can we not then,  with all reasonable pre-
 sumption infer, that the above  are  really the causes of yellow
 fever ?   If we prove that when these are removed, that it does
not occur, is there not another proof of the sufficiency  of the
 cause, especially for all practical purposes ?   And is it not at
war with  one  of the first rules  of philosophising to hunt up 
100           Report of Dr.  Edward II. Barton on the
         extraneous  causes, to account for that of whose origin we have
3ddo-     sufficient proof ? and the 3d proposition is, that these causes ex-
Canse of our jgtjng jn a iegs degree, will produce bilious and periodic fevers.
            With regard to the first proposition, I wish to be understood
         distinctly as stating, that since 1796-7 to the present time there
         has been no great epidemic yellow fever in this city, without an
         extensive  breaking up—disturbance and exposure of the origi-
or the  fiwt nai son 0f  the country ; that this has consisted in digging canals
proposition.  an(j kasins or cleaning them out, either in the city  or its imme-
         diate neighborhood, digging and excavating the streets of the
         city for the purpose  of laying down gas and water pipes, and
         relaying the streets—digging and embanking for railroads and
Proof.     similar  purposes, in the summer season, and relyingly—refer to
         the Chart A, for full and conclusive proof thereof;  and that the
         extent and  malignancy of the disease, has been pretty much in
         proportion to the extent of these exposures.
            The first  epidemic yellow fever that is recorded here, is that
Succinct ori- simultaneous with excavating the earth, in digging the Canal
Bin of ail our Carondelet, and more especially its basin in 1797.   I am in-
epidemics.  formed  by a highly intelligent and observing creole gentleman,
         that the  fevers during the  period  of digging this canal were
         awful in its neighborhood, even with  Creoles;—and that last
         year the  sickness in  the  vicinity of the excavation of its new
         basin was very extensive, although there were few but natives
         and acclimated exposed to it.
            The  next most extensive yellow fever epidemic  occurred du-
         ring the cleaning out  the same canal in 1811.   Then we have
         the next  severe  epidemics of  18l7-'19-'22, simultaneous with
1817.            _            x                        '
,819.     extensive exposures in the streets for pavements—large fillings
J322.      up and enclosures  of the batture, and the cleaning out and
         deepening the  same canal.
            Then follows the great mortality of the epidemics of 1832-3,
         the largest  we have ever had in this country, resulting from the
         immense  exposures  of the swampy soil in digging the Bank
         Canal from the  city  to the lake.   Then follows the epidemic
         fever of 1837, resulting  from  digging the extensive trenches
and 1837.   an(j canaiS) to drain the rear of the First  and Second Districts 
          CHART exhibiting  the   ANINUAL  MORTALITY or  NEW  ORLEANS,
tier 1000 of ih  /'»/<"/""'«" for each Yrardm/rlhrr with Hie KdiM-t. infliic.miiifi or proiludnif it. from //.Vi / with n f" rxrr/ilioiiM to AS.;//.
                                  llliiNlraljni<tliP Kcporl on llie SntiiliTrr Yonilili......I"'.\W Orleans
                                          k K.IJ.IiAKTO.'V.A.3I.M.«).
 
                   Sanitary Condition of New  Orleans.              101

The next largst mortality,  and which has continued ever since,
arose from the large new; canals and clearing and exposure of the1**6"'48'
soil, between the two Canals, in rear of these districts, without
regard to season,  and the immense excavation of two acres of
ground and with the removal of upwards of  336,000 cubic feet
of earth for the foundation of the new Custom-House, in the
heart  of the city—beginning the latter part of October, 1848, J848-'49
and ending in the succeeding August, during which period we&c" and itM
had a severe  epidemic of  cholera with a mortality of upwards consequence8-
of 3,600, and during the balance of the year of 243—with a loss
by yellow  fever of 769.   During the  succeeding year (1850,)
the mortality from cholera was 1,448, and  in '51 of 645, "and
in '52 of 1,326, with the  addition  of 597 deaths from yellow
fever during these three years, for  effect of  all which refer to
chart  A.
   And, finally, which has contributed so much to produce the
great calamity of last year (and  on  which mainly I founded my The  8pecI*
prediction of the  fever in  the preceding May)* was the exten- ca'
                »  ,      ,  .      .              .                epidemic  of
sive exposures ot the earth m making a new  basin for the same
canal (Carondelet)—clearing out the canal—dredging the Bank
Canal—extensive   exposures  of  the earth  in deepening the
ditches between Conti and Common streets, and also in the  rear
of the third  district, the digging and exposure for the erection
of a levee between the  two canals on Lake Pontchartrain—the
large excavations on miles of streets in the centre and front  of
the city—for laying down  gas and water pipes  and making and
relaying pavements—as exhibited in black lines on the Sanita-
ry  map—the extensive exposures for laying the foundation of
 * See published " transactions"' (of that date, page 10) " of the New Orleans Acad-
emy of Sciences," for the details of this prediction
  Is it any more unreasonable for us to predict the occurrence of disease, occurring
under precedent well known condition?, than that nearly all inferior creation should
have the power of foretelling future events that  are essential to their safety  The
instincts of the spider—the tree frog—birds so announce to them, hours and days
beforehand, a coming change in weather ; the Beaver—the Bee, &c , have the pow-
er of foreseeing months beforehand, Hoods, droughts or other inclemencies of the
weather, that would otherwise be absolutely fatal to their  existence.  Surely, this
can only be derived through meteorology proceeding from a sensitiveness or means.
far beyond what we at present possess" If a greater difficulty is experienced with
us, the cause may be found, besides in that of the imperfection  of our meteorological
ins truments—that disease is the result Of a two-fold condition—a meteorological, and
local or personal ens, and that, as yet, observation of the influence of thiacombina-
 ion on the human body is too limited for general knowledge  With more industry
\n collecting and recording facts, the time may not be distant when success shall
'more frequently crown  our efforts.
            O 
102           Report  of Dr. Edward II. Barton on the
          new buildings (especially on Front street,) and the excavations
          and exposures for railroad purposes in the rear of the first and
          fourth districts and at Algiers.  Here then we have a combina-
          tion of materials of exposure  of the original soil unprecedented
          in our annals, probably excepting  that  of 1832,* which  was
          more concentrated, and the consequences have been correspon-
          dently destructive,  in combination with meteorological condi-
          tions (before  expressed) in proof of which  this mortality  con-
          tinued  large  as  long  an  this exposure  continued,,  no  doubt
          influencing the  two epidemics of 1833, of cholera and yellow
          fever, and causing the large mortality of the two succeeding
          years (see Chart A,) and every large mortality since.
            The first proposition then,  is believed to  be fully sustained.
cholera and ^°°king* upon the epidemics of cholera and yellow fever as the
yellow  fever highest of the zymotic class, (of what is called malarial disease,)
highest grades requiring for their existence a great accumulation and concen-
ofge^ym°tictration  of their respective  causes;  the  one being  a  disease of
          the  cool, and the other of the hot months; and believing that
 ■xposure  o  an ex^ensjve exp0sure 0f fresh earth, when conjoined with filth,
          crowding,  &c,  with the  meteorological causes which in  the
heat  and   .        .                         fo
          union of high temperature and great humidity have been always
worst combi-Present' f°rm  tne  worst combination, the occurrence of these
nation.      diseases during the period referred to are fully  accounted  for,
          and amply affirm the correctness of our first  proposition.
            These curious and remarkable developments occurred to me
Hriwthey.              .        ....
          in the course ot  my statistical investigations  and scrutinies into
were    first
made known  ^e causes 0I" tne mortality of this city, in which I have felt a
          deep interest for very many years.   After constructing the upper
          part of chart A, the immense discrepancy in the mortality of
          the several years immediately attracted my  attention,  and as
          there could be no effect in the physical world, without  an ade-
          quate corresponding cause, and as it so much exceeded  that of
without an *         .  .
          the rural districts around  us,  all the chano-es in the physical
adequate                                           °          r •>
cause,      condition of  the city and neighborhood were carefully investi-
          gated and placed to their proper date, under the mortality of
          ---------------------------.--------------.....—■------«r
           * The greatest mortality was by Asiatic cholera that year.                 •«■ 
                   Sanitary Condition of New Orleans.              103

 each year respectively.  The subject became interesting as I pro-
 ceeded ;  its valuable bearing soon became  apparent; a clue was
 evidently found to the causes  of our fatal epidemics; and finally,
 it was clearly demonstrated by the facts collected and exhibited on
 the chart—hi the language of the proposition—that " there has
 been no  great  epidemic yellow  fever in this city,  without  an
 extensive disturbance of the  original soil of the  country," and
 this, I think, has been fully proved,   There is no other to which
 to attribute it; no  other  great  change either in the earth  or
 above the earth, so far as my meteorological  observations have
 extended, (and my investigations in this line have reached as far
          ' \      J        °                                     Too mvaria-
 back as any records could possibly be procured,) and for many ble for a mere
 years back they have been made by me with great care and mi- coincidence.
 nuteness, in order to throw some light on this curious and im-
 portant,  and to us, vital subject.   It has been too constant  and
 invariable for a mere coincidence, and can be  viewed  by tlie
 philosophic mind in no other way than as cause and effect.*
   More fully to satisfy  my mind in  relation to  the important
 bearings of this subject, more especially, since the appointment
 of the Sanitary Commission, to  investigate the  origin  of our
 late great epidemic, I  determined  to extend my inquiries  to
 other places, and see if similar facts  and analogous results were
 recorded elsewhere.   Accordingly, the corroboration has been
 most remarkable, leaving not, a remnant, of doubt on the mind,
 as to the fact or the consequence.
   Prof.  Merrill,  (formerly of Natchez, and now  of Memphis,)
has clearl v traced the successive epidemic yellow fevers that have
  * It is due to myself to say that there may be various errors in the materials ot
which this Chart has been constructed, in a country where there are scarcely any
records (official) of anything relating to the vital statistics of the country (of: birth>,
deaths and marriages )' The data are to be obtained at great cost oi time and trouble,
f,om sparse and occasional sources.  The materials to construct this Chart have ex-
nonded much of these before even their chief value was apparent, by applying them
L each other  They will, I trust, serve the basis of an instructive iuture, ii we are
rn oeinsTuctedby any lesson derived from the past.  I have taken great pains to
make them aiSect as my materials would allow, and do not think it contains ma-
Jerial errors  It would seem as if our object was to avoid records to  destroy the
tenai errors  il  „„_,„.„  It \fi Verv true we  should be ashamed oj them,  but then
fnghttuliacts they  xpo>c  It i,veiy^        canceal the tmth_   About f
^£^^eMoZ^Z"B^oi Health," (that U Boards of Record-ior
times nave we  J""' ",  l „ower\ since 1841, and so far as their records have been
lMx-l\ A  en wr-11  otherw^  it U nobody's business to take care of valuable city 
104          Report  of Dr. Edward Jf.  Barton, on  the

         in a series of years devastated Natchez, to the cutting-down, level-
         ing and filling up the streets.   " This city," says he, " is built upon
         a bluff; in 1816, the city authorities began to  put into  opera-
         tion a plan for reducing the irregular  superficies  to what  was
         considered a more suitable grade.  During all that year a large
         amount of work was done, digging down and filling up  streets
         and lots, without due regard to  the maintenance of a  proper
         drainage.  The succeeding autumn the first epidemic  yellow
         fever occurred, and produced a frightful amount of mortality.
Proofs of the*7             '     v            _ °             .           J
     r   . As soon as  the  shock of the epidemic had partially subsided
cause ot each                              x           i      j
oftheepidem- the work of grading was resumed.   No one could perceive why
ics at Natch- it should be considered the  cause of the disease, and  the work
ez.       went on, with a recurrence of the epidemic  visitation every
         second year, until, the population having been several times
         decimated by death, and business and property greatly declined,
         the city found itself scarcely able to continue the improvements,
         and scarcely worth them if  made.  After the dreadful visitation
         in 1823, the work gradually declined, and  the  subsequent  re-
         turn of the  disease declined in violence and fatality pari passu,
         until  the last of the series, in 1829."
            " Soon afterwards a new  era commenced.   Exuberant pros-
         perity overspread  the land.  A  new population  was brought
         into the city, and in 1834-'5-'6 the grading was resumed to some
         extent.  The doctrine of domestic origin and  artificial  causes
         had again lost ground. The voice of experience was not huard or
         overruled, and the penalty again suffered.   Many of the older in-
         habitants foresaw the result in fear and trembling, and the  epi-
         demics of 1837 and '9 sent many to their untimely graves.  The
         eyesiof the living were again opened to see their danger,  and its
         causes, and since that time  little  grading has been done."
            " Now that these experiments did render Natchez sickly, there
         can be no reason to doubt.   The coincidences were too striking
         to be viewed as accidental.   Besides, the same effects following
         the  same causes, have been observed elsewhere.   Private resi-
         dences and plantation negro quarters have suffered in the same
         way;  also workmen  on railroads and canals—upon levees ancr 
                 Sanitary  Condition of Nevt  Orleans.              105

upon city wharves and landings, as well as persons residing in
the neighborhood of such works."
   And again, notwithstanding previous warnings—in 18-53, at
Natchez,  the  levelling the  streets by the cutting down the ad-
joining banks, and superposing the  fresh  earth on the streets
resulted in the fever.  It is said to have first broken out in the
immediate neighborhood where this took place—that here oc-
curred its largest mortality, and thence it spread to the neigh-
borhood.
   The same gentleman has most satisfactorily ascribed the in- Do of Mgm_
salubrity  of Memphis, to the same cause, and  the  same effects phiB>  ■
have followed similar causes in the rural and otherwise healthy
districts, on the blacks as well as on the whites.
   The severe epidemic yellow fevers at St. FrancisviUe, in  1827
and 1829, were to be clearly debited to the  cutting  down the
hills, spreading the materials on the streets and grading them,
digging cellars, &c, during the summers of  those years,  (from Do     g
personal recollection) and the epidemic of 1839, at Bayou Sara, FrancisviUe
was equally due to the filling up, by spreading fresh earth over and  Bayou
brushwood, and filling up low places.*   And for the only  other Sara.
epidemic known to have occurred there, since its settlement, that
of 1853, may with much propriety be ascribed to parts of a  levee
made and ditches dug—acres of saw-dust from a saw mill spread
and low places filled with it, and for years previous, working ex-
tensively  on  the streets just previous to the epidemic,  and
extensive swamp leveed off and dried up in  the vicinity.f
   At Lake Providence, the  decay from the extensive spreading
of  saw-dust  over the streets  and filling  of lots,  producing a
very offensive odor; unusually low water ; extensive exposure
    ■..                                                      Providence.
of river bank.J
   At Fort Adams,  extensive exposures of the  earth from large
cavings in of  the river bank. ||
   At  Centreville, extensive ditching and stirring up of mud in
the principal streets or roads of the  village—" past summer un-
usually wet,  and heat  of  the  sun very great." §           Centreville.
 •• * Ab etated to me by my friend Dr. J. W. Bell.    t Dr. Brown.    } Judge Selby
' * || Dr. Benedict.     § Dr. Wood. 
106
Report  of Dr. Edward II.  Barton on  the
Natchitoches.
            At Cllnton, working the streets, and unusual disturbances of
Clinton.     ^e soji an(j Qf ^q^ yards during August and  September, and
          to the middle of October.*
            At Trenton, on the Ouachita, soil  greatly disturbed by the
Trenton.    " improvement" of the streets; soil brought from a distance and
          spread on the  main street;  several excavations made for new
          cisterns in May and June; marshes and pools near the town.f
            Dr. Kitridge informed us  that the fever on his own  place—
          in the interior, on Lafourche, arose, most palpably, from spread-
Fourche.    *nS over n*s large yarc-, fresh earth from his neighborhood, not
          a case of the fever then existing within fifty miles of him.
            At Natchitoches, ditches of the town cleaned out in August,
          and a great deal of  disturbance of soil, to lay down  pavements
          in July and August.J
            In Algiers, on the opposite side of the river,  during the last
          season, extensive embankments of earth and excavations were
Algiers.     made for the Opelousas Railroad, the fever broke out  and devas-
          tated that village ; of 350 hands employed on the road, 300 fell
          victims to it.
            On the Jackson street railroad extending from this city, I am
          informed fifty hands out of eighty died of it.
            Of the amount of mortality on the Great Northern Railroad
          I  am not so well informed—their sick being brought into the
          city when attacked.   But the tracing the fever  along the lines
          of these roads will be found in a subsequent part of this Report. ||
            So far for its influence in this state, let us extend  our inqui-
          ries to the neighboring State of Alabama.
            Dr. Levert of Mobile, has most satisfactorily traced every epi-
          demic yellow fever, that has afflicted our sister city for upwards
          of  twenty-eight years, to similar disturbances  of the soil.   So
i)     M   convinced had the authorities become of its injurious influence,
bi!e>       that a city ordinance had been passed,  forbidding it during the
          summer,  which was  most unfortunately rescinded last spring,
          and the disturbance had again taken place to a greater extent
 * F. B. Harvey.   t See testimony.     % Dr. Crocheron.    || Same informed
SO per cent, of the hands died. 
Sanitary  Condition  of New Orleans.             107
than ever—to accommodate the railroad, and to fill up some
low  lots, and the consequence have been chronicled in a corres-
ponding calamity.   I refer, with great pleasure to his valuable
report among our proceedings.
   At Selma, the occurrence of  the epidemic of last season, has
been most satisfactorily accounted  for, in a  similar manner.
" To the removal of old deposits, exhumations, the filling up of
a hollow, various deep and extensive excavations for the foun-
dation of buildings, the filling up and grading streets with it,
and  vacant lots.  The first  twenty cases of the epidemic occurred
within the limits where the earth was deposited and seemed to
radiate from  these  deposits.  Digging commenced about the
middle of July and continued to November—season very  wet
and  particularly  in August.   Fever broke out in September.*
   At Montgomery there had been considerable excavations for
the purpose of laying down gas pipes, and the earth thrown up  °n gomerr'
was  stated by my informant to have been very offensive.
   At Hollywood, on Mobile  Bay, an unequivocal  case of the
spontaneous occurrence of the disease is mentioned by Dr. Ben-
edict, arising most probably (in  a boy)  when the sole  cause to HoUywood-
which it could be ascribed, was  his being exposed to the fresh
earth from digging a well.f  Precisely the  same thing has hap-
pened in Algeria, and mentioned by  the French surgeons, en.
gaged in the same business, those employed in it alone suffering
while all the others escaped.
   At Gainesville, much  disturbance  of the soil  from  diamine1
                '            .           ,             S& & Gainesville.
and  " improving " roads, ditching. &c.  "W ell  dug—on cleaning
it out it consisted of a sticky and stinking deposit. J
   In Charleston  these disturbances are forbidden by ordinance
during the summer season, from their experience of their disas-
trous effects on the public health.  Dr. Simons, who has been  n  areston'
for some thirty years their chief Health Officer, specifies m his
late  valuable report on yellow fever there, that "in 1842, white
laborers strongly predisposed to yellow fever were employed in
 * See the interesting report of Dr. Mabray, among our proceedings.    t See his
interesting paper in our proceedings.   \ Mr. Fulsom. 
108          Report of Dr. Edward H.  Barton on  the
         opening drains and other works, and transferring  the earth  to
         different portions of the city, where drains were opened and the
         earth  deposited—there yellow fever occurred, and the unfortu-
         nate beings who performed that work were the greatest victims.
         The same  thing occurred in 1352.  At the new custom-house
         a number of Irishmen were employed in excavating the  earth
         and piling; a great many were taken sick and died; the sale
         and distribution of the earth through the city had a  baneful
         effect."  Other instances are mentioned of the dangerous influ-
         ence of excavating and exposing offensive materials in opening
         drains and transferring the materials to  other localities, even
         producing sickness in a class of persons who are usually exempt.
            These are some of the valuable  results  of the  investigations
         of the Sanitary Commission.  They would have been doubtless,
         greatly multiplied had it been in their power to visit personally
Value of a (as was their desire) every district in the six  States where this
sanitary sur- epidemic extended.  There is no  substitute  for  effective  per-
vey-      sonal examination on the spot, and the  public interests would
         be greatly  advanced by a minute sanitary survey by competent
         men over the entire region.  No geological survey has a tithe
         of the claims on the public interest,  for  salubrity is the first
         object for accomplishment for the public welfare.  Public wealth
         is often developed by the first; the sanitary condition  is much
         more often advanced by the other.   An ignorance of the causes
         influencing the salubrity of cities, towns and rural districts often
         subjects them to the most afflictive calamities, entirely within
         control.  This has already been made  apparent  by what we
         have already said, and will be made much more so as we pro-
         ceed.
            B,y extending our examination into other climates we find
AuheChesa"the same injurious results have followed the upturning the earth
         for digging canals, opening roads, the establishment of brick-
tornac canals*               .
         yards, and cutting down  of bluffs.  The excavations for the
         Chesapeake and Delaware Canal were very fatal to its laborers
         and the neighborhood, costing hundreds  of lives; and so was
         that for the Potomac  Canal, above Georgetown,  a very  large 
                  Sanitary Condition of New  Orleans.            109

mortality having resulted from the excavations.  The writings
of  Drs.  Drake,  Evans,  Blane, Cassan, McCulloch, Caldwell,And  other
Bailey, Thomas, and many others, are replete with instances in
proof and illustration, and the  whole body of physicians at-in Africa.
tached to the French army in Africa have given their opinion
of  its injurious influence in the production of fever.
   In Martinique, West Indies, " extensive disturbances of the At Martin-
soil, in the alteration and construction of roads in different parts ique.
of  the island, causing great evolvement of miasm,  causing the
fever."*
   At Fort de France, (Martinique,)  " public opinion regarded Ft.de France.
the fever as due to the cleaning out a canal  which  surrounded
the city." f
   The first disturbance of the original soil of a country for agri-
 cultural  purposes (or the  time  during  which  it is passing
 through what I have elsewhere denominated the  "transition
 period ") is known to be highly injurious to  health everywhere ;
 and the devastations on  the early settlers in all  our  newly
 opened  districts of country are too well known but to be merely same results
 referred to in illustration, developing  wherever they have oc- on first ouiti-
 curred the worst forms of the diseases of those climates respect- vat ing a
 ively.   In a few years these subside, the insalubrity following country-
 the hardy pioneer along the outposts of population, to the mar-
 gin of the wilderness, to each newly opened district,  and then
 passing off like a morning cloud before the rising sun.
    The  special injury in a  Southern  country by unskillful
 clearing and exposure of the  original soil, without protect-
 ing the homestead,  has subjected this  and the adjoining
 States, at their early settlements, to calamitous devastations
 from  the most aggravated forms of endemic fevers—consist-Disturbing
 ing of algid fevers, (called " cold plague " from the coldness orisinal 80il
 and blueness of the surface,)  sometimes running through itscause of our
 course  in a few hours, and to which I never thought I couldepidemic-
 discover any acclimation—and it is only since the status of the
* Dr. Amic.   t Dr. Amic.
          P 
 HO         Report of  Ih\  Edward IT.  Jlarton on the

         country (in these respects, clearing and exposure) has become
         fixed  and unchangeable that Louisiana has ceased to be
         called the " grave-yard " of the Southwest.
            Of the sufficiency of the cause to  produce the epidemic
         here,  I trust satisfactory reasons  have been  stated.  Ordi-
         nary fevers of various grades and intensities  of malignancy
         are produced every year by its greater or less prevalence ;
         but the  highest grade known to this hemisphere, (yellow
         fever,) and of such malignancy as characterized it last year
         in an  epidemic form, is alone produced by such an exagger-
         ated condition as then prevailed in a concentrated state, and
The special*"1*0111 t'ne facts presented in  Chart A, I think I am justified in
causeof every coming to the conclusion which I have,  most deliberately,
epidemic yei- after a full reflection upon all the facts presented: that the
low  fever in emanations arising from the upturning and exposure  of the
the Southwest or',gfaa]. so;j fa the summer season., together with filth,  under
       e( certain determinate  atmospheric conditions, has been the main,
         if not the special cause of every epidemic yellow fever that
         has ravaged not only this city, but, the  Southwestern part of
         the United States for more  than half  a  century!  It is no
         exception to these statements that  digging for mines,  and
         especially, in cooler and more healthy climates (or climates
         less subject to fever) does not have the effect above alledged.
         My second condition  {the meteorological)  is wanting  ; that
         it is not always innocuous is well known, (of  which I have
         given  some evidence, and could have furnished much more.)
         Every climate is more or less influenced by particular patho-
         genic entities, giving  it  a liability to the evolvement of spe-
         cial diseases.   That this  has  been injurious over a wide
         extent of Southern  country, especially, of the  United States,
         the testimony clearly proves; that it may be  expected to be
         more mischievous in a hot  and  moist climate, is probable
         enough.
           From the facts adduced and which are  entirely reliable—
         skepticism itself may  well be set at defiance.  It has not been
States. 
Sanitary  Condition  of New  Orleans.
Ill
left to this late day to make these  remarks for the first time,
although they have not been probably as extensively generalized  esimony °
ix>         *                   ■■   -.        ii        j  Hippocrates
betore, and acknowledgments  and references have  been made
                      °                                      and Syden-
of it, in another page.  This emanation from the earth may be
the " something divine " of Hippocrates, it may be  " the some-
thing from the  bowels  of the earth," that the great Sydenham
nearer approached, to which modern science and  observation
has added, the atmospheric condition, to furnish it the necessary
element of activity.
   If  I am  accused of making a  bold  assertion, it is, by  no
means, a reckless  one.  The valuable records in the preceding
pages and Chart,  will fully sustain the position under the most
scrutinizing investigation on the  part  of the city  authorities,
and with its truth and  the precaution, it necessarily teaches—it
must hereafter much depend for its salubrity, its exemption from
the greatest scourge with which  our fine country is so often in-
flcited,  and its future prosperity  and advancement  so much
retarded.
   It is in vain to  say that the facts  which the Chart exhibits,
are but coincidences, the records I have given from other places, Too many co-
the multiplied instances of personal experience, now that public incidence* to
attention has been called  to it; amply attest its probability and be other than
establish its verity.   Coincidence by itself, is of little  account,cause and ef"
                                                             feet.
it is constancy which gives it importance in the relation of cause
and effect  and establishes the law.   Can that be called mistak-
ing  a sequence for an effect—a coincidence for a cause %  Is it
but  a hasty generalization ?—is it a post hoc propter hoc mode
of reasoning to infer a law from a constant  result,  in  one case
of near sixty years uniform sequence (as in New Orleans) ? in three
others, (Mobile and Natchez and St.  FrancisviUe,) of more than
twenty-eight each, and  of a vast  number of others that  these
pages exhibit, that an exception here would but prove the rule ?  mpe proof"
And if proper records and observations  had been made every
where in the Southern country, who knows how immeasurably
they may have been multiplied ?  It is consolatory then to know
that  sufficient facts have been collected  to establish a principle, 
112
Report of Dr. Edward H. Barton on the
          and that our generalization has not been hasty, and it is equally
          important to know that it is in our power to control them !*
             2d. For its existence in an endemic form other causes are
          adequate.  The proposition  then  is that it requires an exten-
          sive disturbance of the original soil, or vast accumulations of
          decomposable materials to produce an  epidemic, presuming
          that the meteorological conditions are present (and hereto-
 Cause  f    ^ore ^ere have been always  causes to produce them, when
 endemics.    we have no recorded proof  of their being present.)  Let us
          proceed a step further, and this embraces our second propo-
          sition, or the causes of our endemic fevers, the difference being
          only in the amount and extent of causation.  The distinction then
          between the major and minor  proposition (the first and second)
          is,  as a general to  a local  one.   The causes are the same,
          differing only in degree—they are essentially identical, vary-
          ing only  in  extent of prevalence, and sometimes in malig-
          nancy, which, it is also fair to infer, proceeds from the greater
          or less intensity of the original cause.   Of these, a certain
          amount of fresh earth  exposure,  with other concurring cir-
          cumstances produces an epidemic yellow fever  and a  less
          (supposing this earth and all filth the same, which  I believe
          they are in effect) an endemic,  what proportion  of influence
          do  they bear to each other 1   That is, the difference between
          the two, is the amount required sufficiently to poison the at-
          mosphere to  produce  either the  one or the other ?  It thus
          becomes almost a matter of calculation as a question of pro-
          bability, which like all similar questions, must be liable to
          fluctuation within the fixed limits  pf possible error.
The cause of  3d.  And this brings  us to our third proposition, of a lesser
our bilious cause of the same materials producing our bilious and peri-
and periodic 0dic fevers.
           The cause of bilious and periodic  fevers, of all kinds, is so
         much a matter of common  observation—is received with so
         much  unanimity by the profession, that they  need not be
          *l did not desire to incumber the text more with the collection of facts upon this
         eubject from our own State—proving the connexion of disturbance of the soil with
         the occurrence cf yellowfever and cholera, or, it might have been greatly extended, 
Sanitary Condition of New Orleans.            113
dwelt upon; I need only here enter my caveat in relation to
the existence of any specific thing; as necessary to their pro-
duction, (and called '• miasm " par excellence)—but believe
as  I  shall hereafter state more fully, that exhalations of all
kinds, whatever impairs the purity of the  air, is  the  terrene
agent, if any is requisite, to unite  with meteorological condi-
tions and moral and  physiological causes in the  production
of these fevers.  The great error  upon this subject, seems
to  me  to consist, in  supposing that any one specific thing is
required, the effect, the disease, is  one thing, but that, by  no
means implies that the causes producing it may not be mani-
fold.   Now it is perfectly clear to  my mind, and  I  trust the
facts  and principles  set forth will fully  bear me  out, that
several conditions are pre-requisite for the effect.
  The  similarity  of the influences, producing these various
classes of fevers, is  most manifestly shown by what occurs
at the commencement and termination of these epidemics and Proof of yei-
endemics respectively—where  the productive causes beinglow  and Pe_
much less in concentration, or weakened in intensity—bilious,nodlc fevera
yellow, and  periodic fevers are constantly observed running™
into each other, and blending their symptoms in the same plac"es,
houses, and even individuals.   A  fever of a remittent or in-
termittent type occurs, and terminates in black vomit and the
haemorrhages.   Another fever begins with yellow fever symp-
toms,  with the  eye, countenance, expression, to convince the
even, inexperienced attendant, that it is yellow fever ; in its
progress it assumes  the intermittent form, and so  terminates.
They are, then, clearly convertible fevers, dependent upon the
more or less concentration of the  same cause, and the sus-
ceptibility of the individual.   They are  constantly occurring
}iert_—even last year, bad as it was, the table F will show how
common it was;  baffling the most  experienced to christen it.
The distinction is a very important one, for it seems to settle
the long disputed question of the identity of bilious and yel-
low fevers—that their differences  exist  in degree only—that
the same may te between bilious, remitting, and intermittent 
114          RejJort of Dr.  Edward II.  Barton on the
          fevers—a difference in intensity arising from a more or less
          aggravation of the cause.  Here are steps from the one to
          the other, that are no less interesting than important—not in
          a merely speculative point of view, but in one of the greatest
 mpo  nceo prac^ca[ va]ue t0 t}ie community; for, if they are the same,
 this in a sani- .    .
          differing only in degree, it settles finally, the great question
          also, of the preventive power of sanitary measures against yel-
          low fever.   Here we  find no  skeptic; no one  doubts that of
          all the  great zymotic or preventible class, fever  is as much
          or more under the control of these measures than any of them.
           The  following remarks by Dr. Pennell, of Brazil, evidently
          a practitioner of acute observation, as he  is known to  be one
 Identity of  -   ,    ,      .               ...      .     ,    _,
          of enlarged experience, are quite illustrative and confirmatory
 bilious  and        7                            .  .        .         .
  „  ,    of the views taken  above: "In  the bilious remittent  of Rio,
 yellow fever.
          says he, the mode of attack, the position of the pains, and the
         state of the pulse and tongue are highly characteristic.  The
         prevailing epidemic preserved these features in a most singular
         manner, and with but little variation."
           " I believe the diseases  are essentially the same.  They
         begin in  the same manner, they have the same diagnostic
         symptoms, and no one can distinguish between them, except
         by their severity; a difference which may arise from a more
         intense  form of the disease, or from a superadded poison, as
         already mentioned.   With the exception of black vomit, I
         have not in the prevailing epidemic, seen a single symptom
         which I have not also frequently witnessed in the common
         remittent of the country."
           "In no other  way than by supposing the disease  of en-
         demic origin, can it  be explained how the natives and ac-
         climated suffer so  little. Yellow fever was never known in
Proofs in Rio.                  n       ,   _         ..           .       .
         Brazil before, and  was, therefore, equally new to them, and
         to those recently arrived. The former  have, evidently, all
         their lives, or during  the period of acclimation, been breath-
         ing a  marshy, or  any other endemic poison you please, in a
         diluted  state, and  consequently  suffered  less  from a more
        fntense  dose.   The poison had for years been incorporated 
                 Sanitary  Condition of jS'ew  Orleans.            Mo

 with their systems.  This  is most conclusively shown from
 the different influence of the disease, by the various mortal-
 ity on the several  classes of the population, [as exhibited  in
 Section IV,] although it is acknowledged, at the same time,
 that almost the whole population was affected by it.
   " In no other way, than by  supposing it to  be of  endemic
   •  •      . ,       -i-ii      1 •         •          1 •     Of endemic
 origin, can it be explained, how ships come into port direct
 from Europe, with  this identical fever on board."
   How eminently applicable these remarks are to us  here, all
 unprejudiced observers well know.
   My proposition,  then, in relation to the causes of our epi-
 demic fevers, has, I trust, been fully sustained and corrobora-
 ted by what has been shown to have occurred elsewhere (my
 other propositions have been  equally satisfactorily  proved.)
 If it will not equally apply to all the places where the yellow
 feverhas appeared, it may be that there has not been sufficiently
          ^"      '     J                          .u     .f Why yellow
 concurring circumstances of a congenerous nature, with the me- f
 teorological condition, which the Sanitary Commission has ways break
 not been able to verify (from causes before stated).   Again, ont with the
 it may explain the  well  understood fact, that many  cases  of apparent pres-
 the disease have been carried to certain villages and country *nce of tha
 seats, and have terminated with the individual, as in ordinary cause8-
 years, not spreading to  the family or visitors.  These appear
 to me satisfactory  explanations of what has been a stumbling
 block, not with the public only, but with many of the pro-
 fession.
   From  the. foregoing facts and observations, it is palpable
 enough that two conditions are  required for the  existence  of Two condi-
 an epidemic fever,  viz: an atmospheric and a terrene or localtions nece&s^
 cause.   The proofs of it are so abundant that whenever theyryforan epi"
 are omitted, it may be  safely ascribed to the fault of the
 observer.  In  all,  and everywhere, the influence of atmos-
 pheric conditions are found paramount and indispensable  to
 the disease, and equally so is what is denominated " the focus
of infection,"—that is, the presence of  some localising filth,
exposure of soil, &c. (all equivalent conditions).  These are 
lib"           Report of Dr.  Edward II. Barton  on the

          universal—there is  believed to exist no exceptions to it.  The
          occurrence of one of the conditions is not  sufficient.  Many
          proofs and illustrations of this have been mentioned in Sec-
          tion  V,  and they  could have  been  greatly  multiplied,
          not  only this year,  but  every  year of  the  existence  of
          vellow fever either here or in  foreign countries.
            That  yellow fever  should  not occur at once upon all ex-
          posed, and in a fair  proportion to their amount, is  also satis-
The presence             -i .    1  t  1 •  1  -i   1   r»    i     i
          factonly explained,  I think, by the fact, that a large portion  of
of an accli-             .                                   .
          our  population is acclimated to the disease, and is  no longer
mated popu-     r  r                                            .    o
Union  pre-  susceptible.   Nor do I suppose it necessary to say, in order
vents effects  to convince the public of the reality of the  causes and effects,
proportionally which I  alledge, that our climate is peculiar; for  there is a
to the cause,  second condition, equally essential to the production of the
          effect, which  may not exist in other climates, although usual-
          ly present here,  viz : heat and moisture.   I am fully sensible
          that different climates have  different diseases, and  that the
          peculiarities  that produce the manifestation of one kind  of
          disease in one climate is wanting in another.  The facts and
          principles, as applicable here, have, I  trust, been satisfacto-
          rily  demonstrated.
            Although I look  upon yellow fever as a specific disease,  to
          which the subject is  rarely liable but once ;  I am equally con-
          fident, that it  is the  result of the aggregation of circumstances
          and  conditions, a  less amount  of which produces the ordinary
ah climates  fevers 0f ^he locality.  This  result  I come  to, after a pretty
          thorough personal examination of the facts, in nymy of those
          climates where this disease has been worst.   I do not think this
          unreasonable, for  we are not without analogies in other diseases,
          even where  they are specific.  Consumption is due  to an im-
          poverished diet, and bad physical  and moral  conditions in  an
          unfavorable temperature, and it is eminently illustrated in Cuba,
          where more of it exists {and particularly in Havana?) than in
          any part of America.  Measles, scarlatina, small-pox, have often
          arisen under certain  atmospheric conditions, (warm, moist, and
          variable—out of  season,) where they have defied  the  utmost 
Sanitary  Condition  of New Orleans.             11*7
scrutiny to detect a personal cause, and may have arisen from
some of those  combinations which originally gave them birth)
and  that in  other  circumstances,  with  the addition of the
important elements of heat and  moisture, give  origin to fever.
Can any one inform us why small pox should have had its birth
about  the  period and place  of  the imposture of Mahomet?
Scarlatina and measles  also derive their parentage  from the
East, and are of comparatively modern origin.  All diseases have
                  1        J           &                    Don't know
had  their time and place  of commencement.  Mr. Meriam informs ,
                  x      J                                  the real cause
us that cholera and small pox at St. Iago de Cuba, immediately of    dis.
followed the fearful earthquake that nearly destroyed that city, ease.
on the 20th August, 1852.  Some diseases  have disappeared—
may be, never to return—but who can  predict it, and upon
what grounds ?   Some appear at intervals of fifteen or seventeen
years, as the eruptive fevers,  cholera,  &c; others at periods vary-
ing from fifty to  one hundred years, and  attack only one par-
ticular  race.   The Mexican  matzahuatl, attacking  only the
aborigines of that country, notwithstanding  other races were
similarly exposed to it—about once in a century.  The " sweat-
ing sickness"  attacked only the English, wherever they were
found, whether in England  or in the heart of Europe!   Most
climates have  their special  diseases  or forms of morbid action.
Need I mention goitre, cretinism, leprosy, elephantiasis, biri-biri ? How diseases
They, unquestionably arose  from some combination of physicalhave  been
elements, that either do not exist in other regions, or that havechangedi
become controlled by the  mode of living, the refinements  of
civilization, the extension of the comforts of life to the lower
class, and the application of sanitary laws to all  the purposes of
living.  I see,  then, no reason why  we  should not be satisfied
with the causes enumerated, as sufficient  for the production of
yellow  fever, and particularly  as  their  removal prevents  or
expels it.   Indeed, it is not affirming too  much  to say, that we
actually know more of the causes  of  yelloiv  fever than we do of
those of any known  disease, beyond  the class " fevers,'''' and as
much as we do  of any in  it!
  The influence  of climatic conditions and modes of life, in 
118             Report of Dr.  Edward  H Barton on,  the
          evolving peculiar forms of morbid action, is not only shown in
          those above  mentioned, but is  felt  also in the great class of
          fevers—the typhus,  of  England,  the great  avenue  to  death
          there—is  materially  different from  the  fever  of  the African
          coast;  and this differs from the  yellow fever of the West Indies,
          which again differs from the plaque of the East.  The parallel-
yellow  fever.
          ism of these,  as well  as their points of divergence, becomes the
          more interesting  and instructive, when we reflect  that  the
          countries are situated in similar  parallels of latitude, that they
          have several points of geographical similitude, and there is the
          strongest grounds  for believing that they are both entirely under
Biach vomit, the influence of sanitary measures.  The plague occurs on the sub-
          sidence of the Nile;  so does the yellow fever on the subsidence
Marshes.             ....                    . .
          of  the Mississippi.  The plague localities are surrounded with
Moisture.    ponds,  stagnant canals,  with decaying  vegetable  matter,  ex-
          haling their poisons to the  atmosphere, accompanied with great
          humidity*   Such  is precisely paralleled here.  The plague is
          sometimes marked by jaundice (or icterosed) and black vomit,
          and yellow fever sometimes has buboes and  carbuncles—as was
          the case here  last year.  One attack usually  exhausts the suscep.
          tibility to the recurrence of the disease, in many instances, much
          more certainly in yellow fever than  in plague.   At Constanti-
        nople, which  is about the latitude of  Boston, there is no accli-
Repetition of   r  '                                      '
attack.      mation against plague, any more than there is  in Boston, New
          York or Philadelphia,  against  yellow fever.   They  are both
          diseases requiring  a  great concentration and  aggravation  of
          their producing causes,  (as meteorological  and  terrene con-
          ditions ) and hence both are diseases of cities, or wherever these
          causes exist in an eminent degree.  Both have occurred in lat-
          itudes far North  of  their customary habitats and birth places
          under strong temptation.   The latter, in England, formerly in
          latitude 52;  in  Moscow, in latitude  57, as late as 1771, '72,
          with a  mortality exceeding our epidemic of 18S3, by at least
          500 per cent.—nearly half  the population dying, and  a similar
          mortality occurred in Marseilles in 1720.   The  former has pre-
Latitudes.
* Prof. Gliddoa. 
Sanitary Condition  of New  Orleans.               119
 vailed under similar circumstances, as far North as 42, and even
 beyond  it; and in  Cairo, from 10th  February to 10th June,
 1835, out of a population of 240,000, fifty-seven thousand died
 of plague, or 23f per cent.
    There is another respect in which their similitude is almost
 equally exact: neither are contagious.   In their endemic form, Neither con-
 this is hardly disputed, but when the  causes producing either, tas'ou9-
 are sufficiently intense to produce an epidemic ; then within the
 epidemic  influence, they  are both apparently so.   For it has
 been  clearly proved, by the long and  intelligent experience  of
 the renowned Clot Bey, (so long the  distinguished Physician-in-
 Chief to Mahomet Ali, in Egypt,) that he had never known the
 plague to be communicated by contact, "when removed from the
 regions of malaria, and all his  attempts  to communicate it had
 utterly failed."  It is unquestionably just so with yellow fever.
 The plague often  occurs alternately at Cairo and Alexandria^
 with constant uninterrupted communication between them, with-
 out the suspicion of contagion, or the slightest appliance of quar-
 antine.   The  same occurs in New Orleans, in  relation  to her
 numerous sister cities which have constant communication with
 her.
   Attacks of plague most frequently take place at night,  when
 the damp and heavy dews predispose to the disease. Such is often
 the case with yellow fever.*
   Their points of  disagreement are  equally remarkable.  In
 Egypt, the plague  attacks most frequently the  natives—those,
 in fact, who live in the greatest filth, and on  the most meagrerjissimiii-
 diet—and  Europeans, and especially those  from the North of tudes.
 Europe, with an appropriate personal hygiene, are rarely liable
             * RECOLLECTIONS OF J R. GLIDPON, ESQ.
  1st. All the plagues remembered by me, (1818, '41) that is about five serious
 epidemics, began at Alexandria about November, after, the rains, and in damp, cool
 weather—temperature, (thermometiically) unknown.  It is also the season of the
 ebb of the Nile, and commencement of vegetation,  (in Lower Egypt) as the slimy
 ooze emergi-s from the flood.
  2d. All were temporarily weakened by the colder and drier weather of January,
with its bracing N.N W. gales
  3d. All arose to their intensest action between February and April.
  4th All vanished, as epidemics by 15th or 30th June
  Hence, (ceteris paribus) the most deadly seasons of the plagues in Egypt, correg.
ponded  to a  temperature and to an atmospherical condition—such as we had at
New Orleans in February and March, 1852.  [Very damp and oppressive.—E. H .B] 
120           Report of Dr.  Edward  II. Barton on the

         to it, and thus are probably much more exempt from it than if
         similarly  circumstanced in this region,  Ihev  would  be from
         yellow fever, although these are  great  protectives.  In  yellow
         fever these susceptibilities are reversed.  The liabilities produced
         by temperature are very different also.   Although each occurs
         sometime after the subsidence of the two great rivers of each
         country; the Mississippi begins to rise in January and February,
         and  falls in  June and July, and the yellow fever occurs  in
         July and August, with our highest temperature.  The Nile be-
         gins to rise in June, and  about the 20th of August the whole
         valley of  the river presents the appearance of a great inland
         sea.   About the antumnal equinox, the waters begin to subside,
Period of oc- and before the end of November the river is once more within
currence.   j^ bankSt  The pleigue usually commences on or before March
         and terminates towards the middl  of  June—the  occurrence of
         the inundation puts an end to the plague—the yellow fever occurs
         on the subsidence of  the Mississippi.  "The experience of ages
         incontestably establishes that  the plague  cannot exist with a
         temperature above 80°, nor a little  below 60°."  With yellow
         fever it is different:  a long continued temperature of about 80°
         is required for its production, and over 90°, unfavorable to its
Temperature development.   Nor  does a lower  temperature,  at once,  ex-
reqmred for Anguish it—being usually a fever of a limited period (60 to 90
         days*,—the epidemic, I mean,) when commencing late, it often
         continues after a frost,  and even when  the thermometer sinks
         below 32°, although  not in the epidemic form—yet it usually
         subsides here with the occurrence  of  cool weather, and even
         when the  average daily temperature is not below 70°, and nt
         all points South of us it subsides when the thermometer is still
         at even  higher  grades.   In other  countries  than  Egypt, the
         plague has existed as a summer and autumnal  disease—reach-
         ing  its  culminating  point in  August  and September, as our
         yellow fever here.  Of  the extent  that  they are influenced by
         sanitary regulations,  I  have already spoken of the  plague;  I
         shall hereafter dwell extensively on that of yellow fever.
* An average of about 60 days. 
Sanitary Condition of New  Orleans.            121
  Egypt has no marshes (properly called), and except during
the period of inundation, the climate is distinguished for itsInfluence of
aridity.  It is mainly on this account that  it is famed for!ts c ima e on
its remarkable influence in the cure of phthisis.  Even as
                                                        and why.
early as the time of the younger Pliny, he states in his let-
ters that it was not uncommon to " send patients  suffering
from a tendency to consumption to the softer climate of
Egypt."
  Such are some  of the  more remarkable  similitudes  and
diversities of these two great monarchs in Eastern and West-
ern diseases, and fortunately, the valuable records of history
bear us out in the  statement that both have yielded signal
triumphs to sanitary measures.
  I have stated what have been the constituents of an  epi-
demic  atmosphere (meteorological and terrene)  so far as the
present state of science will enable us to give them, together „„.
1                                     &        *  &     Effect of our
with the important and interesting exhibit of Prof. Blodget.half dried
I do not deny that there may be others,—that must  be  leftswamps.
to future research to find out.   Both have probably existed
when the epidemic  developed itself; when it has  not,  pro-
bably but one.  The localising circumstance—disturbance
of the  soil, or filth of every kind, (which I presume to be of
a congenerous nature,) has probably been wanting.   Of the
same character do I view half-dried swamps that have been
recently overflowed.  Now, it is well known, that for several
years most extensive inundations have prevailed over a large
portion of our State, and over the cultivated, as well as the
uncultivated portions  of it.  That, as these have become
partially desiccated they reach the conditions of all half-dried
swamps, which are known to be highly injurious to health Know  as
everywhere, and with the  concurrence of the meteorologicalwe d° °f any
conditions, they have  formed that combination of circum-
stances necessary for the  existence and spread of a great
epidemic.
  These inundations are not only connected as one of the
prominent  causes  of our  great epidemic of 1853, but  with 
122          Report of Dr.  Edward H. Barton on  the
          the cholera and sickness  of preceding years.  This  state-
 inundations  ment js not hazarded without extensive inquiry, and is in
        m~ strict accordance with all medical experience, as recorded
 creased sick-
          elsewhere. The lesson taught us is full of instruction, when
 ness in  this
 g        it shows that not only the agricultural interest of the State
          is ruined by these repeated inundations, but, what is far more
          important, the salubrity of its population.   It is demonstra-
          ted then, that the most active supervision upon the part of
          the State authorities is not only  essential for its future pros-
          perity—but for its existence.
            That it should begin in New Orleans is not at all strange.
          It must besin, or be  developed  somewhere,  and  it is most
 Whytheepi-          °               r
 _,  .  u  „ within the  bounds of  probability that  it should first  arise
 demic should                      x         "
 commence in there, where should exist the greatest concentration of these
 New Orleans, causes, and the  largest number of  unacclimated subjects,
          without the necessity  of resorting to  contagion, or even the
          extension of infection, to account  for it.   It must also be
          considered  that the population of the rural  districts, being
          always accustomed to breathe a  purer air, are more suscep-
          tible  of an  epidemic influence when it has broken out.
            In  corroboration of the position that the general extension
          of the epidemic is partly due to the late inundations, and in
          striking conformity to  it,  those  parts  of the State which
Late innnda- have  suffered most from the  epidemic have been the great-
tions promo- est sufferers, so far as we can learn, by  the  inundations.  I
ting the    quote freely from the  high authority of my friend, Dr.  La
spread of the Roche,  of  Philadelphia, (probably,  the highest  authority
epidemic.   now ]jvjng ^ wh0 has written extensively upon the subject.
           " The examples of the injurious effects of draining and desic-
         cation by  artificial or natural means, and conversely, of the ben-
         eficial effects attending complete draining of marshy  and  insa-
         lubrious surfaces, or their complete submersion,  are numerous
         and conclusive.   They  establish, beyond controversy, the fact
         that the insalubrity of marshy localities increases in compound
         ratio  to the degree of desiccation  they have  attained.  They
         show  that the greatest insalubrity and mortality in such local- 
Sanitary  Condition of New Orleans.
123
ities always coincide with the  period  of greatest desiccation, Daneerous m
short of a complete dryness ;  that  this effect occurs earlier in
                                                            to desiccation
hot, than latitudes where the  drying process is slower; earlier    ^ ^^_
when  the season is precocious, and  the reverse  when  it is plete dryne3g_
tardy."
   "The extensive prevalence  of fever during hot weather, after
the  overflow  of  river, lake or pond banks, and at the receding
of the water is well known to all medical readers, and has been
noticed everywhere, and at all times."  " The inundation occa- inundations
sioned by the overflowing of  the Tiber, and the disease result- of the Tiber.
ing therefrom, are referred to by  Livy,  Dionysius  of Halicar-
nassus, Dio, Strabo, &c.  Like effects were observed and noted
in the  twelfth and thirteenth  centuries,  under the pontifical
reign of Innocent III, in the  fourth, under that of Clement V,
and  are  particularly  described by Lancisci,  who accurately
pointed out  some of the  causes of the disease to  which they
gave rise.
   The city  of Strasbourg, in France, is not often visited by At Strasbourg
malarial fevers. In 1824, the banks  of the Rhine were overflowed,
and remained for some time under water.  Soon after the water
had receded  fever began to  prevail, and continued to do so
during three consecutive years.  Nor did it cease before the soil
became perfectly dry."  "The  occurrences recorded in  Italy,
 Germany, Egypt, India,  Senegal,  Algeria, and many  parts  of
our own  country.  The irrigations at  Oran, Karguantil, Silie-
bel-Abbas, and other districts of Algeria, where the practice is
extensively applied to agricultural purposes, and is carried  to
such an extent as to occasion  a sort of daily inundation.  Those
of some of the  departments of France,  as  well as those re-1" *>*<"* and
sorted to in the  rice plantations of this country and Italy, haveIta,y-
 been found to give rise to the same morbific  effects wherever
and whenever the thermometrical  condition of the atmosphere
 is such as to aid in the extrication of malarial effluvia.   "Near
 the walls of a large city stood a very extensive and deep pond of
 water, which for forty years had served  as a  receptacle for all
 the filth  from the houses and streets.  As long as these putrid 
124           Report of Dr.  Edward H. Barton on the
         matters remained covered with water they  Avere productive of
         no mischief; but Avhen they had so far increased as to rise above
         the surface of the water, a most malignant fever spread through
         the tract of country adjoining the city."*
            " Dr. Robert Hamilton,  of Lyn Regis, in a pamphlet quoted
         by Bancroft, and referred to particularly in  the London Medical
         Gazette, describes a remittent fever, produced in that place in
         1779, by  a freshet  which occurred from the sea.  The  inun-
         dations from the sea are generally followed by severer  conse-
         quences, in respect  to health, than those from fresh water.  If
         they extend far they cover  much Ioav  ground under cultivation,
         and fill many  ditches  which,  in many  situations,  cannot be
         drained by any other means than evaporation by the heat of the
         sun. The intermittent fevers which follow are of the worst kind,
         the effect being due to the dead fish that remain, and the efflu-
         via from the destruction of reptiles, insects,  &c, and vegetables
         which are destroyed by sea Avater.  The gale of 1719 Avas at-
         tended by such an inundation, the effects of  which developed by
         the heats of five successive summers and autumns, Avere seen in
         the fevers of those  years, which were more  violent,  universally
         epidemic, and more fatal than Dr. Hamilton had seen them in
         the last forty  years.   These fevers have ceased to show them-
         selves.  The country around, which Avas once one of the most
         unhealthy, has become one of the most  salubrious by the com-
         plete draining of the Bedford level."
AtBassaraas   " When the Arabs,  (as we learn from  Mr. Ives), wish to take
an act of vengeance on the Turks of Bassara, they break doAvn the dykes
vengeance.  or hanks of the river, and inundate the plains.  On its evapora-
         tion the Avater- leaves a marshy sediment which infects the at-
         mosphere, and occasions fatal epidemics.  During Mr. I.'s so-
         journ in that country the mortality from an occurrence of this
         kind  amounted to  no less than fourteen thousand.  The same
         effects are produced at Bassara, and to a highly destructive de-
         gree after the ordinary overflowing of the  Euphrates.  Of the
In Egypt.                                      "   "        '     ~~""~
           * Precisely the circumstances under which Gormley's  Canal has become bo inju-
         rious. 
                Sanitary Condition of New Orleans.              125

consequences arising  from simple inundation, Egypt affords  a
similar example, inasmuch as its season of fever commences Avith
the subsidence of the Nile.  Every one must know that equally
disastrous results have often attended the  overflowing  of  the
Danube, the Don, the Tigris.  The yellow fever epidemic of La-AtLasusy"
guayra, in  1797, the first known to have occurred in that place,
,                                                     x     yellow fever.
has been referred with much plausibility to the OA-erflowing of
the river of that name."*
   The same results occur on the subsidence of the  Nile.  The
exposure  is direct  and immediate  to a burning sun  as before
mentioned.
   The same effects  occur here on the subsidence  of the  Missis-
sippi,  and its early or late subsidence materially influences the
result;  the period  of decline is  the period  of fever.   That the
inundations of the banks do not usually produce their disastrous
effects until the second year, is not difficult of explanation. The
             ->••/•             /         -i    -i  />         Inundations
ordinary condition  of  our swamps (not marshes  half-dried)  is
       "'                       x  v                      '   here do  not
not injurious to health, as is well known throughout the State. produce  dis.
When this is vastly increased by a crevasse, large additions are ease first year.
made to the swamp Avater.  The cultivated country is inundated,
and by the natural subsidence of the water is converted into a
marsh, and has to undergo the  successive  poisonous  stages  of
desiccation, with  the evolution  of results through  solar influ-
ence, which takes a season or two, fully todevelope.  That the
first year of inundation  is not injurious, clearly results from the
immediate remoATal of filth; that the second year the effects men-
tioned follow  as results,  is proved by the folloAving  authentic
data, of its  influence on this  city, aided  and aggravated by
causes I have before  dwelt upon.   Of the direct  influence  in
the country Ave have no sufficient evidence.
 Extensive crevasse, inundating large part of the city and neigh-
   borhood in................................181G.
 An extensive epidemic yellow fever in.................1817.
 The hurricane inundating the city to Bourbon street, 1821.      Always the
 Epidemic yellow fever in...........................1822. «cnd>ear.
  * Ln Roche.
               B 
126          Report of Dr.  Edward H.  Barton on  the
          The rear of the  city inundated by a storm to Dau-
            phine street  in.............................1831.
          The great epidemic of cholera and yellow fever in.......1832.
          A severe bloAV drove the water of the Lake to Dau-
            phine street  in.............................1846.
          An extensive epidemic occurred in....................1847.
          Extensive inundation of the city to Carondelet st. in  1849.
          About three thousand cases of yelloAv fever, and an
            increase  of more than one per cent, in the gen-
            eral mortality of the city above the average in......1850.
          There was a crevasse opposite the city in..........1852.
          Large mortality of the epidemic in Algiers, which
            we have attributed to other causes,  in.............1853.*
            " The pond of Lindre  Basse, in the department of the Me-
Dlfferenturthe, affords a curious illustration of the effects of the different
          conditions under  which the malaria is generated, in modifying
draining pro-           ,                  .
          diseases arising from paludal infection.  The first pond managed
duce different              or                          a         a
diseases     according to the triennial  system common in  Saloque, is two
          years under water, and one year dry.  In the first year it is half
          filled, and gives rise to intermittent fevers; in the second year
          it is full, and typhus fevers prevail;  in the third year, after being
          fished, it is left  dry, and  cultivated as a field,  and in this year
          carbuncular affections  appear.   These diseases  have succeeded
          one another as regularly and invariably as the different  states of
          the pond for a  period of sixteen years, and the idea naturally
          suggests itself that diseases  that have  a  common origin  must
          have a more or less common nature,  however  much they may
          differ in outward appearance."   These remarkable  facts have
          been fully illustrated by what has occurred in the neighborhood
          of this city, and  other parts of the  State, during  the  last and
          preceding years.
 Northwestern   From the following extract of  a  letter to  me from  my  old
limits o f the friend, Judge Bry, of Monroe, Washita, Avho, nearly at the  age
epidemic.    0f eighty,  still devotes himself,  although almost blind, to  the
           * These inundulations doubtless aided the causes to which we have specially attribut-
          ed the epidemics, and epidemics have occurred from the causes enumerated, with-
         out the inundations at, in 1819, '29,  "33, '37, '41, &c. 
Sanitary Condition of New Orleans.             127
cause  of science, the  same views  are put forth  as the re-
sult of his long experience in this  country;  it also exhibits
the Northwestern limits of this epidemic.  " As a general ob-
servation on the river, (Washita,) I can venture to assert that
except at Trenton, where the  epidemic  may have owed its
existence to local causes, and Monroe,  where it seems to
have been brought from Trenton, the valley of the Washita
was never healthier.  From here to the mouth of the river,
(170 miles,) there has not been a case  to my knowledge,  nor
 ,       ,.,      iTT~,.     T        ,     ,     .    Effect of the
above, as high as the Hot Springs.  I expected we should have    , .
           °             r   °       r                    inundation
had a sickly summer and fall, from  an observation of fifty,   Jn  the
years standing, to  wit: when  the  overflowed lands of  La-sprjng.
fourche,  East of the river, are covered by the general  height
of all streams connected with it, late  in the spring, when veg-
etation is far advanced, high  grass, shrubs in leaves, &c, the
season after the secession of the waters  will be unhealthy;
that is to say, that the common autumnal intermittent fevers
will prevail  to a much greater extent than when the rising of
the waters is earlier, and before vegetation is advanced.  It
would be worse than useless  to mention to you my opinion as
to the cause of that effect on  the sanitary condition of that
part of the Washita valley parallel to the overflow of the La-
fourche."
  " I  have also observed  that principally, when the waters
subside,  the Eastern  side of the river is healthier than  the
Western in many localities, of Avhich Trenton is one.   The Effect of ex-
receding waters have exposed to the sun, &c, large spaces or P°8I,re after
flats on the Eastern side.   I  have  seen  the  vapor exhaling mnndation-
from these flats wafted as very thin fogs to the Westward at
the rising of the sun, as if its rays drove them across, the air
being perfectly calm.   There have been what is called several
cases of  the epidemic, which  readily yielded to good treat-
ment and good nursing, but, in my ignorance, I believe  that
they were the common autumnal fever, assuming the type of
the prevailing disease."
  Can it be any longer doubted, then, that the extensive in- 
 128          Rej)ort of Dr. Edward H.  Barton on  the

          undations to which the State has been subjected for the pre-
          ceding four years, has been one of the efficient agents in the
          production and spread  of an epidemic unparalleled  in  our
          annals,  and from a concurrence  of the causes we  have men-
          tioned ]
            Observation and experience must precede science.   We have
          had experience without observation, and if Ave will not be bet-
          tered  by our own sufferings, may  be, Ave "will  by that of others
          —let  us then see Avhat has been  the farther result in those
          nations which have grown wiser and better by the combination.
            " By draining and  clearing at the British colony of Dema-
 AtDemarara. rara> within 6° of the equator, success has followed in render-
          ing the cultivated portion of the deepest and extensive morass,
          probably, in the Avorld, a healthy, fertile, and beautiful settlement.
            "A large peninsular  of land  between  the  DelaAvare  and
          Schuylkill, adjoining the city of Philadelphia, called the Neck,
deiphia     was f°rmei'ly m  its unreclaimed  state,  subject  to  the devas-
          tations of annual bilious  diseases.   Draining, banking, and
          cultivation have converted the marshes into fields and gardens,
          and the spot Avhich  once reeked with pestilence, now yields a
          rich harvest to the hand of industry, and promotes that  health
          which it once destroyed.  Another impressive instance  of the
          effects of cultivation in reclaiming a swampy and sickly district
          to healthfulness and prosperity, is derived from the history of
          Calcutta, and the  countrv around  it.  That city, built in a
Near Calcut         '               *                      J'
a>         morass, on the banks of  the Hoogly,  was  originally a speedy
          and almost certain grave to Europeans, who resorted to it  for
          the purposes of commerce.  But a welt regulated police within,
          and the thorough cultivation of the environs without, have en-
          tirely altered its condition.   The same is true of various other
         cities in the province of Bengal.   The examples in illustration
         of our  subject could be multiplied a hundred fold, were it neces-
         sary, to show  that disease and mortality  are receding before
         the efforts of industry, and  life is prolonged by the enterprise
         of man.   In some of  the  Avorst of marshy lands, where the
         thrifty  Dutchman has robbed the tea of its domains, and which 
Sanitary  Condition of New Orleans.            129
 he only retains by his dykes, and by pumps Avorked by wind-lB Holland-
 mills, the effect of constant cultivation has powerfully counter-
 acted those causes which at Walcheren, a few years back, nearly
 destroyed an English army.
   "The  Pontine  marshes  were once the  home of a thrifty,
 active, and healthy population.   It then contained thirty-three
 towns—now nothing meets the eye of the traveler but here and Near Rome.
 there a solitary post-house, tenanted  by  Avretched beings, rap-
 idly sinking under the  effects  of various influences.  It OAved
 its former condition to its large population and constant tillage
 —to the  extreme attention paid  to  draining the deposits of
 stagnant  Avater, which accumulated upon it;  to the acqueducts
 traversing it in all directions, affording  pure and wholesome
 water ; and to the protection afforded by giwes.  The  present
 condition, is owing to the entire neglect of cultivation—the de-
 struction  of  the  acqueducts, pouring their  contents  over  the
 campagna, giving rise to numerous stagnant  lakes—the forests
 cut down—the Avhole region presents one wide scene of deso-
 lation and ruin.
   " There are some precautions to  be  exercised, however, in
 these drainings, of which it is necessary to be apprised,  for his-
 tory is not Avithout examples of its occasional lethiferous influ-
 ence.  First, then, partial drainings, or reclamations, are much Precautl0M
 more dangerous  than the  condition of  undisturbed  nature.
 Submerging swamps  is  probably less hazardous than partially
 draining  them,  for from  the  experiments  of Williams,  the
 evaporation from  the  surface  of moist  land,  covered with
 trees and  other vegetables^ is one-third greater than  from the
 surface of Avater,  and it is  a  Avell established fact,  that  the
 moister the earth, the more dew falls  upon it (under  a  similar
 exposure.)  Experience has fully confirmed these views.  The
protection  afforded by forest growth, acting as a screen,  to im-
                                                            ty than water.
pede the wafting  of exhalations from recent clearings, has been
often recorded in the history of  medicine, and perhaps may be
the reason why  the ancients  consecrated  the  Avoods  in the
vicinity of Rome  to Neptune, in order to  secure them  from the 
130          Report of Dr.  Edward II.  Barton  on the
Value  of axe.  To the final removal of these Avoods has, Avith some rea-
          son, been attributed an increase of danger to the unprotected
          city.   Near St.  Stephano, on Mount  Argental, a convent is
          situated, which Avas famed for the salubrity of its air, but, since
          the forests which surrounded  it have been cleared, it has become
          unhealthy.  At Villitri, near  the Pontine marshes, the  cutting
          of an intermediate Avood  occasioned immediately, and for three
          successive years, fevers  and  other diseases, Avhich committed
          great ravages.   The same effect Avas  discerned from a similar
          cause, near Campo Salino; and analogous examples might be
          adduced from Volney, Lancisci, Donas, and others.   In our own
          case, a range of forest groAvth could be easily left to  protect us
          from the additional emanations evolved, until effectual reclama-
          tion and cultivation shall have dissipated every possible danger.*
            I should do great injustice to this part  of  my subject, were I
          to pass over the local influence derived from the  conditions of
          our half cleared and half drained swamps in the rear of this
     b 1  f 1 C^ty' on ^ne eP^demic of the last season—with their large, open,
effects of our sluggish conduits, reeking with the most filthy  materials it is
half dried   possible to conceive—the refuse and drainage of a large portion
swamps.     of the city—of  the half  dried and pestiferous basin and canal
          of Gormley,  with  the offensive  soap  and  talloAv  factories—
          vacheries, and dung heaps near it—in the immediate Aricinity of
          which broke out some of the earliest and worst cases  of the
          epidemic, and whose entire neighborhood, in proportion to the
          population, probably, occurred a larger mortality than any other
          section of the city.   (See Sanitary Map.)  And I now reiterate
          my firm and unalterable  conviction, 4hat  it is utterly futile and
          deceiving the public  and ourselves, to anticipate the enjoyment
          of health here,  Avhile the  most thorough correction is not made
          in these and other  hot-beds  of pestilence.   In fine, until the
          thorough drainage  with covered canals—made  in the cool sea-
           * The above quotation is derived from an introductory lecture to my class when
          Professor of the Institutes and Practice of Medicine in the Medical College of Lou-
          isiana, in December, 1835, and published then  Had the warning been taken and the
          advice heeaed, the disastrous results  of clearing and draining, in the mode it wa*
          done, would not have followed—in the large increase of our mortality ever since.
          But, we are in our infancy, and infante require many lessons.  Is that of 1853 suf-
          ficient? 
Sanitary  Condition  of New Orleans.             131
son—should have existed long enough (a year or two)  for an
undergrowth  to  cover  the  soil—now  desiccated—then  the
clearing may take place, leaAdn<_r rows of trees on avenues and
      °    J      r    '       &                             Result of its
streets, to absorb  bad air, but not sufficient to prevent thorough .
                       '                   r             o  improper ex-
ventilation.  The imperfect manner  in which  this has beenposure  gince
done, ever since 1846, and even before—about which time pro-isi6.
gress was made in the great exposure in that district, is
shown by the rapid manner in which the mortality has been
gradually increasing—resulting in an average annual mortality
(inclusive of last year) of 6.86 per cent,  to the entire city popu-
lation.  This is shown on the Chart A, so as to defy all skepti-
cism, and is deriAred from official documents.
  A remarkable instance, illustrative of these views, is furnished
by  what has occurred in British Guinea, during  the  last half The two con-
century.  The yelloAv fever has occurred there in determinate ditions.
or oscillatory  periods  approximating  to a metonic  cycle  (of
about nineteen years).  The only atmospheric element that has
been specially referred to, to which adequate  efficiency could
be properly ascribed, Avas the agency of  the wind (the heat and IUustrate(i _„
moisture there, is always  abundantly great).  The direct effect Demarara.
of these was  to  produce a most unusual elevation of equinoc-
tial tides—even to the extent of thirteen feet;  the consequence
was, as the country is very  low—embankments being noAv
required to keep out  the sea—the draining canals that take
aAvay the  filth of the tOAvn (Georgetown) are imperfectly emp-
tied—the river deposits its detritus in the neighborhood—a vast
embankment is formed from the accumulation of these alluvial
depositions, in and about**and before the town, and  precisely
co-incident with the acme of these accumulations is the  out-
break and development of epidemic yellow fever, and Avhich is
exactly limited to  this condition.   When this  ceases,  and this
embankment disappears, the sea, noAV encroaching and Avashing And in differ-
it away—together with a clearance of all these estuaries, by its ent years.
scavenger influence—the yellow fever disappears.   Farther to
shoAV that this is cause and effect,  so long as the period of depo-
sition and exposure continues,  so  lasts  the disease—when this 
132          Report of  Dr. Edward H. Barton  on the

         ceases, so ceases the disease.  At  the termination of the last cen-
         tury, three years sufficed for the purpose ; so in 1820-21-22 ;
         but, during the last occurrence, it continued about ten years—
         * 1835-46. Heat and moisture exists to a great extent in these
         Ioav countries, robbed of the sea;  so  here Avere both blades of
         my " shears."  Noav, Avhether those were emanations from the
         newly made or  nevrty exposed  earth, formed  of these alluvial
         depositions—producing vegetable  or  animal effluvia or poison-
         ous animalculse, in concurrence  with  atmospherical  conditions
         —is not material  to my purpose,  or necessary to show.   It is
AndinRio.  the conjunction of the two, Avith the almost inevitable effect that
         I wish to point out, and further, that during these epidemic visi-
         tations, "atmospheric changes and occurrences of an unusual
         character are ordinarily apparent," and wherever proper atten-
         tion has been paid to these, they have never been found to exist.
         Hence there occurs a satisfactory exhibition of  all our epidemic
         requirements, terminating in the epidemic itself.  Dr. Candido,
         a distinguished physician of Brazil (Rio), avers the same thing.
         He states most distinctly that "in addition to  filth  of various
         kinds, certain meteorological  states Avere required to develop
         the fever  at Rio, and these  Avere,  a  temperature above Reau-
         mur 20°,  77° Fahrenheit and humidity."*
                      SECTION VIII.

Localising conditions continued, and farther specified—Value of
  pure air—Peculiar air of cities—How  and when made im-
  pure—How much spoiled every day, and value of ventilation.
  Bad air spoils the water—How to procure it good—Bad water
  promotes intemperance—influence of cemeteries—ditto of privies,
  street filth, &c, &c.—How much of the air from these causes
  will kill a bird—a dog—a man—Best pavement— What best
  houses—effect of low empty lots— What is not miasm— What
  is—Drying power not cause of fever—Fundamental proposi-
  tion—Effects must arise from adequate causes—Cause of yel-
  low fever known—Parts of cities where ahvays  breaks  out—
  Proofs—How  spread—Exact value of spontaneous cases—

 * Blair. 
                                  TABLE  P.

                WINDS--AVERAGE FOR  A SERIES  OF  YEARS.

Hygrometry  of  Each  of the  Principal  Winds  at  New Orleans, and

                                  when calm.
DEGREE Or DRYING			AMOUNT OF MOISTURE.			ELASTICITY OF THE			WEIGHT OF VAPOR IS A CUBIC FOOT, In grains.		
	POWER		[Saturation being 1000.]			VAPOR					
1st	N.W.	11°.29	1st	N.W.	.677	1st	N.W.	.468	1st	N.W	5 136
2d	N.	10 .06	2d	N.	.698	2d	N.	.534	2d	N.	5.819
yd	S.W.	10 .03	3d	s.w.	.727	3d	N.E.	.630	3d	N.E.	6.847
4th	w.	10 .01	4th	w.	.740	4th	W.	.616	4th	W.	6.915
5th	N.E.	9 .28	5th	8.	.761	5th	E.	.646	5th	S.	7.181
bth	E.	8 .84	6th	N.E.	.763	6th	S.W.	.664	6th	E.	7.213
7th	S.	8 .21	7th	X.	.768	7th	S.	.743	7th	S.W.	7.229
Bth	S.E.	7 .56	8th	S.E.	.720	8th	8.E.	.759	8th	S.E	8.030
ath	CALM	5 .17	9th	CALM	.929	9th	CALM	.761	9th	CALM	8.254
  iV.  B.—To my scientific readers I observe that some few small errors in the above could only
have been ascertained when the results were arrived at—but at too late a period to  re-calculaw
■ixty pages of figures.
                               TABLE  Q.
Statement of the  Winds in New Orleans—by Months and  Seasons.
January.....
February...
March......
April.......
May.......,
June.......
July........
August
September.,
October___
November.
December.-
N.  N.E.  E.  S.E. S.  S-AV. AV.  N.W. Calm
4-i
34
24
2*
24
1-4
2
34
e.i
5-4
l.
4.4
2.
14
14
2-1
li
14
3
3-4
14
2
1
14
2-*
4.
9
84
2i
14
14
14
14
3
34
14
04
04
04
04
l.
l.
3.
2.
04
1.
04
14
Explanation.
  Being on an average of 11
years—1835-'42 and M8-'50.
BY SEASONS.
Winter...
Spring....
Summer..,
Autumn ..
Winter..
Spring . .
Summer.
Autumn .
16.  I 114
 84|  84
  64
 184|
Ti;-;  '
 15th
 17th
154
174
15.J
 74
124 18
     ;d
16th
l.ith
12.
13.
 64
94	6.	^	84	2. 1
204 84		54	6 4	14
154 14-		8.	44	6.
741 34		44 84		24
4th 17th 18th			6th 19th	
1st	4th 18th		7th	9th
2d	3d 5th		Bth	9th
5th	8*b 7th		4th	9th
  Total number  of days'
wind each season.
  Relative frequ'ey of each
wind during each season.
BY THE YEAR.
|49.
5th   list  |4th |2d  |6th  18th 17th  |9th   I  Relative frequ'ey of each
 40.  .664.404.524. 324l234|  2741  12.j|wind during the year. 
 
■'"                                '  II l__________________________________________________________________________________________________________
                         ERRATUM.
    On "Radiation Chart"—opposite,—for "Radiation of the  Sun,"
read Radiation. 
 
                Sanitary  Condition of New  Orleans.            133

  Several mentioned—What  they prove—Prescription  to pro-
  duce yellow fever—The cause of yellow fever proved—Philo-
  sophical rule—Clear deduction—Practical value—Hope for
  New Orleans—Our duty-Value of truth in Medicine-Health
  first great object in government—Insalubrity of a city punish-
  able offence.
  Let us proceed to the second branch of the localising con-
ditions in the production of yellow fever.
  This subject would hardly admit of an  array of facts, or
attempt at argument in its support in the present enlightened
and  advanced  state  of society, had  not  some doubts been
thrown  upon it, and their influence impugned of late.—
Indeed, in few  things is the progressive march of the age we
live in more strongly characterized, than in the efforts to im-
prove the sanitary condition, by the removal of the fillh  and
offals of  society, as destructive to its welfare, as the effete and
worn out parts  and excretions  of the human being is to it in-
dividually.  The care bestowed on these objects is at once a
test of high civilization and of personal  refinement,  and the Attention  to
performance of one of the very first  duties of civil govern- sanitary mea-
ment, as highly conducive  to the preservation of the health suresatestof
and  lives of its citizens.   The history of  man proves this in clvlllzatIon
every age and nation ; and as attention to  these indicates the and refme~
progressive improvement of nations, so,  their neglect,  in a men'
similar manner, is a conclusive proof of their decline.  In no
countries are these more eminently illustrated than in what
we read in the history of the successive rise and  decline of
ancient and modern Egypt and Rome, in their several revolu-
tions; and  it is farther demonstrated most clearly, that with
this blessing comes   a  higher tone  of public and  domestic
morals—greater elevation of character—improvements in the
comforts and  enjoyments  of  life—and with them a greatly
increased average duration of it.
   At this enlightened day to believe in  the existence of anProvidence
effect without a cause,  is to confess one's self an atheist.   Toinfluence9
express  a conviction  of the impossibility of man's altering or man through
influencing his  physical condition, and, of course, all its con-secon ary
sequences, is to acknowledge one's, self a  fatalist.   The  Su-causes 
l-'34           Report of Dr. Edward II. Bartnii on the

         preme Being acts upon and influences all conditions nnd cir-
         cumstances on earth, through the means of secondary causes.
         These act  bylaws impressed on man's being  throughout his
         existence,  and there exists  as surely laws of disease  as  there
         are laws of health.  If a man infringes on the latter he  fills
         under the influence of the former.  In other Avoids in  some
         climates—some circumstances and conditions in which man
         is placed, either willingly or unwillingly, knowingly or  igno-
         rantly,  his  health suffers  as  a consequence.   If these are
         changed he regains his health.  All  hygienic  and. sanitary
         regulations, all curative processes are based upon these princi-
         ples ; without them we are brutes—nay Avorse—for many of
lustrations, them apply remedies to ailing  conditions.   Disease may he
         considered a resulting punishment for an infraction of the laws
         of  health.  In civilized  communities, where life is highly
         valued, preventive or corrective Taws are made,  that this
         should be  avoided, and special bodies are designated to  point
         them out, and see  them enforced, and to  take  care of the
         health of society, that the  great mass are ignorant of; and
         these are called in our country " Boards of Health," " Health
         Departments,"  &c.
            The localising  conditions consist of filth and impurities of
Filth the great aU  kinds, in the largest sense, constituting the great physical
•nemy  of  enerny 0f  the well-being of man, as street  and kitchen  offal,
health.    t^e ,.efuse 0f stores, the drainage of sugar and molasses hogs-
         heads,  of stables and vacherics,  with deficient ventilation,
         slaughter-houses, soap, tallow and bone manufactories, privies,
         cemeteries, swamps, and the defective drainage of towns; it is
         concentrated  in hospitals and crowded dwellings, where  many
 What it is  diseases originate, and  others  cannot be cured Avithout re-
         moval.  It exists, to a proportionate extent, wherever there is
         a defect of domestic and personal cleanliness;  in fine,  what-
         ever impairs the purity of the air we breathe, the food we eat, or
         the ivater we drink.  They are all resolvable into the first, for
         it is through  it mainly they obtain access to our aliment and
         drink, and through the lungs reach the source of all vitalization.
            It has been as truly as beautifully  said,* that though we
*Girdlestone 
Sanitary Condition of New  Orleans.            135
do not see the air, Ave feel it, and Avhatis more, Ave breathe it.
We live by breathing it, insomuch that it has been well said,
that as plants are the children of the earth, so, men are plants
of the air ;  our lungs being, as it were, roots ramified and ex-Indispensab!*
panded in our atmosphere; and this,  in fact, is the chief ave-
                                                           air.
nue  by which the filth and damp of towns  that are  not well
drained and cleaned introduce their poison into  the  human
constitution.   The putrifying refuse, whether animal or vege-
table, solid or liquid, becomes dissolved into various kinds of
gas, all the  more  commingled with the common air as this is
damp and warm.  These principally constitute the special dif-
ference between  the air of urban and rural districts.  It is
estimated that at least one-third of  the  life  of civilized
man and  even much more in cities; (nay, if it Avas reversed,
and  say that more than two-thirds of our time) is spent in the
confined and,  to a certain extent, deteriorated atmosphere of
houses and apartments, where there  necessarily must  exist.     of
defective  ventilation, where the atmosphere has to be breathed time 6peilt in
over and  over again, with  all  its organic  matter running the house.
through every stage of decomposition, besides other sources
of vitiation,  surprise should no longer  be felt that a city atmos-
phere abbreviates human life.
  There is a peculiar air hanging over  and constituting that of
large cities and all extensive aggregations of human beings or
animated  life.   The  more sensitive of our race easily perceive
it.   Asthmatics are sensible of it, on entering or leaving a city,  ecuharair0
—children—delicate  females—convalescents—those  in feeble
health ; indeed, it is experienced by most persons on leaving a
close city  atmosphere, and particularly if proceeding where one
is exposed to the  influence of sea air ;  and  this is  apparently
independent of ventilation, for, although to the windward of it
you are still sensible of the city  air.  When acting as Chief
Health Officer at Vera Cruz, during the Mexican War, it be-
came my duty (as Surgeon U. S.  Army and Chief Health Offi_
cer)  on one occasion, to visit a mariner on board a vessel tha^
had arrived some hours before, and anchored some two orthrea 
136           Report of Dr. Edward II. Barton on the
           miles from the port, to windward.   I found it a case of yellow
           fever, Avhich Avas then  prevailing in Vera Cruz—the vessel hav-
  t »prea s   -^ come from a nea]thy  port.  She had not  communicated
           with  the  shore, except through her first officer ; so neither the
           wind nor the officer could have communicated it.  It is a curi-
           ous and avcII knoAvn fact, that oil, thrown upon the Avaves, will
           pass to AvindAvard as veil as to leeward.    Such may have been
           the case in the instance just cited, although I Avould not wish
           to be understood to mean, that all serial poisons are not more
           readily conveyed by the  Avinds.  Indeed, Ave know they are so.
           I only desire to express  the  opinion, that  it depends upon  a
           concentrated city atmosphere, Avhich, under certain circumstan-
           ces, no  Avind  can dilute to  innocuousness, it may become dif-
          fused by expansion,  as the temperature is greater.  This is expe-
           rienced in all large  cities ;  and in all, there are portions Avhere
          this impure air exists to a much greater extent than  in others.
          This is more eminently true of the Northern cities, where there
          is such a difference  in  elevation, dryness and ventilation, than
     _.  .  here.   Still, there are  localities here Avhere these differences
Parts of cities
most  filthy ex^ *° a notable degree, and which are the special hot-beds of
and therefore pestilence  wherever it exists, as in  the neighborhood of St.
«iokiy.      Thomas,  Madison and  St. Mary  streets,  the triangle, about
„   ,      Gormlev's Basin, some  of the front streets of Lafayette, and
Proofs.            -                                           J
          finally, the Seventh  Ward.   These  are damp, filthy, crowded
          and badly ventilated, and the  results are  such as should call
          forth the corrective influence of a paternal government.  There
          is said to be a street  in  Charleston, never visited by yellow
          fever, on account of its great  cleanliness; and there are healthy
          and sickly parts of  all  cities,  as we shall by-and-bye point out.
 Test of a  Now, it is  evident, the nearer we  make a city approach the
city's insaiu- condition  of the rural districts, the nearer it Avill reach a state
bnty when it 0f  salubrity.  Our  neighboring parishes had an average mor-
departs fromtalit^ ^  lg5(^ of j^ ^^  UyQ  ^ ^^  rjrj^  ayerage fo,
          this city, for the last seven years, has been near seven per cent.
neighborhood,      f        .                                       .
          The difference  is seldom more than 40 per cent., according to
and shows it to                                       x                 °
b« artificial  ^e reuaDle investigations  of vital  staticians,  (between  town 
Sanitary Condition of New Orleans.              13?
and country), Avhile here Ave find it more than  350 per cent.
That this enormous difference proceeds from removable causes,
Avill be shown hereafter.   There are feAv cities but what Avould
be ultimately depopulated, did they solely rely upon  their own
native population for increase, from the results  of the  concen-
tration of their own filth and congenerous sources of vital de-
generation.   All, and  especially sickly cities, OAve more or less
to  immigration, their groAvth  and   progress.   Hence, their
special value to us, as  important means for our  advancement
and prosperity.
  Every time we breathe,  and this is repeated about eighteen
times per minute, Ave  vitiate the air  taken into the lungs, by
retaining a portion of one  of its constituent elements, which
combines with our blood, refreshing and purifying it—rendering Am our tof
it fit for the  purposes of life—whilst we return, the remainder, air required
with an additional  ingredient,  quite unfit to be breathed over for  respira-
again, either by ourselves or any one else.   Hence it  folloAvs,tion-
that Avere a  person  shut up in  a small chamber, perfectly air
tight, he could not live through a single day.  Each individual
in the course of the night,  vitiates about three hundred cubic
feet of atmospheric air, rendering  it totally unsuitable for  the
purposes of  respiration;  and  no room should be tenanted that size of rooms.
does not furnish at least six hundred cubic feet  of air to each
individual occupant.  The  inspectors of prisons  in England
recommended not less  than  one thousand  cubic  feet for every
prisoner, as  being " essential to health and preservation."  It is
known, that a canary bird,  suspended near the  top  of a cur-
tained  bedstead  in AAdiich  people have  slept, will  generally,
OAving to the impurity of the air, be found dead in  the morn-
ing.  And it is  computed  that the population  of a crowded
town, by the mere natural action of the lungs, in the course of  mount °
                    .              o  ■     i         , i     i  i  air vitiated in
twenty-four  hours, vitiate a layer of air as large as the whole ^ crowded
area inhabited, at least a yard  in depth  or thickness—to  ^y towapeiia^
nothing of the amount spoiled for  all the purposes of respira-
tion by fires and furnaces, lamps, candles, gas and all manner of
deleterious manufactories.   Indeed, were it not for  the provi- 
138          Report  of Dr. Edward H. Barton  on the
          dential arrangement, that  the air  thus vitiated bv  the luii^s
          becomes at the same time heated, and  is therefore  alwavs in
 Absolute  ne-
 cessit ofveu-mo^on *° ascend> making  Avay  for fresh air to take its  place,
 tilation.     we should  be in  constant,  danger of suffocation Avhenever Ave
          were in a room Avithout a draft,  or  in a toAvn without a Avind
          stirring.    This  shows  us* the  importance  of so constructing
          streets and courts as to make the most of the natural movements
          of the atmosphere in the climate in  which  the town is 1 milt.
          For instance, in this city, to obtain  the most perfect ventilation
          of our streets and  thoroughfares,  during  the summer and
          autumnal months—the  most important period, Avhen our salu-
 How promote                               x        x
 tilis<       brity is most liable  to be  influenced  by bad air—the  streets
          should, were  it possible, run  East  and  West  and North and
          South, and always be at right angles, to prevent obstruction and
          permit perfect ventilation.*
             These valuable  reports are  so  full of important practical
 Necessity  of matter, and so applicable to our situation, that I am tempted to
          quote extensively from them.  It is  proved  by them, " That
          the rate of sickness and mortality, of the working  classes in
          their populous towns, is much  greater  than that of the same
          class in the country districts, and much greater than that of
 Diseases not these classes in  the same towns, where dwellings are better
 fromdefective drained and better ventilated.  It is proved, that the greater
        °~ liability  of the working  classes to  the most afflictive and
          painful disorders, does not arise from deficiency of food and
 the poor, but
 ,.       ,  clothing, but from  their living,  usually with no alternation, in
 from  crowd-       °                     o'        j
 ing and filth.  narroAv streets,  confined  courts, damp dwellings and close
          chambers,  undrained, unventilated, uncleaned.  It is proved,
          that  they  suffer  most  severely in  those  cases  Avhere they
          spend  the  day in crowded Avorkshops,  or where they live in
          cellars, or sleep in rooms on the ground floor, or in chambers
 Cost of re-  that have no chimney place, or other vent for vitiated air.  It
 moving filth js  proved,  that in  such situations, the  average duration of
 but  a small yllim.dn ]jfe> -1S at  ]east twenty years less than it otherwise
          might be ;  and that, during this curtailed period of existence,
nnal cost  to________________________________________________________.________________
relieve       * v'de Report General Board of Health of England,—and table of the AVinds here. 
                Sanitary  Condition  of New  Orleans.             139

the working power of those who live, is seriously diminished ,
and much more in their capacity for enjoyment, by a constant
depression of  spirits and health, and by the active attacks of
fever, cholera,  scrofuia, aud consumption.  It is proved, that
this  excess of mortality  falls most  heavily—first, on  the
infantile portion of the community, and next, on the  heads
of families, betAveen twenty and  thirty years of  age.  It is
proved that the burdens Avhich are throAvn by this excess of
sickness and mortality on the poor's rates—to sav nothing of
                  .        .                            b    Resulting de-
infirmanes  and  di<pensaries—of  friendly societies and of
                   x                   "i                  morauzaUon.
private almsgiving, is such  as to exceed the  cost of effecting
those improvements  which would suffice to  make the aver-
age health of  the  working classes  nearly equal to that of the
rest  of the community.  And it is  further proved, that there
is an incalculable  amount  of  demoralization, attributable to
the same causes, and that an  effectual bar is  thus put to the
intellectual, moral, and religious improvement  of this large
portion of the  community."
   The  influence  of crowding,  production  of bad air,  and
the want of ventilation, is  eminently illustrated on the  crews
of collier vessels on the Thames—although  Avell fed, in the
prime of life,  confined  at night and in bad  weather  to  the The poison
narrow limits  of the forecastle, the  sickness and mortality from crowd-
is large.    Such  is  the   cause,  also, mainly,  of  the  im-ing  is organic
mense  mortality  on  board  immigrant ships,  crossing  the matter as well
Atlantic.   In Northern latitudes they die  of typhus  and as  car,,onio
cholera;  in tropical  climates  of  yellow   fever, and  the
mortality, everywhere,  has been proved to bear a pretty accu-
rate proportion to the closeness of the crowding.  The dele-
terious agent, consisting of the effete excretions, has been
proved, experimentally, to consist of highly putrescent organic
matter, mingled with the expired air.  That it is, when re-in-
troduced into  the  living body, liable to  be highly injurious,
may be inferred from the fact of the  careful provision made
by nature for its incessant  elimination from the system.  That
it is  small in amount, is no objection to the intensity of its 
140          Report  of Dr. Edward H.  Barton on  the
         action ; for to the physiologist it is Avell known, that a minute
         quantity of a powerful agent—the putrid  matter introduced
         on the point of a needle, in the  inspection of a dead body—
         a single drop of concentrated prussic acid, placed  in the
         mouth of an animal, is sufficient to destroy life.  It is in our
         crowded bed-rooms, in unventilated schools, upper dormito-
         ries, in overcharged wards  of hospitals and jails,  that  this
         effete  matter taints the air, and, entering the blood, poisons
         the  system.*  It has been before said,  that  this expired
         air   consists  of  two  ingredients—carbonic  acid,  which
         mixes  with  the  atmosphere,  on  the  principle  of  diffu-
         sion,  whilst  the  other,   being  an  animal  excretion, no
         longer held in solution in the colder external air, is deposited
         and particularly clings to Avoolen articles or bedding—clothes
         which are well known to retain this offensive smell a long time.
         Hence  the value of frequently airing these domestic articles.
           In an examination before  a committee of the House of Com-
         mons, the venerable  Dr. Farr had occasion to state, the relative
Comparison vnme ot" pure atmospheric air, as vital food to the grosser elements
of air with of bread, flesh and water, and said, most forcibly : " If a human
food.      being be deprived of these aliments, he dies in a period varying
         from eleven to nineteen days; but, if atmospheric  air be ex-
         cluded  from his lungs, he  dies in a  minute;  therefore, the
         relative value of atmospheric air to bread, flesh and water, is as
         fourteen days to one  minute, and the deterioration of  the atmos-
         phere in which human beings are residing, produces a delete-
         rious effect on life, in proportion to that deterioration."
Necessity  of  -^ne necessity of ventilation, and the injurious effect of a stag-
   'uon'   nant state of the air, has been noticed as far  back, by medical
         writers, as the time of Hippocrates.  By reference to the Table
         of the "hygrometry  of the winds," it will be se^n, that Avhileit is
         calm, that it is most replete and of course, with all that moisture
         can dissolve or hold in suspension, and that, consequently, active
         perflation is indispensable   to purification.  It is Avell  known
         that where the wind blows  freely and strongly, or finds no ob-
* Granger. 
                 Sanitary Condition of New  Orleans.             141

stacles from surrounding objects, localities, which  otherwise
might be expected to be fruitful sources of fever, may be visited
or inhabited Avith impunity, Avhile similar places become insalu-
brious if the air is stagnant.*   " Calms," says Dr. Drake, " per-
mit  the exhalations from foul  localities  to accumulate  in  the
atmosphere which rest  over  them;  but all Avinds operate to
disperse and dilute them with purer air."   The late Professor
Halle, one  of the magnates of the Medical School of Paris, in an
able report on the condition of the river Bievre, near that city
pointed out the fact, that the pernicious effect of the foetid ex-
halations  issuing from  the  river, are  harmless in  situations,
where the atmosphere circulates freely, and is renewed by strong
and unimpeded currents, t
   In the  proceedings of the British Association, we find an
interesting report by Dr. Smith, on the air and water of towns, 0rgMlic mat
which is too important, from its direct  applicability to the  sub- ter aiways i,
ject before us, to pass over without culling a portion of its inter- air.
esting matter.  " If," says he, " air is passed  through water, a
certain amount of organic matter poured off from the lungs, is
to be detected in it." By continuing this process for three months,
Dr. Smith detected sulphuric acid, chlorine, and a substance re-
sembling impure albumen.   These  substances are  constantly
being condensed upon cold bodies, and in a warm atmosphere,
the albuminous matter very soon putrefies, and emits disagree-
 able odors; this is the ordinary smell of close  rooms, producing
 oflensiveness, Avhen space is disproportioned to the number of
 occupants.  Such was eminently  the case last season, in yellow
fever rooms, Avhen not properly ventilated.   By eramucausis, this
 substance  gives rise to carbonic acid, ammonia,  sulphuretted
 hydrogen,  and  probably to  other gases.  By collecting  the
 moisture of a crowded room by means of cold glasses, and also
 dew, in the open  air, it  was proved  that  the former was thick
 and  oily, capable of decomposition, and  productive  of  animal-
cules, while the  deAV Avas beautifully clear and limpid.  Large
 quantities of rain Avater have been examined by Dr.  Smith, and
   * La Roche.   t La Roche.
             T 
142          Report of Dr.  Edward H.  Barton on the.
          he says:  " I am noAv satisfied that dust comes  down  from the
          purest air, and that it is simply coal ashes."   The rain Avater of
          Manchester is considerably harder than that of the neighboring
          hills.  This can only arise from the ingredients obtained in the
          towh atmosphere; but the most  curious point is the  fact, that
ding rains.        .         .                                    ...
          organic matter is never absent, although the rain continues tor
          several days.  The state of the air is closely connected with
          that of the water; what the air contains, the Avater  may ab-
          sorb, and Avhat  the water has dissolved or  absorbed, it may
          give out to the air.   It was discovered that all organic matter
          in filtering  through the soil, is very rapidly oxidized.   The
          nitrates he found in the London water, prevent the formation
          of any vegetable matter, so that none can be detected, even
          by the microscope, after a long period.   In summing up the
•orbs what-
          results obtained ; Dr. Smith  remarked, that the  pollution of
ever air con-                                                 x
tains       *ne a*r m crowded rooms, is really owing to organic matter,
          and  not merely to carbonic acid,  that all the water  of large
          towns contain organic matter ; that water purifies itself from
          organic matter, in various ways, but principally by converting
          it into nitrates—that water can never stand  long with advan-
          tage, unless  on a large scale, and should be used when col-
          lected, or as soon as filtered.
           Water rapidly absorbs noxious gases, and  is  always  in-
          jured when exposed to their influence.  In  this city  the  cis-
          terns which  usually furnish most of our drinking and  cook-
Absorptive jng water are commonly placed in close  proximity, in  our
powero wa-narrow back yards, with the privy, bituminous coal, and  all
ter.
          kitchen and  house refuse, and sometimes becomes so  much
          impaired in its purity as  to be utterly unfit for use.  Professor
          Hoffman has stated that such is the  capacity  of Avater that
          one thousand gallons of it will dissolve twenty-five gallons of
          nitrogen, one thousand gallons of carbonic  acid, fifty  thou-
          sand  gallons of  ammonia,  the very  gas which  escapes so
          largely from privies, and the police filth  of every dirty  town,
          carrying with it vegetable and animal matters in a high state
* Grainger. 
                  Sanitary Condition) of New Orleans.            143

 of putrescency.  From hence it will be  seen how important
 it is that the drinking water, and that used for domestic  pur-
 poses, should be brought underground from the rural districts
 at a distance, and that the plan suggested on the erection  of
 the British House of Parliament, to ventilate the building by
 the introduction of air from the country,  was a very wise one.
   Experience has already shown that those who use rainwa-
 ter in preference to any other, and more especially, filtered „
                                           x     J        Value of rain
 river Avater,  are much less subject to cholera when it prevails, water if kept
 than those who use any other kind of water, and of course, it fol- pure.
 lows in congenerous affections, as diarrhoea,  dysentery, the
 bowel complaints of children, &c, indeed, experienced men
 are so  well  aware of this, as sometimes, to  have the water
 boiled, they  allow their sick in some delicate disturbances  of
 the digestive organs, and keep it well corked  for  use.   The
 effect of  boiling it, is to purify  it, by removing the noxious
 gases it  contains, and for the deposit of its principal earthy
 materials.  In large cities where the water is very apt to be
 impure, it can scarcely be used alone, hence the temptation to
 mix it with alcoholic beverages, giving grounds and furnish-
 ing temptation to intemperance, and it is a valid one. To sup-
 port this holy cause then, and to keep  up the healthy habit
 of drinking water alone, the water must be kept pure.  The Moral and
 real and  true  relation, between  moral  and physical degra-phyBical con"
 dation,  is now  beginning to be correctly appreciated underdlUon depen"
 the improved sanitary states of all classes of society, and the
             .....                                  la* circam-|
 important truth is being demonstrated, that the moral as well
 as the physical condition may be greatly  ameliorated.  Min-
 isters  of the law, as well as of religion are discovering that the
 scavenger and the architect are among their best allies.*
  Food is injured by bad air, and more particularly by moist-
 ure, as flour and all the ceralia—meat by moulding, and speedy
                                                          jured.
putrefaction,  and salt food, as fish, pork, &c, by the  salt at-
tracting the moisture of the atmosphere, and liquifying.  Sugar
and molasses also attract moisture,  and  are injured by heat,
* Rogers. 
144          Report of Dr. Edward II. Barton  on the
Injuries re-
sulting from
cemeteries.
         ferment and become acescent, run off and impair the purity of
         the atmosphere, and thus all  are  injured by the climate, and
         add their mite to impair the  general salubrity.
            There is  probably no climate in America where the vicin-
         age of cemeteries would and does  do, so much damage to pub-
         lic health, as here.*  Rapid and prolonged decay results from
         the great moisture of the climate, and comparatively small
         desiccative power. Burying, almost universally above ground,
         (in the cemeteries of the city) the  mortar connecting the brick
         work soon splits, giving exit  to injurious exhalations from the
         within decompositions.  The force of the gases (and especially
         under the augmented temperature of summer, when they are
         most  injurions) are often so very  great  as sometimes  to
         burst the leaden coffins, (when  made  of it,) and always to
         escape through the pores of the wooden ones, and to split the
         metalic ones and the brick and plastered work of the vaults,
         contaminating the atmosphere for a great distance around. In
         no case then, if permitted in  cities, should a dwelling be per-
         mitted nearer to these yards than  several hundred  paces, ac-
         cording to the frequency of interment.   The period in which
         the body is undergoing decomposition, varies according to its
         age and size, the season,  and the more or less exposure and
         completeness of the tomb.  The sextons inform me, that three
         to six months is an average period.  Let it be longer or shorter,
         the process is constantly taking place, and any A'isitor to the
         grave-yards can easily  satisfy himself that the confinement of
         the decomposing bodies is too imperfect for the safety of the
         community.   In those countries where tombs are not used, the
         body  is disturbed for the repetition of the interment, before it
bodies to the
         shall have become indistinguishable from the soil. The amount
acre annually.                        °
         of space recommended in  countries more regardful of the
         public health than here is that there should not be much above
         one hundred burials  annually in an acre of ground.  In some
         of our cemeteries in  and near the city,  that do not embrace
         many acres, thousands are buried  in every year, f
How soon
bodies decay.
* See Map.   t See Cemetery Report—Table G, 
Sanitary  Condition of New  Orleans.             145
     ions
in London.
   The following regulation, (introduced by Lord Palmerston,)
which is in force in the burial grounds of  London,  is emi-
nently applicable to those in this city, if they are to  remain,
and those without the city, that " no interment shall take place
within ten yards of any part of the boundary of the city ceme-'
tery,  and that the  intervening space shall  be planted with
shrubs, evergreens and trees,  in such a manner as shall pro-
mote the absorption  of any deleterious emanations, and at
the same time  permit the circulation of the air.  Also, that
the cemetery shall be underdrained, so  as to prevent the  ac-
cumulation of water in the graves and  vaults, and  that no
grave shall be opened until after a lapse of  fifteen to  twenty-
four years, according to the age of the parties."
   The sentiment now almost  universally prevails, that intra-
                  i-i-iir.il                    •     lntra-mural
mural interments should be forbidden, as no less inconsistent.
                                                           interments
with  due respect to the remains of the dead, than with  a safe gnbstitnted jn
regard to the health of  the living ; and that, as perfectly com- rnrai cemete
patible with both, the beautiful custom,  so full of delicacy andries.
taste, so accordant with  some of our  most sacred feelings,
should be encouraged, of erecting rural cemeteries, on spots
retired, and distant from the busy hum of human intercourse
that the holy feelings  due to the last remains of our kindred and
fellow-citizens should  not be obtruded on by either levity  or
business, but be in harmonious  association with  that beautiful
kingdom that God has made for our comfort and enjoyment.
   Probably, there is no  cause  so  productive  of  bad air,
and so difficult  to  be  gotten rid  of here, as  night  soil
and street  and   back  yard filth.   It is the great difficulty
everywhere.   In  this  city, we  are peculiarly situated  in
regard to both;  we  cannot dig pits of more  than two feet
anywhere without coming  to water, and in  the back  parts of
the city, to half that distance, this being dependent mostly upon
the amount of rain recently fallen, not  on the  height of the
river, as supposed.  This makes it the worse,  as in the  summer
season most rain  falls, and the evolution of the  gases  greatest
and most injurious.  Hence, open pits (as night  soil is lighter 
146          Report of Dr. Edward II. Barton  on the
Amount of ,
         than water, and is always on the surface, giving its noxious gases
         to the atmosphere) are not applicable to om- position ; and street
         filth is not required for manure in our fine alluvial soil.  If we
         reflect for one moment  upon the offensive fact, that near five
         thousand six hundred tons of night soil, and about fifty thousand
         tons of urine are exposed here aunually, to undergo the process
to constantly,             .                ,  .     it       •
  ,  ,  ,. of fermentation and decomposition, exhaling their noxious and
and to be dis-                         x       '        °
posed of    poisonous gases to the atmosphere we breathe, and absorbed by
         the water we drink, contaminating our most private recesses, (for
         there they are generally located,) where  the air being mostly
         stagnant, it is apt to remain permanently.  The amount of ma-
         nure from domestic animals,  of kitchen offal, is at least as much
         more—of more than five thousand bodies, buried within the city
         limits—of street and gutter filth, constantly undergoing decom-
         position—with its frequent upturning and spread upon the
_,       f streets, (not immediately removed, however, as it should be,)
the city tem-D}7  tne scavengers—probably, four times as much more.  Then,
peratnre  and we  have the frightful aggregate of upwards of  three hundred
moisture.   thousand tons, the  larger part of it of organic  decomposed and
         decomposable matter, submitted to the putrefactive fermentation
         every year, under  our very noses, besides  that from gas works,
         tallow and soap chandleries, &c, &c, in an area  of seven and a
         quarter square miles, together with the baneful influence in al-
         most every direction, of swamps uncovered  and covered by forest
         growth, and  all this in a temperature which, for nine months in
         the year averages  73°.31, while there is  an average humidity
         during that period of .820, or within .179  of actual saturation!
         This  is bad enough if it cannot be remedied, and too bad if it
         can!
           On investigation by the General Board of Health of England,
         on the influence of livery stables and vacheries,  they were found
         to be so injurious as to be denominated " fever nests," and so per-
         nicious even  to their own tenants (cattle) that the manure was
         ordered to be kept in covered receptacles ; and  in relation to
         slaughter-houses, they were found not  only injurious  to health,
         aud offensive to sight and smell, but the poisonous atmosphere 
Sanitary  Condition of New  Orleans?            14?
was even found to injure the quality of the meat, disposing it to
taint, and  promoting its rapid putrefaction.   In some of these
houses, the  meat would scarcely keep sweet thirty hours, and
such I have found to be, on inquiry, a general fact here.
  The  special  gases,  the  principal effluvia eliminated from
privies  and  the other  sources of vitiation just mentioned, is
knoAvn to be  composed, mainly of  sulphuretted hydrogen and Amount oi
ammonia, and  experimental physiology* has shown that one
     .                                                      poison a bird.
cubic inch   of this gas, in 1500 cubic inches of air, will kill a
bird, and one cubic inch in 800, will kill a dog, and that a man Adoe-
cannot live, where  the air  he inspires is  impregnated Avith a a man.
300th part, and suffers in a corresponding degree when  a  less
proportion of these poisonous  gases exist.  Matteuci informs us,
that sulphuretted hydrogen is the  only body, Avhich,  having
acted on the blood, even in very small quantities, renders  this
fluid incapable of being arterialized by oxygen.
  Streets, as a source of disease, are much dependant upon the
qualities of  the soil of  which they are composed.  If sandy, ?treet3 M a
although to the eye,  cleaner, they  absorb and retain all  the source of dis-
filthy materials of a liquid nature, that falls upon them, until ease.
an elevated  temperature gives them back to the surface,  in the
               1         °                            '       What good
more,  and  indeed,  only  poisonous condition of an aeriform  dbad
compound:  this, it is well known, constitutes the  most danger-
ous  ballast  of ships, and  it is from  this cause.  The "cleanli-
ness" of such streets, is illusive—deceiving, by appearances, their
vicious deposits—concealed, not destroyed.  Streets  of  clayey
materials and partly of sand and vegetable mould, such as com-
pose our streets, whose absorbent  power is  less, retain, on the
irregularities of the surface, what is not  absorbed or passed  off,
and  exhale  it to the  atmosphere, keeping up a high degree of
saturation, with it in solution.
  Houses, in a climate like ours, should  be so constructed as to
promote  the maximum of ventilation  and  the  minimum ofHouse8
moisture and temperature.  Where these are not fulfilled, with
a propel protection from the inclemencies of the weather, ( hot
* Theuard & Dupuytren. 
148
Report of Dr. Edward  H. Barton on  the
          and cold) they fail  in  their objects.  The admission of light,
        . etoo, is important in the construction of a  dwelling,  to  the
          enjoyment of health and the prevention of disease.   It renders
          disease  milder when it occurs,  and  makes  it more  readily
          amenable to medical and other treatment.  There is reputable
          medical testimony to prove, that some diseases, in dark alleys
          and cellars  cannot  be cured, without it.  Dark corners and
          places  in  dwellings  are always the hiding places of dirt and
          filth, and particularly in the habitations of the poor.
            Our empty squares and half filled lots,  are  pregnant sources
          of disease.  These require  as much,  or  more, attention than
 Empty lots as streets, as they are eight or ten times more extensive and more
 a source o   repiete with every kind of filth.   Often, in  secluded,  unven-
          tilated spots, they constitute so many receptacles and fountains
          for the evolution  of that poisonous material  that is so fatal to
          the public health.  Hence then, the vigilance  of the authorities
          is ten-fold more  required  there, than  in  the  streets, where so
          much negligence  takes place before the very eyes of the com-
          munity. Little is done (while they are neglected) to purify the at-
          mosphere, if these  efforts, limited and spasmodic as they are, shall
          be confined to the streets, if they should be left to private apathy
          and  indifference.
            The various  hypotheses  based  upon the  supposition of a
          specific something, which is denominated  miasm, eliminated by
         the  decomposition of organic  matter  has been shown  to  be
The true mi-           r             °
asm is  h t-s0 U^erty untenable by its several opponents  respectively, of
ever impairsanv  one  idling  possessing this multifarious and  mighty power,
the purity of that Ave have for many years abandoned the whole as untenable*
the air.      and  that of the " drying power," among the rest, which, having
         nothing definite in the form of reasonable experiment to support
         it, or rather  in defiance of it, and  in  the very face of experi-
         ments which utterly disprove it, that I  have long come  to the
         conclusion that there is no such specific agent,  but believe them
         all right and all wrong, when exclusive, and that whatever im-
         pairs the purity of the  atmosphere is  pro tanto, for the time
         being, the miasm, or rather the mad-aria.   In a practical report, 
Sanitary  Condition of New Orleans.             149
 such as the present is intended to be, it  is no place to offer the
 the explanations which have  satisfied my mind in relation to
 what is called the  "laws of miasm."   We profess  to deal with
 well established and incontrovertible facts and to make them
 the basis  of  all our  suggestions for future  improvement; we
 may, nevertheless,  be pardoned if we find it requisite for neces-
 sary explanation, to exercise the privileges belonging to the first
 advance in science, and brush away  the cobwebs, and shoAv
 what this alledged cause is not.   We  then proceed to show
 that the explanation which  they have  attempted, in relation to
 the disturbance of the soil, is utterly irreconcilable with the
 facts, and it is for that purpose that we depart from the purpose
 laid down for our guidance in this paper.
   The  cause  of this influence, indeed the cause of all what is
 called malarious fevers, ( bilious and yelloAV fevers inclusive) has snpp08ed
 been ascribed to "the  drying process" in  soils recently or not cause of fe-
 long since saturated with water, without direct proof, with no vers.
 allegation of experimentss and  with  no  other evidence than that
 there " has been a  hot sun and preceding moisture."  Now, I
 might content myself in stating, that the  hygrometer is the only
 recognized sufficient test of the existence of this "drying power,"
 and  the amount of moisture  in  the  atmosphere, and there is No proof.
 neither allegation or evidence that this  has been used.  That
 Avhen these injurious influences take place in  the highest degree,
 the drying power is at  its minimum, and thai the moisture is
 usually then at its maximum;  the meteorological tables accom-
 panying this Report, show this in a most conclusive manner.
   The main ground furnished by Dr. Ferguson, who is the au-
 thor  of the hypothesis,  is,  that during  the period of a  great
 drought in the hilly districts of Spain, the streams were  dried
 up, and the British troops were encamped in their beds and hoi-
                                                             of Dr. FcrffU'
 lows, (I quote from memory,) and so fatal was the fever result-
 ing, that all Europe thought  they were  annihilated !  To expe-
 rienced Southern physicians it is well known that there are no
places so fatal to health as these beds  and similar apparently
 dry hollows and their outlets, and that it is in proportion to their
 insulation from ventilation, and that it  consists of a stagnant,
Explanation
of Dr. Fergu-
son's hypoth- 
 150           Report of Dr. Edward II.  Barton on  the

          damp and poisonous air ; that it was this that was so fatal to the
          British army, and not the drying process.   There  is no  doubt
          that if the Dr. had  experimented with the hygrometer it  Avould
          have informed him that the  air was saturated rcith  moisture
          during the greater part of every night, and that if he  had dug
          into the beds of the late streams he would have found water not
          far distant.
            All the theories  of miasm singularly fail,  in  attempting to
          prove too much.   A specific  miasm, eliminated  by decomposi-
 uired for ab- t*on oa* °^ organic matter, must and should, as is alledged, pro-
sorption into duce disease under all circumstances; so far as lining the lungs
the system,   it is composed of  organic matter, passing  the  most delicate
          membranes into the  system, is deemed utterly incompatible with
          that  demonstration  made  by  our able colleague,*  viz: that
          nothing can pass through  those membranes unless in a state of
          solution,  in which state the organic character must  be lost! the
          physiological condition of the individual, and the existing meteor-
          ological state being entirely out of the question.
            The advocates, however,  of the  influence  of the  '' drying
          power," do not so interpret the modus operandi of  their agent,
Why it can'tnor present us the philosophy of it.   Malignant fever is most
be the " dry- apt to seize an individual about daybreak.  This is  supposed  to
ing  power." be owing to an alledged great fall in the thermometer at that time,
          instead of ascribing it to  a change in the physiological condition
          of the individual then always occurring.   The  most frequent
          hours for  the attack of malignant disease (yellow fever, cholera,
          plague, &c.) being after midnight, or early morning hours, being
          precisely  those periods  known from  statistical  investigations, as
          most fatal to  human life, or when it is most apt to terminate,
          three to six.   The  real difference between  bed-time and day-
          break is  only three to four degrees, by actual observation, and
 So  from  a this, too,  is always a gradual, regular decline.  Now, if it  is due
physiological to any meteorological  condition, it is to the hygrometer, for I
 cause, or hy-have often noted a difference of half a degree in the  temperature
 grometric.   0f evaporation between day-break, my usual time of making it,
»Pro£ Riddell. 
Sanitary  Condition of New  Orleans.             151
and half an hour to an hour before ; that it is that much lower;
the evaporating power is that much greater ; that it rises at day-
break ; while I can perceive no difference in the  dry bulb ther-
mometer, placed by its side.  Again, a fall, a moral emot:on, any-
thing that suddenly shocks the nervous system, and particularly,
during the existence of a mortal epidemic, produces the develop-
ment of the disease, although, but  for this, no such occurrence
would probably have happened.  The " drying power" is most ac-
tive at midday, and is at  its minimum at night, when the air is
almost saturated with moisture, and often entirely so in sickly
seasons, as during our epidemic last season, yet, yellow fever, as
well as the whole zymotic class, is very apt to occur at this time,
and in seasons and regions where  this exists in the greatest de- __,
                     °                           o           Always mois-
gree,  is precisely there Avhere  they are most rife,  and Avhere the ture in the at_
drying power is greatest, and the air elastic, is just those tvhere there mother*.
is most health !   During the greatest droughts, there is always a
provision  of nature in the subsoil  for the necessary supply of
moisture,  as Avell as in the atmosphere.   The term is but one of
comparison; were there no moisture existing at the time,  vege-
table  as well as  animal life must  cease.   I have often noted,
during what Avas called great droughts, the air, at my  morning
observation, saturated with moisture, and during the "dry season,"
on the elevated  plateaux of Mexico,  I  have seen the  dews so
heavy as to Avet the road half an inch or more in depth, which
at first I attributed to rains during the night, and many a time
have I descended from  my  horse   at daybreak to examine it.
The country is rarely sickly when  simply dry.  The driest por-
tions of the SouthAvestern States are the  healthiest, as may be ..    .   .
                                                        J    Absorban t
seen by reference to the maps I have constructed of those States, soils only ap_
deriA-ed from the mortuary returns of the last census, and pub-parentiy
lished in the fifth volume of  the Transactions of  the Am.  Med. cleanly.
Ass.  Pensacola, Mobile, Bay St. Louis are dry more in appear-
ance than  in reality.'*  Their absorbent soils permit a percolation
of Avater to the clayey subsoil, but a few feet beloAV, beyond Avhich
 * I have tried for years, in vain, to procure a record of their hygrometrical con-
dition. 
152            Report of Dr. Edward H.  Barton on  the

         it cannot proceed, and it then becomes a reservoir for an evapo-
         rating temperature, whenever this occurs.  That this is reasonable,
         is demonstrable from what Ave know of subsoil moisture under a
         high temperature.  I know it further from my OAvn experiments.
Conceals, not _,,    - .      ,            ,                      ,., . ,
         lhat this was the case at the disastrous encampment at Yv alcheren,
destroys filth.
         where the moisture could be easily reached by thrusting a walking
         cane into the sand, and the notoriously fatal  spot opposite Lis-
         bon is as remarkable for its luxuriant mushrooms as  for its  mor-
         tality, and we very well know that these flourish only in very moist
         situations.   The periods and places of the occurrence of the epi-
         demic  of last year, as traced out in  Prof. Blodget's  interesting
         communication, showed most  conclusively, that  the epidemic,
         only broke out as the country became moist, that as long as it con-
Healthy as   .
         tinued dry, whatever was the temperature, and it was very eleva-
         ted, health remained; and finally,what is better established, from
         long and well attested experience, than that one of the most pro-
         lific sources of foul air and bad smell in ships, has been the putre-
         scent matters absorbed and retained by gravel, sand  and other
         earthy substances used for ballast, and that however  apparently
         clean ships are kept by washing, they are never as healthy as when
         this process is effected by dry rubbing by the " holy stone," as it is
         called.  The " drying process "  always exists in the proverbially
         healthy occupation of ploughing, which is only injurio«s during
         the first process or year of exposure.  The simoon  is a drying
         blast.  It sucks up our fluids, and desiccates everything it reaches,
         but it has never been accused,so far as I have heard, of produc-
         ing/ever, much less yellow fever.   Nevertheless, I so far agree
         with these gentlemen as to ascribe much influence to the drying
         power in the production of influenza, pneumonia, catarrh, rheu-
         matism, and even cholera, &c, but so far as my experience and
         researches have gone, not  bilious or yellow  fevers, and these
         experiments  have extended over many years  and climates, and
         during the worst fevers  known in the South.
            Let us repeat, then, our conviction, that no one agent pro-
         duces what is termed malarial fevers, but that they depend 
Sanitary  Condition of New  Orleans.             158
 for their existence upon the two-fold condition expressed in }he A tw°-fold
 former part of this Report.                                 condition  re-
   A fundamental proposition, an imposing truism of sanitary Qnwite'
 science, is, that every effect springs from some adequate and
 commensurate cause.  This is a law of nature, as applicable No effect can
 to disease as  to anything  else.  No  disease can  arise andariseb,atfrom
 pervade a country, or section of country,  or even attack aan adequate
 single individual, with out being due to some atmospheric,CaUSe'
 local  or  personal cause, the discovery and extirpation  of
 which will at once arrest its  further diffusion.  The curative
 physician seeks for the causes of disease, for the purpose  of
 more thoroughly comprehending their mode of action upon
 the human economy* in order to apply  the  proper remedy. Dfffierence of
 The sanitary reformer pushes his inquiries into the " field  ofcurative  and
 causation," for the purpose oi preventing those ills which  itpreventlve
 is the province of the other to palliate or cure.   The  one en-s<a'
 deavors to ameliorate the ills to  which individuals at present
 prove subject, while the other has  a far nobler,  and  philan-
 thropic object, to prevent the ills to which whole communi-
 ties are subject.
   If, in the present state of this  interesting inquiry into gen-
 eral and special causes, we find  certain effects  invariably to
 follow, and  in the same relation, it requires no great sagacity
 to ascribe the  one to the other; nor any rare gift  of pro-
 ,       /•     n  i                                        consequence.
 pnecy, to foretell that, on the occurrence of the one, we may
 reasonably expect the other.   Such are the circumstances
 that characterize the occurrence of yellow fever in this cli-
 mate, the invariable sequence to extensive disturbance of the
 original soil, with the atmospheric and local  conditions to be
 pointed out in more detail presently.   There are many dis-
                                                          Must be a
 eases with whose causes we are  utterly ignorant,  at present,
but with which we shall doubtless  become acquainted hereafter every di9ea3e
in  proportion as we acquire a more  accurate and  minute ac-
quaintance with the laws  and  constitution of  the atmosphere
of the climate we live in, and with the physiology of organic
""Rodgere. 
154
Report of Dr.  Edward H. Barton on the
          life.   It is thus with leprosy, elephantisis, syphilis, and most of
          those now recognized as due to specific poisons. In relation to
          epideme cholera, we may be ignorant of its precise cause, but
          in the progresss of a study of the conditions which influence it,
          we will become acquainted with the accessory, preventible and
          instigating local circumstances which ivjiuence'\t, the localising
          circumstances that are tender our control.   So of yellow fever;
          the exact amount of causation, either local or general, the sine
 And as much
          qua non, to its production, Ave can scarcely measure, from <le-
 of that ofepi- ■x             x
 demic yellow *ect of accurate and precise observation;  yet I am most fully
 fever  as any impressed with  the conviction  that we are sufficiently ac-
 other.      quainted with its ordinary causes to prevent it, which is the
          only valuable or practical part  worth knowing.   If we can
          control these  then,  we  shall be exempt from this  terrible
          scourge.  It is particularly here  that  false  facts  and im-
          perfect information have done so much injury,  and thrown a
          cloud upon the subject it is so difficult to dispel.   If then, we
          can clearly prove the places, the very spots and parts of cities
          that are the  favorite haunts, nidus, birth-place and field of
 Because we growth of this disease, if with increase of the alledged cause,
 can trace its (ne effect is in proportion multiplied, if with its limitation the
 origin and the ejj-ect is also limited,  and  if with this  removed  the  effects
«ausesprod0-a]so  ceage  jfc ^  gQ  fa). t()  ghow>  not Qnly  the  cms<,
         of the disease itself, but of  \t% preventives, and  will  prove  a
         valuable lesson to us, worth all  the  theories and hypotheses
         of visionary dreamers from the time of Paracelsus to the pres-
         ent day.  A careful inquiry into the facts will  I trust, satisfy
         all fair minds that the common sense of mankind has not been
         mistaken in attributing the prevalence of this disease to the
         causes  mentioned,  not only here but abroad.  The record
         presented in the Chart, ought,  I humbly  conceive, convince
         all.   The Sanitary Map of the city will show the influence of
         these localising conditions.  No city that Ave are acquainted
         with  but has these infected spots.   The  main peculiarities
         which distinguish them, are filth of every kind, moisture,
         g&gnant air, heat, and  a crowded population,  aided  by .the 
                Sanitary Condition of New Orleans.            155

accessory circumstances  of intemperance  and  bad habits.
They are usually situated in those parts of cities where filth Seats of these
is most apt to accumulate.   In Northern cities, Avith a  de- causes  in a11
clivity to the river, or part about the wharves, as in the neigh-large cities"
borhood of " Fort Hill,"  as  it is called, in Boston, has been
its hot-bed there from time immemorial; so about the "slips"
and Avharves and docks in New York,  Philadelphia and Bal-
timore, where are  the  egresses  of their  filthy sewers—the
 concentration of all the  polluting detritus  of these cities.
And so of the "infected districts  in  Norfolk, which is con-
 fined to a space of two or three hundred yards, and mostly
 made ground."   And so of  the most parts of Charleston  and
 Savannah.  In New Orleans it is not limited, as it is  in them,
 to these localities.   It, however,  exists  here on  the river
 bank,  because at  this  season (August and September)  the
 river is low and the bank exposed, leaving an extensive  sur-
 face—the common receptacle of all kinds of filth—^and here,
 or not far distant, we find the large amount of unacclimated
 population ; but it first breaks out and  spreads in St.  Thomas
 and Madison streets, St.  Mary street,  about the Markets, at
 the triangle, Gormley's  Basin, &c. &c,  (see map, as before
 mentioned)—all filthy, crowded  and badly ventilated locali-
 ties.   These are plague spots—they exist in all cities that are
 badly  policed—the sores first fester and mature here, and the
 bad air or virus is  generated  and  multiplied  as the season
 advances—extends to the  neighborhood, and if it meet with a
 congenial atmosphere, throughout the city—and from an en- Why limiMi
 demic of a locality, it becomes, with concurring causes, a-wide
 spread epidemic.   If otherwise, if a more dry or less impure
 air is met Avith—if more attention has been paid to  sanitary
 measures—it is more limited, and its progress can sometimes
                                       .      i'i3i   A-nd how ex-
 be measured as to its surface, extent and even height, day by
                                                           tended.
 day.   Such has been the  result of experience in New York,
 and measurably in Philadelphia, and the  " infected  district"
 can be and has been  "fenced out," and its gradual extension
 actually calculated as so many feet per day.  This cannot be 
156
Report of Dr. Edward H.  Barton on the
          shown here  for  two reasons: 1st,  because these conditions
          themselves are always more or less  combined and extensive ;
          and. 2d, the presence  of an unacclimated population would
          prevent its being so clearly shown.  It exists in the air—it is
          the consequence of the causes mentioned—it is the poisoned,
          infected atmosphere, and not individual—not contagion.  A
          person taking it in  the infected spot,  and going into a pure
          atmosphere, has never  been  known to extend  it.  If it is
          taken to a congenial atmosphere, it  contributes to its further
          extension.  In this  city and in  the country  during the last
          year, there existed an epidemic influence  (as  formerly ex-
          plained) ; the congenial  atmosphere was nearly everywhere,
          more or less aggravated by localising  circumstances, and the
          disease spread extensively, and more particularly where those
          localising conditions existed in excess, (as above mentioned.)
          This was the case, too, at Algiers, where the disease has not
          extensively prevailed many years, (although only  across the
          river), produced by extensive disturbance of the soil, for rail-
          road purposes,  and followed by a large mortality throughout
statements to tj,e village.  These  localising conditions existed, probably,
 e o   uture everyWnerem   Many of them have been mentioned in a former
          page.  For the sake  of the verity of  history, and for the
be made up at .
          inestimable value they promise for the future, a full and scru-
once.                          J r
         tinizing  investigation should extend over  the entire region
         that was reached by this  disastrous epidemic, that all the
         facts be collected and recorded,  and promptly, too, before
         oblivious memories and  fabulous statements  shall bring to
         doubt the  real features, and  the authentic history of this
         remarkable year be lost, and  we realize, in after times, as
         opposite  and parallel to most those  in  Carpenter's work on
         the yellow fever of this country—mostly made up of a tissue
         of statements, both at home and abroad—that have been ex-
         posed and refuted over and  over again—many of Avhich are
         personally known to  me to be without any real foundation, of
         which I  had made record at the time of their occurrence. It
         has been also proved from the embarrassment the Commis- 
Sanitary  Condition of New  Orleans.            15?
sion has met with in eviscerating the real facts, even from the
more recent transactions of last summer.
   .Nor is the rocky post  of Gibraltar an  exception to the re-
quirement of a localising condition from filth, &c, for the  pro-
duction  of yelloAv fever.   Although it  has the appearance  of
great cleanliness without, as all military stations have, yet Avithin,  ' ™ *" Ver?
 .   .                               J             ,-J         'filthy  within
the houses are admitted to be, and are notorious for their filth,..
                                                            ' the houses,
crowdedness, and want of ventilation, and even the  disturbance and crowded.
of the earth in the vicinity, has been noticed to have had a most
injurious influence on the public health.    " Two successive epi-
demics of yellow fever, namely those of 1804 and 1813, broke
out in the same spot, the dirtiest in Gibraltar, Boyd's buildings,
and the epidemic of  1814 broke out at CaA^ellero's buildings,
a place Avhich competed with Boyd's in its state of filth and pol-
lution."  " Whenever," says Mr. Armil, " the  epidemic breaks
out in Gibraltar, it has always commenced in the filthiest spot
and this  was the case in the late Adsitation."  The  same facts
have been demonstrated by the best authority, to exist at Bar-
badoes, Jamaica, and other parts of  the  West Indies, at Dema-
rara, &c.
   The city of Havana is situated on a closed bay of six or eight
miles in  circumference, land-locked on every side Avith lofty hills, Bay of Hava-
with the  exception of one narrow outlet  to the sea, at the North, na.
with marshes about the estuaries of the several small streams
that empty into it, bringing the organic detritus of the surrounding
country,  mixing its fresh with the salt Avater  of the ocean, occupy-
ing near  two-thirds of the marginal circumference of the bay. Causeg
   This bay receives all the filth of a city  containing near  two
hundred  thousand inhabitants—is in many places very shallow,
exposing, at low tide, (the tide here being three to four feet) ex-
tensive surface, with all kinds of putrefiable materials, to the
                                r                           Of the insaln-
sun.  The Avater of the bay is often very offensive.  All vessels brf   f
pump their bilge water into it.   It cannot be changed;  it is so city<
full of  decomposing materials that the British naval  service has
a standing order not to use the water for any purpose on board
their ships of  Avar.   From experiments made Avith it, it putrefies 
158          Report  of Dr. Edward  H. Barton, on the

         on standing a single day, Avhile sea Avater taken at a distance of
         fifty leagues from land, requires three days.  The  streets of  the
         city proper are very narrow, (about tweh'e feet wide,) and very
         badly ventilated, from being irregular,  and very crooked, and
         there is a high wall still further obstructing it.   The habits of
         the mass of the people are of the very Avorst description, and
         from the high price of food of every kind, (from the heavy tariff
         imposition of a despotic government,)  the  mode of living is
         wretched in the  extreme.   That yelloAv fever should exist here
         every year, is not at all astonishing, with a high temperature and
         great moisture.  It has even been contemplated to make  another
         avenue to the sea, so as  to produce a  current and occasional
         change of Avater  in the bay, Avhich Avould prove a most salutary
         measure.
Description of   Vera Cruz, although built upon a sandy plain, is but a few
Vera Cmz.  feet above the- level of the sea.  The wells  are from six to
         eight feet  deep.   There  are extensive SAvamps and low
         grounds around it, emptying  their  sluggish currents into
         the sea, under its Arery AAralls; impairing its qualities so much,
         that, together with  the filth of the city, which is emptied into
         it, it is in the same condition as that noticed above in tho
         bay of Havana,  and during the rainy season (the sickly sea-
         son) ponds  are  formed in other directions outside the Avails.
         These are about fifteen feet high, and materially obstruct the
         ventilation of the city, and have been found to be so injurious
         to the public health, that  I deemed it an act of duty to solicit
         its  removal to windward or seaward,  so as to permit perfla-
 aMe °  '  tion from that quarter during the summer season (of 1847.)
         The habits  of the lower  orders are extremely filthy,  and the
         public quarters and forts, when taken  possession of by the
         American army, could not be exceeded  in filth.   That this
         should be a chosen seat  for the yellow fever is not at all  as-
         tonishing.  I possess the official records to show its influence
         on the denizens, and  on the Mexican army for a number of
         years, Avhich I will state  in  another  page when I come to
         show the influence of sanitary measures on sickly cities.— 
                  Sanitary  Condition  of New Orleans.              159



Let it suffice now to say that it has fully earned the reputa-

tion of being  one of  the  most sickly  cities in the yellow

fever region.*

   1 state, then, as  a universal fact,  with the exceptio probat

regulam, that  filth of  every  kind,  with  heat  and  moisture, Cans« of yet-

with sufficient duration, produces yellow fever.    The records low fever.

upon the subject are so affluent, they absolutely  so crowd the

historiesof the disease, that it is really embarrassing  to select

from them, and many  volumes  Avould not suffice to trace and

embody  them.

   Finally,  and to leave  not a doubt upon the subject, if we

can produce instances of the presence of yellow fever, where

there has been  no possible intercourse or communication from

abroad, or  from any  extraneous sources whatever,  as far as

human scrutiny could ascertain, should not the most skepti-

cal  yield up  their  doubts, provided we  can satisfactorily

ascertain and point put  the existence of the causes  and  con-

ditions I have alledged.    It is through such  demonstration

that we  reach and  develop  the  important and impressive

truth,  that  in the concentrated filth which  localises it within

the geographical limits of  its range,  (though it  has  been

sometimes assumed to have had a foreign origin,) we present

  * The causes productive of yellow fever, are so thoroughly understood  by all
those who  have practiced much, and long, in tropical regions, it is so well defined
and so accurately known, that even a prescription is furnished by them, for its sure
and rapid production, it is as follows :
  " Take, of soldiers newly arrived in the AVest Indies, any number; place them in
barracks in a low wet situation, or in the  mouth of a gully, over the brink of a dry
river, or on the summit of a mountain, and to leeward of e  swamp, or of uncleared
ground, and where there is no water, or  only  bad water; give them, each, twenty-
two inches of wall in their barrack rooms; let their barracks be built of boards, or
lath audplaster, and have neither galleries nor jaloueied windows, but close window
shutters, and a hole or cellar under the flooring for containing mud or stagnant
water, and holes inthe roof for the admission of rain, the windows only fourteen inches
from the floor, so that they may be obliged to sleep in the draught of air; let them
have drill every morning on wet ground, and when fasting; guard mounting and Prescription
all kinds of fatigue net in the morning or evening, but during the hottest time of the
day- when on sentry,  no shade to keep oft' the direct rays of the sun ; bad bread, to produce
putrid meat few vegetables, plenty of new rum, especially in the morning; discipline
enforced by terror  and punishment, not by  reward and  promotion; an hospital yellow lever.
similar to the barrack  room, without offices, always crowded, plentiiully supplied
with rum  scantily with water; a firm belief  in the doctrine of contagion, and a
horror of approaching  any person affected with yellow fever.  Let these directions
be attended to  in Trinidad,  or even in Barbadoes, [and he might have added hew
Orleans 1 and especially when the air is stagnant, or charged with noxious vapors,
subsequently to long droughts, the soldiers will soon die, some of them with yellow
 ever, some of them with black vomit,  and those first  in the rooms where these
 lireetions have been most faithfully observed/'
 This recipe is eminently applicable to New Orleans, and will ever produce the
 esults, as long as it ia so "faithfully foUoised." 
160          Report of Dr. Edward II. Barton  on the
         the spontaneous cases, where nothing of this kind was possible,
Great value of where the only agents known to be present, were a combina-
the spontan - t|Qn Qf gj^ Qr  (jecomposable materials, or  disturbance  of
         soil, (their equivalents,) with the  meteorological  conditions;
Settles the  an epidemic  atmosphere !   It is precisely here, then, where
•nbject.    it was impossible to arise from any other source.  The cases
         presented by  Dr. Benedict, of this  city, as  occurring  in
         a secluded spot  in the interior of the country,  about a mile
         and  a quarter  back of Hollywood, are  exactly  of this char-
At Holly-  acter.   This intelligent and observing physician,  with  no
wood.     theories to  support,  but with  a fine talent for scrutinizing
         observation,  here  accidentally  pitches  upon  no  less than
         seven unequivocally  spontaneous  cases, and  after the most
         diligent inquiry, finds that it was impossible they  could have
         arisen from any imported or extraneous source; and here he
         discovers every  condition  that he afterwards learned that I
         deemed important for the spontaneous occurrence of epidemic
         yellow fever,  viz :  disturbance of soil, unusual  humidity,
         (great rains  and heavy destructive mildew,) elevated tempera-
         ture, great radiation, (that  is, great and distressing difference
         between  temperatures of  sun  and shade,) and cold nights,
         ultimately*.    These are  valuable  proofs of  my position,
         conclusive to science, and  valuable to humanity.
            Hardly less  valuable  and corroborative, were the cases
         occurring at Gainesville.   Here the cases Avere clearly spon-
         txneous,  without any  possible  origin, (either  personal  or
         through  goods,) but  from the  soil, as  mentioned in another
 vu'e<                              .         X-   •      •
          page, high  temperature, intense radial ion, epidemic atmos-
          phere, f'uit  rotting extensively and prematurely,  native cows
          dying without obvious cau?e.f
 Do. in Wash-   -Dr. Kittridge. the  re.-pectable member of the  Legislature
 ington.     from  Washington, states to me, unequivocally,  thai when  the
          yellow fever first occurred on his plantation,  there was  not
          another  case  of it within  fifty  miles, and  that it arose soon
          after his extensive yard was spread  entiiely  over (in older
* Sse his intereiting paper.   t See Mr. Fulsom's report. 
Sanitary  Condition  of Neio Orleans.             161
to raise and  level it,) with fresh earth from  the neighbor-
hood. (This was mentioned in a preceding page, for another
purpose.)
   The case of Mrs. Selby, the wife of Judge Selby, of Lake
Providence, breaking  out  in  a remote  part  of the  toAvn,
                                                            Providence.
without possible intercourse with any one.
   At Trenton, it  originated  spontaneously, from the causes T
mentioned ; several families struck with it at the same time,
in different parts of the village.
   In the town of Franklin, in  this State, the disease both
spontaneously originated and terminated  in it, with no suffi-
cient evidence of its importation, and no local cause assigned
for its origin.
   The case of the "Black Warrior," in Mobile Bay, affords an-
 other striking instance of its  spontaneous occurrence, in an Bla<* war-
 epidemic atmosphere.*  The first Mobile cases clearly appear torior-
 have originated in the  neighborhood, where there had been At Mobiie,
 considerable   excavations  for  railroad  purposes,  and the
 spreading of it to fill up low lots.  ( For details I refer  to Dr.
 Levert's valuable  paper.)
   The eruption of  the fever at Selma, was clearly due  to the
 same cause, and is in precise parallel with  the  earlier cases  at
           '          r     r                          _    Selma.
 Mobile; excavations—cutting down embankments and spreading
 the fresh  earth on the streets  and low lots exposed to  the in-
 tensity of a scorching midsummer's sun.  Dr.  Mabry,  in his
 interesting paper,  clearly and  unquestionably shows that the
 fever originated from these causes.
   'At  Demopolis, Ala., same spontaneous cases occurred, being
 .                 .         ii-       •           1      Demopolis.
 insulated and at a  cnstaiwe, and having no intercourse whatever
 with the  ■ a e of f.-ver exist ng;"  "nor were the nurses more
 liable than . ther people." f
   At Saluria, Texas, spontaneous cases occurred, without even „ ,  .
              '     ' l                                     Saluria.
 the suspicion  of communicated infection.  J
   A Port Gibson, the same thing  occurred, where no possib'ePortGibgon_
 communication Avith the sick could have occurred. §
*Dr. Benedict.   t|Drs. Ruffin and Auhe.   J J. H, Brown.    §Dr. Wharton. 
16:
Report  of Dr. Ed-ivnrd H. Barton on  the
Baton Rouge



Centreville.



Natchitoches.

Washington.


Martinique.



Bermuda.






Barbadoes.
Local sponta-
neous origin
fromfilth.&c.
   "At Baton Rouge, a number of cases occurred Avithout inter-
 course, or suspicion of it, Avith other cases, on  the river bank
 under the bluff." *
   At  Centreville, La., the first case spontaneously occurred in a
 mulatto, sleeping near an extensive rotting bank of chips, <fce.
 Wind blew steadily over this b?nk  on the village, and the dis-
 ease progressed, f
   At Natchitoches, the two first cases evidently  spontaneous. J
   At Washington, La., the three first cases had not been exposed
 to yellow feA'er.§
   In Martinique, W. L, "yellow fever always developed spou-
 taneously.'' ||
   In Bermuda, the  spontaneous  occurrence from local  causes
 was equally  satisfactory:   an old hulk, that Avas very offen-
 sive. ^T
   From direct information,  Avhich the Commission has received
from Barbadoes, the first case  clearly originated in a native,
having a pretty stagnant gutter at  his door, from decomposed
 animal matter  from a slaughter-house  and a  piggery  in  his
 yard;  he died  of  black vomit."   In  fifteen  days the disease
 broke out near  a crowded church  yard in a low situation—here
four died  in  one  house—it was  confined to this locality for
some time, but  finally spread over the island."   The majority
attacked Avere natives. **
   At Rio Janeiro, the  yellow fever "broke out in a particularly
 offensive spot—low, croAvded,  ill  ventilate'i  lodging houses;"
 abundant sources for it in low, flat grounds, in filthy, ill drained
streets, frequently turned up to dry, the neglected receptacles of
all kinds of impurities, in conjunction with atmospheric changes."1
   " The city is situated on a bay, nearly land-locked, with little
tide—sandy and occasionally clayey soil, night soil thrown every
night into the  bay, and becomes  very offensive from the flux
 and reflux of the tide."  The first cases were clearly of spon-
 taneous and local origin—the first, in one  of the above described
boarding-houses, a Danish sailor,  direct from Finland, and  the
second belonging to a vessel that had come from Bahia, which
  *Geo. A. Pike and Judge Carrigan.   tDr. AV. B  Wood.   jDr. Crocheron-
 § Dr. T. A. Cooke.   || From a communication from Dr. Amic, Doctor-in-Chief, to
 the Sanitary Commission.    fiFroui printed testimony from Bermuda.   **Dr.
g nclair. 
Sanitary  Condition of New Orleans.               163
at the time  was healthy, and no others of the crew fell sick,
and the next ten or fifteen cases Avere all from this filthy neigh-
borhood."*
   But there  are other evidences of  its spontaneous origin here,
no less satisfactory.   " Several masters  of vessels, without being Spontaneous
questioned, declared  that they  entered the  harbor Avith  the
                                                             sea.
fever on board, although coming direct from Europe; that as
soon  as  they approached the coast  and came Avithin the influ-
ence of the breezes from shore,  their men fell sick with fever."f Do- on arrival
And several vessels are mentioned whose crews took the diseaseln port"
soon after arriving in port, without intercourse with the shore.
   " Many persons in the country around Rio, caught the fever,
though they had no communication, direct or indirect, with the
sick,],  being  evidently—as in the case of  the shipping—within
the influence of the epidemic atmosphere.   While those farthest
off were not  so influenced, and the disease carried among them,
did not extend."
   "It is a curious  circumstance^ and may perhaps tend to elu-
cidate the origin  of yellow fever  in Brazil, Avithout  haAdng
recourse to a specific source of infection;  that for the few years
previous the  fevers of the country, evidently not infectious, but of
high temperature or marsh origin,  have clearly been changing
their characters.   The  genuine remittent has been but little.     ,
                        o                                     trom  change
seen for the  last three  years.   In 1847, '48, and '49, it was re-of climate<
placed by a  fever of its own  class, popularly known  by  the
name  of polka, but, in  reality, a remittent, and  during  the
present year (1850) it has been replaced by the yellow fever—
a disease, also with similar features.§
   Nearly every one of  the Inspectors  General of Hospitals, of
England, in  the West Indies, admit yellow fever to be of local  pin"
origin;  and Dr. Rush  most feelingly and  eloquently recounts
and laments the different opinion, he, at  an early period enter- HospitaIs,
tained of its contagiousness, and died  firm in the conviction of
its domestic  origin.
  * Dr. Pennell.   t Dr. Pennell.   f Ditto.    § Do., and report to Sanitary Cora-
miiiiion, by Dr. Pennell, through U. S. Conaul, R.G. Scott, Esq) 
164          Report  of Dr. Edward II. Barton on  the
            The spontaneous occurrence of  this  disease in ships from
          Northern  climates, as soon  as they have  reached a tropical
          latitude, having foul holds, are numerous and entirely reliable.
          Holds of ships are worse than cellars, ( proverbially unhealthy
in ships at sea ag ^^ are^ wJien fa^ an(j filthy,)  for they have the delete-
          rious addition of  bilge water, in  slight  motion, Avith refuse of
ern ports.
          every kind, concentrated m an elevated temperature of stagnant
          air, my colleague, Dr. Axson, shows  it to have occurred  in the
          ships; illustrates  the same fact:  that  this feA'er pursues or
          breaks out in such ships at sea, and in port, that it is often con-
          fined to  them, and  that it is only finally gotten rid of by the
          most thorough cleansing.   The ample records furnished by Dr.
          La Roche, in his interesting article on yelloAv fever, in the April
          No. for  1853, of  the  Amer.  Med. Journal, and in  the  second
          Report on quarantine and yellow fever, presented to the British
          Parliament, in 1852, furnish the amplest attestation of the local
          origin and local cause; they  all concur  to  prove, without the
          shadow of a dissent (both the land  and sea causes) that filth
          and fresh earth, (the principle  evolved being probably the same,)
          with  atmospheric conditions, has produced, and by  sequitun,
          will produce yelloAv fever—that it originates it, and that the cause,
known.     of yellow fever is known.  And I know of no rule of philosophy
          where we have  produced an  effect  and with a sufficient cause
          for it, that compels us to look beyond it.   This is most happily
         in strict  accordance Avith the  principles that run through the
          whole system of causation in other diseases—(and why should
          yellow feArer be  an exception?)  the stronger the cause, the
          stronger the  effect, under  the same circumstances.   That  a
         fever  of  the highest grade of  malignity known in this  hemis-
          phere, should proceed from  the  greatest concentration of influ-
          ences known to be injurious to our race, that in a minor degree
         produces the prevalence of diseases of the same class, of a lesser
         grade, has been  shown in a preceding page.   As yellow  fever
         is at the head of its class in  the Western Hemisphere, so plague
         arising under analogous conditions, is at the  head of its class in
          the Eastern  Hemisphere, and as plague for a long  series of
Cause of yei-
low fever 
                 Sanitary Condition of New  Oihum.             165

centuries  has been shown to be under  the  control of sanitary
measures, (and would be now, but for the fatalism of the Turk,
that makes no improvement, and is wrapped up in his contented
ignorance and statu quo,) so, yellow fever can be controled by
the same sanitary measures; and this is really the only valuable And " °°n"
part of the subject.   It lays down the  important foundation 0ftrolabls"
prevention, it erects there a slately structure, on which  should
be emblazoned in lasting letters of living light, sanitary re-
form, and let us look to  it, Avith the same sacred duty we owe
to our stricken city, as we do to those monuments that remind
us of the birth of our political rights and national independence.
And if we cannot prevent it—if an Almighty Providence, in his
wisdom, has cursed us beyond all the other nations of the earth,
and Ave have no remedy after full trial, let us hug our chains,
as  the condemned, and, like the  bigoted  Turk, display  our
philosophy, and bear it!
   The foregoing views so fully corroborate the highly important
"conclusions" of the General  Board of Health of England—
drawn from the  most reliable living authority,* and are so fully
explained by the  principles applicable  thereto, contained in
these pages, that I cannot avoid inserting them here.
   Conclusions of the General Board of Health relative  to  yel-
low fever.
   ''1.  That yellow fever  epidemics break  out  simultaneously
in  different and distant towns, and in different  and distant parts Conclusion*
of  the same town, often under circumstances in which commu- of General
nication with infected persons is impossible.                    Board of
   "2.  That yellow fever epidemics are usually preceded by   ea l  °
the occurrence of individual or sporadic cases of the disease,
                                                            yellow fever*
which sporadic  cases  are likewise common in seasons when no
epidemic prevails.
   " 3.  That yelloAv fever epidemics, though occasionally extend-
ing OATer large tracts of country, are more frequently limited as
to  the  space  over which they spread, often not involving the

  * Kindly sent me by a member of it—Mr. Chadwick—through our mjnieter in
London. Mr. Buchanan. 
160           Report of Dr.  Edward  II. Barton on  the

         whole of a town, and sometimes not even any considerable dis-
         trict of it.
            '' 4. That yellow  feArer epidemics do not spread from district
         to district by any rule of gradual progression, but often ravages
         certain localities, while they spare entirely, or visit ATery lightly,
         others  in the immediate neighborhood, with which the inhabi-
         tants are in constant inter-communication.
            " 5.  That yellow fever epidemics, Avhen they invade a district,
         do  not  spread from  the houses first infected to the next, and
         thence to the adjoining, and thus extend as from a centre ; but,
         on  the  contrary, are  often confined  to  particular houses in a
         street, to particular houses on one side of a street, to particular
         rooms in the same house, and often even to particular rooms in
         the same story.
           '' 6.  That in general, when yellow fever breaks out in a fami-
         ly, only one  or  two individuals are attacked;  commonly the
         attendants  on the sick escape ; and when several members of a
         family are successively attacked, or the attendants on  the sick
         suffer,  either the  epidemic was general in the locality, or the
         individuals  attacked had gone into an infected district.  -
           "7.  That when yellow fever  is prevalent in  a locality, the
         most rigid  seclusion  in  that locality affords no  protection  from
         the disease
           '' 8.  That on the other hand, so great is the success attending
         the removal from an infected locality, and  the dispersion of the
         sick in a healthy district, that by this measure alone the further
         progress of an epidemic is  often arrested at once.
           " 9.  That such dispersion of the  sick is followed by no trans-
         mission of thr* disease, not  even when the sick are placed in the
         wards of a  hospital  among patients laboring under other mala-
         dies.
           " 10. That no one of the  preceding facts can be reconciled
         with any other conclusion than that, whatever may be the  exci-
         ting cause of yellow fever, it is local and endemic in its origin;
         and the evidence of  this conclusion are therefore cumulative.
           " 11. That the conditions which  influence the localization of 
Sanitary  Condition of New  Orleans.             167
yellow fever are knoAvn—definite, and to a great extent, remov-
able ; and are substantially the same as the localising causes of
cholera, and of all other epidemic diseases.
   " 12. That, as in the case of all other epidemic diseases, in
proportion as these localising causes are removed or diminished,
yellow fever ceases  to appear, or recurs at  more distant inter-
vals, and in milder forms.
   "13. That consequently the means of protection from yellow
fever are not quarantine restrictions and sanitary  cordons,  but
sanitary works and  operations, having  for their object the
removal and prevention of the several localising conditions,  and
where such permanent works are impracticable, the temporary
removal, as far  as may be possible, of the  population from  the
infected localities."
   Now skepticism must yield up its doubts,  and even sophistry
can no longer contest the demonstrated truth.   A certain com-
bination of conditions, in certain localities  produce  in thousands
of instances, yellow fever.   There are rare exceptions to it,
these conditions are known—they are the same in all.  The
effect is the same, and the instances  are  innumerable—the
attestators are  intelligent and perfectly reliable.   There is no
assignable motive  why they should testify falsely, and it is
ail in accordance Avith the common sense and common expe-
rience of  mankind.   Can any thing, short of mathematical No room
demonstration, make it stronger ?  Could it properly be attri-skepticism.
buted to the sole agency of the above  means in  a single une-
quivocal instance, it would be no longer expedient to look to
contagion or importation for additional agency;  yet we have
unnumbered thousands  to  prove our position.   One  cause, d,,.™.,^
which is equal  to an effect, is always sufficient to account for tion,
it.  If another be associated with it, which neither increases
nor decreases the effect,  I do not know by  what  rule of logic
it  can be  supposed  to  be instrumental  in the production of
it.  All other views  are subsidiary to this,  the true practical^
                                "                          Its vaot prs
value;—for, if  the public  mind  is satisfied that the cause istivxUtlWt
known, the remedy is palpable enough.  It will be no  longer 
168          Report of Dr.  Edward II.  Barton on the
         a  question  of dollars and cents, it will no longer be a ques-
         tion of the inconvenience of a part  of the  citizens leaving
         the city for  a few months ; it is vastly more.   It is a question
         of life and death, between the  hecatomb  of victims offered
         up to  ignorance and neglect, and the  enjoyment of health
         and  the comforts of life at home.   It is between New Orleans
         as a mere factorage, for she is nothing more, with this con-
         stant liability, and  New Orleans in  the full exuberance of
         salubrity, unequaled  in  her climate, with fine promenades,
         public gardens and parks, with  railroads connecting her on
         one side  Avith the Atlantic cities and the old world, the cradle
         of the human race, the favored haunts of science and civili-
         zation ; on another with the granary of the world, and on the
         West, on the  sun sitting on the golden regions of  California.
         Her name will no longer be a theme for aversion and alarm;
         she will no  longer  be the " plague  city "—the " sepulchral
         city."  It will then be a pride and boast to  hail from  New
         Orleans.   Surely this is worth striving for, and Ave shall prove
         that all this is within our poAver, that it only  requires us to
         put our shoulders firmly to the wheel, and that you are bound
         by every principle to OAvn the impulse which duty prompts,
         and a sense of self-preservation and a just pride aids us in
         carrying out.   These,  then, are  the promised fruits of this
         commission, and should they be realized,  no  small honor in
         coming time,  will  redound to him who originated the plan,
         and the council which adopted and put it in execution.
            The practical importance of knowing the  cause  of a  dis-
         ease  consists  in  the means it directs us to use in the way
The impor-  faffa of prevention and treatment, and it is  for that reason that
tance  of  we j,ave  ^we]j g0 ]ong upon it.   It is thus also, in the forcible
  awmg  t ejangUage 0f jyjj. Chadwick, "getting at the  antecedents, and
caueeofadis-      .                                     . .
         mounting to the sources,  we reach too, the origin  of orphan-
         age  and widowhood, of intemperance,  and  above all, the
         fountain of the greatest mass of moral evils ; and it is here that
         our remedies become ultimately the most radical, effective and
         praiseworthy. 
Sanitary  Condition of New  Orleans.             169
   Prevention is better than cure.  It is infinitely less costly,
 and more easily accomplished.  Ten or twenty thousand dol-
 lars, judiciously disbursed, may prevent the occurrence of a
 fever, or an epidemic, that millions cannot cure or pay  for,
 in the loss of life, character, business,  &c.  For the sake ofPr;event,on
                i r>   .1            n n  ...      .            better than
 convenience, and tor the purpose of facilitating investigation,
 aiding the memory, and grouping those  diseases proceeding
 from congenerous causes, statists have  classed them into  cer-
 tain divisions, such  as have  been presented in  our record.*
 The class zymotic embraces those which, in the main, distin.
 guish one country from another in a sanitary point of view.
 such as epidemic, endemic, &c, (fevers, intestinal diseases, &c.)
 where this class is large, as it is in this city, being five times
 greater than it is in Northern  cities, the place is esteemed
 sickly, and when small, the reverse. This class is in a great
 measure under the influence of sanitary regulations, and called
 "preventable," because they can be prevented, and  the atten-
 tion paid to and the efforts, made in their prevention is also a
 test of high civilization, and the estimate that people entertain
 of the value of human health and life.   The mortality that is
 unpreventable is, in  most countries,  a constant  quantity.   In
 England  it is  estimated  at  betAveen  ten and eleven  per
 thousand of the Avhole mortality.
   The great value  of knowing the cause of disease (and the
 fatal consequences of a mistake) so far  as to be enabled to
 prevent them, is so forcibly set forth by that eminent man,
 John Hunter, (on the diseases of Jamaica,) that 1 quote them : Fatal col,8e"
 " In military physic, the great improvements to  be  made  are quence3 of  a
 not so much in the cure as in the prevention of diseases, which
 depends altogether on a knowledge of their cause.   If  dis-
 eases arise from the air, contaminated from the foul ground
 of a camp, or the  exhalations of a marsh, it can only be
avoided  by a change of situation, or by taking  care not  to
come within the sphere of activity  of such noxious causes.
Let it  be supposed for a moment that a mistake should be
 • Table F. 
170          Report of Dr. Edward H. Barton on the

         made, and that the camp or remittent fever be not considered
         as proceeding from their proper causes, but believed  to  de-
         pend upon contagion.  It is evident that complete destruction
         to all must be the consequence of such an error, and in med-
         ical history there is reason  to fear more examples than one of
         this might be produced ! "   How singularly, and how prophet-
         ically has this great man portrayed the condition of things in
         New  Orleans! and  hoAV  truly he says that  "destruction"
         must ensue from such an " error."  If  full faith is put in the
         " importation of the disease " as necessary for its prevalence,"
         and "contagion should mark its footsteps," our city would in-
         deed, be likened to our State  emblem  ! and like  the pelican
        foster in our bosom the poison that  is sucking our  vitals, then
         may Ave bid adieu to all sanitary measures, and to any hope of
         our amelioration and advancement!
           This entire subject is so  vast and so important; the mate-
         rials are so abundantly developed by the humane investigations
         of the English Government, and kindly distributed, and much
         of it is so applicable to our situation, notwithstanding the dif-
         ference of climate, that the temptation  to quote far exceeds
         the  limits allowable to this report.  In the  report " on the
         experience  in diseases, and comparative  rates of mortality,"
         by Mr. Lee, it is abundantly shoAvn by all that has been said
         of the destructive ravages of fever in small towns, and  even
 isease no  ^n vmageSf jn various parts  of  the  country, " that diseases of
         the class termed preventable, are not inherent in, essential or
dense popu-
         peculiar to places of  dense population."  That the remedy is,
         that " the air is to be purified by immediate removal before de-
         composition, of all organic matter, and  other refuse capable
         of producing malaria, and town visitation will be as little  re-
         quired, irrespective of forms of streets, courts, Sec, and the
         density of buildings," and his deductions are that he can find
         no valid reason why towns should be more unhealthy than the
         most salubrious spot in the country ! "   That  " one-half  of all
         the existing disease and mortality  is in  excess, and prevent-
         able !"  That "excessive mortality ought to be prevented by 
Sanitary Condition of New  Orleans.             T71
means compulsory on all parties, without exception.   And he
comes to the  conclusion that all the causes point to localised Locaiisedfiith
filth, accompanied with moisture, as the great cause of disease the cause of
and death" in that latitude.  Had  those conditions existed aUdiseMe-
here, with our high temperature,yellow fever would have been
the certain result.  He goes on farthe*1 to state, as a convic-
tion from his  inquiries, that the great mass of the people lose
nearly half the natural period of theirl>ves by such exposures;
and he came  to the conclusion, after examining a large num-
ber of towns, that "the inecitable mortality of the kingdom
is not greater than ten to one thousand}per annum, while in
some it rises  as high as sixty-nine or  m46ce.  And the remark-
able fact was elicited from the inquiry, that let the district be
ever so unhealthy, or  ever so salubrious,  the  inevitable mor-
tality is nearly a constant quantity.  He goes on farther to say
                                                            Typhus inde-
that typhus, the great preeminent  scourge of the country, is
essentially independent of, and unconnected with geopraphical cUmate
position,  climate, physical contour, geological strata, or other
uncontrolable circumstances.   That there is no intrinsic con-
nection between density of population and a high rate of mor-
tality, and the avocations of the people:  that where neither
                          /•i             -iii-            -^-" depend!
surplus water nor organic filth is removed by drainage, there
   1                                       "                 upon reinov-
the greatest destruction takes place, without reference to any in  filth and
other consideration, and that the ratio of mortality is directly moisture.
proportional to the badness of the drainage."
   He farther states, in his  conclusions,  that, " although the
                                     ,     f,     .            The rich suffer
poor are  the chief sufferers, yet no class of society escapes
r                          J                     J     r   as well as th«
the pecuniary consequences of preventable disease—that the poor>
use of narcotics and habits of drunkenness, are, in numerous
instances, developed and  increased  by  defective  sanitary
arrangements, and  that, in twenty-nine places visited, the
pecuniary loss on one years' excessive sickness, funerals,  and  he cost of
lost labor, is  about equal to  the first cost of complete works Hot
                                                            diseases equal
water supply  and drainage in  the  same  places.    And  that
        ' ir  J            o                J.                   to the whole
THE  MOST PERFECT  SANITARY  ARRANGEMENTS  ARE THE pnWic incom-
largest pecuniary economy, and the cost of preventable dis- 
IT2          Report of Dr.  Edward H. Barton on  the
         eases is equal to the whole public revenue of the country !  He
         concludes his most valuable paper with a number of sugges-
         tions, from  which the following will fulfill our present pur-
         pose, viz : "that a penalty should be exacted on all places Avhere
         —upon an average of seven years—
           1st. The mortality..ha? been greater than 20 to a 1000 of
         the inhabitants ; or
           3d. Where the p.roporftous  of  deaths  from  epidemic,
When penalty                   ,  "•    »       ,    ,          1  .   .  •
         endemic,  or contagious diseases has  been  equal  to  l  in
on the public                  °
authorities to400; °r
beexacted.    4th. Where the average  of all  who  have died has not
         exceeded thirty-five yfi^rs."  How eminently applicable these
         remarks are to us !
           The  amount  of " preventable mortality" is  more  than
         half of the whole mortality.   Last year it was more than
Proportion of           ,            ,       T           ...        ...
         five times that amount  here.   In every  epidemic year it is
         largely increased, of  course, and this has been shown to be
         pari passu with the increase of the  causes assigned—that is,
         with the preventable  causes.
            Poverty, filth, intemperance, wretchedness and crime have
         a  similar  paternity.   Disease  originates  from  them, and,
         taking the winds of the morning, it  spreads itself to the utter-
         most parts of the earth.   Wherever it finds food it localises
         itself and becomes developed,  and hence, under a certain con-
         centration, the inhabitants of the  palace, as of the  hovel,
         become its  victims.   Hence, all the world  is interested in
         sanitary measures—in eradicating the seeds  of disease,  and
         thus make a brotherhood of all mankind.  Had not a concen-
         trated malignancy, from filth and bad habits, in  a congenial
         atmosphere, on the banks of the Hoagley, have  given a rise
         to  epidemic cholera, the human race might have been saved
         that afflictive scourge.  But  why  limit  it to cholera 1   The
         same principle may be applied, with equal justice, to yellow
         fever, plague, leprosy,  the venerial  disease—nay, is there one
         disease to which  man is subject, that is not the result of the
preventable
mortality.
Origin of dis
ease.
Of cholera^ 
Sanitary Condition of New Orleans.             173
 rupture of some one or  more  of those great hygienic laws
 which the Almighty has laid down for our guidance ?
   A  civilized, refined  and  humane government  is  known
 from the care  bestowed  on  the health, and  the value set  on Evidence of
 the  lives of its  citizens.  In a  Republican government it civilization.
 should  be considered  a joint-stock  concern, and  we should
 put in practical action the first law  of our being—self-pre-
 servation.  Carelessness in such governments—a neglect of
 this,  its most important concern, is as  unexpected  a priori
 (as they are all joint sovereigns,  and  unfortunately depend nsmatoreo
 .       7      .  __ .          ,          ,               x    sanitary laws.
 too much on Avhat is ignorantly supposed  an individual con-
 cern,) as that those who live  by the sickness of others, should
 be almost the only  originators of laws and means to prevent
 sickness !  Yet such is the fact.  The profession of medicine
 is the true philanthropism.
   In a society of laws and a Representative Government, where
 the governed give up a  part of their rights and  property, Legaiciaimof
 too, for the proper preservation of the  remainder,  it is clear the civil Pow-
 that there is no more sacred deposit in  the hands of the rep-er to protect
 resentatives of these rights  than that  of our health.  My health.
 neighbor may commit such  a nuisance as may destroy the
 health or comfort of my family.   The  law takes aAvay from
 me the right to interfere.   The  power  is  with  the  body
 politic, who represents and with whom is deposited my rights,
 and as rights and duty are correlative, it becomes the duty of
 society  to interfere  and abate it.   A flagrant case is put  to
 show how clear the principle is.   The body politic is bound
 to abate nuisances,  however  small, or is responsible for the
 consequences !   If a bridge across a street or highway is de-
 fective and a citizen becomes injured  in consequence, the
 corporate body is amenable.
   By the constitution  of our country,  no  one is allowed
 to injure  or take away  the  life of another, without being originaiopin-
 compelled to repair the one through his property and means, i0n of Do.
 and suffer for the other the felon's penalty.  It has been de- Rush.
 monstrated, that the great mass of the mortality of this city
has arisen from preventable  causes; on whom, then,  should
fall the  merited penalty of  this neglect ?  Our  late  distin-
 guished countryman, Dr. Rush, with a prescience which often
           x 
174          Report of Dr. Edward II. Barton on the
          accompanies true  genius, said:  " To all  natural  evils, the
          author of nature has kindly  prepared an antidote.  Pestilen-
          tial fevers furnish no exception to this remark.   The  means
          of preventing them, are as much under the power of human
          reason and industry, as the  means of preventing the evils of
          lightning and common fire.   I am so satisfied of the truth of
          this opinion, that I  look forward to the time when our  courts
          of law shall  punish cities aud villages, for permitting any of
          the sources of malignant fevers to exist Avithin their jurisdic-
          tion."  The General Board of Health of England, with the
          Earl of  Carlisle  (better knoAvn in this  country as Lord
          Morpeth,) at its  head, says: "The British  Parliment  has
 Fim Legisia- legislated on the conclusions submitted, with an accumula-
 tive action up- x^on OI" demonstrable evidence, that  the causes of epidemic,
 on it.       endemic, and contagious  diseases, are removable ; and that
          the neglect, on the part of the constituted  authorities, to re-
          move such  causes, as far as they are obviously within their
          control, is a punishable offence !   The foundation which  the
          legislature has thus laid  for the  physical,  and consequently
          for the moral, improvement of the people,  is  recognized.
          Half a century ago, it Avas  said by a  great  physician and
          philanthropist, that the time  would come, when the legislature
          would punish communities for neglecting the known means
          of  preserving  the  public health, and  that prediction  the
          British  Parliment has been the first to realize."   That "phi-
          lanthropist"  Avas our own great countryman,  Dr. Benjamin
          Rush, of Philadelphia.
           If, then, we have arrived  at this  important fact, to what
          cause yellow fever is to  be  ascribed, if we can no longer
 As much the ,   . .                       ....       7       •  ,
          plead ignorance, as  an excuse tor inaction, we nave no further
duty of city  r     *  .       .                       ',     •   ,   , .  ,
          excuse for its continuance among us, and 1 do seriously think,
authorities to     . */.                     °       .              J
          that it is  as much the  duty  of the civil  authorities, to keep
keep off  yei-  .                       J                   .
        .  this city free from yellow fever, as it is to keep it exempt from
       te t any °^ier  controlable calamity !   This is bold  ground,  and I
life in anymteil<^ *' to De 6Ucn'  I have not come to it hastily; but that
otherway.   xS not *ne question ;  is it the true ground ?   Have the reasons
          I have adduced, from the investigation the subject has under-
          gone in the preceding pages, been sufficient to convince our
          people that we have been  suffering under  c^ntrotable evils ? 
Sanitary  Condi,tion of iVew  0ileum.            1?5
That is to be the true ground before the people now.  If I am
not greatly  deceived then,  in  this  much cherished idea,
reform is the great watchword applicable to our situation, Reform Ae
and no stone should be left unturned to remedy the evils 0fgreatquestlon
the past,  and arrest the doAvnward march of everything.—
Leaving, then, the great principles of philanthropy, of benevo-
lence, of intelligence, nay, even of self-preservation, out of the
question,—those  which usually move great communities to
action,—let   us  appeal to the  mere  pecuniary  interests 0fItssacredne**
the public.  That alone,  is motive sufficient to move most
bodies, as low and sordid as it is.   With no position  on  this
continent, if on the globe, equal to it as a mart of commerce;
where  nature, for  that purpose, has done everything,  and
man nothing, (for health exclusively,)  we  are permitting
every village of yesterday to  outstrip us in the race of popu-
lation, of wealth, of public monuments, of social improvement,
and intellectual enjoyment; and  last,  but what is first in  im-
portance, health, Ave stand  positively  lowest in  the scale.
Every  little village, whereA'er situated,  enjoys  a  salubrity   s,ame"
 ,   .       t     m- .  .      • c 1    -i •     ■  •        i     an(* disgrace-
that is our due.   Ihis  is a painful  subiect; it is one that is
                           1             .                 ful neglect;
humiliating, nor would I have referred to it so often,  were it  _,
          °                                                yet may prove
deemed irremediable. It is not so.  If once, when our popu- a great bleM_
lation Avas forty-three thousand and  thirty-one,  (in  1827,) i„e.
our mortality did not exceed 2.22  per  cent.!  and in many
parts of the country it does not exceed half this now !   If, in
former times, this country enjoyed a salubrity almost prim-
eval, has the soil so changed,  the climate become so  delete-
rious; has additional population  evolved such a poison, or
have we  become  so deteriorated  by the golden  dreams that;
most persons entertain  on first visiting this country, that no
efforts were necessary to acquire it, that it only required to
stretch out the hand and gather,  and that the primal injunc-
tion, " by the sweat of your brow shall you earn your bread,"
is no longer applicable ?  If such has heretofore been  the
prevalent opinion, as it should seem it has, the sad events of
1853 are sufficient to disabuse it.  That calamitous visitation 
176
Report of Dr. Edward H.  Barton on  the
          may yet prove a great blessing to the country, if it shall have
Certain result brought; home to our people the sanitary and salutary lesson,
if sanitary t^at ^ t^e fAcl% wg ^ave garnered, the principles we have
          evolved, and all the hygienic laws and practical  n suits Avhich
lished.                         JB              l
          can be so obviously deduced from  them,  Avhen once fully
          adapted and rigidly enforced, will insuie to New Orleans an
          exuberance  of health, it  has never  yet attained, and causa
          her to rival, in salubrity, the healthiest large  cities on the
          globe!
                               SECTION  IX.
            recapitulation of causes and results.
         Meteorological causes—Special terrene causes—Greater care re-
            quired  in fast growing  cities—Can't acclimate to filth—
            Tracing the progress of the disease by digging—Filth, inun-
            dations of  the  coast and throughout the  State.  Sanitary
            Map of the city—Application of principles—Location of filth
            and disease, the same, the one resulting from the other, in each
            ward,  with the ratios to population—"fever nests" "and
           plague spots,"—the mode of spread of the fever.
            Before  proceeding  to the  application of our remedies, it may
         be  best, in order to be thoroughly understood, to make a reca-
         pitulation of our positions.
            The duty of tracing  the outbreak of this fever—its origin
         and transmissibility has, in  the division of duties,  devolved upon
NotofforeigmEiy colleague  Dr. Axson, and most ably and graphically has he
importation, performed the task ; clearly demonstrating, that it was not from
         foreign importation that it was derived, but, although connect-
         ed  with  foul  ships from European ports,  that  it was  due to
         domestic birth and growth, whether at the Levee  or elsewhere,
         and that  at its  divers origins, there was no necessary connec-
         tion the one with another.   Now it becomes my duty, undjr  the
         resolution in  exposing  the  sanitary condition cf the city.'f to
         show what and where those  causes were.   They have  before
         been  referred to in general, wherever it has been attempted to 
                Sanitary  Condition of New  Orleans.             177

demonstrate their applicability—the influence of such causes in
similar aud in different climates, their direct bearing upon  for-
mer epidemics, and on their influence in the rural districts, and
I now proceed to show their special influence in the production
of the late epidemic.
   The causes assigned were two-fold, and these formed the con-
stituents of the  epidemic—1st,  meteorological, and 2d.  ter-
rene.
   To the 1 st. belonged A—a long continued range of tropical
temperature preceding the  outbreak—the average  at midday,
of the  two preceding  months  of May  and June  (instead of
being a month later)  being nearly 83°, and which continued Meteorolo ;_
throughout the epidemic.  B.—An unusually high hygrometer, cal or ciimatio
which continued and increased,  exhibiting an almost  saturated causes
atmosphere.  C.—Heavy rains.  D.—unusually high and dis-
tressing radiation.   And E.—An unprecedented  intensity  and
continuance of  stagnant air.   The  unusually  early  establish-
ment of this tropicoid condition, in the elevation of winter tem-
perature, to that of spring,  and of spring to that of summer,
thus anticipating by more than a month, the usual evils of au-
tumn, with an aggravation  of the burthens ordinarily incident
to it, with the extraordinary combination of those which pre-
ceded them, were  the main atmospherical elements which
composed it.  These are stated in  detail in the tables and for
the three epidemic months—four or five times daily.
   2d. The terrene condition was composed—A.—of the up-
turning and exposure  of the original soil, in the cleaning out Special ter-
the canals Claiborne, Carondelet, Marigney, &c.   The immenserene causes'
exposure in making a new basin on Bayou St. John; digging on
St. Paul street to Bayou St.  John ; digging ditches and clearing Earth expo-
between Conti and Common streets,  making a new levee  and sure.
ditch  on  Lake  Pontchartrain,  the digging  and embankments
on the Northern, and  Jackson street  railroads, and extending
up within half a mile  of Carrollton—approaching the river and
extending near twenty miles in the rear of the  plantations—in
the centre of the  city, the exposure of the subsoil for tvater 
178           Report  of Dr. Edward If. Burton  on the

         pipes in Bourbon street, near the Water Works (where some of
         the first cases occurred)  New LeAree  and Post 84,  and other
         parts, to the  extent of about a  mile,  and for gas probably as
         much, and principally in Apollo and to Nayades and Dryades, in
         Galvez and Perdido streets, and* repaving Annunciation, Royal
         and Chartres streets.
            B.—Extensive digging and embankments of earth at Algiers,
         opposite the city—being almost  eighteen inches high, and eigh-
         teen feet wide, ascending the coast for about twenty miles, run-
         ning from  half mile to  a  mile from the  river, in the immediate
         rear of the plantations.
            C.—The  exposure of the naked bank of the river for about
         six miles, many parts of  it made a common receptacle of, and
         reeking with garbage and filth of all kinds, exposed to the sun
         and rain, without  a single police officer, to prevent its being
         made a common deposit for these  nuisances, or covering or throw-
         ing  them  into the river, besides the  fermenting drainage  of
         sugar and molasses hogsheads on the  Levee.
            D.—The  filthiness of the streets, privies and  back yards, a
street*.    matter of  common observation by the public, and complaint  in
         the  newspapers, the gutters often twelve hours after a rain,
         which had washed  them clear, bubbling up with a gas through
         dirty water.
            E.—The large number of unfilled  empty lots and unpaved
         streets, in various  parts of the  city,   and  particularly in  the
Unfilled lot-. Fourth District, which  was much the most severely scourged
         with the fever in proportion to  its population—these low lots
         being  a receptacle for, and exposing filth of all kinds and stag-
         nant putrid water.
            F.—The large open drains in and near the city, including the
    , .   large ones in rear of the  First and Second Districts, and Gorm-
Open drains.   °
         ley's Basin half filled with the refuse of its district.
            G-.—The nuisances of soap and tallow chandleries  and the

           * The extent of the excavations for these purposes in successive years, I have in
         vain  sought for.  In 1837, I have been informed the yellow lever was very fatal to
         those employed. 
Sanitary  Condition  of New Orleans.            179
large  collection  of manure near  the  vacheries of the Fourth Mannfact0_
District.
                                                           nes.
  H.—The interments within the city of six cemeteries,  the
receptacle of 7,063 bodies during last year, to lend their impor-
tant aid in corrupting the air.
  L.—The numerous slaughter-houses in the Fourth District, siaughter-
and the many large vacheries and livery stables, with their offen- houses, &c.
sive and polluting exhalations
  K.—The  crowded, filthy  and unventilated dwellings, in
low, damp situations, many in half-drained and unpaved lots crowded and
and courts, with filthy, stagnant water under the floors.     filthy houses.
  L.—And about sixty thousand of unacclimated  population
which has  been  added to the  city since  the last severe
epidemic of 1847, and we have aggregated together materials
to produce an epidemic, and the food to support it unprece-
dented in this country.
  No man who is acquainted with these circumstances should
be at  all surprised at the disastrous results which  folloAved;
there  was no difficulty in predicting it a priori ; but our great PubIic k  jn
misfortune here  is that the people are ignorant and keptigno- ignmancei
rant of the  condition of things.  Delusive assurances  are
constantly dinned into our ears of the " cleanliness and salu-
brity of the city," which after a while, deceives even the more
intelligent, and produces carelessness and quietude of the public
mind, when the  most ceaseless vigilance  is  urgently called
for, from our position, and no official Board  lias existed  for
years, whose special business it should have been to attend to  this
important concern !  The large addition to our population is
not properly estimated, nor its results, and some explanation
is necessary.  A  population of exotics,  unacquainted with
the requirements of hot climates, huddled together, in close,
damp, unventilated apartments, Avith filth, poverty and intern-In fast grow-
perance, furnish materials  in every climate for epidemics.  In,ng c,ties a
more  rigorous regions, of typhus;  in the hotter climates of
every class of fevers, from the mildest to the most malignant. ^^
In cities of rapid  groAVth, there is always  a tendency  to an 
 1 tip          Report of Dr. Edward II.  Barton on, the

         excess of this kind of population, Avhere the people increase
         faster than the city itself, buildings of an appropriate kind
         are not found; hence the diligence and the surveillance that
         is required on the part of the civil authorities to extend that
         species  of guardianship  over these materials of its labor as
         well as  of its wealth, and future growth and prosperity, which
         they are usually ignorant of.  The more dense the population,
         that is, the nearer men and habitations approach each other,
         the more curtailed the term  of life, especially, in a hot cli-
         mate.   Filth accumulates where there are no pavements, as in
         many parts of our city,  where was the greatest mortality last
G  test mor- season-   The poisonous matter sinks into the soil, a danger-
taiity where ous compost is formed, which, from the closeness of the habita-
no pave- tions, ventilation  does not and cannot remove.   During rainy
ments.     seasons, (the season  of  heat and fever,) its tendency is to
         spread,  and when the temperature becomes favorable by ele-
         vation, disease results.   That this is not always the case when
         they are apparently favorable to  its production, only  shows
         that these require time for their peculiar  combination and
         physiological  susceptibility to develop it although sickness of
Mortality not some  kind or other is always  present.  The  constitution is
from want of slowly undermined, and  the duration of life materially cur-
acciimation. tailed.  It is  then, erroneous to suppose that these rookeries
         are not injurious to health, because they do not always produce
         fever and yellow fever.  There is neither necessity nor proprie-
         ty in denominating this " want of acclimation" The accusation
         is no less a slander upon the climate than it is upon decency.
         Filth is  offensive to the mass of mankind, instinctively—as in-
         jurious to his health and  well being.   It would be much more
         so, were it  not associated with  habits and exposures that tend
         to harden and invigorate, and thus render the system  able to
         bear what to another, totally unused to it, and more delicate-
         ly raised, would be early fatal.  Man cannot become so accli-
         mated, (or so habituated to it) that it will not affect him; with
No acclima-
    „,   climatic conditions he can, because God made one, and man
aon to filth.                                                   '
         the other;  it is at war with the elements of his being, it dilapi- 
                 Sanitary  Condition of New  Orleans.             181

 dates the very foundation of life.  In another page it has been
 shown that more than sixty per cent, of the natives of Egypt
 at times fall victims to their endemic fever, the plague,bom and
 brought  up in the midst of it, and in at least two parts of our
 country, Petersburg and Bristol, no native reached the years
 of maturity until certain physical conditions, on which they de-
 pended, were altered ; and the miserable, squalid and unhealthy
 condition of the crowded  and cellar population of all cities,
 is ample proof of the fact.  That man  may become accli-
     j  .   .                                               tent aeclima*
 mated, that is, accustomed to certain   atmospheric elements, uble
 such is the elastic poAver of his constitution, is admitted  as a
 fact of universal experience, and is explicable under physio-
 logical laws, but to attribute the mortality that  has occurred
 here to his wanting this  attribute, arising  from  these  condi-
 tions, leaving other things entirely out  of the  question, is a
poor and baseless excuse for indolence and carelessness, and a
 reflection upon the habits of  our people—a stain upon the
 public authorities, and exhibits an  ignorance of the climate
 and of its influence on man.
   The test of the salubrity of a city or country is hardly  to
 be estimated by its influence on the native population; if so,
 what is esteemed the most healthy region would be  misnamed,
 for there are but feAV countries that are not favorable to those
 born there.  Hence it is that  we denominate  the coast  of
 Africa, Batavia, Calcutta, &c, the most fatal to human health
 and life, (in Rio, New Orleans is classed among them !) yet, the ti* true test
natives of these countries respectively,  do not so denominate ofthesaInbri"
them, and in  fact, we know that they enjoy great physicalty of a eoun~
health and vigor. But who ever esteemed a place sickly where
he lived!  it is one of those pardonable weaknesses we can as
easily forgive, as account for.   Hence then, the true test of
the salubrious condition of a country must be  in its friendliness
to the stranger—the facility of its being reconciled  to the re-
quirements of his constitution, and not merely to the native—
the acclimated—the habituated to  all its  otherwise noxious
impressions, and such is the resiliency of man's constitution, 
182          Report  of Dr. Edward H.  Barton on  the
          that he can almost become reconciled to anything—exceptfilth!
          —Let me be understood: acclimation  literally means, that the
          constitution  can become reconciled to that Avhich  forms  the
          climate of a place—that is, its atmospheric conditions of heat,
          moisture, &c.  This has nothing  to do with  what I have else-
of acolima-                                       ,
          where denominated the  " terrene " conditions.  Habituation to
tion.
          the  things around us is often called  "acclimation," and  can
          often  be procured by  a few  months' residence, but it is  not
          acclimation, it is only a fixation of habits and a reconcilation to
          the things about us, the rupture  of which is the cause of so
          much  diversified sickness to travelers of all kinds, new soldiers,
          &c.—in fact, to all who break  the habitual course of ordinary
          life, that regular  routine which is so conducive to  lengthened
          existence, and which the system has become so reconciled to as
          to adopt it as one of the laws of its being.
            The difficulty here, then, is not  that of  acclimation properly
          considered, for  this  can  be easily acquired,  but it  is to those
TbereaIneed>noxious causes (filth <fec.,) that are injurious every where (and
          to which there  can be no acclimation), the more so, where heat
          and  moisture are superadded  to  them.   The  climate of this
          place,  then, is not lethal per se, but by those factitious conditions
          imposed upon it, which we have the power, and it is  our sacred
          duty, to remove.   Hence then, aAvay with the  nonsense about
          the difficulty of acclimation, which only tends to blind the igno-
          rant ; if we are to have a healthy city, we must have a really clean
          one.   It is the first; it is the second ;  it is—in the paraphrase
          of Demosthenes—the last essential requirement.  However it
          may be, it formed an aggregation  of materials, with the meteor-
          ological adjuvants, sufficient to produce  yellow fever, in  any
          part of the present and former yellow fever regions, if in the
          East, a plague ; it far exceeds the prescription to produce yellow
          fever, mentioned in a note at page  371, which in the opinion  and
          experience  of eminent men accustomed  to investigate yellow
          fever  for a long series  of  years,  was amply sufficient for its
          origination.
            The compound  origin, then, is a clear and  unequivocal one, 
                Samtary Condition of New Orleans.             188

and rests on contingencies, which after a most thorough exam
ination, I am fully convinced, the ability, the science and inge-AU wme,iia"
nuity of man  can counteract.  The task, too, is  not such able*
gigantic one.   It  can be  accomplished without difficulty, by
public wealth (not much), by public spirit, of which we have
plenty for purposes not half so valuable, and more by public
determination.  A hundred-fold  more of each has been wasted
upon objects, not a thousandth part of the worth of this—nay,
whose value sinks into insignificance in comparison.   Can any
thing be too expensive?  Can any object be nobler?   Can any
earthly blessing compare  in magnitude, to restoring salubrity
to a wealthy and populous city, and thus putting her in a condi-
tion to fulfil her great destiny, if it succeeds!  But, in order to
succeed, it has to be done completely—no half-way measures, no
temporary expedients; they are failures to the great public now,
will again fill this city Avith mourning, and are disgraceful to the
intelligence, and a stain upon the philanthropy of the South.
   Before proceeding to the remedies for the disastrous condition
we have taken so much trouble to point out in detail, the result
of which  it was  so  easy  to predict before hand, let  us dwell
for a moment, on the immediate and  direct effect  of  these
agencies, which have to light us through  the investigations of
the Commission, to show how demonstrably applicable our po-
sitions are.
   The statement  of the amount of  disturbances of the original
soil, shows that this  as much  exceeds that of former  years, as
    '                                      J J        z    )   Tracing the
the mortality exceeded that of any other, except from  the com-  ro ^^£
bined effect of cholera and yellow fever, in 1832!  That  atfeveirfromth9
Algiers it commenced with it, most obviously aggravating, if it city, into the
did not originate the  fever there, (as it did in the city  in 1797) country.
causing a large mortality—300 out of 350 hands employed
on the railroad, dying of  it; that this disturbance  extended up
the coast, being at a distance from  the  river from one to one
and a half miles;  that following up the line of the road,  the
villages of McDonogh  and Gretna successively bore the brunt
of it* influence; that the  unprecedented amount of fevers on 
184           IdjHtrt of Dr. Edward II.  Barton  on the.
         plantations, near aud in the rear of which  these  embankments
         were made, of  Mrs. Waggaman's Avhere the sickness avus great
         and  the mortality large, of Mr. H. R. AV. Hill, Avhere the sick-
         ness was unprecedented—nearly every one suffering from it—Mr.
         Hill himself and another gentleman falling victims to it; that on
         the Jackson Street Railroad, from the heart of the  Fourth Dis-
         trict, the mortality Avas fifty out of the eighty  Avorkmen em-
         ployed, and  from  the Avhole of that district probably  much
         greater than from any part of the city ; that this effect Avas added
         to on the Great Northern Railroad, nearly 50 per cent, of the force
         employed, having died of it.*  That this road extended within
         half a mile of Carrollton, Avhere the mortality avms very great, of
         this disease, (and I believe, for the first time,) thence some ten or
         fifteen miles in the rear of the plantations of the Messrs. Kenner
         and others, where sickness and mortality marked  in its track the
         devastation of this fever ; probably the first  time the yellow fever
         was in  any of these  rural districts on either  side of the river.
         That the probable reason why it was not so destructive in the
         rear of the Second District of this city in  the more immediate
         neighborhood  of the  exposure  from  digging the Carondelet
         Basin, was that it consisted (Avith rare exceptions) of an accli-
         mated population, who almost alone were exposed to it, although
         the sickness with them Avas very great.
Effect of in-   That the tracing this  fever throughout the  Southwest, (so
undations.  far as we have been able to extend our  investigations,) there
         have been similar disturbances  of  the  soil, or  other adequate
Why rural causes of  localization ; that the extensive inundations, to Avhich
district^in various parts of the State has been subject for divers years back,
other states ^ag ]ieen one 0f ^he principal causes of greater infliction on and
        er near our great streams, than  in States not  thus subject, and con-
         sequently, this is the cause why they have  not thus  suffered in
         their rural districts ; that these devastations did  not  occur at
Why  fever
late in some once> Du* jus^ xlx proportion,  (as seen by the Report  from Prof.
places.     Blodgett) and as soon as the other  condition (the other "blade

           * The actual mortality here could not be procured—the sick were usually sent to
         the city, when taken. 
                 Sanitary  Condition of New Orleans.              185

of the shears"—always essential) Avas present or matured, viz :
the occurrence of a sufficient amount of moisture.
  In the resume"  of our facts, principles and deductions, for the
purpose of making the subject more clear,  satisfactory and  con-
clusive, I present the—
                SANITARY MAP OF THE  CITV.
  Let us illustrate our principles still more closely, and apply
them to the actual condition or our city during the last year, by
inviting an examination of  the Sanitary Map  we have prepared
after so much labor*, presenting the localization of all the cases
of yellow fever of the  year, in the separate  Wards, together
with the main causes which produced  them, delineated on the
Map, thus furnishing the argumentum ad hominem, or practical
test of the truth  of our principles.
  We sat out with certain  propositions in  relation to the cause
of our epidemic and endemic  yellow fevers, and gave the facts
and reasonings thereon.  We have given the record of the ex-
perience of other cities and countries, in strict corroboration of
our views.  From reasoning & posteriori, we have stated in ad-
vance, by an  a priori application, that an epidemic disease 0fApplicatio*
the worst form, must occur as  a  result of  existant conditions. fofreasonmB"
Ttiat prediction was most fully verified.   I now proceed  to  a
still more practical application, by exhibiting the Map, having
marked on it the locations  of the  various  nuisances, to which,
theoretically and practically, we refer as the  main cause of the
epidemic, (and I use the  term in an extensive sense, embracing
the principal causes offensive to  health,) together  with the
localization of near  23,000 cases of yellow fever, which I have
collected from private and  public sources,  and the presumptive
locations of the balance (about 6,000), making in all a total of
29,120  cases.
  I desired  to construct a  Map  exhibiting  sanitary districts,
formed  solely of portions of the city having contiguous similar

  * In the construction of this Map, I have received most invaluable aid from Major
S. G. Blanchard, of this city.  Mr. D'Hemecourt, the Surveyor, and the able Street
Commissioner, have also lent me their kind assistance.
  t Published Report of the Academy of Sciences, of this city, for the year 1853, 
186
Report of Dr.  Edward  H.  Barton  on the
          sanitary liabilities.   That Avould have been rather more exact,
          provided I could have obtained  the amount of population in
          each, so as to show the comparative  influence.   That I found,
          after full trial, impossible.   I then  determined  to adopt  the
 Difficulties in  ...        '                                     .
          division by Wards, such  as they were Avhen the United States
 computing                               J
 the popuia- Census was taken, in 1850, as I Avould then have a standard for
 t^n      ratios—presuming that to furnish the necessary data, and from
          which I could compute the increase  of population, in the three
          years  that had  elapsed  since  1850.  Accordingly, that was
          adopted as the only  possible plan.   After completing the col-
          lection of the localizations, as far as it was possible, I then pro-
          ceeded to apply them.  Upon scrutinizing the only returns sent
          here from  Washington, in which  there  Avas any division by
          Wards, I found the population of three Wards in the First Dis-
          trict enumerated in one aggregate, and the slave population left
          out altogether ; and as a most remarkable and unusual number
          of cases of yellow fever had occurred with that portion of the
          population (and it is believed) for the first time, and were inclu-
 city returns ded in my  localizations, it Avas absolutely necessary to embrace
 cot reliable  them.   To surmount these difficulties,  I had to consult all the
          census  returns of the city and  State for the last seven years.
          These I found so  utterly discrepant that I had  to calculate at
          last upon a comparison of each, and  various probabilities, and
          make the best approximate estimate of the total population of
          each Ward the subject was susceptible of, and accordingly pre-
          sent  table  R, not as the exact population, but  believed to be
          as near it as it was possible to get.
            Again: in  order to avoid making the Map too  large, or on so
          small a scale as to be indistinct, it Avas necessary to exclude the
          exhibition of  some important agencies, to  which great efficiency
          has been ascribed in the production of the fever, viz: basins and
          canals that have had their filty detritus exposed  to the atmos-
          phere, levee dug and embanked, and the Ioav sAvamps and open
          drains of the entire neighborhood.
Total cases of  -p^e  number  of cases of yellow fever occurring in the city
y«iu>w  fever, during ^g vear are estimated to have amounted to 29,120 
Sanitary Condition of New Orleans.
187
  At an early period the Sanitary Commission issued a
circular, requesting professional  gentlemen, and  others,        Cases  from
to transmit to it  a statement of the  localities of their
yellow fever cases, and all other cases  of the zymotic
class.  A few responded at an early day,  in full; most
of the others were personally solicited by me.  The gen-
tlemen whose names* are mentioned in a note, below,
kindly  furnished data, which, with  those  before men-
tioned,  amount to..............................  7,624
  The   Howard  Association promptly furnished  its
records, and from it, and several of the members, who
                                   ...     .               sources.
attended cases not recorded on their books—what was
called "outside  cases"—and from the various  public
institutions,  mentioned in another  page, Avas  procured
the  localization  of..............................14,680
   To these is to be added those of  the Charity Hospital
and some other  institutions, which  do not record Avhat        From charity
part of the city the cases come from that they receive,
were equally distributed in the different Wards,  in the
proportion  these Wards had  already furnished  the
known cases—these amount to....................  3,872
   The Sanitary Commission, after a full examination of
the  list  and the localization of the distribution,  and  of        Balance how
those who had furnished them, that from  some portions
of the city few physicians had complied with our appli-
cations, were of opinion  that  2,994, distributed  among
the  four districts, according to these apparent deficien-
cies, would be  a fair equalization.  They were  accord-
  *The following professional gentlemen have kindly responded to my application
for Ae locaSK their yelfow fever cases and are> entirted to^the thanks of the
Sanitary Commission therefor, viz:  Drs. Benedict, Copes Henderson Wood, reel
«T Knv»li«H  Axson Dalton. Rhodes, Davezac, Cantrelle, Seguin, Lemomer,




Hons and deductions connected with the Senitary Mop 
188           Report of Dr. Edward II. Barton on the
          ingly divided among the several Wards of each District,
          upon the principles just  laid  doAvn................  2,994
                                                               29,120
            Accordingly, I present table R, which  presents in its  first
          column the Districts and  Wards, separately;  the second  col-
          umn furnishes  the estimated population;  the  third, the cases
          occurring in private  practice, as reported to me,  and in such
Explanation  Pu°lic institutions, in which the localities were noted, amount-
of Table R.   ing to 22,304.    These, as being  more definite, are calculated
          separately, and their  ratios placed in the fourth column.   The
          fifth contains the estimated unreported, and upon the principle
          stated above; the sixth furnishes  the  aggregate of the whole,
          and the seventh, the ratios these bear  to  the population in  the
          second.  The last column  furnishes  the  estimated proportion,
          in population only, the colored bear to the whites in each Dis-
          trict, as they are less susceptible of yellow fever than the latter.
          I wish I could add the proportions of the already acclimated, in
          each, also, but that was impossible.
            It is to be deeply regretted  that  it is found  necessary to
          form  estimates,  instead   of  calculations from precise data.
          As the subject Avas one of  vast importance  to the community,
          extraordinary pains  and  labor were  expended  to  make  the
          results approximate to truth as  near as possible.   It is believed
          to do so, and will be obviously useful for most practical pur-
          poses.
            In presenting these important details, in procuring the local-
          izations from my professional brethren, and  the philanthropic
          members of the Howard and other Associations—from examin-
 onrce* o m- jn^ ^ iocaHf{es 0f ^q various nuisances—the " pest houses "
          —the unpaved, filthy yards, and low lots and squares—(ponds,
          in the rainy or sickly season)—basins—canals and open drains,
          and the filthy materials thrown from  them—the  exposure of
          fresh earth—the cemeteries—vacheries, livery stables—slaugh-
          ter-houses and unpaved streets,  to which so much evil has been
          so properly  and so justly attributed—information has been ob-
          tained, opinions received and facts gathered, so much in accord- 
                            TABLE R.
        COMPARATIVE SALUBJilTY OF EACH AVARD IX THE CITY.
  Localization of Cases of epidemic  yellow fever, occurring during the
year  1853, in  the several Districts and Wards of the city of New
Orleans, (according to their division in 1850,) in ratios proportioned to
the population  of each.
1 I	2	3	4	5	6 | 7 j 8		
Districts AND Wakds.	Estimated Population of 1853.	Number of Yellow Fever Cases Reported.	o o => B . <D"£3 £-c = p.. 3 oo §•	Number of cases from Public and Private practice unreported.	Total Number of Cases.	o .. o a P 06 lj* (S'S'S	Estimate of the Proportion of Colored to the Whole Population in each Distbict.
Is/ District.							
1st Ward,.-	7.179	2.567	.357	732	3.299	.459	
2nd do. ..	6.447	1.092	.169	312	1.404	-217	
3rd do. - -	9.453	1.211	.128	346	1.557	.164	
4th do. ..	9.125	1.535	.168	438	1.973	.216	
5th do. ..	8-545	794	.092	226	1.020	.119	
6th do. ..	9.639	910	.094	260	1.170	.121	
7th do. ..	10.307	2.988	.289	852	3.840	.349	
Totals,.......	60.695	11.097	.182	3.166	14.263	.234	13.55 pr. cent.
2nd District.							
1st Ward,. -	6.105	365	.059	143	508	-083	
2nd do. ..	4.671	582	.124	228	810	-173	
3rd do. ..	4.089	295	.072	115	410	.100	
4th do. ..	7.389	459	.062	179	638	.086	
5th do. ..	8.561	760	.088	298	1.058	.123	
6th do. ..	13.237	366	.027	143	509	.038	
7th do. ..	5.934	318	.053	126	444	.074	
Totals,.......	49.926	3.114	.062	1.232	4.377	-087	26.17 pr.cent.
3rd District.							
1st A Yard,-.	12.227	566	.045	193	759	062	
2nd do. ..	5.120	891	-1.74	305	1.196	.233	
3rd do. ..	7-426	928	.128	317	1.245	.167	
4th do. ..	3.429	024	.007	8	32	.009	
Totals,.......	28-202	2-409	.085	823	3.232	.114	24. pr. cent.
\th District.							
1st Ward,-.	3.220	1.407	.436	341	1.748	.542	
2nd do. ..	3.460	1.175	.339	284	1.459	.421	
3rd do. ..	3.347	1.371	.409	332	1.703	.508	
4th do. -.	3.169	1.114	.351	268	1.382	.433	
5th do. ..	2.114	586	.277	370	956	.452	
	15-310	5.653	.369	1.595	7.248	.473	12.05 pr.cent.
Grand Total,..	154-133	22.304	.144	6.816	29-120	.188	
 
 
                 Sanitary  Condition of Next)  Orleans.             I89

mice and corroboration of the sentiments so fully expressed in
other parts of this Report, .that it seems to be tautology to
repeat thorn here.  Nevertheless, as facts, hoAvever, portrayed to
the eye and of localities near and around us, knoAvn to all, have,
usually, a more lusting impression upon the mass than theoret-
ical principles, or statements from abroad, hoAvever  strong, ap-
propriate and well founded—attention is invited to the delinea-
tion of these various sources of disea.se on the Sanitary  Map,
and then  to  the table R,  to  show  the consequences of them.
So clear and convincing are these facts, Avhen brought to explain
each other, that  longer skepticism on the subject is set at defi-
ance.  Let us, then, scrutinize them undei the folloAving circum- propositions.
stances :  1st.  If,  on examination, it  is  found  that when the
various sources (above enumerated)  are found, and there, like-
wise, has  prevailed the yelloAv fever,  and almost in precise pro-
portion to their existence.   2d. If this fever has prevailed there,
not only in numerical proportion to the population, but in pro-
portionate  malignancy.   3d. If Ave find that all antecedent ex-
perience Avhich has influenced society in the  establishment of
sanitary measures,  is here  confirmed and  corroborated.   4th. Andresultl-
That our city has been suffering a  frightful  calamity, resulting
in great injury to the population, and a ruined reputation, and
from removable causes ; and, finally:  5th. That all, or nearly all
our past calamities could have been prevented ! Surely, there will
be  no longer any  hesitation as to  the adoption  of  the  most
efficient and speedy measures,  not only to correct them and
prevent their  repetition,  but  to set ourselves right in the eyes
of our countrymen aud  the world,  to whose public opinion
none are too exalted and none are too low to be independent of,
or  uninfluenced  by,  as well for the  sake of the direct interest
of the city itself.   But to the proof—and I shall commence
Avith the upper part of the city:
                    THE  FOURTH DISTRICT.
  This district is estimated to have  contained, in 1853, fifteen
thousand three hundred and ten inhabitants, without including
a lar^e proportion  of recent immigrants, the  whule of Avhich,
            z 
190           Report  of Dr. Edward II. Barton  on the
Population
and number of
           for the year, has been estimated, in another place, at about five
           thousand, divided  among the four districts in a very dispropor-
           tionate degree.  These,  of  course, Avere first  subject to,  and
           earliest felt  the epidemic influence, and living mostly in impov-
           erished circumstances,  were crowded together in the cheapest
        ,   and most comfortless dwelling's.  The number of cases of vellow
 cases in 4th                             °
 District     fever in the entire district, is  estimated to have  been  seven
           thousand two hundred  and  forty-eight, of which five thousand
           six hundred and fifty-three  Avere reported to  me by the physi-
           cians iu attendance, in Avhich also are included those from the
           Howard Association, and other institutions,  and the balance
           allotted, bv  the Sanitary Commission, from public  institutions
 Ratio per 1000       '  "             *'                    x
          and  physicians not reporting.   Being at the rate of  four hun-
          dred  and fifty-tAvo per  thousand of the population; more than
          double that  of  any of the other districts.
 Cans*.       Let us see how this can be reasonably  accounted  for.
            1st—In this district  there are but  tAvo pavements.   These
          are of cubic stone blocks, and are very good, as far as they go.
 Irt—Want of                                    '' °    '■            J.  °
          One extends across the entire breadth of the  district, near the
 pavements.                                                      '
          river, and the other one-third  lower doAvn  and about one-half
          of the  breadth.    There  are  several  extensive  plank  roads,
          (which are delineated on the  map,) but much the largest part of
          the district  is  not paved at all, and especially the  sickliest
          portion.
            2d.—This district has a vast number of unfilled squares and
          lots,  below the level of the  streets;  some of which  are  even
_M_i       built upon,  on  piles or bricks, having water almost constantly
or ponds.    under the houses,  Avhi<vh are of wood,  old  and rotten,  and
          during the rainy season, (which is the sickly  season,) become
          ponds, and often very nauseous ones too, and are at all times the
          receptacle of filth  and impurities, the drainings of the yards.
          These are also  mostly noted  on the map.
            3d.—Three extensive  cemeteries exist in the district, in which
8d- Three                                                      '
   .  .     were buried, last year, near three  thousand dead bodies.  It was
cemeteries.             '     J    '
          in one of these that the offensive exposure  of  boiies occurred,
          so painful to the public. 
                 Sanitary  Condition  of New Orleans.             191

  4th.—Not far from the centre of this district, was the earth
exposure,  necessary for laying down  the  Jackson  and L ke
Pontchartrain Railroad; and Avithin  its limits exist one of the4th_Earth
most dangerous and disgraceful nuisances in  the  citv,  the  halfexp08nre an
__.,,  , .--,    ,   T>  .       „                        "          Gormley'sba-
hlled Cxormley basin and Canrd, the common receptacle of the
                                                1            sm and man-
drainage and filth of a large portion  of this  and the adjoining nfactorief_.
district, bordered by most  offensive  tallow and soap manufac-
tories.
  5th.—Probably almost equal to any of  these, are the  Ioav, sth-Crowd-
crowded, filthy lodging houses, particularly in Adele, Rousseau, ing houses.
and St. Mary streets.
   6th.—And finally,  the  extensive  butcheries  and A'acheries.
   These amply account for any amount of sickness, Avhen united
to  the  remarkable  meteorological condition of  the  year, to Slanghter
the entire satisfaction  of  any inquirer  after truth,  and  Avho houses, &c,
will apply the  best recognized principles  of medicine  to its
explanation.
   With special  reference to the wards themselves,  it may be
said that the First  Ward, Avhich has the largest ratio of insaiu-   t Ward_
brity,  that a very large portion of it in  Adele,  Rousseau, and Cause3 and
St. Mary  streets, were but  a series of low, crowded, and filthy proportion.
"pest  houses,"  inhabited by the loAvest class  of people,  Avith
scarcely any pavements, and many unfilled  lots and  stagnant
reservoirs of putrid water.   The proportion here Avas five  hun-
dred and  forty-two per one thousand.
   That the next worst ward, the Third, contained all the ceme-
teries, and most  of the vacheries; on the lower portion it was M d°--««i
bounded by  the new  Jackson street railroad, (five-eighths ofdo"
Avhose laborers fell  victims  to  the epidemic) and the SAvamp.
The proportion here, Avas five hundred and eight per thousand. 5thdo_and
   That  the next  worst ward, the   Fifth,  contained all thedo
butcheries, and many  low  empty lots or ponds.  The propor-
tion here was four hundred and fifty-tAvo per thousand.
   That the Fourth Ward, which is  the fourth also in the ratio 4th=ftad do
of  cases, more than three-fourths of  the cases actually occurred
immediately around and in the vicinity of that horrid nuisance, 
192            Report of Dr.  Edward II. Barton  on (he
         Gormley's Basin  and Canal, and the extremely offensive soap
         and candle factories about  them,  the  rest of the  ward  being
         comparatively healthy.   The proportion is  four hundred and
         thirty-three per thousand.
           The Second Ward has numerous low lots, (or rather ponds,)
         houses on unfilled lots, small crowded tenements, and few pave-
         ments.  The  proportion  here is four hundred and  twenty-one
         per thousand.   The boundaries of  the Avard are sIioavu on the
         map.
           The character and malignity of the cases  in  portions of this
         district eminently  illustrate the position, that Avherever the
         causes enumerated  existed in excess, the virulent character of
         the disease Avas  usually  proportioned,  and that there existed
         there  a concentrated influence, inimical to human health and
         life, that set at defiance, in a great  many instances, all skill  in
Malignity of
       .  medicine, and all the resources of art and  kindness.  Two of
 the cases in         '
proportion to these  have been particularly reported to me, viz: the vicinage
concentration of Gormley's Basin, and Adele, St.  Maryland Rousseau streets,
of the cans*, near it, in the immediate neighborhood of both  of Avhich places,
         the epidemic  had some of its  earliest victims.  Of the first, an
         intelligent physician, Avho had a large  and painful  experience,
         reports to us, that he " Here Avitnessed  the disease  in its most
         " malignant and revolting aspect.  It was not in individual cases
         " only, that it thus  shoAved itself, but the type in the district
         " was uniform ;  day  after day I was  reminded most forci-
         " bly  of Boccacio's graphic description  of the plague  in
         " Florence ;  they  almost uniformly  bid defiance to  every
         " variety of treatment.   From the  very inception of the dis-
         "ease, dissolution  was stamped  upon  their countenances,
         " with a distinctness appalling to behold.  Not only this, but
         " even in the small minority that recovered, their recovery
         " from the fever was  followed by the  appearance of furun-
         " culi from the crown to heel; and in one or two their shat-
         " tered frames  sunk under the drain which followed their
         " maturation.  The condition of  this portion of the city was
         " disgusting  and revolting beyond all  expression j filth  of 
Sanitary Condition of New  Orleans.              193
I  " every character crowded the  streets, gutters, pavements,
  " and even the houses in many instances.
    Remarks and observations of the same tenor have been made
  to me by  various members of the HoAvard Association in  rela-
  tion  to the cases in Adele street, and its neighborhood, Avhere
  they  so nobly devoted their time for the benefit of  suffering
  humanity.
    The First District, or next in order, is  estimated to  have
                    .                                         1st District-
  contained 60,695  inhabitants—11,097  cases  of yelloAv  fever„   ,  .
                                  '              J           Population
  were  reported to me by the faculty and  members of the Hoav- and ca3eg_
  ard Association  and public institutions, the balance,  or 3,166,
  was estimated by the Sanitary Commission,  upon the grounds
  already stated,  from public institutions, and physicians not re-
  porting—producing an aggregate  amount of  14,263, and a ratio
  to  the Avhole population of 234 to the 1,000.
    The difficulty in accounting for the sickness here is no greater
  than  in the district above  it.   True, it has more pavements, but
  a very large portion is Avithout them, and they are of  the worst
  kind  (or pebble pavement)—but very partially protecting  from
  evaporation or absorption.  The sanitary condition of the Avhole
  river front of the First and Fourth Districts was doubtless  in-
  fluenced much by the extensive disturbances of  the soil on the
  opposite  side of  the river, the Avind bloAving almost every day
  from  that quarter, and also from the foul ships in front of them.
    The First Ward, bounded by Felicity, Benjamin,  Magazine
  and the river—exhibits the largest ratio of sickness.  Here ex-i*tWard-
  isted  the  spots of Lynch's Row, and a  nearly • similar  one  on
  Tchoupitoulas  street, and many  other houses in the neighbor-T'ynch'3 Ro
  hood consisting  of croAvded,  filthy  tenements,  Avith  unpaved
  yards, privies running over and into the streets, the nests of the
  lowest and most intemperate  population, and so of Whitney's
  old pickery and of similarly offensive blocks  in  Pacanier and Whitney's
  other streets.  These fever fountains have  been for  years the p><*ery.
  receptacles and manufactories of pestilence.  Whenever an epi-
  demic has visited the city, whether yelloAv fever, cholera,ship fever,
  &c.} here  have been its favorite haunts.  " Lyuch's Row " is euti- 
194          Report of  Dr. Edward II. Barton on the
          tied to the pre-eminence, for, I am credibly informed, that during
Blocks in Pa" the epidemic cholera in the Avinters of 1848-9, no  less than
canier and   10g dead bodies Avas taken from it in a very short time.  It is
other streets.  conspicuous for jts filthy and crowded condition, Avith overflow-
          ing privies and bad ventilation, as they all are.   To Avhich  add
          an extensive river  front Avith the banks the receptacle of fi th,
          the batture embracing ponds, Avith exposure of  soil  in relaying
          Annunciation street, during the summer, aud intercourse with
          filthy ships, and the condition will fulfil any expectation  of in-
          salubrity, however exaggerated.  The number of cases traced to
          and allotted to it is 459 per 1,000.
            The next worst Ward is the old Seventh, formed by the new
          Canal, Circus  and Canal  streets,  and the sAvamp.  Here  ayo
          have an extensive disturbance  of the  soil for laying  pipes  for
          five or six squares doAvn Perdido street, from  Philippa—the Girod
          street Cemetery, Avhere was buried during the year  638 bodies
          —the  filth  from  the  dredged  canal, and  the open canals and
          drains and receptacles of filth from the upper part  of the  city
          and SAvamp in the rear, and the fever nests  of Iloey's and Cole's
Nuisances in. Rows, near the Work-House, consisting of  small crowded filthy
          rooms, badly ventilated, with bad supplies of water.   This ward
          is but partially paved, Avith the  same kind of  pavement as in
          the  first—the  cross streets  not  at all; in this Avard are located
          tAvo extensive Hospitals and the Gas  Works, occupying several
          squares,  having large open  drains  and the SAvamps justjn the
          rear.  The number of cases of yellow fever in  it was 349 per
          1,000.
            The  Second  Ward having for  its limits, Magazine, Felicity
          and Thalia streets, have scarcely any pavements, the open Mel-
          pomene  drain extends nearly through its centre, extensive dis-
2d Ward.   turbance  of the soil occurred for the laying of pipes in Pyrtania,
Cause-..      Apollo and Bacchus and Clio streets,  and Gormley's Basin and
          Canal immediately adjoins it.   The proportion of sickness Avas
          277 per 1,000.
            The next  in rank is the Fourth  Ward,  margined by Thalia,
          Camp to Julia and doAvn Julia  to and Avith the canal.  This is
4th \\ ai-j.   characterized by having the open  drains  of part  of the  Mel-
Cau*ss      pomene, Avith its refuse of city filth exposed to the  atmosphere,
          the open  Ti'iton Walk conduits and the stagnant canal, with the 
                 Sanitary  Condition  of New Orleans.            195

exposures for laying down pipes in Prytania and Camp streets,
Apollo and Bacchus streets, extensive  exposures of earth for
several squares (5 or 6) in Erato street,  from Dryades for the
same, also at the lower end  of Calliope street, for the same and
for railroad purposes.  The  ward is but partially paved and very
badly drained in the rear, and very low, and badly supplied with
water for the purposes of cleanliness.  The proportion 216 per
1,000.
   The Third Ward, bounded  by Benjamin out to Camp and
down Camp to Julia,  and thence to the  river,  embi-aces the
                                                            3d Ward.
crowded  thoroughfares and dwellings  about the market and in
North and South streets; the fever brooding place of 82 Julia,
better knoAvn as McConanfs or Mitchell's Yard, Leeds Row, on Feverne9ts-
Melicerte  street,  the  old German  Theatre on Magazine street,
and about the " triangle'' with their crowded, filthy and bad
ventilated rookeries, Avith a large exposure of batture in front,
and its filthy  bank and wharves—the  result  here  is  164 per
1,000.
   The Sixth  Ward, within the  limits of St. Charles, Canal,
Circus and Julia streets, is Avell paved  (but Avith pebble stone
only)  and contains  the dangerous nuisance and fever spot of6th  ard>
Kirwan's Roto, in Philippa street, sometimes known  as "Irish
Bow," and was the theatre  of a large  mortality last year fromFevernest9.
the crowded, filtliy and  unventilated condition of its rooms—
the same  objection holds to the confined  and crowded buildings
                            x   nx  x       •                   Causes.
around Poydras Market, and the filthy  and  immoral receptacles
in" Perdido street, and the "fever nests"  produced by the large
livery stables vitiating the atmosphere of an extensive neighbor-
hood,  near the A*ery centre of the ward, and having the refuse
of extensive hotels.   The proportion is 121 per 1,000.
  And lastly, the Fifth Ward, bounded by Julia, St. Charles,
Canal and the river:  this ward is similarly placed,  and bring
the location of the principal hotels and restaurats, is exposed
to their refuse, with their susceptible  subjects  of recent im- Causes.
migrants  and strangers,  its   bad sanitary  condition  must be
attributed largely to the disturbance of the soil in preparing 
196
Report of Dr. Edward H.  Barton on the
2d District.
Population
and cases.
2d Ward.
Causes.
5th Ward.
to erect the large number of new buildings in front, and in ta-
king up and preparing for neAv pavements there, and  for gas,
and  water ; the extensive batture and filthy river banks and
wharves, and the large livery stables in its limits.  These last
mentioned wards Avere  not visited by the fever  until a late
period.  The proportion here is 119 per 1,000.
   The Second District.—This contains an estimated pop-
ulation of 49,926, with 3,145 cases reported  to me  by  pri-
vate practitioners, and  occurring there, known to the How-
ard Association, with  an  allotment of the balance to make up
4,377 cases, or  87 per 1,000.  The cause of this immense
difference is obvious enough, and although the several wards
differ in their proportions of  these cases, the causes  are as
manifest as their great difference in amount.
   Ward  No.  2, bounded by Canal, Rampart, St. Louis and
the Swamp, having  more than double the  amount of the
average of the district, or 173 per 1,000 embraces in its limits
all the cemeteries  of the  District,  (of four squares)  and in
which were buried last year  1,163 bodies, the open and  half
stagnant Claiborne and Canal street  drains, and  ihe filthy
conduits in the rear, the receptacle of  a large portion of the
foul and corrupting materials of the upper part of this por-
tion of the city, and vicinity, and the influence of the  swamps
and open drains beyond.
   The Fifth  Ward, immediately North of this to St. Philip
street embraces the open canals, Carondelet  and Claiborne,
the recipient of the filth of the upper portion of the  city and
not beyond the influence of the large exposure of earth made
for this canal and its new basin, and its enlargement.   The
proportion here is 123 per 1,000.
   The most of the balance of the  cases in  this district oc-
curred in the front portions of the third, fourth  and sixth
wards, in the vicinity of the markets, and in the disgusting
and  horrid purlieus  of this neighborhood,  in  the first few
blocks of Main street, Philip and Ursuline streets, and in Gal-
latin street.  Language  fails in portraying the loathsome ex- 
Sanitary  Condition of New  Orleans.           197
hibition which these fever manufactories presented; they can
only be paralleled by some  of the  plague spots in the  firstFever ne9ts in
and  fourth districts.   A  large  portion  of them consist offrontofthe
boarding'or rather lodging houses, occupied, many of them,
by croAvds who only sleep there, eating  and working out,
with no privies, (these being monopolized by the tenants on
the ground floor,) the streets and levee opposite  are used  for
this purpose;  small  rooms are sometimes occupied by whole
families;  some use them for raising fowls and dogs,  and as
receptacles for vegetables for market, and the refuse of the
unsalables  of the market,  from day  to day, with little regard
to removing the half decayed relics.  No doubt these condi-
tions Avere greatly aided by  disturbing Chartres and Royal
streets, for relaying pavements, and Bourbon street, for laying
down large water mains.   An  active  and efficient practical
member of the Howard Association, who  attended  in  this
part of the district in his report to me says that" along every
street AAdiere paving or digging for laying the Avater pipes was
carried on the disease was remarkably more intense, and also>
from actual observation, here  and  in St.  John  Baptist, the
mortality was  greatly in  proportion to the rooms or houses
being nearer the  ground."   The filthy state of the river bank
opposite, (the river being very low,  as it always is during our
epidemics,) and particularly that portion devoted to the drain-
age of sugar and molasses.  The balance of that district  is
comparatively healthy, being Avell paved, with a large propor-
tion  of acclimated population, Avhich aids much in explaining
the comparatively inefficient influence of the pestiferous spots
pointed out, on the population.
  Is it at all astonishing that pestilence here has its favorite
                      °     *•            ■                  1 he reason
haunts ?  Is it not more astonishing that it does not exist here, why ydlow
and in such places every year—nay, all the  year ?  Nothing fever. &c._
shows  clearer to my mind the conviction of the true expla-not all the
nation of the views put forth in a preceding section in relation year, and why
to the necessity of  the  existence of two  conditions for  thislimited  t0 M
class of fevers.   It surely is a munificent and merciful dispen-or M day8. 
 19$         Report  of Dr. Edward H. Barton on  the

         sation of Providence, otherwise, the local population of such
         tainted spots that I have pointed out would be entirely cut off
         and why is it  that yellow fever epidemics have a limited du-
         ration  of from sixty to  ninety days, whether it breaks out
         early  or late? the meteorological  change  always  ensues,
         with—drawing one of the conditions on which the  pestilence
         depends!
           The  Third District contained  an estimated population
3d District,  of 28,202, in Avhich 2,409 have been reported tome, and 823
         have been allotted to it, (as before explained of the other dis-
         tricts) making 3,232, or 114 to the thousand.  This is a large
Population  number for that district,  and arises mostly from the crowded
and ratios.   an# filthy condition-of localities and houses devoted  to pur-
         poses such as  I have just described about St. Philip and Main
         streets ; these are their rookeries in and about Enghien and
         Moreau streets, the dirty, rag depository on  Ferdinand street,
         a four story  block, the  receptacle of every species  of outcast
         filth ;  cheap lodgings for immigrants, and the poorer and more
         reckless of the laboring class*  requiring always the closest
         surveillance on  the  part of the  civil  authorities to  prevent
         their creating and evolving a poisonous atmosphere that will
         infect the neighborhood, and in no situation is the paternal
         kindness and  vigilance of municipal government more con-
         spicuously shown, than in correcting and repressing  the haunt9
         and manufactories of disease, crime and vice.  It is arresting
         it at the fountain head, it is ascending to its  sources.  The
         cupidity of landlords who lease^  and the sub-lessor, even
         to the third  and  fourth  classes, who does it under him,  the
Consequences       <             ,        ,
         sole obiect of whom is to derive the largest  profit  out of the
on the com-       J                              an
munity     smallest space, and the least trouble, doles  out to  the poor
         occupant the  least possible  space; these, in many  instances,
         are immigrants, who are ignorant of the  pregnant fact that
         crowding here is much more dangerous than it is in cold  cli-
         mates, where they come from ; it is also composed  of a large
         portion of our valuable laboring class, who are mostly  reck-
         less, and also ignorant of or unable to apply any measures 
Sanitary  Condition of New  Orleans.             199
of personal hygiene;  the consequence is the inexorable pen-
alty, in loss of health and life;  the neighborhood becomes in-
fected, and the community suffers directly, and indirectly, for
the support  of hospitals, infirmaries,  and  orphan  asylums,
the repression of crime and vice, the  extension of disease,
and also in the loss of  labor, that is  one of the main ingredi-
ents in its wealth, and in loss of character
  Most of the cases in this district Avere from public practice—
(that is from eleemosynary associations,) showing at once the char-  *nM '
acter of the subjects and the sources of the disease.  The balance
of the district exhibits a very low milesimal insalubrity.  The dis-
turbances of the soil, in digging  for laying down pipes, and the
cleansing out drains, and exposing their detritus to the summer's
sun, and the filthy bank of the river in the neighborhood, being the
common deposit of filth, here existing the greatest insalubrity,
(this nuisance has been a common  cause of complaint for years,)
together with the polluting air of a cemetery,  in which was buried
during the year 2,446 bodies,aided much in  adding to the num-
ber and force of the epidemic here.  The map shows the loca-
tion of  these, and reference to Table  R will exhibit the state of
each of  the wards, here and throughout the city.
   In the allotment and distribution made of the cases to the  sev-
eral wards and districts, it will be seen that there is a vast differ-
ence in numerical  ratios.   It is to be borne in mind, however,
that there is a great difference in the  relative number of the ac-The number
climated in each of the districts, being greater in the respective of accumated
districts  in the inverse ratio of the number  of cases, but, most population
manifestly, in insufficient amount at all to diminish the force and diminishes the
nature of the conclusion come to, that the cases occurred in  pre-ratios"
cise proportion  to filthiness and  crowding, and the other condi-
tions named of the several localities specified, and some of these
in the Second and Third Districts, would nearly vie Avith some
of the worst in the districts above,  and had the proportion of un-
acclimated subjects been greater, the number of cases would more
nearly have equalled some*of the  worst feyer nests and plagua
spots up town. 
200           Report of Dr. Edward II. Barton on. the
            The condition of the population on the opposite side of th
          river, is not embraced, directly, in our investigations, and hence
Algiers.     jt jias nQf. rcceive(j t]mt attention Ave have devoted  to this, and
          our information is less  definite and special.  The white  popula-
Popniation,  tion  is estimated to have been  about 3000, and there Avas pro-
ratio and    bably  fully half that number of cases  of fever.  This  avhs, no
cause.      doubt, mainly caused by the large  disturbance  and exposure of
          the soil for the railroad and  leATee.
            It  is well known that the disease commenced at its  various
          headquarters—pest houses and  infected  localities, and the filthy
Origin of the shipping mostly from Northern and European ports, about the
fever.      same time ;  that it continued in most of them  throughout the
          season, that in a very feAv (probably but one) it attacked the most
          susceptible subjects only, and then abated for the nonce;  that it
          ahvays seizes  the most susceptible  first; that this is usually in
How the fever ^ie fishiest, Avorst drained and  paved,  and Avorst ventilated and
spreads from most crowded portions of the city;  that here it  seems to gather
locality to lo- force and strength, and extend to neighboring portions, that this
caiity.      was specially  verified with  us, and  that to show the nature of
          pavements  alone, it was at least a month  and even more after
          the epidemic broke out, before it reached the paved portions of
          the city, and those grades and classes of society that paid more
          respect to their hygiene—personal and domestic—that so infhien"
          tial are these in their  protective capacities, that some susceptible
          families and subjects, liA'ing  almost  in the midst of the infected
          districts, escaped, almost entirely, by proper attention to them;
          that, finally, the whole city atmosphere  seemed more  or less
          tainted with the influence and extension of the poison, as the ma-
          teries morbi became more matured  and the resisting power over-
          come, as if the  multiplication of decay, disease and death con-
Difference in sumed the ozone or purifying  element  in the atmosphere.  It
 Northern thus  seemed to form an  electric  chain—the links successively
 cities,  and feeling the influence  until the Avhole becomes affected and sur-
 cause.     charged.  Northern cities are differently  situated from  ours in
          their variations of elevation, and of ^course, in their atmospheri-
          cal relations, an epidemic yellow felloAv has consequently never
          prevailed  throughout their entire extent.  So true is it, that the 
Sanitary  Condition of New  Orleans.              201
conditions Ave have taken so much pains to point out, find illus-
trations and applicability every Avhere.
  There is no arguing  against facts,—the most unprejudiced—
the most unequivocal testimony is furnished by intelligent  men
who have no theory to  support, in  the  fullest  corroboration of
         ...         ,.,.■..                 .       .    plain facts.
the practical views set  forth in this report.  And it requires
nothing but a visit and  familiarity with these haunts  of disease
and festering sores  to convince  the most  skeptical  that filth
(croAvdingis the same thing—for it speedily generates it) high tem-
perature and humidity produces yellow fever,—and yelloAv fever
of the worst form,—that its type usually depends upon the con-
centration of the productive causes, Avith individual exceptions,
with  strong resisting  power—the exceptio  probat regulam,—
that from these foci, it emanates as by radiation and  expansion
—dependant  somewhat upon  the direction of the Avind, and
thus contaminates the entire community (where the  conditions
                                           .              i  Why all in-
can be assimilated.)   These facts are conclusively shown by the ^^
manner in which the disease originating in these centres—spread
during the last summer.  And it is well known that Avhere yelloAv
fever is not  the result (as this  is confined  to a certain class  of
 subjects) nearly all other diseases are  aggravated by it, by lessen-
ing the tone and vigor and resisting power of the individual.
 All then are interested  even to the extent  of the health and
 lives of their  families,  in the earliest adoption and strictest ap-
 plication of sanitary measures—and to  be coerced Avith the
 whole force and funds of the body politic.
   With all  our labor,  and it has  not been  small—we  have
 proved little more than has  been proved a thousand times be-
fore —that one of the most efficient agents in the production of
                                , ,      i    .*   ,1         The occur-
 yellow fever is filth of all kinds.  May it be  estimated as a cor-
 J                                                         .  rences around
 roboration of antecedent and well established facts and  convlc-usmoreaptto
tions;—may it make a practical impression at home, since they ^
 have occurred in our midst, and been but the application of the
 pregnant facts occurring in localities, that  cannot be forgotten
 by those who witnessed them.  If there are other opinions,—as
 would seem, by our having done so little heretofore  to prevent
s impressive. 
202           Report of Dr. Edward II.  Barton on the
          these terrible results—they have been gravely rebuked by the
          occurrences of the year, and must now yield to the demonstra-
          tion before us, '' opinionem commenta delet dies—natura judi-
          cia confirmat.u
            No man can say—or ought to say—-that he can dodge—or is
          uninterested in  this question.   If he  is no  longer subject  to
          yellow fever, yet vitiated air affects the sanitary condition of all.
          Is there one so insulated that has the effrontery to say, he is not
          interested in what  so  deeply affects the welfare  and prosperity
          of  society,  pecuniary,  commercial,  social,  moral,  religious?
          if so,  society should  arise in its might and  banish the wretch
          from among us,—he is no longer fit  to participate in the num-
          berless blessings for whioh we are indebted to the kindness of a
          merciful Providence.
            The largest portion of the population  of this city, has had
          their nativities out of  the  State.  The United States  census of
Proportion of 1850  informs us,  that but  one-third of the population  only
natives and  claims a Louisiana  nativity or 38,337,—that  18,136 derive
those born   theirs from other portions of the United States, and that 55,541,
elsewhere m  or  near]v  half come  from foreign countries,  leaving  out the
     rean"' colored population altogether.   The proportions  in which they
          have been  affected by the epidemic, is stated in  table  H.  On
          the  " cost  of  acclimation"—Seetion III.   It  is evident that this
          large  immigrant population, forming  more than two-thirds  of
          the white population of the city—-aud constantly augmenting in
          a still greater ratio, claims  the greatest value—in measurably
          making this city what it is (and  what would it have been with-
          out them ?) and every consideration in a hygienic point of view,
          for they form the element of its future growth and destiny.
                        SECTION  X.
        REMEDIATE  OR PREVENTIVE MEANS.
How far man can control temperature,  moisture—Influence of
  wooden houses—Best pavement—How  to influence winds—
   Whence their  bad qualities.  How and when streets to be 
                Sanitary Condition of New  Orleans.             203

  cleaned—Custom  elsewhere-^-Empty lots as a source of dis-
  ease— Other causes, Gormley's Basin.   Streams of running
  water in the streets.  Difficulty as to privies—The great one
  —How remedied— Value of drainage—No farther burial  in
  cities—Best water, what—City water and city air the same—
  Plenty of  water required for health.  Surveillance in erection
  of houses—Certain buildings forbidden in cities for a two-fold
  reason—Influence of social habits on yellow fever.
  In the practical application of these important measures, the
only Aralue  of the preceding investigations—we propose treating
them in the same order we haA'e heretofore embraced.
       heat  and radiation (i. e. direct and indirect.)
  To say that man has no influence on meteorological condi-
tions, is to degrade him to the level of the lower animals.  Man Man's influ-
is, probably, the only animal that understands how to  arrange ence on tem-
temperature to suit  him and apply it to his diversified wants, p«ature.
and has been defined by some naturalists " a  cooking animal."
Temperature when  too great is controled by domestic covering
of various kinds, by large  rooms  with lofty  ceilings  and  by
occlusion.   St.  Paul's in London, is said to be  10° cooler than
the surrounding buildings (from its A*ast extent), and so of  all
large rooms.  By excluding reflected temperature and  keeping
the rooms dark, we can here  procure a  temperature,  seldom
exceeding 82° 4'.   So great a difference does this make when
effectually done, when aided by thick walls to prevent the trans-
mission of heat, that we can in this way approach the  average
temperature of  the latitude.  The depression  accomplished in
this way, at the North, between in door and out door temperature,
is so  great  that some physicians there, have  given it as their
opinion, that it may be even hazardous to health!   Large rooms
with the power of perfect occlusion  here, would  answer many
valuable purposes.  They would not only be cooler, but supply
a body of fresh air,  and if opened at proper times only, be
drier.  No one, rightly informed, dreams of a high temperature
being the sole cause of yellow fever; otherwise it would prevail
over half the  habitable globe.  That a  prevalence for  some 
204           Report of Dr.  Edward II. Barton on the
          months  of a  range from 80° to 88°, is essential to its produc-
          tion has been shown in another place, and is undeniable.  With
          an average temperature throughout the day of about 79° during
          the five  warm months, every mode by which Ave could protect
          ourselves from direct and reflected temperature should be adop-
          ted, planting  trees in the public squares and  broadest  streets,
          furnishing shade  and pure air during the day, and absorbing
          the noxious gases during the night, encouraging the erection ot
          verandas to  our houses, erecting an extensive shed on the river
          bank, where is the greatest exposure of the unacclimated popu-
          lation, and  seiwing for recreation Avhen the business hours and
          business season is  over, during  the  sickly period of summer,
          streams  of water constantly passing through our streets during
          the day  (not night,) Avould greatly promote this important and
          healthful purpose, the more so as the temperature of river Avater
          is much  below that of the air.
            The important practical question then is  answered, that by
On a larger   these means we have much control over temperature.   This is
scale.       done on a large scale, by extending our improving hand into the
          neighborhood, removing  the  forest groAvth, and draining the
          swamps and cultivating the soil.  We not only lessen the amount
          of moisture thereby, which does so much injury,  but  exchang-
          ing  the  moist  to  a dry condition,  we increase the perflation
          thereby,   and  hence by  increasing  evaporation (the  drying
          poAver)  and lowering the dew point, Ave really loAver the tem-
          perature to our feelings, at least 5° during, the  warm months
Actual  proof now, and it  Avould be greatly increased Avith the improA'ement
here.       suggested.  This has actually been already accomplished here
          in relation to temperature to a certain extent, by our more ex-
          tended  clearings  creating increased ventilation, beyond that
          enjoyed  in 1807-10, for  by comparing Lafon's tables  at that
          period and ours now, there is an  average depression  of about
          3°, AArhile the  extremes are less.*   The influence of temperature
          is so great on health that it has been ascertained in London
* See chart to Report to State Medical Society. 
                 Sanitary  Condition  of New Orleans.             205

 from actual  observation, that a depression of 10° in winter is
 fatal to 300 additional of its poor weekly!
   It is perfectly obvious, the nearer Ave can make a city approach
 the country of its vicinage, as to heat, moisture, dryness, and
 cleanliness,  and all those conditions which conduce to purity ofJu8t how "
 air, and of course, salubrity, we shall, in  the  same proportion,
 improve it.  There  are  feAv rural districts in  the United States
 much  more  healthy than those  in our neighborhood.   The
 average mortality during a very sickly year, when the United
 States census was taken, made it amount to about two per cent.
 which is a convincing fact that the climate is not sickly per se,
 but has become so from superadded conditions.  Let this en-
 courage us to reneAved exertions and bring it back to what it
 has been and ought  to be.
   Moisture, probably the most important meteorological condi-
 tion that influences the health of man, is the moisture in the
 atmosphere, I mean  that condition which is beyond and measu-
                                            J                Moisture.
 rably independent of rain.   This  is  measured  alone by the
 hygrometer, its destructive influence when conjoined with a high
 temperature is well known and has been dwelt upon in the pre-
 ceding pages.   Rains, in ordinary seasons serve  to deplete tem-
 porarily, the atmosphere (as shown by the hygrometer,) not so
 last summer.  There was almost constantly a  high dew  point,
 indicating a repleted condition, productive of a want of elasti-
 city in the air, a constant sense of great fatigue,  easily induced,
 an exhaustion of nervous energy and a constant demand upon
 the system for a  fresh supply  of  power to sustain the flagging
 energies of life; the perspiration became offensive " funky " that
 no washing could long remove, and may have aided in giving
 rise to the opinion entertained by  many of the faculty, that
 they "could  detect  a yelloAv fever subject by  the smell alone."
  Most fortunately for us, this most destructive agent can be
 erreatly controlled by a removal of the multiplied causes of its
 °    •'             J                                         How removed
existence in this city and neighborhood, which has been pointed Md remedied
out, as our unfilled lots and squares, (in wet seasons made ponds
 of) unpaved and half paved streets, (as pebble paA-ements may 
 206          Report of Dr. Edward II. Barton  on the

          be denominated), and back yards, our  partially drained vicin-
          age, open conduits and neighboring swamps.  Hence the con-
          stant fogs to Avhich Ave are subject, the  dampness of our  stores
          and houses, immeasurably increased by the ereetion of buildings
          directly on the damp soil, (the floors thus lasting only three or
          four years), instead of being at least a foot above it, for the pur-
          pose of ventilation.   The first stories of all buildings are more
          damp, and consequently more  unhealthy,  than  those above
          them—moisture not being an elementary constituent of the at-
          mosphere, but only held in suspension by  it.  The Italians know
          this so well, by long  experience, that  they  only occupy the
          upper  apartments for  sleeping.  We  are  thus, measurably,
          above its reach, and the higher the better, especially during the
 Italia* cus-  existence of  mortal  epidemics, and  particularly  during  those
 10m.       hours  when  we  are  most  susceptible of disease (at night.)
          That poisonous exhalations that affect our health are limited to
          the lower strata of the atmosphere,  from whence they  arise,
          there is little doubt.   Whether it arises from  its combination
          with  moisture, it  has  not been certainly ascertained, although
          most probable.   As a practical  proof of  these views, it is well
          known  that when in Constantinople, Aleppo,  and other cities of
          the East, Europeans retire to a domestic quarantine, during the
in  the East existence of the  plague,  they escape  the   disease  by confining
during the   themselves  to the upper floors of their houses.   In like  man-
piague.     ner in the lower districts of Maryland,  Virginia, the Canadas,
          and Georgia.   Those  persons who sleep in the upper stories
          are,  during  the autumnal  season, most  exempt  from bilious
          fever.
            Wooden  houses here, besides decaying sooner, are more liable
          to partake of all the Hygrometric (as well as thermal) proper-
Why wooden ties of  the atmosphere, than brick, and hence  should be dis
homes bad   couraged as more prejudicial to health in this climate.  Doctor
          Rush has said, that in  the yellow fever of Philadelphia of 1793,
          the greatest mortality  took place in wooden houses.  This cer-
          tainly accords with experience here and  in Savannah.   In Nor-
          thern cities  much improvement in salubrity has been ascribed to 
Sanitary  Condition  of New Orleans.            207
Experience
the abandonment of wooden materials  in the  construction of
houses, and in London, an exemption from the plague since the
great fire of 1656.   The liability of liquid  filth to sink into
and adhere to wood, will  aid much in accounting for  its insa-
lubrity,  besides the  meteorological  explanation of its great'
liability to decadence.   It  was a noted commendation of an
Emperor of  old,  that he  " found  Rome built of brick, and
left it  of marble."   I trust it will be  the  distinction of this
generation to substitute brick or stone for Avood in all  cases in
this city.
   A large portion of all this can be remedied by a perfect pave-
ment, which, for this climate,  should consist of materials that
would  neither  admit of absorption nor  evaporation, by a
                                 ..             .,..     Thorough
thorough—not partial—(for then  it is much worse) draining of   .
the entire neighborhood, and then a renewal of the forest growth.
Here ventilation comes  in to the  aid of temperature in the
desiccative process.   By  having the drains covered, by filling
up all low lots—if these are done effectively, and the system of
draining duly adjusted—it must be drier in the city than in the
                                                            sary
country.  But if the roofs  of the houses are of shingle, and no
pavements, and imperfect drainage, the water that falls settles
or sinks mostly in the soil, sapping the foundation of the houses,
rendering the floors  damp  and filling  the  air with vapor, or
remain  in the soil until an elevated temperature brings it forth
in all its fatal combinations.
   The best protection that exists against most of this,  exists in
a pavement that will neither absorb or retain water or  anything
                                     .    ,      .       ...  Whatconsti-
else; that  is,  one  that neither  permits absorption or sinking
into the soil, nor exhalation from  it; that, while it is perfectly pavtment#
convenient for  all  the  purposes of communication, either of
pleasure or business, at all hours and seasons, rapidly carries off
the water that  falls upon  it, which, to  us  here,  is of almost
equal importance.   This is nearest fulfilled by one of iron, by
cement of different compositions ; next, with  cubic blocks of
Btone, united by cement;  then, of thick plank, and lastly, by
round or pebble stone.  To these  last, the objection is very 
208         Riport  of Dr. Edward  It. Barton  on the

         decisive, as it fulfills but in a  very  partial  degree  the primary
         objects mentioned.  It permits both absorption and exhalation,
         and especially retains,  in  its  numerous interstices, all the filth
         that falls on it.  There is  another objection to it, in the diffi-
         culty  of keeping  it  clean.   It requires  ten times more labor
         than  those  do which  are smooth, and the  practice is freely
         indulged of  allowing the dirt  so scraped up to remain for hours
         or days in the streets, to be washed into the gutters by a tran-
         sient rain, or trampled in by travel, before removal—thus doub-
         ling the labor and  increasing the  danger—while all that the
         others require could be exacted (without much burthen) from
         the front p>roprietors daily.
            If,  then, the pavements (in streets  and  backyards,) are
The city may ail perfect, the city would be actually drier than the country,
be made drier a most important  accomplishment for every purpose.   With
than the    abundance of water, filth is easily removed before decompo-
country.    sition, and we thus, at the same time, obtain two important
         objects, the prevention of moisture and the removal of filth.
            The value of pavements in the prevention of disease, is
         known in  all cities, in every quarter of the globe.  It has
Proofs of the been eminently  illustrated in Philadelphia, Norfolk, Louis-
vaiaeofpave-ville, indeed,  in eArery city on the continent, and beyond it.
menta.     They are more  eminently applicable in a hot climate, with
         a constant reservoir of moisture beneath, than elsewhere.—
         It is recorded of Vera Cruz, that so great was their influence
         that after that city teas paved, there wtre eicht, continuous
         years of exemption from yellow fever, notwithstanding there
         was a constant  accession of foreign  population from  abroad
         and the interior!
            The drainage by machines, in the rear of the city, should
         bo so effectual that no water  should exist within two or three
         feet of the  surface, and  that, no doubt, can easily be done.
         They have  already materially lowered the before invariable
         level  of  the water beneath  our city and suburbs, and the
         land has apparently risen near a foot in consequence.
            It is satisfactory to know, that we can both moderate the 
Influence qn
amount of
precipitation.
               Sanitary  Condition of New Orleans.            209

amount of rain liable to fall, and the amount of moisture as
shown  by the  hygrometer.   An  extensive,  dense forest
groAvth not only invites moisture, (that is rains,) but retains
it.  Its removal, in clearing the country, is known by expe-
rience, to dry up springs, and actually lessens precipitation.
I found by measurement,  (with my rain gauge,) about one-
third less rain in  the vicinity  of Vera Cruz and Havana,
than Baron Humboldt  did more than half a century before,
most of the  original growth being removed by a  reckless
clearing.   The Spaniard cuts down, he never plants, as  seen
wherever he  has established his  foot.   Spain is probably the
most denuded country in Europe.   Both the soil and climate
of Cuba have been impaired by this  wretched system, the
seasons  altered and  the country impoverished.   The same
has been  effected  in that  beautiful country,  Mexico;  the
foot of Attila has been planted there, and comparative ster-
ility has followed,  and were it not for what Baron Humboldt
calls "the force of the  climate,"  in many parts of it,
sufficient nutriment could  scarcely be raised for the support
of its inhabitants;  and, as it is, occasional famines desolate
the population.   Such, also, occasionally occurs in our oAvn
states, from our rather reckless clearings; the rain gauge
has not been sufficiently long  in  use to measure the exact
differences.
   Clearing the low country then, and thoroughly draining it,
dries it, and  as it has been shown, greatly tends to improve
its sanitary condition, is urgently  demanded here.
  As  stagnation of  air is always accompanied with most
moisture, the converse is equally true.  Winds  disperse it,
and powerfully add to  the desiccative process; and this is
in proportion to the force with which they blow,  and  the
                                                        winds*
quarter Avhence they come.  By reference to the table of the
" hygrometry of the winds," in  the annexed tables P and Q,
the amount that each brings to  New Orleans, on an average
of a series of years, is  shown.  That from the Northwest
htving the least, and 1 hat of the Southeast most.  By clear 
210          Re2>orl of Dr. Edward H.  Barton  on the

         ing the country, not only is the force of these winds increas-
         ed, but  probably their  frequency.   " Force''' of the winds
         is explained on the caption of the tables, and from actual
         experience, it has been ascertained, that the quantity of fluid
         removed from the system, (or surface exposed,) is found to be
         nearly three  times  as much in a " moderate breeze," and
         upwards of four times as much in " a fresh wind," as  in a
         calm or  stagnant state of the atmosphere.
           To  winds have  been  attributed various  occult qualities,
         with special powers; these we pass over, as below our notice,
         the  accuracy of modern science demands  something more
Their proper- definite.   There  are certain qualities which we know they
ties_.       possess, and  they are expressed in the above tables.  The
         much dreaded Chamsin, Simoon, Puna and Harmattan  are
         known now to derive their deadly properties mainly from their
         possessing the desiccative property in excess ;  whatever else
         they may contain is more  a matter of  inference.  When,
         for instance,  winds  blow over certain  marshes,  or other
         places, it is deemed that they derive certain properties, from
         the effects that follow; and this is found in certain countries
         as an invariable sequence, as that yellow fever never occurs
         unless where there  is a great  accumulation of filth, hence
         it is inferred, that there  is some essential connection between
         filth in  the one case, and certain qualities in the marsh in
         the other.   Our epidemics are always accompanied with the
         predominance of the East and Northeast winds; these blow
         over marshes, (our  Pontines,)  mostly covered with a forest
         growth,  which, although not impossible to drain andclear, are
         far beyond our present resources.  These East and Northeast
         winds, are those also which predominate in Savannah during
         their epidemics.  " For twelve miles  they pass  over  the
         margin of the river, absorbing the moisture and the poisonous
         gases on its margins."  They  have been remarked from an
         early period, and are called there the " Samiel of Savannah."
           But there are winds that bear deleterious properties, and that
         usually predominate in our autumnal seasons Avhich  are in our 
Sanitary Condition of New Orleans.              211
Our influence
on the North
wind.
power, and it becomes our duty to correct, viz:—the North wind.
This wind blows over the six or eight miles of swampy ground.
between Lake Pontchartrain and the city, conveying to us what-
ever is injurious from it, and is almost entirely under our control,
that is, so far as  these deleterious properties are  concerned.
                                                               on
With these corrected  by perfect desiccation, clearing and plant-   .
ing, (shrubbery, grass, &c.,) we shall then  enjoy the protective
qualities of the Lake breeze, so much needed from that quarter,
and which gives  to New  Orleans what no Southern city has,
viz: — protection -from  the too  great  desiccative   properties
of this Avind at a period of the year, (the autumn,) Avhen a cer-
tain amount is required for health.
   The removal of filth, as the cause of impure air in cities, and
all its baneful consequences, is, at once, the great difficulty, andSmallrev#nnt
the first duty of the municipal authorities of all cities, inasmuch devoted t0
as the lives of the citizens  is of more ATalue than anything else, preserving
And  yet. how incompatible with  this very natural feeling are keaith.
the main expenditures of city councils and Avhat a small fraction
of  the revenues of cities is devoted  to the Health Department !
When the true interest of bodies politic  and  social are under-
stood and appreciated, it will be altered.*
   As the first great cause of our epidemics (the disturbance of the
original   soil) is  certainly the  most  deleterious, a  city  ordi- To forbid the
nance should be passed forbidding it, to any extent, during thetD™n^p
season of elevated temperature, that is, from May to October,  for rei
any purposes Avhatever; and so of analogous conditions,  clearing
out and exposing the  filth  of canals and impurities of all kinds,
of  half-dried  swamps,  Ac,  of  the great exposure  of  filth  by
deposits on the river bank, and the  duration of the  exposure  of
street filth, after it is collected  or spread upon the streets.

 1852, it was deemed that •W/Wp™^foS sources, hundreds of thousands were
than wee* tuna that am?unt/?"°™ *°SSons! Not to be benefited by an
 obtained, and the city injured to the extent «* "?™8[ ™  the wave of obl&on
experience that ought to have been so ^"^f^^ate for the same was also
over it as of the hundred lessons betor* ; ttae  year- estl™«efi f he Uw ezpevses^.
$10,000, while $15,000 was  to be devoted tthe^equirem       ^ ^    ^
 showing their relative estimation out ot a levenue 01 » ,   ,
 of our reckless injurious follies I
hot weather. 
211!            Report of Dr. E'lward  II. Barton on  the

            We next proceed to that source—the fountain head of the
         contamination of city air—we mean the  back yards, Avhere all
Back yards
filth.
          the offals and filth of families is concentrated,  including privies.
          As this requires a different action in the present or contemplated
          condition, we shall  separately consider it, and proceed, first, to
          recommend a mode to get rid of  the former.
            Every yard should be paved in cement and graded to the street
          to facilitate the removal of rain and refuse water, and prevent it
          and filth of all kinds, being absorbed into the soil, and constitute
          a sore to fester  Avherever the temperature is  sufficiently elevated
          to invite it, which is the case here, nearly the whole year.  In
          each yard should be a well constructed sink  below the hydrant
          and falling into covered  drains which should lead to the  street
before decom-
          sewer.  The entire offal of each  family should be thus carefully
position,                                         "                      *
          run off daily before decomposition  ensues, and this great source
          of domestic indisposition prevented by thorough domestic clean-
          liness, and this is only to be effectively done by abundance of
          water, the solid parts to be conveyed directly to the dirt-cart,
          notice of  its arrival being given by a  small bell—the cart should
          be a close one.
            It is our deliberate conviction that all street and yard filth
          should in this climate, be removed before sunrise, (at least in the
          hot  season ) before the influence of the morning sun has had
          power to exhale the poison of the compost to the atrnostphere, and
          before drays and  carriages  or rains have spread it again on  the
          streets, and the dirt-cart should immediately follow the scraper,
          and by sunrise every thing be found clean.  This night work is
          done in New York, and although  not sufficiently done, yet it can
          be, and ought to be, and particularly here.  In the city of Mexico
          an excellent custom prevails of enforcing upon tenants the duty of
          sweeping their half of each street to the  centre by sunrise every
          morning, and thence it is removed  by the public carts.  This could
          be  most reasonably and should be, exacted  here on all streets
          where the corporation has  incurred the additional cost and  the
          occupant  enjoys  the  additional  privilege, of having  square
          blocks placed before his property.  It should be required for seA'en
And before
Custom elsi
where. 
Sanitary  Condition of New  Orleans.             213
months daily, and for the balance of the year weekly might suf-
fice.   The dirt should be removed to the rear of the city.   This,
Avith the Avater running  in the  streets  (as advised by our col-
league Professor Riddel 1)  would effectually ansAver the important
purpose of keeping the portions mentioned clean and pure.
  No filth must be left on the banks of the river, and a special Bank of riT«r
police be detailed AA'hen the river is in a falling condition, Avhich kept clean"
is precisely that period of the year Avhen  it is most dangerous
to the public health, (Ariz : July, August, and  September).  See
tables C, D, and  E.
   All lots loAver than the crown of the street should be filled Low lots fin-
up immediately.                                              «* °p-
   Livery stables  and  vacheries,  containing  over four head  of
cattle, should be  removed beyond  any square containing fifty vacheries and
population or ten dAvellings;  the same of all slaughter-houses, manufactories
soap, bone and candle manufactories, or others creating nuisances removed to *
all chimneys connected with any manufactory or  trade  injuri- certain dis-
ous to the public health  (as defined  and interpreted  by yourtance-
Health  Department), should  be  removed  summarily,  if the
offensive material or  quality cannot sufficiently be  got rid  of
hy the chimney being elevated high enough  to  consume it,  or
extending it beyond the atmosphere of  our dAvellings.
   Gormley's Basin should have lime spread  over  it and filled
up,  and the space planted Avith trees and shrubs, and the place Gormley's ba-
appropriated to the public as a square for recreation and refresh-sin filled and
ineut; the canal leading from it, together with Melpomene, and pIanted-
all the draining canals, covered, and Avhen cleaned out—which
should always be done in the  winter season—their dangerous
filth immediately removed to  a distance, and in bulk, and lime
spread on it.
   Our project contemplates  running water constantly through
the streets during  the day, and all the draining canals, and  as Running wi-
the  temperature  is, on an average, at least five degrees colder t» in the
than the temperature of  the air, it would aid much  in  cooling "treeW'
the atmosphere of the city.
   Whenever stagnant ^water  is  exposed, to the sun in moderate
            cc 
 5214           Report <f Dr.  Edward II.  titirion  on the

          temperature, vegetable infusoria1,  of the  class  algrr,  and also
          fungoid vegetation, appeal- rapidly.*   Many tribes of these veg-
          etable productions  appear  to die  Avith great rapidity—some-
          times in one or two days—and then decompose.  Immediately
          after these,  animalculav life appears.   Stagnant  Avater is  the
          mo*t favorable to  this  order of vegetable  productions, Avhich,
          in giving rise to animalcular life, appears to keep pace Avith the
          animalized excreta discharged in the house  drainage of towns.
How efficient  ^                                                =>
          This insalubrious order of production is indicated by the smell
          in stagnant  or nearly stagnant ornamental Avaters, such  as the
          stagnant portions of the  Serpentine rivers,  which lun-e excited
          so much declauiation.   Certain degrees of motion in a\ ater are
          unfavorable  to  the production  of algce  and other  infusorial
          plants, the tissues of Avhich are destroyed  by SAvii't motion, but
          a large portion of them are found  in slow  running Avaters or
          open  canals Avith little traffic.   The  same round of life  and
          death also takes place in  open and shallow reservoirs, and in
          open cisterns, where the water  is frequently changed.
„  ,         Light, hoAvever, appears to be necessary to the production of
Light rsquir- .      .             .
ed        infusorial and fungoid vegetation,  and their formation is pre-
          A-ented by such covering as  excludes the light and heat  of the
          sun. \
            Night Sou..—This is one of the greatest nuisances of large
          cities—probably the greatest—as tending more to the deteriora-
Night soil one  .,,"..,
          tion of the purity ot the atmosphere than any other, and is the
of the greatest            *   '              x             J
difficulties    most difficult to be got rid of, where declivities  are not large
          and water power great.  Its large amount—the poisonous qual-
          ities of the gases extracted from it constantly, in a high tempe-
          rature—lie at the foundation of all health and police laws.  Its
          exclusion from the body after the  purposes of life have been
          served, and  its removal to such a distance as no longer to con-
          taminate the  air he  breathes, are almost equally essential to
          healthy  existence.   In our position, water is so near the surface
          of  the earth (say from two feet to six inches),  dependent upon
* Report General Board of Health of England.
( Report Gencro! Boordjof Health of England 
                 Sanitary Condition of New Orleans.             21 o

the amount of rain that has recently fallen, in digging a pit  to
receive it, Avater rises, and the surface of the night soil  is always
near the surface of the earth, offending the olfactories and vitia-
ting the air, situated, as it usually is, in the least ventilated part
of our premises.   It is proposed, then,  that privies  be built  How rem»"
above, or  partly above the surface of the ground, in cemeut-  died-
ed brick  work and proper  water  closets, with  ihe curved
tube, rendering it impossible for any gas  to  escape from  them.
From near the top of this pit is a tube  or pire, at  whose exit
is a  strainer, to the street  drain,  admitting only the  liquid
part.   It thus becomes mixed with th& Avater constantly passim
through the streets, and is at once conveyed away and  its  impu-
rities destroyed  and sunk in the  larger  bodv  of water with
which it is mixed  (one part to two hundred parts of water being
found to neutralize  all its  impurities.)*  Where  this  is not
effected—or  in the condition in  which  the  privies  are now
throughout the city—immediate steps  should  be  taken that
every chamber or pit containing night soil should  be rendered
air-tight,  and connected by a  ventilator   (a  tube of an inch in
diameter  will suffice)  to the kitchen chimney; and  as there i*
 almost always a fire there, and consequent upward draft, the gas
 would either be decomposed by the high temperature or carried
 so high in the atmosphere as not again to descend.  When thelf not watw
pits become full, they should be  emptied, and wheneArer this closets> re~
 takes place, deodorizing substances should  ahvays be  used, andmove ga8
 probably  the aqueous solution  of the  chloride of zinc  is the'rouK
 best.   As some families are disposed to  neglect this important* imney!t'
duty, to  the great  annoyance  of  their neighbors, it is recom-
mended  that the vidangeurs be licensed here, as elseAvhere,
under special instructions from the Health Department; f that
no privy be emptied but by  its cognizance, and that period  be
recorded in a book kept for that  special purpose, stating the
street, house, &c, so that it may be known to  this Department
who neglects that important duty.  All should be  thoroughly
emptied  aud deodorized in  May and June.  An  inspection  of
the records will sIioav who is delinquent.
   Savamvs and Drains.—Running Avater in the  streets  absorb
 the vitiated gases, removes the lighter filth, dilutes the  worse and
  *By actual experiment.   fAVithout co*t. 
•J 16
Report  of Dr. Edward II. Barton  on the
          refreshes the atmosphere.   The larger drains should be covered)
Effectof rnn-for reasons stated in a preceding page, thus having all the ad van-
ning wat«  tage Qf un(jergroim^  sewers.   A full and  perfect drainage is of
through the  great jmp0rtance |0 t^e 0;ty>  'p0 tjje ext<Mlf it has already heon
          carried, it Avill have  accomplished  much good for our future,
          when it shaft haA^e been perfected in the manner stated.  It lies
          already materially loAvered the line  of former invariable level
          of water.   The  Araluable  space gained has been large.  It has
          been found the invariable  result of the extension of drainage in
          other cities that  the portions so drained and those  paved  have
          greatly improved in health, in proportion to their proper exten-
          sion, and that drainage alone vastly improves the entire neigh-
          borhood.
            The swamps in the neighborhood must be effectively drained,
          and  that hot-bed of pestilence removed, and the  distinction is
          really very small Avhether one dies of yelloAv fever or any other
          disease of the zymotic class—intermittent, bilious feA'er or boAvel
          complaints.  These,  and particularly the first, haAe  greatly in-
          creased  since  the last eight years, during which the  imperfect
          system of drainage and clearing has been progressing in the rear.
          No!   The drainage must be at first, thorough and complete :—
          the forest-growth may then be removed with safety, when a new
          under groAvth shall have sprung up out of  the recent marsh, to
          protect the otherwise exposed soil.
            The inevitable ills resulting from the six cemeteries mentioned
Cemeteries in in a preceding section, can only be effectually remedied by for-
the city cios-bidding further interments  in them, and invite the proprietors
•J.        for the sake of the  living, to select a more appropriate and, re-
          tired spot, more free from the encroachment of any future crowded
          habitations.  The propriety of selecting  a much more remote
          spot, Avill be the more apparent, when I mention, that a cemetery
          once occupied  the very centre of the business mart of this great
          city, near and about the corner of Canal and Camp streets! and
          another Avhere the present basin of the Canal Carondelet has
          been dug.   Say, what  Avould have  been the consequences had
          they been continued ?   And yet  Ave still  have most of the pre-
          sent city cemeteries in comparatively central positions, in close
          proximity to large mercantile and crowded populations!  Surely, 
                 Sanitary  Condition  of Xtw  Orleans.             21T

our progress of extension is not to be arreste<I, by the injury liable
to be sustained by the vicinage of corruption, or by awe of or re.
gard for their lamented  remains !
  That the mortality is not greater immediately around them to
the natives,  (of Avhich we are ignorant) may arise mainly of its
consisting of an acclimated population, though it must be inju-
rious to all,  as materially aiding to impair the  purity of the city
atmosphere.   (That it is highly injurious to the unacclimated—
See Sanitary Map.)  It is iioav a common sentiment, almost uni-
versally  prevalent, that intermural interment, is  injurious to
health, and should be strictly forbidden by laAv.
   Pure Water  and an abundance  of it, are as essential toTO
                                                              Plenty of wa-
health as the  air Ave breathe    In this city the capacity for ob- ter of tiie besl
taining both is unlimited.  The river Avater from the great length kin(1.
of  the stream, has deposited most of  the organic particles  that
 shorter streams obtain from the Avashings of the earth by rains,
 and Avhen its mineral  admixtures are  deposited by infiltration, it
 bears  the reputation  of being one of the finest waters in the
 world.  NeArertheless, there is a general concurrence, ancient and
 modern, that water that  has fallen in rural districts and percolated
 through a sandy soil and there collected, is the purest and best
 adapted to all the purposes of life.  Rain water is known to con-
 tain an appreciable amount of iodine, and has a marked  influ-
 ence on affections of the urinary organs, on dyspeptic complaints
 and intestinal diseases.   Nothing is  more essential  to health
 than pure Avater.  Rain  water Avhen collected  in the closely built W;iterhow
 parts of cities, not only collects the filth and soot  off the roofs, impaired.
 and atmosphere, but the gaseous impurities  with  which the air
 is  impregnated;  and it has been demonstrated, that howeA-er
 long the rain has been  falling,  foreign ingredients will always be
 found  in it.  This Avater  should  be filtered as it comes from
 the roof through the gutters into the cistern, by passing through Howpurified
 a bed of charcoal, and its power of absorbing atmospheric impuri-
 ties and a nidus for musquetoes checked by having a float of wood
 on the surface of the water in the cisterns.  If,  notwithstanding all
  these precautions, animalculse should be found in it, and the liabili- 
218           Report of Dr.  Edward II. Barton  on the

         tyof being a breeding place for musquetoes, as all stagnant Avater*
         are, may be obviated by placing small fish in the cistern.   The pre-
         sence of animalcuhe in large numl>ers,aud itis believed that few cis-
         terns are Avithoutthem, indicates the existence of animal and vege-
         table matter usually in a state of decomposition, which invariably
         acts injuriously, if the Avater containing them, is used largely for the
         purposes of loot 1, and the effects will be the more immediate and
         marked Avhen the animalculse are large and numerous.  The Ger-
         man naturalist Ehrenburg, as the result of very extended obser-
         vation, established the fact that the existence of visible animalcu-
         he, generally indicates the presence of a lower series of invisible
         animalculse descending in magnitude to the smallest monad of the
         most simple structure, so small that there  is probably no smaller
         organized creature on Avhich it can feed, which as is commonly
         conceived, by arresting organized matter on the very limit of the
         organic world, and converting it into its own  nutriment,  it fur-
         nishes in its turn, sustenance to higher orders of animalcular life.*
            The above high  authority then states it as an aphorism that
         those who drink water which has stood for some time exposed
Tow« water is m atown, drink town air, whilst they who drink water brought
lownair.   direct  from an elevated rural district, without such exposure,
         are drinking country air !  All this is easily understood, and
         the water in our hydrants  is liable  to the  same  objections,  so
         far as exposure on the water works mound  makes it  so,  al-
         though it is not as  much so as the cisterns in our back yards,
          exposed to the contamination of every vitiation there arising,
          and the more so, if in the thickly built parts of our city.
            But water is not only demanded as a necessary of life,  for
         its own purity, but is required for purifying our clothes, houses,
          yards, streets, and it is utterly impossible to keep anything in
          a cleanly and healthy state Avithout its  abundant supply  for
          all these important purposes.   For these reasons, the  Avater
          works should belong to the city, and eArery house that is built
          should compulsorily (by  city enactment) be  supplied with it.
            From the peculiarity of our climate and position the sani-
* Report Annual Board of Health. 
                Sanitary Condition of New OrUan-s.             219

tary condition is so much influenced by the structure of our
dwellings that no building should be erected without due sur-Snrveillimce
veillance of the authorities.   This could not  be reasonablyonbuildil,gs-
objected to,  as it  is but an  extension  of  that  care for the
health which is exercised for the  lives of the citizens in
causing buildings to be made sufficiently strong, and in the
protection of property, providing against the combustible na-
ture of materials in the thickly built  parts of the city. • The
controlling the moisture and crowding are  the great enemies
we have to guard against.  These are corrected by ventila-
tion and space.  EA*ery floor should be raised at least six
inches, and the  higher the better, above  the level of the crown
of the street before the door, and have corresponding outlets,
front and rear, for ventilation, always open.
   Houses should be so constructed as to enjoy most advanta-
ges from ventilation with such opening to Southern quarters as
°                                                    .    Direction of
to have, if possible, the advantages of the drying and enliven-,
ing powers of the wind and sun in the yard, and when prac-
ticable, on streets at right angles from the river, so as to enjoy
the refreshing  and  purifying  influence of  the currents of
water.  Of course, all houses cannot embrace all these ad-
vantages; we mention those which are best, and the principle
 on which based.
   Not more than a certain per centage of  ground should be
 used for buildings, so as to admit ventilation and light.  From    Ketttain
 the high value of ground in cities  men take advantage,  con- amount rf
 suit only their  own profit in the  erection of buildings, the ground t0 be
object being to realize most out of the  space, by over crowd-built on.
 ing them with houses  unfit for the residence of human beings,
 regardless alike of the propagation of disease and the increase
 of mortality.  The safety of the community,  (which  is the
 supreme law) requires imperatively that such  a selfish disre-
 gard of public rights and interests should  cease.
    The amount of pure air necessary for respiration has been
 before stated, and in  the surveillance of buildings particular 
 -20          Report of Dr. Edward  H. Burton on the

          notice should be taken of the size of sleeping rooms corres-
       .   ponding to the number of occupants.
            It is recommended that the dampness of stores  and store-
          houses, as well as dwellings, ?o common  here,  be removed
     amp   by a free use of stoves; for  dry goods, and many  other arti-
 ness of stores     ,     -,■>■,.   iii      -,   • x       ■  xx  •    1
          cles, it would be invaluable, and  aid  materially in the ven-
 removed.
          tilation of all rooms for every purpose, chimney flues for draughts
          should be made in every room.
            No hospitals, jails, poor-houses, asylums, or buildings liable
 why certain tQ ^e much cr0W(]ed. should be permitted  in the thickly built
          parts of the city,  either to impair the purity of the air, or be
 to be in thkk- ....     .                          .
          lmured by its  impurity,  but removed to  the  neighborhood,
[.built places.  J       ...                    .
          where their inmates can enjoy the advantages of a free ven-
          tilation.
            I cannot close this  part of  our subject, of the local causes
          and remedies for our insalubrity, without referring, as a faithful
          historian,  although  most  briefly,  to  the  influence of social
          habits on yellow  fever, and especially, during  its epidemic
          prevalence, as it is the result of my now very lengthened ex-
          perience in it, that no cause  is equally influential.       >
            Civilization, which has so  much lengthened  the  catalogue
 Influence of                        _  _
  .  ,t ,.    of human ills, is—in this instance—to be debited, either truly
 Kjeial habits.                                                          •
          or falsely on the balance sheet, with not a feAv of the moral and
          physical ills with which society is burthened.   Drinking, as a
          social habit, barely dates back beyond two centuries.  In  a
          hot climate its destructive influence has been found cotempo-
          raneous with the habit, acting in a line with all  its injurious
          influences.  The triumphs of temperance, and the  disastrous
          effects of over indulgence in this debasing vice, were never
          more conspicuous and lamentable than during our  terrible
          visitation last summer and fall.
            During the whole course of the sitting of the Sanitary Com-
 Efiect of «-mission, as a  court of inquiry into  the  causes of the epi-
 temperance.  demic, and  its  great mortality, the inquiry  was  usually
          made of those we examined, of the influence of social habits, 
Sanitary  Condition of Neio  Orleans.            221
(intemperance,) upon the liability to the disease, and on its
results.  The answer was almost uniformly, that it not only
increased  the liability  to attack,  but greatly  lessened the
cliances of recovery. This is most singularly and impressively
illustrated, by the record I have  received from the  " Sons
of Temperance," showing  that of these about five hundred
remained  in  the city during  the epidemic, of which, only
seven fell victims to it; the proportion being 1 in 71.42, or
1.40 per cent.; the mortality of the balance of the city, "ofmortalit
those who remained," under similar circumstances, being
1 in 15.43, or 6.48 per cent.,  or nearly five times as many.
A more valuable commentary  on the  advantages  to  be
derived from temperance here, during the most malignant
fever this country has ever experienced, cannot be found in
those annals of philanthropy.  May its record long exist as
a  standing monument  of its protection  against pestilence,
and speak, trumpet  tongued, as  a warning to the  South,
against its alliance with disease.*
   The explanation of the cause of the value of temperance,
is perfectly apparent to the dullest comprehension, for it is
a truth that  holds good in every  climate, that in proportion
to  the  healthy state of  the  digestive organs, which intem-
perance always injures, sooner or later, is the constitution
enabled to resist  the causes of disease, and to pass through
it more safely when under its influence.   This  is eminently
illustrated in  those  two most formidable diseases, yellow
fever and cholera, whose  throne  and citadel are these im-
portant organs ;  and could the per centage be  ascertained,
of  the exact difference  in mortality, in cases  where  these
organs were  lessened in their power of vital resistance from
intemperance, and where they were in their  original integ-
rity, it would form  a  most valuable argument in  favor of
temperance ; especially in a hot climate, where it is so much
  *In conference with contractors for various species of public works, as canaling,
original or cleaning out; digging, or exposure of fresh earth m various ways; the
difference in health and capacity for labor, in favor of those abstaining, and thoso
indulging in ardent spirits, furnishes a triumph to the cause ot  temperance, that
ehoula cause its adoption everywhere
            DD 
2*22          Report of Dr.  Edioard II.  Barton on  ths
more injurious than in others,  that was  ever furnished  to
the public.
  During the existence of the yellow fever in Vera Cruz,
in 1847, it was announced by me,  (as Chief Health Officer,)
that any man who went from  a debauch  into  yellow  fever
died, no exception  could be found to it; it is believed the
announcement had a most salutary effect.
                               SECTION  XL
         Comparison of New Orleans with  other cities, and application
           of the subject—Penalty  incurred  by man  congregating in
           cities—Highest class of disease in different climates produced
           by it—Proofs of high civilization—How extensive fires pro-
           duce  sickness—Effect of  sanitary measures in Louisville,
           Norfolk, Wilmington, Charleston,  Savannah, Mobile, dc.—
           Climatural parallel with  the  Southern cities— Value of the
           Mississippi River as a scavenger, dec.—The delusive cleanli-
           ness of cities  on a sandy foundation—Vera Cruz; its mortal-
           ity, civil and  military, under Mexican, contrasted with that
           under American domination—Triumph of sanitary measures.
           There is no more convincing argument, or more satisfac-
         tory proof of the positions taken,  and  the  principles laid
Foundatu»ofdown in this Report,  than by reference to  what has been
ail wnitary  flone ^y our sister cities on this continent.  The illustrations
«aw».      £rom abroad, of the value of sanitary regulations, personal
         and general, are  coeval  with our  race;  indeed, ever since
         man congregated in cities.  Disease  is the result of  the
         transgression of the natural laws ;  these  laws must be under-
         stood, to be complied with.   The organism of man should act
         harmoniously with the laws of matter.  In a  state of nature,
         and in a congenial atmosphere, this is so.  When the luxu-
         ries and refinements of life  are carried to a high degree, man
         pays the penalty of his enjoyments, by a subtraction from his
         original stamina. It is by restoring these, and a removal of the
         impediments to their free exercise resulting from his congre- 
Sanitary Condition of New Orleans.            223
gating in cities, that constitutes the requisition and lays the
foundation of all sanitary regulations.   Man must forego the
advantages flowing from this social aggregation, with its high Penaky of
cultivation of intellect, its advancement in scientific pursuits °°ne,t,ffaUllB
and the mechanic arts, and the greater refinement of inter-
course and manners, and domestic comforts, or correct the
inevitable  evils of crowding, filth, bad ventilation, and the
predominance of vice, or pay the  penalty in greater brevity
of life, and the multiplication of human infirmities.   This
penalty is very  sure, varying from twenty to forty per cent.,
or more, between urban and rural districts, that is, between
the use and  abuse of sanitary laws.   This great mortality
is usually embraced in that class  of maladies, denominated
by Dr. Farr  (who first introduced the term) zymotic, con-
sisting of the class  of diseases of epidemic, endemic, and
contagious qualities.   These differ in intensity in proportion
to the concentration of the cause,  varying in grade from the
mildest ailment up to a disease of ferocious malignity, differing
in type  and name  according to climate; having for its head
in the North  the typhus gravior of authors ; in the East, the
plague;  and in the West, the yellow  fever, as  crowning
monarch of the whole, exhibiting  the  result of the greatest
intensity or concentration of causes producing them, respec-
tively.  These  are not mere  speculative opinions, they are
the result of years, if not of ages, of experience, corroboratedrt " wi«a°«
by the product of daily and hourly observation.  When duly flQm pMte,t"
considered and properly appreciated, it is the wisdom of the
present  gathering  the fruit of  knowledge from the lessons of
the past.  High civilization and  a proper estimate put on
human life, is known by the enlightened application of these
principles.  The prosperity of communities,  the health and
happiness of individuals, and the moral standing of societies,
in a great measure, depend upon them.
  The best proof  of this position is that by the application of  ;
sanitary  laws—the  duration of  man's life  has been materially
increase!,  and diseases have been  greatly lessened in number 
224          lujjvrt of Dr. Edward II. Barton on the

          and espeeiallv in iutensitv in those countries in proportion to
          their application.   Formerly the plague  sAvept olf millions, and
          returned either annually or every feAv years*, it is estimated that
          but a few centuries ago, half the human race, then existing, fell
          its victims Avithin a short period, Avhile now it is limited to  tho
          dominions  of the  Turkish fatalist, av!io applies not these laws.
          In the early part of this century yellow fever  devastated  tho
          Southwestern  parts of Europe.   It has  yielded to the hand of
          improvement.   InA'estigation in  England, has  laid bare  the
          causes of typhus and the hand  of amelioration is fast lessening
          its ills.  In our own  country,  the  application of these laws
          has almost entirely driven yei Ioav fever from the North of Charles-
          ton, and there it occurs but  rarely and greatly  lessened in
          malignity, and the thorough  understanding and application of
          them Avill drive it to regions where they  are entirely neglected.
            The effect of the application  of sanitary measures in improv-
          ing the salubrity of a city have been mostly anticipated, in  the
          preceding  part of  this report, the skepticism existing here,  the
          vital importance of the subject  and the  ignorance of the  fact
          (the improvement, whenever it has taken place, being attribu-
          ted to other causes) Avill excuse our dAvelling a little longer on
          them, in their illustrative application.
            It has been before  stated that our Northern cities were  for-
          merly as subject to yelloAv fever as NeAv Orleans,  and that at
          least one  of them has suffered as much .or more from it than
          this city, without excepting  the late extraordinary outbreak,
          that in each of those cities it was confined to a locality, more or
alone subject                    ,
          less extended—that these Ave re proverbially the most filthy parts
ver        °f those cities, that these cities  have special  sanitary liabilities
          varying from  difference of elevation and drainage, which we
          have not, that these portions have  always  been exempt from
          yellow fever, that they have been healthy since they have ex-
          tended their pavements and been secured, that they  all have
          constantly a careful police, and that water has extended through-
          out their  limits, and that they have never been Avithout an
          intelligent and vigilant health department, that to these causes 
                Sanitary  Condition  of New Orleans.             225

are justly attributed by the intelligent  and observing of their
own people, hi immuuity they enjoy from yelloAv fever, that
the late  apparent exception in the case of the bark Mandarin,
at Philadelphia, last summer, is in entire accordance Avith what
has been stated, for it Avas well ascertained by me  when  there,
that  the first  cases of yelloAv fever did not originate from that
vessel, nor did any- of her crew take  the disease,  but it arose
from the negligent police of the neighborhood, especially made
so by being the  outlet  of two half emptied seAvers,  that  this
disease Avas confined to very narroAv limits, that it Avas con-
stantly visited by persons  from a purer atmosphere Avithout
extending the disease,  that in this  immediate  neighborhood,
there had been an extensive fire, a few years ago, and the houses
had been rebuilt  and improved, and  that although in contact,
as it  were, Avith this " infected neighborhood," but two cases
occurred out of  170 knoAvn to have taken it.  Fires  here like
those  in  London  and Hamburg,  and every Avhere, if followed
by better buildings, have had a fine effect on the sanitary  con-
dition of the locality.  But Avhen they have not been so followed
or a summer had intervened, they have  become  plague  spots,
from  exposing their cellars, privies  and filth of all kinds, and
their collections to sun and rain, which have been verified from
 the fires in Charleston, Savannah, Wilmington, being one of the
 probable, if not main causes of several severe epidemics in those
 cities, so well is this understood among them, that fevers  have
 been predicted from  this cause alone.
  • These views will be strengthened as we come South.   The
                                 , .            i i •■•    __•     In Louisville.
 city of Louisville was formerly subject to annual bilious fevers
 of great intensity, she was in fact, once  called the " Grave-
 yard  of the West," being subject to  bilious fevers, rivaling
 yellow fever in malignity, and which threatened to depopu-
 late  the town.   In 1822, it amounted to 4.64  per cent.  In
 some families nineteen out of twenty were sick at  the sameEffectofpav.
 time; some families were entirely cut off.   There  was  then .ngand ^
 but one street paved, and at least eight ponds within the town ing
 limits.  By draining, paving, and  a  suitable  police,  it now 
2'2G
He pur i of  Dr. Edward  It. Barton on the
Norfolk.
Paving and
draining.
Wilmington
Delusion of
•a&dr soiL
 enjoys a salubrity equal if not superior to any large town in
 the West.
   Norfolk Avas once one of the sickliest cities on thesea-board,
 and frequently subject to yellow fever.  By draining, paving,
 and filling up her low lots, the collecting reservoir of humid
 filth of all kinds,  she has ultimately become entirely salubri-
 ous.   From a letter from Dr. Upshur, with which I have been
 favored, I quote freely.  He says: " Many years ago,  mias-
 matic fever was a very common disease in Norfolk, during
 the autumnal months.  No  case,  however, originated in the
paved parts of the town.  Within the last five  years  avast
 amount of paving has been done, and Ave now have very little
 intermittent or remittent fever.  Indeed, our sanitary condi-
 tion has improved pari passu with the paving of streets, filling
 up of lots,  and increased attention to the cleanliness of our
 streets, and other sanitary regulations;  so that from having
 been the most unhealthy of the Southern parts, our city has
 of late become a  proverb for its healthiness.  Our mortality
 averages only twenty  per month, out of a  population of six-
 teen  thousand," which is only one  and a half per  cent, or,
 fifteen in a thousand, which, if true, exceeds that of any town
of its size, either  on  the sea-board or in  the interior, and
confessedly wrought from being one of the sickliest by sani-
tary regulations.
   Wilmington was once   proverbial for  her severe bilious
fevers, and occasionally, yellow fever.  She is situated on the
banks of the Cape Fear river, (here  fully half a mile wide
with  extensive marshes and low grounds beyond,) on sandy
hills, having an argillaceous base, with a more or less admixture
of an alluvial soil; .-springs  issue from these hills, constituting
slow, sluggish streams, with various stagnant ponds, receiving
the drainage of the town, when it does not sink into the sandy
soil of the place, it  being thereby concealed from the public eye
is  probably, as injurious to  the public health as  if exposed,
as  in either case it  only awaits the meteorological conditions to
become actively noxious. In the former cam the condition is 
                 Sanitary Condition of d,ew Orleans.             227

 worse, as it is deceptive, leading us blindfold to repose faith in
 a security that is delusive.   This is particularly the case when
 the clay sub-soil is not distant, as in Mobile, and other towns
 along  our Gulf coast and  on the Atlantic, to which the moist
 filth sinks, not so low, probably, as the  line of invariable tem-
 perature of the latitude, and never too Ioav to be acted on by  a
 very hot summer.
   Under this condition of things sporadic cases of yellow fewer
 occurred nearly every A'ear, and a bilious fever of a malignant „,.
                                                       *">     Elect  oi
 grade; and finally, a severe epidemic yellow fever, in 1821, de-a^^, an4
 manded the  urgent  attention  of the citizens of  the  place, clearing.
 when the above condition was altered, pools filled up, culverts
 opened,  filth remoA-ed,  neighborhood  cleared, and  sanitary
 measures fully established, and Avith these haA-e eventuated  the
 re-establishment of excellent health.
   Charleston.—This city  lies but  a  feAv feet above high Avater ,n  Ch;irlet.
 mark of the bay before it, and is partly formed of made ground- ton effect of
 This port has usually been found to be  particularly  unhealthy, drainage su-
 it lies  on  a peninsula, almost surrounded by  the rivers Cooperia* "i1-
 and Ashley, the neck cut up by creeks and ponds, and extensive No earth dU_
 swamps in the neighborhood.  The ponds and creeks haAe been turbanc*.
 filled and drained;  the Ioav grounds and lots filled up, leveled,
 and thoroughly drained by underground seAvers; a careful avoid-
 ance of disturbing the original soil of the streets, &c, during
 certain  months, for gas, Avater, or other purposes;  the con-
 stant study of her meteorological condition  by her intelligent
 faculty, and the establishment and  enforcement of sanitary regu-
 lations have had the effect of so improving her condition that
 from being one of the sickliest,  she has become one of  the
 healthiest cities  in America.  I quote from  a  recent report  on
the yelloAv fever of Charleston, by one of her oldest and most
repectable physicians,  (who has been her Port Physician and
Chairman of her Boards of Health for near thirty years*) : " In
proof I say these plans have been progressively going  on, and
in proportion has the healthiness of the city been improved, and
 *Dr. T. Y Simons. 
 'dl&           Report  of Dr. Edward II. Barton on the

          Avhile  the public  authorities are  gradual,  nay, I  may  sav,
          actively pursuing this plan, I firmly believe it Avill be the cause
          of making the city not only one  of the healthiest,  among  com-
          mercial cities, but may possibly make us, in a great  degree, if
          not entirely,  exempt from yellow fever, and should it occur,
          lessen its virulence and mortality.   From long experience  and
          observation, I regard it, the solemn duty of the public authori-
          ties to go on  with this plan, regardless of expense, not only for
          the preservation of  health, but for the extension  of commercial
          prosperity."  These are valuable practical  facts,  the result of
          long years of experience, from high authority, (as most of us
          know personally,) and uttered in an enlightened city, Avhere such
          advice Avill be appreciated.
            The city of  Savannah has  been greatly improved by the ex-
          change  of the dry-culture for the  Avet in the  extensive  rice
Savannah,   swamps in her  neighborhood, and her mortality  has been  re-
          duced to about half of AArhat it Avas before.
            To the soil  of Savannah the same objection is applicable as of
          Wilmington and others, it is mostly  of a porous sandy nature,
          and all sorts of putrid  debris become accumulated and incor-
          porated Avith  it, the offals  of city life, and instead of pure sand
Clearing andor earth, which  may have  originally constituted  the surface of
draining.    the ground, a  species of compost is  formed  and an active fer-
          mentation and decomposition is taken on, AvheneArer there is heat
          and moisture  enough to produce it, * this  the true cause  Avhy
          she has heretofore  been  so sickly, although noAv so much  im-
          proved.
            The verity  of the explanation that has been given, in relation
          to the sickliness of sandy soils, is shoAvn in the fact, that it does
Why a ramy no^ a]wayS require a continued rainy season  to  CAolve or pro-
season not - ^uce ^e (jggj-gg 0f humidity  deemed essential for the develop-
          ment of fever.   Rains in such a position may  have fallen long be-
for sickness           ,                             ...
        ,  fore.   This occurred at the Bay St. Louis during1 her disastrous
where a sandy                             ^
 j,        epidemic fever of 1820, "the spring season Avas uncommonly
          Avet and rainy—converting a large portion of this extensive plain
* Waring. 
                 Sanitary Condition of New Orleans.            229

into a  sort  of  temporary  marsh, with standing water in many
places  covering considerable areas of land"—"thedistrict is im-
perfectly drained by bayous, and in many places, during the wet
season, the  water stands in pools upon  the  surface until it dis-
appears by  absorption  and evaporation,"—''the  drought  then
continued thence from  June  to October."*  Kxperiments  with
the hygrometer would have settled the point of the presence of
moisture or  not—that there Avas an  abundance of Avater a few
feet beloAv this loose soil eould  have been easily enough shown;
I have long essayed to procure  the hygrometric condition of this
neighborhood and of cities similarly situated, in vain.  Assertion
supplies the place of fact, an apparent, condition  takes place of
the real one, and Ave have an additional false fact substituted for
the truth, another stumbling  block to the  progress of medical
science.
   In relation to all these  Southern cities and towns it would bePai,aIlel of
very  instructive, Ave re  all the  materials  at  hand  to run a New Orleans
parallel between them and New Orleans.  Their meteorological with other
conditions have many  marks  of similarity.  Our Avinter  tern- Southern
perature is not  so Ioav, our summer temperature not higher: ourc,lle*-
enhanced hygrometrical condition is more or less  in excess, hit
it is more under control, for our SAvamps are more susceptible of
drainage: the precipitation  here is somewhat  greater, but  then
it is in our power, in-part, to correct this, not only in relation to
its amount, but  to ha.-,ten its discharge in neighboring reservoirs.
It cannot, become absorbed here and thus retained as it is with
them.   Underground sewerage and thorough  surface drainage
then can probably do more for New Orleans  that  it can lor ah our mm
them.  All the filth that collects  in and about New Orleanscanbere,,or_
can be removed by these and other means, for Ave  have only to
throw it, upon the surface of the great and unequal scavenger,
which a kind Providence has mercifully offered us  and which we
so blindly refuse to use,  (to the extent we should) to wit:  the
mighty river before our door, Avhile the above cities have but three
or four feet of tide and  but a few feet elevation above it, giving
* Or. Merrill.
           EE 
230            Report of Dr.  Edward  II.  Barton on  the
          and returning the mixture, but rendered Avorse  by the addition
          or to sink into their absorbent soils to return upon them as  a
          concentrated poison,  at  uncertain  periods, Avhen  the  other
          requisite—the meteorological condition shall occur.
            Let us do justice en passant, to our noble riAer :  a Avide per-
          vading influence for evil has been  attributed to our  great  bciie-
Auribmes of factor—that  resistless stream so  pregnant Avith  blessings to us
the Mississip- w}ien managed rightlv,—be the credit then where it is due. It is
pi nver.     we^ known an(j atlmitted that all sluggish streams in hot climates,
          eAren those that admit of a moderate tide of tAVO, three or four
          feet, by uncovering its banks, bars or islands pregnant with or-
          ganic remains are highly injurious to health.  The  Mississippi
          has none  of these attributes, it is a deep stream (of 100 to 150
          feet) throughout its passage in Louisiana,—it is a rapid stream (of
          from two to five miles per hour) always productive of a salubrious
          ventilation, and when Ioaa', uncoA^ering mainly sand-bars within
Canse of the^ banks,—it has little or no  organic matter in it;  and hence
Minority  o ^ overflows required for the cultivation of rice would not be so
          injurious as other streams Avhich  are  different.  The offensive
          materials on its banks  opposite  the city is derived from  the
          shipping and the city refuse.  For these reasons probably fewer
          rural districts  in  our country are  more salubrious than  those
          situated immediately on its banks with the SAvamps at a distance
          coArered and protected, so different from  the sluggish tide water
          streams throughout our  country, on few  of Avhich  can the au-
          tumnal season be passed in safety.
            The  comparison of Mobile  with  New Orleans in relation to
          their hygrometrical condition I cannot  make,  because that of
 Mobile.    our sister city has not been  made by her scientific men; but,
          excepting her Western quarter, she has as much to increase or
          to give intensity to that Avorst condition as  NeAV Orleans.  Her
          average annual precipitation is larger by more than/ow inches
          than ours, (years 1840, '48.)* If her streets are comparatively dry
          and clean on the surface, it is but to deceive one, a sandy soil Avith
          asubstratum of clay, not far distant, only conceals that Avhich Avith
Probabla hn-
aridity.
•North—N. O. Journal, 1851. 
Sanitary  Condition, of New Orleans.               231
us can be Avashed off, and deludes Avith a semblance of cleanliness
without  the reality,  Avhile the festering poison only awaits the °n,y  ttPPa"
metcorological condition to lend it wings  and give it  virulence.****"**™-
That such is the fact is rendered probable from the circumstan-
ces,  the explanation given, the rationale and  the results, and is
fully justified from what we find to be the case in other  coun-
tries similarly  located.   I need only refer here, in illustration
and  corroboration, to the malignant fevers of  Walcheren, whose .
                                                             where.
situation is much like it.   The fevers of  Pensacola, of Bay St.
Louis,  of Galveston,  of Vera Cruz,  are  thus mainly accounted
for, all of Avhich clearly demonstrates, that there is no substitute
for an impermeable pavement in, a hot climate.
   The distinguished Dr. Fordyce seems  also to have been of
the same opinion.  In his fourth  dissertation, he refers  to  the
''insidious and dangerous character  of these  sandy soils.   Per-
fectly dry and being  clear from wood,  Avith Avater  only a foot
or two from the surface, so destructive to the British army on a in Flanders.
saudy  plain in Flanders, and again to a region in Peru where
Avater is  every  Avhere to  be  found at  about seventeen  inches
below  the surface of  the  earth, although the  country  is itself
barren for want of Avater, and uninhabitable from the number
of dysenteries and semitertiaus that  take place  in it."
   Vera  Cruz is another instance in the midst of the  yellow Vera Cruz.
fever zone,  still more unfavorably  situated than any that has
been mentioned, and proverbial for its pestilential  climate, that
                     1       .        x         .        _    sanitary raea-
I have some scruple in referring to.  For several reasons 1 am
                                            ....           sure*.
urged to  do so, hoAvever, by my colleagues, as furnishing a great
and  direct triumph to sanitary measures.
  From the extent and fatality of  the vomito here and the seiz-
ure and occupation of it by the American army, being in  the
very nick of time for its devastations, it Avas fondly calculated
in Mexico and  extensively believed  in Europe, that  here  the
American troops Avould  meet  a  worse  enemy in the climate,
than in the army of our foe.
  The  position of Vera Cruz is peculiar,  it is situated  on  the Description of
Western  shore of the Gulf of Mexico, in latitude 19° 15' North}CitJP ^ its
on a sandy plain, elevated about five  feet  above  the level  of  the neiehborhood
sea, in the rear of the city are sand hills varying in height from
twen'y to forty feet, and distant from  10 to 1500 yards, between 
232     /    Report of Dr. Edward II.  Barton on  the

         these and  the city during the rainy season are large \»>ols <f
         standing water, extensive  marshes  extend to the Soutlnvot,
         covered more or less Avith mangles and other brush wood, with
         numerous small lakes or ponds, these empty into the sea along
         the South Avail of the city and are the principal means of fur-
         nishing Avater to  the  mass of the inhabitants, aud is largely
         influential in the production of  the insalubrity of the place and
         have been complained of for centuries.  The city is paved with
         coral rock obtained from the sea.  It is surrounded Avith a  high
         Avail (about fifteen feet) so greatly interrupting ventilation, that
         as Chief Health Officer of the place in 1847,1 strongly advised its
         being pulled down as it faced the sea, or to windward.   The
         streets were formerly kept very  filthy, and the place very badly
         supplied with water either for domestic use or cleanliness.  Such
         was its condition Avhen taken possession  of by the American
         army under Gen. Scott, in March, 1847.
           In order to make the comparison as just as possible, betAveen
         the Mexican and American regime, the periods under considera-
         tion shall be as approximative as possible, that is, immediately
         succeeding each other; hence, for the Mexican, I take the years
         1845-46 and the tAvo first months of 1S4Y.  The civil and mili-
         tary I  am  fortunately  enabled to seperate, and they are both
         derived from official sources.   For  the American,  I  commence
         after but two months of possession, Avhen the greatest mortality
        incident to  the recent  conflict, Avas in some degree  abated,
        although  this continued large throughout the season, resulting
        partly from this  cause and  partly from  the  hospitals of the
        place being made the general hospital of  the  army invading
        Mexico, and hence was greatly increased from this  cause,  and
        from  the large number  of  camp  followers and retainers and
        others carried there, in part by curiosity,  and the  period  em-
        braced in the  comparison  comprehends  only the most sickly
        months in the year on the part  of the  Americans.  The  civil
        and military mortality are also separate and are all derived from
        official sources. 
                 Sanitary  Condition of New Orleans.             233

  The ratio of the mortality of the Mexican civil popu-rER CEST'
lation during the years 1845-46 was..............   6.28 Civil mortali-
  The ratio of their  military mortality  for the years       ty, and miiita-
1844-'5-,0  and part of 1847 was  ascertained,  but the       ry,d"rins
amount of the force was not clear, it is put at somewhat
                                      '                      regime.
less than it  Avas found  in 1847, which is probably one-
third too much.  The  ratio of mortality to the strength
assumed, is....................................  13.90
  The ratio of total mortality to total  cases admitted
into their hospitals is............................  19.49
  The ratio of mortality,  of the diseases  of the  skin,
which were very numerous  were omitted,, would  be— .  25-70
  The proportion of deaths by yellow fever to the Avhole
cases admitted Avere.............................  85.23
  And the proportion  dying of yellow fever to the esti-
mated strength  avhs.............................   7.95
  The total mortality  in Vera Cruz, in 1847, during the
American regime, embracing only the five sickly months
from first May to first October, of the civil population,
including strangers and foreigners of  every kind,  not
officially  attached  to  the army, was (by official returns
to me) according to the estimated population, and con-
sisting too, mostly of the  most reckless people on the
face of the earth, and  comparatively feAV acclimated, to  3.52
  The mortality of tlie military during the same period,
embracing soldiers, quarter-master's men and all attaches
of the army, including those left in the hospital on the de-
parture of the army for the interior (a very large number,)
the men  sent  from that army  from time to time, to the
general hospital at Vera Cruz, the army consisting most-
ly of undisciplined soldiers, unaccustomed to the  climate,
was..........................................   4.46
  One-third of this, or 33. IS per cent, consisted of yel-
low fever.
  The mortality of the first infantry, embraced in the
above, is  entitled to a separate consideration:—it  garri-
ican regime. 
234           Report of Dr.  Edward  11. Barton, on the
         soned the city the Avhole summer, and is a fair compari-
         son Avith the mortality among the Mexican soldiery.  The
         aggregate  force Avas  2,047, and the aggregate mortality
         74, or.........................................   3.G1
            (Inclusive of a proportionate  mortality by yellow fever
         of 14.80 per cent.)
            Let us analyze this statement a little more in detail.
            It appears then that the average mortality of the civil
         2?opulation at Vera Cruz, (duriug, of course, the Mexican,
         regime)  amounted in the years 1845-6,  to...........   6.28
            While the same population under the American re-
         gime, in 1847, compared, not of settled citizens acdiiua-
Tlie mortalityJ    '                   .
      ... ted measurably to the soil exclusivelv, as before ;  but of
ol  the civil               J                     - '
population  those, and incorporated Avith them all that large class of
ahoutone-  reckless camp-folloAvcrs of a victorious army, with all their
half, and of dissipated  habits, amounted to......................   3.42
the military    aVnd  that the mortality among the Mexican military
„.bout one-  at t]ie same y\iX(Xi during  the years  1844-'5-'6 and part
fourth during jg^ Mnounted to..........\....................  13.90
the American         .         ,
            And the mortality to cases......................  25. /0
in comparison
            Of which the A'omito or yellow fever, constituted of it.  85.23
            While among our military, including  attaches of the
         army of every grade, the mortality amounted to.......   4.46
            While in the First Infantry (military alone) amounted
         to  but........................................   3.61
            The bare statement of the foregoing valuable facts, is its own
          best commentary : it is furnished as an instance of  the influence
          of sanitary  measures in a hot  climate, on unacclimated  people,
         even under the influence of peculiarly  unfavorable circumstances.
            After the lengthy recommendations given of sanitary measures
          in the preceding pages, it Avould be little  more than repetition to
          say more  than that  these views were carried out Avith military
          precision,  and that it consisted in the strictest policeing, rigidly
          enforced, at the earliest hour,  and the strictest temperance ad-
          vdsed;  tropical fruit,  and particularly  if unripe, forbidden.  The
          city was divided into districts,  and responsible agents and physi-
with the Mex-
ican regime. 
Sanitary  Condition of New  Orleans.            235
cians appointed to each, and required to report to the Board, at
short intervals, the state of each, together with the number and
character of the diseases occurring.
                      SECTION XII.
  Resumi.— We shall now bring this Report  to its close with
the following Recapitulatory Propositions and Corollaries.
  1st. That the insalubrity of Ncav Orleans, AAiiieh has now con-
tinued for so many years—with some remarkable exceptions—is „
                - •>                                *         New Orleans
not natural to her, or necessarily incidental to her position ; thatnotsick, ,„,,
it is the  cause of the high  price of  everything, and  the  direct „..
means of retarding  her progress to  prosperity,  and Avhich Avill
continue  to exist until effective measures are taken to remove it.
  2d. That the direct and inevitable change of climate alone, is
not the sole cause of the mortality of immigrants, but the union „  ,.
                               J         °                  Mortality not.
of the climatic with the terrene conditions under different «V-owln(,towant
cumstanccs, Avere the efficient agents in the destructive influence 0f aceiima-
on each  class of people as  pointed  out  according to nativity; tion.
that man cannot become acclimated  to the second cause,  or ter-
                                                            Can t  acch-
rene (filth, &c.) any Avhere, and  that the acclimation to our first raatetofilth_
cause (or atmospheric) Avould be trifling, if the conditions consti-
tuting  it, Avere so modified, as Avas clearly  shown to be, in our
power.
  3d. We have endeavored to proA'e what Avere the constituents
of the epidemic  yelloAv fever of 1853, that they consisted  of cer-
                                _                           Epidemic
tain atmospheric and terrene combinations  ; that these causes, so
          i                                                  constituents.
far as AAre had  the means  of ascertaining, Avere  confined  to the
limits of  the fever district;  that it began Avith these causes and
ended with them, throughout the limits of the epidemic region,
and that  when these ceased, so terminated  its influence on man,
  4th.  That one of these causes, (the atmospheric,) is more or
less present  here every summer, and  that Avhen the second  (or
terrene) exists in sufficient  amount,  an epidemic is the certain 
23C           Report  of Dr. Edward It. Barton on  the
          result, so far as near sixty year's  experience will  go to prove it;
The efficient j.]^ ^jj, tenene condition is mainly composed of  extensive dis-
cause o  a  ^ul.]:)ances< or upturning and  exposure of the original soil of the
our  epidem-           .     ..     , •   ■>    x    x           1     • 7   ■   i
          country; that without this there has been  no such epidemic, al-
ios.
          though, between the occurrence of  some of them, long periods
          have elapsed ;  and  that its ravages or maliguity appears to have
          been pretty much in proportion to the extent of that disturbance.
            5th. That for the existence of an epidemic, a  wide pervading
Epidemic not atmospheric cause being one of the essential elements, an epide-
          mic disease cannot be imported, and that as a contagious disease
contagious.                                       ...
          cannot depend upon a general cause tor its existence, but must
          derive its qualities from a specific one ;  epidemic yellow fewer is
          consequently not a  contagious disease.
            6th.—That to constitute an endemic yellow fever, the differ-
Requirements ence of aa Inch from an epidemic Avas fully  pointed out, that the
foranendem- apparent contagion Avas only the extension  of the epidemic prin-
ic        ciple, a lesser degree, of the same, or Avhat Avas  believed to he
          equivalent, (filth  of all kinds, and decomposing  materials) with
          a lesser degree  or intensity of the first  or  atmospheric constitu-
          ent, Avere essential.
            7th.—That Avhen these causes did not exist in  a sufficiently
      1,111 high degree  to produce yellow fever, intermittent,  remittent
          bilious, or other periodic fevers Avere the result,  demonstrating
          by  the clearest analogy that they  proceeded from  the  same
          cause, and that they differed only in degree  and intensity, a
          major amount of the very same materials being required to pro-
          duce yelloAv fever, as aminor one does for bilious or periodic fevers.
            8th.—That all  these fevers are produced from local causes,
          more or less extensive, and that the fevers, the result  of these,
          Avere limited to these bounds, that these causes are well under-
and local ef-
fec        stood, and were extensively pointed out in detail, that wherever
          the epidemic extended, there  were causes to localise it, thatAvhere
          these did not exist,  the cases of  the epidemic conveyed there did
          not extend, and that consequently, that all these fevers arising from
          bad air, are no  more contagious or infectious the one than the
          other, the liability to them is limited to the bad  or infected air
required for
periodic fe-
vers. 
Sanitary  Condition of New  Orleans.             23*7
and personal susceptibility; and finally, that these are of the
greatest importance  in  their  practical  bearing  on  sanitary
measures.  And,
  9th.—That the temporary epidemic cholera  which  occurred
here early in December, it Avas shoAvn, depended also, upon two
      .                                                      demic chol-
conditions, an  atmospheric and a terrene ; that the  first  of
                    1                                       era.
these was different from that required to produce epidemic yel-
low fever, although the second was believed to be the same.
  From all Avhich the folloAving corollaries were deduced; viz:
  1st.—That an epidemic yellow fever in NeAv  Orleans, if pro-premies
duced by the causes stated in our third proposition, as believed, comroiaUe.
being knoAvn, is controlable, that is, preventable.
  2d.—That an endemic yellow fever, arising from the same  or Do. ofendem-
equivalent causes, as above, although in a lesser degree, can also,ira-
be mainly, if not entirely controled.
  3d.—That the causes of bilious or periodic fevers being knoAvn
also, to arise from a smaller amount, or more diluted condition no.ofperiod-
of the same circumstances, although  more general  and exten-ie fevers.
sive, and more  dependent on i>ersonal hygiene, it is in the power,
as it is the duty of  the civil authorities to mitigate, if they can
not entirely control them ; and finally :
   4th.—That it was demonstrated, that by the proper appli-
cation of curative  measures, by the establishment of proper New Orleans
sanitary laws  and  police  ordinances,  rigidly enforced and Can be  made
effectually carried out, New Orleans can be made as healthy healthy.
as any city in  America ; and  that it was not only the interest
of  the  city to accomplish these  important  purposes,—but
that—
   5th.—A penalty could be as much enforced upon the civil Claim3  forle_
authorities for neglecting the  removal of conditions subversive gSi\en{0Ke-
of health and life, as for any purpose  for which society was mem.
formed.
   Proofs and illustrations were furnished of  the influence of
sanitary regulations in various cities of the old world and  on
this continent, and what they had accomplished in removing
             FF 
233          Report of Dr. Edward H. Barton on the
          causes of disease and restoring sickly cities to the enjoyment
          of salubrity.
            A comparison  was  instituted between  New Orleans and
  er prospen- 0far American cities,  and particularly Avith Southern cities,
          with a running commentary  on their comparative liabilities
 pends upon               °
 h ..      and immunities, and the important result Avas come to, that
          our city was far fiom being in an irreclaimable condition, and
          that she could compare favorably with any of them.
            It has been as truly as beautifully said,  that intelligence is
          not only synonymous  with moral  power, but  with health.*
          Health manifestly depends upon  our observance of certain
 synonymous
  ....  ..   laws,  which the  Providence  of God has  entrusted for our
 with health.
          guidance,  which are  recognized by  all  mankind and are
          instinctive.  When these  laws are  broken, punishment (that
          is, disease,) inevitably  follows, sooner  or  later;  but it is in
          our power, as it is our  duty, to  comply with them, and exert
          the faculties He has given us for our welfare.   We can only
          know the future from the past;  it is the part of wisdom to
          know that like causes produce like  results, under similar cir-
          cumstances.  The constant recurrence of  yellow fever in the
          epidemic form, whenever there  have been large disturbances
          of the soil, and never otherwise,  in so long a period as  sixty
          years, and in proportion to that exposure, must be something
 The real cause more than a mere coincidence: it seems to the Reporter ai
 of our fevers,  well attested  as any fact in history or science, as too intelli-
          gible to be misunderstood; invaluable as a Avarning, and the
          memento  on  that Chart as plain to us as "the handwriting
          on the wall " to the prophet of Israel. No less palpable, and
          as little to  be disregarded, are the "plague spots" which have
          been  demonstrated here, as in  other cities, that here, in the
          midst of filth of all kinds, are the true birth places of disease.
ah cities im-  an(j j^ wag equally  clearly shown how much it  was in our
proved by  p0wer to remove them, and that it was our duty and interest
       ia"to do  so, not merely on account of present prosperity, but
Bures except
New 01    even  *"rom  a  D*guer consideration, the  promotion of  the
*Marx Willis. 
Sanitary Condition of New Orleans.            239
great interests  of religion.   Our reputation abroad  for
salubrity is ruined, reform is now only left us.  All cities,
wherever  situated, whether in the old  world, the  highly
favored seats of renowned monarchs, covered  with marble,
drained and watered by works that are still the wonder and
admiration of the  world, or in the new,  the selected marts
of far enriching and enterprising commerce, have been sub-
ject to epidemics;  which, like the monaxysinal diseases, the
trials of infantile life, stand as tests  of the constitution.
Many quail and sink under the trial. New Orleans has stood
many such trials;   she is now at a crisis, and it will depend
upon her people to say whether she shall recuperate or not.
Her consulting faculty, (this Commission,) have pronounced
her entirely susceptible of cure,  if their advice is folloived,
otherwise  not.   A neAV era has  manifestly sprung up, it is
signalized by the  appointment of this first Commission of The certain
inquiry into the  real,  not  suppositious, condition  of NeAA7resuItofprop"
Orleans.   We look upon it as a proof  that the great refor-er ,neasnre9
mation so much needed, and without which  no permanentaop
prosperity is to be expected for  this city,  is about to com-
mence ; that the influence of sanitary measures is at last to
be attempted, and we can not avoid the prediction, that it
will eventuate as it has in all other places, in future pros-
perity and advancement.  Nothing else is noAV wanting to
repair the errors of the past, and it does no violence to prob-
ability to foretell  from them the most brilliant future.  If
the  Sanitary Commission shall  not  succeed in  convincing
their fellow-citizens of this, and  that  the  same  principles
are applicable to  our city as to all others, which is the true
practical  object of their appointment,  then  that appoint-
ment will have been superfluous.  But, if we  shall have
shown by unmistakable facts, figures and argument, that we
have nothing peculiar in our climate or position, but what
is entirely accessible to amelioration and amendment  by
the hand of reform;  that our city may be  restored to salu-
brity ; that her reputation for perennial pestilence  shall be 
:-10          Report of Dr. Edward II. Barton on the

        no longer applicable; that  upon the broad foundation of
        sanitarv measures we  can erect  a  monument of public
        health, and, that if a beacon light is erected on its top, and
        kept alive by proper  attention, our city will soon be second
        to none in  this  first of earthly blessings; the appointment
        will not have  been made in vain.
                              SECTION  XIII.
                          KEt'OSIMEXDA T IONS.
          We accordingly offer to  the Council the following recommenda-
            tions :
            1st.—To adopt the  system  of Seiveragc—the system ap-
          proved of by the Sanitary Commission,  as reported by our
 Sewerage,   colleague, Prof. Riddell—embracing  streams of running
          water constantly through the streets, from the river or other-
          wise, from March to  November,  during the day only.
            2d.—The  drainage, in the most complete  manner, of the
 Drainage.    neighboring  swamps and levees on Lake  Pontchartrain, to
          keep out the Lake water.  This is to be effected by machinery
          and covered drains, and these to be dug in the winter season.
          After  this is fully effected, in  the opinion of your  Health
          Department—
 Forest "rowth   ^d.—The removal of the forest growth, excepting for ave-
          nues and parks.
            4th.—The  completion of the pavage of the city  (removal
          of the round stone) by square blocks, united  by cement, and
          the avenues may be (temporarily) by thick planks.
            5th.—The purchase and extension of the Water Works to
 Waterworks.
          every portion of the city, with  fountains in each of the pub-
          lic squares.
 Shed on river    ^th.—An extensive shed the  entire front of the business
         part of the city.
Trees.        ^n-—^° plant trees in all  the public squares and  princi-
         pal streets. 
                  Sanitary Condition of New  Orleans.             241

   8th.—To fill up Gormley's Basin and make  a public square Gormley's ba-
 of it.
                                                            sin.
   9th.—To make covered  drains of Gormley's and  Melpo-Covered
 mene's Canals, and all the other drains of the city.           drains.
   10th.—That the slaughterhouses be removed to such dis- e,
      _                                                     Slaughter
 tance trom the city, and all vacheries and livery stables having honsM vach.
 over six animals, removed  to squares having fifty population eries and Liv-
 and ten  dwellings.   The same of soap and tallow chandle-ery stables.
 lies, or other manufactories or pursuits  that have a tendency,
 in  the  opinion  of your  Health Department, to impair the
 purity of the city atmosphere.
   11th.—The adoption of  a system of privies, according with prjTie3.
 the recommendations in  this Report.
   12th.—To discontinue interments in the city  limits.         Cemeteries.
   13th.—To prevent any but the  most superficial  disturb- Disturbing
 ances  of the sod of the city or neighborhood, from lstMaysou
 to 15th October.
   14th.—To establish  a  Health  Department on the plan Health de-
 detailed in the next section.                                partment.
   15th.—To  establish a  quarantine station,  not nearer  than Quarantilie
 eight miles from the city, as a  branch of the Health Depart-
 ment.
   16 th.—To carry out fully the system of privies described in
 another section of this Report.
   And finally; to order at an  early day, a complete  Sanitary
 Survey of the  city before  the warm weather sets in, under Sanitary snr-
 the instructions of the Health Department, of every house,  lotvey-
 and back yard in the city, to be most thorough and searching
 for eA-ery cause of  disease, Avith plenary authority for that body
immediately  to abate it.   To  ascertain  from every family the
number that have not been vaccinated.
  A book of record  to be kept, Avherein  shall  be recorded the
                           1                                Book of
reports from the Inpsectors  of the special condition of every ^^
square in the city, Avith plans and diagrams, for  present action
and future reference, blanks  being furnished by the Health  De-
partment, enumerating the duties and objects of the inspection. 
242          Report of Dr. Edward It.  Barton  on the
                                SECTION XIV.
          Ordinance for  the Establishment of a Health Department ft?
                           the City of New  Orleans.
          Be  it ordained by  the  Common Council of the City of New
            Orleans :
            Section 1.—There is hereby  created a Health Department
          for the City of New Orleans.
            Section 2.—This Department shall be constituted by the
          appointment of the City Council, in Joint Session, of a Board
          of not less than three Physicians of the City of New Orleans,
Health De-  eminent for their services, experience and practical knowledge
partment to  0f sanitary laAvs and influences, Avho  shall have  resided in the
consist of   city at least  ten years, and  whose term of service shall be five
Three Fhysi- years.
ciang         Section 3.—It shall be the duty of said Health Department
          to elect, on its first meeting, one of their number as presiding
          officer, Avho shall preside over its deliberations; be the organ
          of communication Avith this  Council  and the Public, and  draAv
          up the annual report.
            Section 4.—It shall be the duty of  this Department to have
President and surveillance and control, under the orders of this Council,  over
his duties.    everything that may affect  the  salubrity of  the city of  New
          Orleans, or have a tendency  to  impair the same; to visit and
          inspect all hospitals and infirmaries for the reception of the  sick;
          to see that they do not admit any contagious disease;  that they
          are kept in a cleanly and not croAvded condition, having not more
          than one patient to every one thousand feet of space.  They shall
Dutiesof said yjsjt an(j inSpect) likewise, all Jails, Lock-ups,  Asylums, Board-
Heaith  De- \ng^ or other Houses, liable to suffer from overcrowding or filth;
partment.    Manufactories, Livery Stables, Vacheries, Slaughter-houses, and
          any  place which it has reason to believe there may be a nursery
          of filth,  impairing  the  purity  of the air.  That the space al-
          loAved  in lodging-houses  for  each individual shall  not be less
          than six hundred cubic feet of space for each adult.   To see that
          the cemeteries are in a proper condition, Avith the poAver of re-
          moval for neglect.
Penait   for    Section 5.—All  persons  occupying houses for lodgers,  or
          AArhere the said Department may have sufficient reason to believe
o  structmg   |.|iere may exjs£  a p>reach 0f this Ordinance, are hereby forbidden
inspectors of j.Q 0bsf_ruct the examination of the same by themselves or  their
Health De- Inspectors, under a penalty of fifty dollars for the first offence,
partment.    one hundred dollars for the second, and five hundred dollars for
          the third, or taking away the license.   And  this sum shall  be
          sued for and recovered before any Court having competent ju-
          risdiction, and the said amount recovered shall be accounted for
          in the expenditures for the support of the same, and it shall  be
          the duty of the  City Attorney to prosecute for the same. 
Sanitary  Condition of New  Orleans.             243
  Section 6.—This Department shall keep an  office in some
central building, to Avhich shall be placed in their special care,
all the mortuary records of the city of NeAv Orleans, and shall 0ffice  and
appoint their own  Secretary,  which office shall remain open RecordSi
during the usual hours of business, and the books and  records
of said  Department shall ahvays be open to the inspection  of
the members of this Council.
   Section 1.—It shall be the duty of this Department to have
prepared and keep blank books for the folloAving purposes :
   1st. One containing an accurate  record of each and every Book of Rec-
burial in each of  the several cemeteries appertaining to this city, ord for each
in which shall be recorded the name, birth-place, sex, color, age, branchof the
period and place of residence in this city,  and the cause  of Health  Dd_
death of every one buried in any of said cemeteries.
   2d. A book to record the Aveekly or other reports of the Dis- Partmellt-
pensary and other physicians, (hereafter mentioned.)
   3d. A book to record the daily and Aveekly statements of the
Inspectors, (hereafter mentioned.)
   4th.  A book to record the reports and applications of all the
vidangeries.
   5th.  A book to record the reports of those selected to make the
sanitary survey, from time to time.
   Section 8.—It shall be their duty to select and license the Number   of
Inspectors or Health AVardens for the city, whose number shall ^"ors  or
not exceed nine, and who shall serve, under the instructions  of  ar ens-
said Department,  and Avhose duty it shall be  to point, out  andnutyof.
order to be abated anything that may, in the  opinion of  said
Department, impair the salubrity of the city.   They shall also, v°nA^m>
 license all Undertakers,  Vidangeries, Sextons,  and no others Sevton9j  Vj„
 shall be recognized or perform the duties appertaining to those dangeries.
 several callings, without such license,  under  a  penalty of two Penalty and
 hundred dollars.   And it shall be  the duty of  said appointees duty.
 to obey all the lawful orders of said Health Department relating Apermitfr.m
 to their said duties.   And, further,   it shall  not be  awful for Health De-
 any Sexton to bury or any Undertaker to convey any body from partment to
 or into the city of New Orleans, without having previously  *>■££»
 ceived  an order  to that effect from  the Health Department,      ^
 under the aforesaid penalty;  and for  a second offence, to be liar    ^
 ble to a penalty of double'the amount, ami  to be deprived of
 their license.
   Section 9.—It shall be the duty  of said  Inspectors, in  theDuty  of ln_
 Districts to be appropriated to them by this Department, to  he    r
 constantly occupied in visiting their  several  Districts, and  to
 give a written report of the  condition of every  house, back-
 ward privy, open lot, street, alley  and building, mentioned  in
  ectionfo/r of this Ordinance, in writing, each week, under such 
244          Report of Dr. Edward H.  Barton on  the
         blank heads and instructions as the Health  Department shall
         furnish.
            Section 10.—It shall be the duty of said Health Department
         to cause to be rendered at the  expense of the proprietor or oc-
Duty to have CUpant Qf .my [louse or premises, Avhere  there shall exist any
nuisances re- nujsance—and eA-erything is denominated an  nuisance that, in
moved.    the opinion of said Department, shall im; air the purity of the
         air of the city—Avithin a delay not exceeding one day in summer,
         and six in Avinter.
Empty lots to   Section  11.—It is hereby ordained  that  every empty lot
be filled.   shall be filled six  inches above the crown of the street within
         sixty days after this Ordinance shall lake effect.   And that no
Cemeteries  Cemetery within  the thickly inhabited  parts of the city shall
disused.    any longer be the receptacle for the burial of the dead, after
         the 30th April, inst.
            Section  12.—It shall be  the duty of the Vidangeries  to
Duties otvi-have  a permit from said Department previous  to cleansing
dan eries   any Pr'vv> stating in their application,   (which shall  be duly
         filed and recorded in a book appropriated to it,)  the number,
         location and proprietor of the house whose privy it is his in-
         tention to clean.
            Section 13.—It is hereby made the  dut}7 of the physicians
Cemeterycer- Qf t^]S cj^  and of the families of all deceased  persons, and
tificates.   attendants on such deceased, to  give  such  information  in
         relation to each deceased person as is required in section 7th
Fromwhom-of this Ordinance, under a penalty of  fifty  dollars,  without
         which no burial certificate shall be issued, unless the Health
         Department is satisfied it could not he  procured.
Districts nine   Section  14.—This   city   is hereby  divided  into nine
         Wards, in each  of which there shall  be established a Dis-
         pensary, under  the instructions and surveillance of the Health
penBanesand Department, where medicines shall be distributed to the poor
Physicians to gratuitously, on the certificate and prescription  of the Dis-
attend  poor] pensary Physician of said Ward, on his being satisfied of the
Bick.      inability of the sick to pay  for the  same,  which  certificate
         shall be duly recorded as a voucher for the same.
            Sect ox  15.—The City Council shall elect immediately,
        y"and hereafter, in  the  first Aveek in January of each year,  a
sician  ap- physician, duly qualified by experience of at least five years
pointment,  in this city, of the diseases  of the climate,  of education,  of
qualification", which a diploma from some recognized, respectable  Medical
         College, shall be required, and of good  moral  character,  to
         each  Dispensary  District.
            Sec i ion  16.—It shall be the duty  of said  Physicians to
Duty of ditto, attend the poor of said  Districts, respectively,  gratuitously
         prescribing for  them  at the  Dispensary, at some regularly 
Sanitary  Condition  of New Orleans.             245
appointed hour, and at their houses, Avhen they shall be una-
ble from disease to attend the said Dispensary; to vaccinate said
poor, and to report the condition, as to salubrity, and  of the
character of the  diseases prevailing, and  a record of each
case prescribed for, to the  Health  Department,  in Avriting,
Aveekly—in default of Avhich the poAver of removal is hereby
given to said Department, and  temporary  substitution, until
his place shall be regularly filled by the Council.
   Section 17.—The  Health Department is hereby required
to inspect the Quarantine Stations, which shall be considered
but a branch of this Department, and advise with the Q,uar-To <*»>"'"•
antine Physician  on all subjects relating to his duty, and to quarantine.
see that the several officers attached to the Station perform
in a proper manner,  the duties required  of them by  law.
And it is made the  duty of the  Quarantine  Physician  to
report the condition  of all vessels arriving  at this port from
any other port, as to cleanliness, and oi  the  number and san-
itary condition of her passengers and crew, and  especially if
any contagious, infectious, or  febrile diseases   shall be  onduty of '"
board,  and report.    This  shall   be  done  (if  the  imme- Physician.
diate advice  or  the  action  of the Health  Department  is
required) at once: otherwise, Aveekly.   It  shall also be its
duty to prepare from  time to time, in  conjunction  with  the
Quarantine Physician, such  rules and regulations as may be
required for  its  government, subject to the approval of the
Council.
   Section 18.—It shall be the  duty of the Health Depart-To publish
ment, during the existence of any epidemic,  disease, to publish advice during
instructions to the  public, succinctly embracing short advice an epidemic,
on its prevention and treatment.
   Section 19.—It shall be the duty of said Health Depart-
ment to keep a Meteorological Register, and record  the  tem- Meteoroloei- <
perature, barometer, winds, amount of rain and hygrometry ©f cai record kept
the atmosphere at least three times a day.  To make and pub- and published
lish a Aveekly  report of the number  of interments in the  city weekiy, with
cemeteries, with such particulars in section seven as said Health Cemetery re_
Department  may deem  of  interest to the public, Avith  an
  . x      . ,    J  ,    ,   .    ,          •  i     i     a      l turns weekly.
abstract ot the weather during the same period, and an Annual
Report, with all the particulars  bearing  upon  or  appertaining Annualreport
to the salubrity of the city, Avith such  suggestions  for its im-
provement as  it may recommend.
   Section 20.—The  compensation of the  President  of  said Compensa.
Department shall be $3,000 per annum, and to each assistant ^
$2,000 each;  to  the Secretary  $1,200; and for office, station- IO
ery, blank books and blanks, and aid in organizing  the office the
 first year, $2,000, or as much as may  be  required.  To  each
 Dispensary Physician  $600 per annum ;  to the Inspectors, each
            GO 
248           Report of Dr. Edward H. Barton on the
$500 per annum—to be  paid monthly, on  the order  of the
President of the said Department, and it shall be his duty  to
settle annually  Avith the  Comptroller the expenditures and
receipts of  his Department in January of each year.
  Section 21.—It is hereby ordered that an immediate Sani-
tary Survey be made of the entire city, under the instructions
of the said Health Department, Avho shall issue printed instruc-
tions to the Inspectors in blanks, and a plan  of his District, and
such other aid as they may require to  facilitate  it,  embracing
the following  particulars, viz: The condition of every yard,
whether paved or not, and how cleaned ; the number,  extent,
and location of all lots that are beloAv the level of the croAvn of
the street; if supplied, and how, with  water ; the number  of
tenants  and boarders in each house; the construction of each
house—of wood or brick; the condition of  the priries; the
condition of every drain, canal and basin, and cemetery, and
manufactory, slaughter-house, livery  stable, and  vachery, in
each District;  the condition of the levee and bank of the river
and swamps contiguous to districts bordering thereon.
  This inspection shall be recorded as the first in the Book  of
Record  of Inspection, showing the exact condition of New Or-
leans on this foundation  of a permanent Health Department
for said city.
  Section 22.—The Health Department is hereby authorized
to furnish health certificates to the shipping,  of the condition of
the city, and to charge for the same $2 each  to the domestic
shipping, and to the foreign $5, and to account for the same in
the annual settlement with the Comptroller.
                      SECTION XV.

Modes of Raising the Means necessary to Defray the Cost of
                   the Recommendations.

  The large means required to carry out fully the views of the
Sanitary Commission, and  which is deemed requisite to restore
this city to salubrity—-to  enable her  fully to compete with any
city of this Union, either  in relation to  health or the great pur-
poses of commerce, we are  fully sensible, she could not, at once>
bear, under  her ordinary  resources, and it is  farther obvious,
that  crippled as she has  been, by the calamities of years, she 
Sanitary  Condition of New  Orleans.             247
cannot noAv sustain a  heavier load of taxation than she is now
laboring under.   These, we fear, (if men submitted  to) would
farther tend to paralyse her recuperative energies,  and put her
beyond the possibility of competing Avith  her more fortunate
rivals.
   It becomes our duty then, to point out some extra means be-
yond the ordinary resources of the city revenues, to accomplish
objects in the  highest degree urgent and  important  in them-
selves, and which we deem indispensible to her entire salubrity.
Nor do we doubt could these objects be effected, she  Avould be
as  healthy as any city in the Union.  If some of these modes
of raising this  extra revenue are evils  in themselves, they  are
certainly much  less  than  those they will aid in  effectually and
permanently removing, and be of but a temporary character in
themselves.
   1st.—The city Council might reasonably  expect from
the fund derivable from the sale of SAvamp lands......$200,000
   2nd.—Three years  ago a recommendation was made
by the late General  Council of the city, that an appli-
cation should be made to the  eighteen States directly
interested in its salubrity, to induce them to  unite in re-
commending to the  General Government to transfer to
this city 200,000 acres of  public  land, for  which  pur-
pose it created a Board called " TJie Permanent Sani-
tary  Board,'1''—Avhose duty it was  made to initiate the
necessaiy steps  to obtain  it.   That Board organized and
drew up a Report—in Avhich the  claims   of NeAv Or-
leans Avas  set forth,—through which it Avas clearly de-
monstrated that there  had  been  expended  by  this city
and the State of Louisana for the actual  and prospec-
tive population  of these States not less than  $2,000,000,
and that it Avas  morally  and equitably  right, that  that
sum ought to be considered  due.   The Report Avas ap-
proved of by the Board,  but there required an outlay of
some $200 or $300  for  printing, &c, and as there was
no sum appropriated nor could be procured,  nothing far-
Sale of
■wamp lands.
Public lands
from the Uni-
ted States. 
248         Report  of Dr. Edward It.  Barton on the
McDonogh's
bequest.
Tonnage
duty.
Loan from
McDonogh'i
estate.
ther could be done.  The  claim is deemed a just one,
and if the proper steps  were taken, a large sum could
most probably be raised from it.
  A reconstruction  of that board is recommended,
or its duties might  be devolved upon  the health
department.  As this will require time, no amount is
put down as arising  from  this source.
  3d—The estate of the late  John McDonogh, will
have a  contingent fund to be available after some
years.   It is believed that a considerable sum could
be raised from this source; it  could be  used on the
basis on which a sum could be obtained on credit,
say.........................................$35,000
  4th—The President of the United States has ad-
vised, in his message to Congress, that a tonnage duty
on all vessels visiting the several ports  and harbors,
be left at the disposal  of  the States  respectively.
This would be just,  as  enabling each to collect a
large amount of money, required and received in pro-
portion to the importance of the port, to be appropri-
ated to the wants and requirements of these ports, to
facilitate the various advancements and  conveniences
of commerce.
  Tihere would be a very large amount derivable from
this prolific source, say only....................$500,000
  5th—The final adjudication, by the  Supreme Court
of the  United States, of the large estate of Mr. Mc
Donogh to the cities of New Orleans and Baltimore,
leaves  subject to  the control of this city a large sum,
which it has been proposed to invest in railroad stock.
It is conceived that the first interest  of New Orleans
is its salubrity; all else should be considered subsidi-
ary to  this.   Railroads are  the second  great duty of
this city ; but without health, they only  make a great
winter factorage of it.   With health, railroads will
make it second to no city on the continent.  Its salu- 
                Sanitary  Condition of New Orleans.             249

brity, and its reputation for salubrity, must precede it,
now its reputation is gone.
  The amount to be derived from this source is very
large, say...................................$400,000
  6th—A special tax on the property of absentees is
not constitutional, but some means should be devised
by which to apportion, somewhat more equitably than
is now done, the various incumbrances of civil govern-
ment—the benefits and burthens;  and particularly
during  epidemics,  these  latter are very onerous  on
those who remain to discharge faithfully their  duties
to society.
   The authorization to raise a certain sum by lottery
to be solely appropriated to the removal of the causes
influencing the salubrity of the city.
   Here then is the enormous sum of...........$1,435,000
besides the contingencies that have not been estima-
ted, but little  more than half of whichv would make
 New Orleans one of the healthiest cities on the con-
tinent, and one of the most desirable residences; put
her in the front rank of American cities, and with her
 railroads, defy all competition. 
 
                  0catl)0 in Xctu   (Orleans  Miring  tl)e  near  1833;

       ■i^iuWvvui) lid naAx)  VSIqM) *1)  g^ li^taAti) x\d  loiul) (^Wuuaiu), xw\xl) ILaM *U  jC.oxW  8Majy\IW-

ALSO, THE  SEXES AND  COLORS WITH  THE AGES AND PLACES OF NATIVITY;
                        COMPILED FOR THE SAXITA11Y COMMISSION BY I"). MAOGIBBOX, M. D. 
-'s 
                 TABLE  G.

Monthly  Returns from  each  of the  Cemeteries.
1853.
Cypress Grovo No. 1......
No. 2, or Potterstield.....
Odd Fellows' Rest.......
.St. Patrick's.............
Charity Hospital.........
Lafayette, or 4th District.
St. Vincent de Paul......
Hebrew, on the Ridge___
Hebrew, Lafayette.......
Protestant........'.......
St. Louis No. 1...........
St. Louis No. 2..........
Totals.
Jan.
Feb.
A'ril
May Ju'e
July
1371 469
104| 224
  ll ...
  21  25
 22
 14
 70!
A'g. Sep.
 151
1424
 52
1038
 917
1177
1040
  7
 71
 218
 67
 136
518  487  508 510 676  668 2132 6298 1621  700  747 759  15572
Oct.
Dec
Total.
  480
 2690
  121
 2558
 2638
*2696
*2446
  22
 *124
 *633
 *334
 *830
  * Those thus marked (*) are within the city limits, and amount to 7063.

                          EXPLANATION.

  There are some discrepancies in  the report in relation to the  monthly
mortalities—the monthly returns by the cemeteries—the aggregate mor-
tality for the entire year, and number in the tabular return of yellow fever
cases, Avith those from Avhich I have made my calculations, which require

notice.

  For the first three, one explanation will suffice, for about one-third of
the year  was  there an  authorized board to record the number, and the
cause of death—for the balance of tbe year it has  been  difficult to  get
the cemetery returns and they do not correspond.

  In relation to the number of deaths by yelloAv fever, many were stated

as " unknown " " unspecified"—whose deaths  were probably caused by
yellow fever;—anxious to arrive as  near the truth as possible, the Sanitary
Commission has authorized me, during the epidemic, to add a large por-

tion of these to  the  yellow fever mortality, which I  have done in  the

daily returns in  the  tables C, D, E. 
TABLE  N.1
Qlcte.OA(AoA\\\;       Jc       (Sxw.)       vvUuyu.      |v\       \\\v      ^YcaV        \S  5  0.
-OfTSIDE.
MONTH	-■
January .. February . March ..'.. Mav..."._	
Jane...... Juiv......	
Au-u.-t... September.	
"ember... November. December.	
Total .-u-L-raj	'e.s..
Tr.Mi'r.uATriu:  op  Jiryixg  Powek,  on
  EVAPORATION.    I FORCE OF EVAPORATION.
B A It O M K T K R.
     MOISTI'RE.         Extremes  0*
(10(10 being saturation.)   j    Moistire.
44.22 4-.20(53.9i|i9.9ii 47310 37,591   472-I   42.:V, 45,5'; 40.9544.93 2*.2 ■ 43.51-53.54
50.l9 5i;.l4!d3.93j54.93 5(1.05 4n.59j   4-..08  JJ4-.24 Vi.72 52,-0 50,1*3(1.4  49.35 57.2]
.).i.>.'.t).-,.i.>|:ij:i.^:i|.ii.l(Ji)v;.4.5.'..>.9ir.   rn.a.i  - j.") 1.19 35,50 >-.70 >0.i7 5i.2  .">."».•>■* fu.U.
02.2072.1(1,78.9010*.3370.37 35.010,   r>'.H9  j 01.33 12.79 05.7o .111.09 30.9 I (15.930s.lrl
dd.037d.ni;.-0.22l72.l973*22-.00l   (1».*5  |o5.01| 17.50 0-.-2 17.11 23.9 j|d5.5-fi9.9
75.51 *3,I0 *5.2d!7*.7d-9.73 21.000   7-;.2*   72.5-72.20 74,-2 73.2 1 14.1;  7:1.4-75.5:
7(1.85-2.03.-2.1 .-75. II 79.-- I-.09 I   8.52   74.59 7 I .(1(1 79.14 72.13 I  1.4  |75.14 7tl.li!
70.27-3.19 -3,-2 7*.7.5-1.25 19.99.   SI.40  I 74.115 74.99 75.9-J 75.9- 13.2 ! 75.197(1.91
~5   r  •    "
_x _-- l be -
WEICIIT  OF ArAPOR
ix a cubic foot, in
      Grains.
72.3 177.9-1 ,-0.2d'74.7(1711.23 -211.99
07.37 07.09 72.3-|95,5-00.-l 3-1.99
.13
9.9.17
                                           9.1*7.). 7571. -979.93 2-. II
                                           -.9,- 58.87 01.99 59.31 42.(1
                                           -.9(1 59.-5 (19.0-59,10 33.4
                                   .....I   j I 15,12 I-.22 47.5* 1(1.(17.40.8  , .

02.09 I1S.94[72.41:97.13 07.79 27.3d|!   61.34* [ d-.95> 19.(14 (13.99 91.78 24.97j [91.72 I
-395.19 119>l)|(ll. 9994.9239.090  5).ll
91 52.-9 50.93,52.74 5:1.9(1  9.321   -li.Ol
l-.2l;l-.3-  1.8(1 -.3:1
.291139.322 39.31:
790  .933;
i-H  uaf>i; hI.sTk. .if,si:':;'..">":ii :>.»!•<',  4.1325,-51
■>3.9li!53 54l! 1 8042.31 2.13  5.43 17.4 i|3(>.243 39.20(1 30.204 39.420130.23S] ] .7 9  .945  .(1.1(1  .920  ,-45  .464' ill •' -2(1 ob.s'ns. .)3(>|  1.294 4.535  4.90-4.579
               ' i.i.73 2.40,  5.;ra.59.4 los^SoV^TM^oi 30.-3^59.25930.2021   .54;,  .940  .fi-ii,  .919  .832  .fi4^,o  --r> oWns. Ah :,^.o-~ rci-i' MlWiM
iil^i-l'ljll'   .'*7 1tiJl  2.03  (i.532-!.5  j|:ll.257-20.2!)0 39.241 3l).25li:!0.-209   .33
19.-:M-, 139  1.92 12.72 3.37  5.7.di). I   3! .220 39.2(14 30.228 39.239 30.23
           75,-0 7 1.95!  2.93 1:1.90 3.94  0.04 22.9
           70.0070,10   2.20 I 1.12 5.27  (1.2115,-
           70.3370.13'  1.02 !).]3i 2,-3  4.52 18.3
           72.9,172,11 |  2.12! 9.51 2.9 1  1,-129.7
09.l904.25i02.07 92.31 J  4.29 13.51 3.59  7.1339.1
59.7903.73:02.1:1 ll.*5i|  2.77 9.95; 3.52  5,1121.9
47.71153,5-, .0.74 59.(17i|  4.19 8.7] 5.16;  (1.92 17.3
39251 39.2-1 39.239 39.254 30.25(1  5.00
3f.-.2(il) 30.289:39.25.- 30.201,00.205  5.97
3'U94 30.222I39.IH 39.181919.191   .25
3(.ls5 30.2l7i39.17339.192'39.191!  .31
Ol 230 30.201 !:19.232 39.22-- 30.231   .55
3! .33! 39.355 3'1.293 39.337 311.329   .32
2! .901) 39.007 29.970 30.141 !30.033!  .9]
Ol.OOOl.nri 2.2-11.57  3.31  5.7021.97||3(.225 3D.201 39.210 39.250,30.224  2.2-
909  .609] .921  .833  .6131m " 20 obs'ns.l.i',-7i  1,147 0.531; 7,1300.-94
.909  .005! ,-9-2  .842:  ,17i: 11" 29 obs'iis.1.5291  7.1 —7.5921 8.0237.001
.899  .003  .884  .s]5:  .59999 •' 3 olis'ns.  .19199.92--.732J 9.0489.13G
.939  .793  ,-42  .-25:  .390  I)-'.") olis'ns.  .iM1  9.099-.4811] 8.315 8.798
.950  .75(1' .915' .873,  ,1!-• II •' II ohs'ns.l. '.52  9.0519.51519.945 9.737
.932  .732, .90*' ,-57!  ,19-. .1) " 14 obs'ns. 502  -.492 8,173, 8.82*8.507
,*70  .049  .8-9  .89-li  .051-! II " 9 ohs'ns.  .'.5c  5.7(115.870 (1.530(1.053
.921  .720  .893, ,84(l|  ,l-li: 0 " 8 „bs'ns.  '.2"  5.-4211.909! (1.200().059
,*-2  .745' .844  ,-23:  ,103-9 " [4 obs'ns. 507  3.0204.239J 4.1074.007
,929  .094  ,-90  .*59',  ,514
.101
.1-5 0,541
.147 6.724
Annual averages
07.79
61.7s
01.91
on indebted to Prof. Fortliey lor this 1-oh.iim ; it was male at Carrolltoii, eight miles ahovo tho city; mid is tho average of nearly three year.- prrcedin.; April, 1?.'3.
[TAHLE o.J      (7
i)U'\u';vo\<
caws   a Ad
i'   i
V            iv   v                 11         -11
MONTHS.
    KADI A TION;
SOLAR AX1) '! ERRIsTRIAI,
   aspect or  M\V;
     or amount of
l.'lcarnesss  in  Tentlu


\  s  ;
>a
-Tlll-IIR  DIRECTION'  AND FoitCE.
January, - -  -
February, - -
March,.....
.\,,ril,-------
May, --..-.
June,.....
Julv,......
August,----
September, -1-
Oetober, -- J
November,  - (.
Dec-ember, - .
                              '-  "si 1r-:<d'-_"-\-*  1
 .71 23,-3 32.71 20.15] 1.23j 5.32 5.19 5.71  7.7 1 5.9,-|ili;, I
 .05! 23.40! 34.72 20.1b| ,-4!, 3.2*i 4.7l! 3.K I 0,10 4.3-  U I
1.1325.57 20.1)0, 1(1.*!.! 1.17 5.00; 4.12! 3.*3' 5.3- ,|.59|| 9.1 I
 .91  22.52'18,-7; 17.14!l.17 5.93 5.43 5.93 - 'XV 0.3311 3:_ I
 .90'2I.I- 16.90 21.05, .72 7.22 7.12 4.77; 9.9(1, 7.04J! (i.O1 I.
 ,-3 23.15 I-.2- 20,-9 1.09 7,11 0,-0 4.(13:8.30 0.-J  9] 2.
9.39|25.9   25.15 20.7*; 1.07 11,-1  3.43 2,5-ll 0.81, 4.11  ('■'; 2.
 .30;25.43'3I.27 29.3;
 .04 25.71  25.7- 27.7!
 .39,22.94 24,-3■ 24.0(1' ,53 5.51,5
1.13-14.4*1 19,19 ll.99| (1.30! 4.73 5
3.2', 10.95' 17.21 12.25 4.57!|5.2I!4
9I,"3». J>(
91, 3.(12.0
971 4.',: 2.0
10 2'<  J.9i:!
75J 2.',! 2.11
01.'■ 8!'2.00
33; 1.M.2';
7.78;  I

.12  5.7(
02! 5.40! 7.0 03! 3.93! 7,50 8(:'5.2'.- 7.01 2: 5.901 7.03 1- 4.54J7.00	(1.34 5.71, (1.93! 5.73'	2| ! .Hi-ll 2,-2 19 1.97 1:J 2.21 O-'j 2.55	■U 2.11 5.1 2.95 (l.( 2.54
11 1.0: 7.11	5.70'	07! 2.02	48:]|l.99j
::.' :;.('	2.0 2.0*
3.1	1.35
5:j	1.80
7.1	1.92
).(	].^
•»•"	1 -(1
9:;	J.8!)
9.',	13-2
9	1,-3
93	1,-2
 1 ;i 2.41
 :,|! J.95
5.l-|1.91

 4f ''">■ •«
~.'J| I.Oi
 ij 1.00
 ii 1.55
 2j 1.00
 91. 2.00
 3 12.08
 0<i2,)l
I.1. 2.10
',:, 1,10

 " 1.89
   I. .19
   1.33
   0.00
   9.
   1.00
2. ; 1 .51
2.1 1.02
l.,2.9
2.3-
2.0-
1.51
2.01
l.OOl To 1.01
9
.14
l.| 1.(101 0i,3.5(
50.1  1.41 l21.ll 1.
21,1.33
5. ! 1.2i
I'i! 1.2-

O.l! i.oi-
23.-]'1,14!
 I1. 2
 I'i 2
 1.  I
 I 1 I
 1.'. I




31
.33 2.00.  (Ii
,42 1.77,  D
,75, 1,—!  1.
-I.' 1.72'  2.
(10 1.5*  (U
75! 1.33.17."
00 1.021  3.
lil ! 1.541  1.1
II 1.09!  21
    Tiie "Aspect  of the ,Sky" is taken on a scale where 0 represents entire elouJit
of tho AVinJ, ou a scalo from 0, representing cai.m, up  to (i, a violent storm.
and  parts of the .-Uy, clear up to 1(
10; 1.7.837.

   1.23___

 clearness
Ain't, j Periods
  of       Of
liiial  liain.
       Duriui;
            V
 3.19'    4""
 4.(li If
 (i,-7l
 1.-4-!   2    1
 3.-49|   5 j   9
 1.757!  11     2
ll.79,-|  18 I   4
 7.0101  111   0
 5.045  14 I   3
 5.175]   3    3

 -l,50!:j   7 !   4

(12.041'  94 I 32
and the Toece 
       SUPPLEMENT.

REPORT READ BEFORE THE ACADEMY OF
      SCIENCES OF NEW ORLEANS. 
 
TABLE  OF  CONTENTS TO SUPPLEMENT,
                                                                PAGE.
How public opinion on Sanitary Measures  artificially formed in New
      Orleans.....................................  ............     260
The risk in telling the truth—what is that truth ?..................     262
Rainy season in our part of the delta same throughout the same......     264
Rainy and sickly seasons concomitant..............................     264
Less rain in New Orleans than any part of the State................     264
New Orleans not warmer than formerly—is cooler.........,........     264
With whom yellow fever is very fatal.........................     266
Comparative virulence of yellow fever now and in former years.....     266
What is " original soil" and its equivalent.........................     266
Difference from  ordinary mud....................................     266
Inclination of the soil in New Orleans to swamp....................     266
Proof that filth the cause of fever.................................     268
Proof that bilious and yellow fever exist at the same time...........     269
Where yellow fever most predominant............................     270
 Do.  in Charleston and Savannah................................     270
Plague in Egypt................................................     272
Effect of dry air on..............................................     272
Why at Walcheren and Pontine marshes no yellow fever............     272
Yellow fever sometimes far in the interior.........................     272
Effect of moisture...............................................     273
Cause of different type of fever....................................     273
Analysis to prove that different amounts of  a poison or influence pro-
       duce different effects and also act on different parts of system..     274
Difference of yellow and bilious fevers  may thus result—proofs......     276
Our ignorance  of the early etiology of the plague as well as yellow
       fever....................................................     ^
Whence the bases of sanitary or primitive science.........  ........     278
Degrees of temperature necessary for yellow and bilious fevers.......     278
Why yellow fever did not spread in certain  places, and why  it did in
       others...................................................     S*79
Two agencies essential for yellow fever............................    279
                  a                                                281
 Propositions proved.............................................
 What is malaria................................................    281
 Whence will be derived our knowledge of the real cause of fever....    281 
 
                    REPORT

                            READ TO

THE   ACADEMY OF  SCIENCES,  NEW  ORLEANS,

               IK DEFENCE AND EXPLANATION OF THE

REPORT OF THE LATE SANITARY COMMISSION TO THE CITY COUNCILS,"

          By  E. H.  Barton,  M. D.,  its late  Chairman.

               "Dies errorem delet, veritatemque illustrat."
   It was not to.be expected that the late Sanitary Commission, in the
fulfillment of the important trust confided  to  it by the Public Councils
of the City, would in the investigation and disposal of the various deli-
cate and  long  disputed  questions  before the  Medical  and Scientific
public, so finally put them all  beyond dispute, as to leave no ground for
dissent.  The subjects involved in the discussion have long engaged the
profession and the public in the mazes of controversy.   It did not flatter
itself with the  expectation that all  these  were to be settled at once.
But it anticipated from the  courtesy of the Profession, in view, no less
of the  magnitude than of the complicated character of the  points in-
volved, (being strictly those of a scientific character,) that the discussion
of their merits, their value  and the new principles evolved, would be
temperate, courteous,  and  strictly confined  to  the  subjects at issue.  In 
260
Supplement.
this, it has the honor to acknowledge, it has not been disappointed, and
that,  with one single exception, the  Report has  met,  throughout the
whole Union,  with a kindness  of reception- unsurpassed  in  literary
annals.   If there there has been any departure from the unanimity which
has characterized its reception elsewhere, it is upon points where greater
detail and illustration were deemed  necessary in the Report itself, and
we gladly avail ourselves of the opportunity, to make farther  explana-
tion ; to fortify points  not deemed  sufficiently explicit, and to prove, by
analogy, what is insusceptible of any other  testimony.   In  pursuance of
this intention we  shall proceed to examine  a  paper addressed to the
Legislature by our  friend Dr. McFarlane—professedly on "Quaran-
tine."
   In  analyzing this criticism on our Report, (for the greater part of it is
no less,) we  willingly confess, that  the Doctor occupies a very  different
position from that alluded to above.   He is a gentleman of education,
and we  cheerfully admit  he has fine acquirements, and gifted with  a
most  exuberant fancy, and although endowed with  some extraordinarily
queer notions, has that churacteristic of genius, which makes the worse
appear the better reason.   In the examination of this remarkable paper,
it  becomes our duty to say, that he is in the constant habit of supplying a
most defective memory, with a most  fertile imagination ; fancy supplies the
place of facts, and the sober and unsuspecting reader is fairly fascinated
and carried  away  by the exuberance of  its creation.   But  neither
science nor truth  requires  such lofty flights, and  we shall find it proper
to clip the wings  that soar beyond their sober  dictates, and test  their
value by the  humbler and rather vulgar  standard of reality.  The only
trouble  this  examination  has cost  us, has  been  to saparate fact  from
fancy—to  distinguish  the true from  the  assumed,  and to show that
assertion  is not proof.  Archimedes  said  that " if he had a  place to
stand on  he  could move  the world"—so with  this gentleman—admit
his data and  his positions  are proved.  Now,  this task of separation has
not been an  easy one, simply because, with  h:s pruriency of imagina-
tion, he has winged  his flight over periods where there exists a great de-
ficiency  of records.  To be sure, it  was much easier to  deny the  verity
of his assertions at once—to meet  them by assertions in turn,  and call
upon him for  proof, which we knew did not exist.   This might answer 
Supplement.
261
very well  in a court of justice—but in  a discussion before the public
would be  little heeded.
   This gentleman has informed us that he " is the oldest member of the
Profession here."  Now age has its attributes as well  as its privileges.
From aga should spring wisdom—the fruit of long and enlightened ob-
servation.   But one of the sorest attributes of age, is a defective memory
and  inappreciation of recent discoveries in  science.   If,  then, in the
course of these observations, I shall  have to point out a very remarkable
failing here, he has furnished  a ready excuse in the patriarchal age  he
boasts of.   But  age  cannot sanction  errors, and time, which writes  its
furrows on  the  brow, does not always  purify the  mental vision.  Age
and opportunities  of  knowlege  are  legitimately to be  boasted  of, when
the evidence of their right use can be poiuted out, through successful
industry, exploring the mysteries of our science and in trophies which
have benefitted mankind.   These—these are the true triumphs of wis-
dom.  They are  putting  to  their proper use, the splendid education
spoken  of, and the fine talents we  know he  possesses.  We  shall not
follow the example he has set  us, but leave our cotemporaries to say, if
the course we have  pursued, in investigating the causes of  phenomena
whose effects have been so disastrous, as to enable us to understand and
prevent them, is not  making  a better use of education and  the humble
talents we possess, and is not being more useful to mankind, and leaving
more enduring  monuments behind us,  than all  the corruscations  of
genius and all the brilliancy of a meteoric blaze.
   It  will  become necessary, in defending our Report, to  expose these
errors of fact as well  as errors of  reasoning.  If the gentleman has de-
parted from " the established doctrines of the medical  profession and of
the whole civilized world," as he  boastingly acknowledges, and wanton-
ly sacrificed them  for those whose tendency is to keep this country in  a
statu quo, forbidding all  hope  of amendment hereafter; we, neverthe-
less, give  him credit  for  good intentions, because we have  long known
intimately the source whence  they emanate.   But the  consequences re-
sulting, are  no less to be deeply deplored, for, if carried out,  as they have
been practically carried out here for many yearsuihey are fraught with
vast injury to the city, which we  are equally sure he  does not see, as
they are accompanied with no recommendation for alteration or amend- 
262
Supplement.
ment—thus leaving us nothing  but lamentations for the past, and with-
out hope for the future!   It was feelings very different from these which
gave  birth  to the  Sanitary Commission.  This city, with  no equal  on
earth for commercial purposes, has been staggering and struggling under
a wretched reputation  for insalubrity for  many years, which, if  it could
be removed, as we  are very sure it can, her unequalled  resources would
be at once developed; it was with the full conviction that there was some-
thing radically wrong in the constant succession of devastating epidemics—
notwithstanding all the "Buncombe" writings  and assurances to the
contrary, which first gave birth  to this  investigation  into its causes.  It
would then  have been  false to their honorable appointment, false to their
noble profession, and above all, false to the community which had looked
to them  for sound advice, and  an intelligence, corresponding in some
degree, to the enlightened  advancement of the  age we live in, did  we
not repudiate all such heterodox notions—notions not having their basis
in common experience, are unsupported, we firmly  believe,  by all  we
know of man's nature.
  The course  pursued by our city authorities, for a  great many years,
has been  empirical  in the  extreme—never  to acknowledge that there
was any need for the cauterizing hand of surgery or science, in  the face
of an  annual mortality exceeding that of the most celebrated battles, and
in a  ratio more than  double  that of any large  city in  America.   This
disastrous course must be mainly attributed to those  who,  assuming the
credit of  having examined the subject, have  been instrumental in form-
ing a public opinion, whose affects we all see around us.   These  have
asserted that New Orleans is " one of the healthiest cities in the Union,"
which was proved  by  an  array  of  testimonies from various travelers as
far  back  as a century ago ! and  farther corroborated  by deriving the
average age at death by selecting it from epitaphs on tombstones! these
irrefragible  proofs have been constantly dinned into the  public ear, until
finally, it has become a kind of moral  treason to admit that people die
here at all!  and all who attempt to stem  this  torrent of lies and toady-
ism, are held up as enemies of the city—as attempting to " write down"
New  Orleans.   And even if one dares to tell the truth in a public docu-
ment,* we are accused of saying things "least flattering to New Orleans."
* Board of Health Report, 1849. 
Supplement.
263
And, really, one must have some moral courage, in the face of a public
opinion thus artificially formed, to dare to tell the unvarnished  truth.
Antl what  is that truth ? a mortality of near six per cent., for near half
a century, instead of their " unparalleled salubrity !!" and an occurrence
of ten epidemics  of Yellow Fever and Cholera in eight years, with a
mortality of 77,338 during that time, or,  near half the present popula-
tion of the city—officially published!   To show that this  is but the
necessary and  inevitable result of the  circumstances  around  us—these
very  precise conditions  have  existed and  produced these very results
under analogous  climates  and conditions,  wherever they have existed,
and that in proportion to the  cause so have been the  effect,  in the most
unvarying  manner !   When  pinned to the wall  to  account for  this
frightful mortality occurring  year  after year,  the impudent and un-
grateful reply is—"it  only  consists of immigrants!"  immigrants who
have made this city what  it  is, and consists  now of no  less  than two-
thirds of the white population.  Is it not  time that this audacious and
 miserable system  of public imposition should cease, when  the reputation
 of the country is ruined,  the hand of improvement palsied, and  we
 are losing some  of the  best of our citizens by emigration ?   Is it
 not  time   that this veil of  concealment  and  falsehood  should  be
 withdrawn—and that we should look the  facts  steadily in the face ?   Is
 it not time that the truth  should be told in all its naked deformity—if
 we ever intend making an attempt  at amelioration or change ?   Indeed
 the  sanitary condition of New Orleans is not, at this day a matter of
 opinion, with  the mortuary  returns and  the census  of  the  population
 before us, for half a  century or more; it  has,  unfortunately  for us,
 passed from opinion to fact, about which there  is no room for  dispute by
 any honest inquirer.   The data  are not contested and are incontestible.
 With the variation of these causes so  has  varied  the disease.  Can
 proof be  stronger ?  It would really seem from all the  facts, the  testi-
 mony and the reasoning, that all well constituted  minds  would come  to
 the same conclusion, where the weakness—where  the imperfection of the
  argument and conclusion is, I confess, I  am utterly unable to see; and
  it is certainly a poor compliment to the intelligence of this  people to at-
  tempt to  humbug them  in  this way.  The people  of  New Orleans  in
  matters to which they have directed their  special attention, have  no 
264
Supplement.
superiors in shrewdness and sagacity.   Upon the  subject of the public
health, they, like most others, will  readily submit to be flattered.   The
time has come, however," to speak the truth, the whole truth and nothing
but the truth."  No city on earth, notwithstanding  its great commercial
advantages, can long sustain such drains as we have undergone.   It must
cease,  or there is no help for New Orleans.  There has been no attempt at
denial of our facts, and we are very sure our conclusions are irrefutable.
   In  relation  to the  present  paper—data are  assumed—hypothetical
views  set forth, and untenable objections to our positions, which I  now
proceed  to examine.
   The following quotation embraces these unique views and objections,
and I  give them in extenso in order to do their author full justice.
   [It  was here intended to  give three-fourths of the entire paper of Dr.
McFarlane, to  comply  with  the last  remark—but as, wherever objection
is made, the objectionable part is quoted, it was deemed superfluous.]
   Let us test these averments by the rule he has  himself laid down, viz.:
" That  medical philosophy in  order to be useful must  be  accurate."
"During 1825  there  were not  twenty  days in which it did not  rain
violently throughout the whole year !"    This, of course, is all ad captan-
dum,  as there is no record of rain falling in New Orleans at that period,
and it is just as easy to say it fell every  three days ; aud be it remem-
bered, that all this is from  memory, a memory extending  back beyond
the average age of life here!  But there is  a mode of arriving at the
probabilities upon this subject,  which,  although it has  cost  me  some
labor,  is not without its value, in various relations to this subject.   Fail-
ing in records, which I am convinced, after  much research,  do not exist,
I have accurately calculated every record of rain that I  have been able to
ascertain has been made in the delta of  the  Mississippi for the last forty
vears.   From  these calculations I have learned three valuable facts :
   1st. That a very rainy  season  in one  part of the delta is very apt to
exist over the whole.*  2d. That  an unusually  rainy  and sickly season
  * The great value of this information to the commercial as well as agricultural interests of
the State, will be readily understood by intelligent men.  I have not been called on, from the
course of my argument, to extend my researches into neighboring States.  But its direct bearing
upon the productions of our cotton bearing States, as well as others, is obvious enough, and is
eminently entitled  to the regularity of national record, to be published monthly, from every
parish and county in the South;  and it might be made the duty of the principals of the Public
Schools to do so, from instruments furnished by the State. 
Supplement.
265
are commonly concomitant; and 3d. That less rain falls in New Orleans
than any part of the State,  (by near 19.48  per cent.) so far as any
records have been made, and these records have  extended from the low
lands of  Placquemines to the  high grounds of Washita!  The first is
not at all improbable, because the  direction of the rain-bearing  winds all
proceed from the same quarters—that is  from the S. E. to S.  W., (the
Gulf of Mexico  and submerged delta.)   Of the second, I  have  before
spoken in the  Report, and the result of this examination still farther cor-
roborates it.   Well, then, I have the record of the year  1825 and the
following years, made by myself, in this State near  the Mississippi river,
between  30 and 40 miles farther north than  New Orleans, and the re-
cord of that very year shows fourteen inches less of precipitation occurred
than the average  of 13  years, and  the average of the  three  following
years were almost equally small—they were  all comparatively healthy
years in New Orleans,  as we see  bv the  Cemetery returns, and the
strong presumption is were comparatively dry years.   The  year follow-
ing this series (that of 1829)  was one of the greatest  precipitation in
that record, it  was  a year of a severe epidemic in New Orleans,  and by a
like  probability, a very wet year.   A  large amount of rain fell in the
winter and spring months, in the position referred to, (in 1825) and it is
probable the same occurred  here—nor does it  require  a great deal of
rain, on the much used unpaved soil of the streets of New Orleans  to
produce deep muddy holes.
   Nor is New Orleans actually warmer now than it was 30 to 40 years
ago, notwithstanding "the slate roofs and brick houses and  pavements."
On the contrary, and on this subject I can speak with the record before
me—it is  actually cooler, from 2  to 3 degrees on  the annual average,
probably arising from the more extensive clearing and draining  in  the
neighborhood, admitting a freer ventilation, and the extension of these
very brick  houses complained  of,  which are much cooler than wooden
ones.
   So,  also, yellow fever has been  found remarkably fatal with "rag
pickers,  scavengers,  grave-diggers, and those who dig  in  the streets,"
unless  when they consist of acclimated subjects.
   Again, to show that yellow fever is neither more frequent nor virulent
now than formerly, I have constructed the following table, embracing  all 
266
Supplement.
the epidemics since 1816—when the ravages of the disease began to be
more definitely recorded, and divided them into four periods, viz. :
                                                      I Average .  Average
                                                      mortality duration of
                                                       per WOO.  epidemic
                                                              ; influence
The first embracing the short period of 6 years, containing the four
     epidemics of 1817, *19, '20, and '22..............................  20 80-100] 77# days.
2d. Embracing next 11 years, containing the three epidemics of 1829, i
     '32,and'33...................................................I ]4 62-lOOj 40    •'
3d. Extending to '42—9 nine years, including the three epidemics of.
     '37, '39 and '41.............................................., 12 25-100  56%   "
4th. Extending to the present period—12 years, and including the five
     epidemics of 1847, '48, '49. '■'i3 and '54.........................i 20 62-100' 55    "

   But let us proceed farther in testing the accuracy of the averment—
" that there  did not occur a case of yellow fever in  New Orleans for  six
years afterwards"—that is, after and including  1825.   The published
returns of  the  Charity Hospital  alone  exhibits  a record of  1344 cases
during  that  very period!  and  that  house  usually furnishes from  one-
fourth to one-third  of  the  mortality  of the city.   Comment is unneces-
sary.
   But, let us  proceed—the term " virginal soil" was not used  by the
Reporter,  " original soil" was.   The  soil, as deposited  by the river  on
its banks, is  known to contain very little organic matter, and  the simple
disturbance of that soil  alone, it is  not  believed, or ever stated, would
produce the  influence ascribed to the " terrene."  What is specially de-
nominated and comprehended  under this term was distinctly stated to
be the rich alluvion of the country-1—the   marsh mud—the detritus and
remains of vegetable and animal life,  and  to be equivalent to putrifiable
substances of all  kinds,  the filth of kitchens, stables, vacheries, privies,
and every species of  filth  and  offal—the relics of civilized life—from
whence preceeds the bad air produced by  this disturbance and decompo-
sition.  These are found  mostly in our back yards, in the gutters, streets,
open lots, and  are especially conspicuous  where our  pavements are dis-
turbed, (for  the pebble-stone pavement  is eminently objectionable  in
being  the best filterers and  retainers of putrescent organic matter.)
The " disturbance"  of  these  is  always  very offensive  in  hot  humid
weather, (the meteorological condition) and injurious to health.   So the
detritus and filth  of our canals and basins, when dug out or cleansed,
are composed, mainly, of these same materials,  also  the deep cuttings 
Supplement.                         267
and excavations for our railroads, the first cultivation of the  soil for ag-
ricultural purposes;  all are followed by sickness when the meteorological
condition  is present and of sufficient duration.  These results are be-
lieved to be uniform, the  proofs  are positive, the facts are not denied.
They are evaded by a  side issue, which will be examined presently.  It
was never said, meant  or  pretended, that cutting through a sand or clay
bank would produce these effects.  Now, precisely analogous to this was
the composition of the "mud of Camp and Magazine streets, and those
impassable  gulfs  of 6 or 8  feet  deep, in  which hundreds of horses
perished in 1825 !"  These  are not offensive to smell, have  not  much
organic matter in  them, and are  but little injurious to health, except
from the humidity they promote, in an unfavorable season.  The streets
of New Orleans, from Levee  to Ram part streets, were composed, originally,
mostly of river mud, and afterwards covered with our wretched pavement,
and it has never been  asserted anywhere by us, that that mud, however
"disturbed," .would produce disease.   But take up any of  our ill con-
structed pavements in  the moist summer season, and particularly of the
gutters, wherein  is  deposited and retained  most of the filth,  and the
nose, even at a respectful distance, will detect the difference between the
materials  filtered beneath them, and common mud.   It was for this rea-
son  the Sanitary  Commission advised the  construction of  pavements
that would neither admit absorption or exhalation.  What was asserted
is expressed above, and defiance  of any exception to the rule, as  laid
down,  is  offered.   Since the publication  of that Report, public  atten-
tion  has been called to the subject—numerous instances have  come
to light,  strongly corroborative  of that important truth, and  none to
oppose it.
   The  organic poisonous matter,  then, is satisfactorily  accounted for,
without the necessity of looking for it in the " argillaceous deposit," and
thus furnishes " one of the blades of the shears  of fate."
   But it is said—" there being a declivity  of 10 or 12 feet from the ele-
vation of the levee to the swamp, one deluging rain is at any time enough
to remove all superincumbent filth, and convey it to the swamp in the
rear of  the city."   The folly of this is made apparent, when  it is known
that wo surface washing will  remove that which is beneath the surface,
and after  a few hours of the " most deluging rain," filthy bubbles of the 
268
Supplement.
most corrupting materials, may be seen, during every sickly season (that
is when the meterological condition is  present) arising from  the subsoil
and imperfect pavements, where some little water is left.   But, again, I
wish my  friend to be  brought down from  his  lofty imaginings; this
beautiful inclined plain of " 10 or 12 feet from the elevation  of the levee
to the swamp," turns out to be, that  from Levee  street (not the top of
the levee) to  Rampart street,  is about six feet, and the  balance about
two, in  as many miles.  But in the whole  of  this course, subject to
every kind of obstructions and retardations, so that a rain, say a sudden
one of one inch in vertical depth falling in an  hour, (a very unusual
occurrence) is positively hours in reaching the swamp, and  all, who re-
flect for a moment,  are aware of this fact, for in the central portions of the
city, where the  greatest declivity or inclination  occurs, and where the
pavements are most  extensive, there  exists,  in fact, comparatively but
few obstructions, except bridges, and we all know that it  is  often hours
before we can pass the streets, (after such a  rain  as above)  which then
are converted into almost impassable canals and miniature rivers.   How
much much more so  is it beyond Rampart street,  where this " inclined
plain " has more than four times the length, with about one-third of the
declivity,  and hence  the necessity  of deeper gutters to  carry  off the
water and filth, onward to the swamp.
   " The results of investigations made in  this  and corresponding regions
make it manifest that wherever heat, filth, moisture, decomposition, ex-
halation and malaria are combined in  sufficient concentration to produce
disease,  there yellow fever  cannot exist!!!"   The italics are his own.
All this  is truly " the  antipodes of the doctrines of the  Sanitary Com-
mission,"  as  " IT IS OF  ALL THE WORLD."  The capitals are
mine.  The  result  of investigation !!! why,  it is  exactly the reverse.
The records of the dead—the records  of the  Profession—the history of
every sickly place and country—the experience of all mankind, all accord
in an unanimity, no where surpassed, that filth (in the enlarged sense)
produces  disease everywhere, and particularly in  a warm  and humid
climate  and  season.  So intimately is cleanliness associated with our
ideas  of health, that  it has become one  of the  strongest instincts im-
planted in our nature, corroborated by divine revelation, and  participated
in, as a strong  conservative power, by the lower  animals, even  at the 
Supplement.                           269
earliest age, and man estimates and  cherishes this, just in proportion to
his elevation in the  rank of civilization and intelligence.  The cau-es
producing it are known to be at war with his being—they consist, main-
ly, of effete worn out matter,  of  organic  materials, passing  from  one
stage of life where, in the order of  Providence, they have  performed the
task assigned them, and  fulfilled the circle of all created thing-s, and are
no longer fitted to perforin  this duty a second time, until their allotted
round is past.  The Report is most conclusive upon  this subject—the
facts upon which it is based  are  undented and undeniable.   It is there
conclusively demonstrated, that filth .does  produce fever, and  with  the
meteorological  adjunct, yellow fever ; that in the parts of cities where
these are most concentrated, are its peculiar haunts; that these effects
are in pretty precise proportion, both in numbers and malignity, to  the
predominance  of the aggravated  causation—and  the very places, spots
and houses have been designated, and not satisfied merely with a reference
to other distant cities, places and periods, they are  pointed out here, under
our very noses and eyes—the witnesses are all before us—the testimony
is direct—the facts irrefragible—they are undeniable ;  but now, forsooth,
to gratify a whim, our friend  has  exhumed  a most fanciful hypothesis
from its sleep of centuries, where it never was  exalted to any higher
dignity than " the on dits of travellers."   But, seriatim, let  us  see upon
what grounds it is now hazarded.   Let us examine that " demonstration
which is as  clear as any proposition in Euclid."
   The  first proposition  is, that " where malaria  is sufficiently concen-
trated to produce disease, there yellow fever cannot exist."
   This  has  been most thoroughly answered  in the preceding paragraph
—not occurring where there could be  any room for doubt—but before
us all, where  the real difficulty consists in  avoiding  to  see  it;  where
exists the festering sores of the city's filth is  found the city's mortality;
where year  after year are  offered up  the catacombs of  those valuable
laborers, who constitute  our real wealth, to the insatiate  archer, and in
lines of lurid light illumine the dark holes  and sinks where  the innocent
victims of erroneous opinions and erroneous action, or want of action,
could read a lesson to make ' umanity shudder, calling aloud for the cau-
terizing hand of reform, ruining the reputation of the city and blighting
her commercial prosperity.   But the subject is not left here ; it is shown, 
270
Supplement.
 by the most unexceptionable authorities, living and dead, with a like ex-
 actitude of  time,  place,  and circumstances—nay,  by  testimony only
 limited by historic records, and  confirmed by  all  reasoning from  effects
 to causes, and vice versa—that these  effects exist wherever these  causes
 do, and  that in proportion as they are removed, or gotten  rid of, or
 cease, so subsides or ends  the effects.  Let us examine the argument
 furnished for its support, in place of and  in substitute for facts,  which
 are directly opposed to it.
   " Yellow fever is different from bilious or miasmatic fever ;  this, in its
 progress and phenomena, is acconrpanied with visceral engorgement and
 frequent returns, which is not the case with yellow fever, and that, there-
fore, ' whenever  miasmatic fevers  exist,  yellow fever never  occurs.'"
 The  most casual examination of any cemetery return in  this city, and
 particularly that  of  1853  and accompanying  map,  will most fully an-
 swer this statement.  And what do these silent, but most unanswerable
 records show ?   They show, and  the  demonstration  is before our eyes,
 that  in  this very city, during the worst seasons and the hottest  and
 moistest months, the filthiest localities  are reeking with yellow fever,
 while the balance of the class (for as I  class them all together as pro-
 ceeding  from  the same cause, but in  a  minor  degree)  of miasmatic
 fevers—as intermittent, remittent,  bilious, congestive  and  pernicious
 fevers, prevail at the same  time and place, as  well as  at  other periods.
 The following table, derived directly from our cemetery returns, presents
 the simultaneous prevalence here of both, in separate columns.  A very
 cursory examination of this table will fully satisfy  the honest inquiry
 after truth, that the same fevers do  occur in the same city and locality;
 the  susceptibility of the subject, and  the filth, etc., of their habitations
 constituting the only difference between them. 
Supplement.                          271
Relative frequency and  cotemporaneous  occurrence of Yellow Fever  and other

        Miasmatic Fevers.   Derived from the Official Cemetery returns.
Tear.
1858




1852

1851

1850

1849
Disease.
Yellow fever ..........
  (Other miasm'c forms,
  as remittent, intermit-
  tent bilious,  conges.,
  per's, typhoid fevers.
Yellow fever...........
Miasmatic fevers.......
Yellow fever...........
Miasmatic fevers.......
Yellow fever...........
Miasmatic fevers.......
Yellow fever...........
Miasmatic fevers.......
40!  23  201  36
48;  64  63
t39
>"S  i ■<
 2  31152L5133 982

39  55  94  90]

  •         10!  68
38;  78  105  78! 109
               *4
63 $11  *3>; *59
 li   :    !   4
26'  32!  32  68
  ;   '   ii  n
48  47  441  93
*76
 62
205
214
 70
		
,_;	.o	f>
	H	a
		
	o	©
o	»	Q
__	--	--
147	28	4
31	18	25
221	no	ac't
109	no 1	ac't
*62	61	$35
33		
144	42	43
416	112	9
62	43	42
7849

 560


 299
 741
  12
 596
 103
 752
 769
 593
* One week missing.  + Two weeks missing. $ Three weeks missing.
The following memorandum was  extracted from Dr. Fenner's Southern Reports,

    and  was derived from the cases occurring  at  the Charity Hospital, and is

    further corroborative of the same.       .
1849.		• 1 109 ! 9i	114 143	138 225	117 163	69 164	2 155] 368 180 160 1	2S 59^ 191	374 520 763 720 285 142	130 360 101	6 684 115	1066
	1 Typhus, typhoid, Ee- j ■< mittent, bilious con-(tinuous. ;											4439 1910
    Thus, in precise accordance with these principles, in parts of the coun-
 try where prevails  the  less severe forms of  these fevers, the causes do
 not exist in such an aggravated degree  as in low grounds, the estuaiies
 of rivers, the outskirts of cities; but where they exist in an eminent de-

 oree, in  hot,  humid weather, in  parts  of cities where there  is  concen-
trated the  most filth,  in  dark,  unventilated alleys,  in  crowded rooms,
 where human offal, the  worst  poison of man, is accumulated,  and where
 the  habits correspond,  here exists the most  malignant forms of fever.
 These very  spots are the  birth-places  and abiding homes  of yellow
 fever ;  everybody, who will take the trouble, may .see it in these places

 every year ; they are the very places which give birth and  prevalence to
 it  in all cities  liable  to this  form of fever.   They have been specially

 pointed  out in the  report. 
272
Supplement.
   Why these effects should not  always ensue at once from exposure to
these conditions, is no more known than why some  people never take
the fever at all, nor, than having had certain diseases once, we are no
more subject to them.   But we do know that time is  an important ele-
ment in the causation of disease,  and that susceptibility varies with the
physiological condition   But who shall say we  shall never know them
in an investigating age ? who shall set limits to the progress of knowl-
edge ? only those who never take the trouble sincerely to inquire.
   Again, precisely the same exhibit is made in relation to Charleston
and Savannah,  as  their  records, now  before  me, abundantly prove.
Whenever  a cause exists to aggravate the sanitary condition of either of
these places, yellow fever occurs.   Accordingly,  the  draining, paving,
and other  sanitary reforms  in Charleston, have made  that one of the
healthiest  of American cities, subject  to occasional  epidemics,  during
very remarkable seasons, from some  hygenic remissness.  The aggrava-
tions in relation  to Savannah, since the great improvement in her health,
from  the adoption of the dry culture  instead of the wet, for  rice,  have
been  owing to special causes—some of which have  been pointed out.
Savannah,  although having some cases of yellow fever every year, has
particularly suffered from three very fatal epidemics, viz.: that of 1817,
'20 and  '53—during these the  additional malignity (certainly during
two if not three of these occasions) were imparted to the disease, by cut-
ting down  and leveling the streets, spreading the refuse and offal of the
yards and kitchens  on the streets, and otherwise disturbing the soil by
digging trenches for gas and water-pipes, and filling up squares and lots
with fresh earth.
   Egypt — the  Campagna or   Pontine  marshes — Walcheren  and
Chagres, have each their peculiarities, but afford no argument in excep-
tion to the  principles laid down, as I proceed to show.
   The causes of the  diversity of the  types of diseases  of different cli-
mates, medical investigation has not  yet fully developed.  Of that large
class denominated fevers—the main  outlet of human  life—varying in
the estimate of eminent men, from one fourth to two-thirds—the mys-
tery may be more nearly solved than is now generally imagined,  The
Plague  in  the East, the Yellow  Fever in the West,  and the  Typhus
Gravior in  England, are,  by general consent,  at the head  of their re- 
Supplement.
273
spective classes, in these several great ranges of country.   These climates
differ essentially, not more in their  temperatures than in their  hygro-
metiic properties, and  in  the mode of living of their respective popula-
tions.  The climatic details are too limited in relation to Egypt to apply,
fully, this mode of  accounting  for the  plague,  especially there.  Two
facts are  well known in relation to the influence of causes readily arrest-
ing it.   1st.  It i.s  speedily put a stop to by the prevalence of dry winds
from the deser .   2d.  It is drowned out  by the supervention of the Nile;
an instance  is mentioned where this was  so remarkable, that five  hun-
dred less died of the plague, the day after an  occurence of this kind,
than the day before.
  The same principles apply to Walcheren and  the  Pontine marshes,
the  insalubrious  condition  of  both  derive their controlling  influences
from their excessive  humidity, their temperatures are known to be too low
to produce the development af yellow fever.
  Although it is not entirely true that yellow fever  is confined to sea-
ports, as supposed, or  places near the sea, yet  it is  uncommon for it to
break out or spread  much in the interior—nevertheless, it is well  known,
and experienced  practitioners will  bear  me out, that sporadic cases do
sometimes occur far in the interior, when aggravated conditions of heat,
moisture  and filth exist  in adequate combination  to furnish sufficient
cause.  It is then developed without farther difficulty or need of " seeds,"
etc.   Thus  it has occurred  at  Natchez,  Woodville,  Bayou Sara, and at
other places on the Mississippi, near the  gulf, and insulated places far in
the interior, where it was absolutely impossible for it to  have been con-
veyed or imported, none being in New Orleans at  the time, nor as far
as we know, within  500 or 800 miles.   The very idea of " germs " of it
remaining over a season or so, is too ridiculous for  argument and only
requires  to  be mentioned to  be repudiated  by all men of  experience.
Thus then, the only prop the contagionists have had, has been knocked
from under  them, and the true and only explanation  has been made
upon scientific principles.  From all the observations I have been able to
raake__of the cause of this notable exemption, to the extent it  actually
does exist, it is clear to my mind, that it  arises as  much, and probably
more  from the difference  in  the hygrometric  properties of the atmo-
sphere than in differences of temperature, (of course in combination with 
274
Supplement.
the terrene.)  This can  ouly be proved  by accurate experiments,  and
these have not been made.
   It is to be deeply regretted that, at this enlightened day, accurate and
extensive experiments  have not been made with the hygrometer, ther-
mometer, etc., in direct connection with their important  bearing  on hu-
man health and life.   It is nothing new,  I know, to attribute the origin
and extension of malarious fevers to great heat and moisture, but it has
been  done  in a very indefinite manner, and as  often disputed,  and no
precision has been  connected with  it, and no principle  applied,  until of
late.  Many nave denied  this connection, because the precipitation ha-;
not been large enough in their estimation—being unaware of that worst
condition—the hygrometric state of  the  atmosphere—which they have
at the same time unknowingly admitted in the form of mould on  leather,
furniture, etc.   Now, it is not merely gratifying  to scientific curiosity to
know that  this property can be detected with philosophical precision, by
instrumental observation, but it is a practical fact, of the  utmost value to
society, as upon a foundation of a knowledge of a cause of disease alone
(and this as one of  the most controlling ones particularly) can we build
the structure ef prevention.  Sanitary laws, then, must  have their only
rational origin.
   In the discussion of  the cause of the difference of the types and grades
of fever, there is an important omission, which I will embrace  this op-
portunity to supply.  Nothing is  more common, not only^iere, but in
Mexico, South America,  the  West Indies,  Savannah and Charleston,
during sickly  seasons, while  yellow  fever may  be prevailing  among
strangers or the unacclimated, for the  natives or acclimated, to be  affected
with a milder  grade of fever, under the same exposures—thyy are often
so similar in type, as to be almost impossible to  distinguish between the
two.  It is the same with the Africans (their first season) when taken to
different regions, where the yellow  fever  may be existing, although the
yellow fever proper, hardly exists in Africa, but  an equivalent malignant
type of fever does,  to which they are habituated.  This  occurs constant-
ly, when  approaching in  grade, they  run  into each other, and inter-
change  symptoms, according to  susceptibility and treatment.   This
difference   of   susceptibility   satisfactorily  accounts  for  the  diversity
of effects  in  individuals exposed  to similar  influences,  one  having a 
Supplement.
275
very mild attack and  the  other one  of great ferocity,  without  its
being  at  all  necessary to attribute them to two distinct poisons; the
yellow fever  in the  stranger  being equivalent to the milder  grade of
periodic fever in the native.   It  is precisely similar to what occurs in a
man accustomed to indulge in ardent spirits or opium, an ordinary quan-
tity or dose,  has little or no influence on him, while  on one  not so
habituated, a real toxical effect is experienced.
   This difference of susceptibility,  also varies in the same individual at
different periods and from different causes.  We  often see a man pass
through one or more,  nay, through many yellow fever epidemics, in the
closest and most intimate intercourse with the  sick, and yet  with the
most perfect  immunity, and in a subsequent season fall a victim to it.  It
is, then, during the existence of an epidemic, the rule of prudence, sedu-
lously  to  avoid  committing any  act of imprudence, that can unbalance
the constitution during its prevalence—such, for instance, as a debauch,
a fit of passion, a fall  from a horse or carriage,  a sudden fright, etc.   I
knew an instance some years since, where near a dozen young  men, who
during their first year  had escaped the  prevailing epidemic  to an  ad-
vanced period of the season, and who determined  to celebrate their
triumph by a feast, which terminated  in  a debauch; in  the course of  a
couple of weeks, there was but a single survivor, and he was an invited
guest  and acclimated.
   But there are direct, opposite and beautiful analogies in our  profession
 to prove that the same poison or agent may produce diversified effects on
 the  same  individual, that is, act  on different organs, in different quanti-
 ties or doses.   For  instance,  a small dose of opium exhilirates,  a large
 one produces cerebral congestion, a small dose of arsenic strengthens and
 fattens, with a slow undermining of the constitution, a large one kills in a
 few hours, more or  less; a small  dose of ipecac or antimony sweats, a
 large one vomits ; chamomile sweats, vomits,  or acts  as a tonic, depen-
 dent upon its mode of administration ; and how numerous the influences
 do we expect from mercury, dependent upon the quantity and mode ad-
 ministered.   Fluctuations in the weather, and  particularly hygrometric
 changes, produce catarrh,  pleurisy, pneumonia, and sometimes various
 intestinal-gouty and febrile affections, dependent upon the amount of ex-
 posure and  individual susceptibility and predisposition,  The balmy air 
276                         Supplement.
 which sustains our being, the purling brook which furnishes the  pabu-
 lum for all animated nature and the deadly poison, have the same atmoic
 elements, limited in number, but diversified in combination, which pro-
 duce such  different  effects.  But why  multiply examples,  which  are
 absolutely numberless, to prove a truism  in medicine ?  Is there any
 plausible reason why there should be required a difference in the nature
 of  a cause productive of fever, while a medicine, merely by a difference
 in quantity, should have such  a diversity of effect?  There  is certainly
 none.   It is in the one case as  in the other, different portions of the or-
 ganism are assailed by virtues inherent in the dose, or amount of poison,
 and such an  interpretation is consistent with all we  know in medicine
 and in nature.   This is most aptly illustrated in the  mode and rank of
 the organs on which  the pathological influence  is displayed, and thus
 admirably corresponds with the apt analogies just furnished.  Thus the
 one attacks the more  vital structures—the citadel of life—the brain, the
 sanguiferous system—those of cerebral life ; the other, the instruments,
 the  organs by which  the   body  acts  and  continues existence, the
 branches—the outposts, as it were—the liver, spleen, mucous membrane,
 which by reaction, sympathy and symptoms, interpret the  place and
 character of the attack, and call for treatment through indications.  In
 the first, time is not allowed for this effectively ;  in the second it is; and
 it is through a long  course of actions and reactions of and on the or-
 gans, showing the great  difference between them.
  But there is another proof, well known to medical men, which beauti-
 fully illustrates my position, although it  has been most unfortunately
 used as an argument against it.   It consists in the liability to attack; in
 the case of bilious or periodic fever, a second or a third time, or more, in
 fact, the  oftener it is endured, the more liable to its  repetition!  This
 arises solely because the  organs become more and more crippled  at each
 subsequent attack.  This is not so in yellow fever, because these organs
 are rarely  embaiTassed  by the disease.   It is the higher  range over
 which  it passes,  and when the system is not entirely overthrown, re-
covery is apt to be rapid, thorough and perfect, and  a remarkable  reno-
 vation of the system is often known to result from it.
  Let us apply these  remarks and illustrations to the  subject before us.
 Yellow fever has been denominated in the  report, the highest and most 
Supplement.
277
malignant grade of fever known in the Western hemisphere, the proof of
which is, that its mortality is much greater;  so deadly are its attacks at
times, that  the patient succumbs in a few hours; sometimes the first
symptom  is the fatal black-vomit;  haemorrhages occur from all the mu-
cous surfaces; at an  early period the fatal  look  is  exhibited, and the
patient is walking about actually dying; there is  not a pain or a symp-
tom, (properly so called,) the sympathies connecting the system are dis-
solved, the fatal blow  has been struck at the centre of being, and man's
majestic structure is in ruins.  Now, this worst form of febrile disease oc-
curs precisely in the seasons and places, where in the concurrence of all ex-
perience  and  reasoning from data thus  furnished, we should a priori
expect it  to occur, viz.: in the filthiest cities, where the least attention is
paid to sanitary police, and in those veiy spots, places, houses and alleys
of those cities, which  are filthiest, most crowded, and  the  inmates of the
worst habits;  and  it occurs just  in  those  seasons and parts of seasons,
when these effects are most calculated to  have their  worst influence on
the human body, viz.: in the hottest and moistest seasons;  and if there
is  any want of uniformity in these outbreaks of yellow fever occurring
where all these filthy materials are present,  it solely, arises  because the
other  constituent,  (the second blade of the  shears,) the meterological
condition, which is either absent or defective.  Here, then, is the combi-
nation necessary to render  effective the poison productive of the highest
grade of fever—yellow fever.  On the contrary, the other forms of mias-
 matic and  periodic fevers occur, when these execesses do not take  place,
 in  the same exaggerated degree.   It is then  the causes (or poison, if you
 will,) being in less force, the minor  organs  and  instruments of life be-
 come assailed, and symptoms, which  are their interpreters, direct to  the
 local action and attack;  now we see  the liver, the spleen, the gastro-
 intestinal mucous  membrane,  the system of organic  life,  to bear the
 onus; time is allowed for reaction, and the struggle  is made by  the sys-
 tem  to resist the disorganizing  tendency on the special organ.   The
 " Chagres fever," the  jungle fevers of India, the bilious and marsh  fevers
 of  our own country, satisfactorily illustrate the action of all  these secon-
dary influences, and  all most strikingly show the analogy between  the
causation of different classes of fevers with the effects before pointed out,
and the influences of medicines on the system just stated.   Can demon-
stration be clearer ? 
278
Supplement.
   A high dew-point (may be, with other aid) will produce bilious fever,
by acting on the materials of the blood and the secretions, and thus on
the instruments of life; but  for this latter (yellow fever) it requires  a
concentration  of these  agencies with others, to give intensity,  and thus
as we have different effects with  medicines, according to their dose, so it
is with these agents, and yellow fever  is  the result.  This is not mere
speculation, nor does it depend  upon  analogy alone, but it has  every
presumption in its favor, from  the  actual occurrence  of the disease (yel-
low fever) under circumstances where this  exaggerated  condition  alone
exists.   Can stronger proof be required \
  It is easier to account for the difference  in the types of fever on the
thermometrical or latitudinal than on the longitudinal scale.  All  medi-
cal history informs us of the geographical limits of fevers, that where the
temperature is high  or long continued,  with a great amount of moisture,
they increase in malignity, (other things being equal,) as these diminish,
they lose  their severe type or grade, until they finally cease as we ap-
proach the  arctic or antarctic poles; and  not only fevers, but disease
almost disappears, and  navigators visit, remain months and years, and
return from  those regions without scarcely losing a man.  But it is more
difficult to say why yellow fever should be at the head of its class in the
West and plague in the East.   There are climatic and hygienic pecu-
liarities that are still  unexplored by which it may be  explained,  provided
we seek for them  in the  true spirit of  philosophic research,  and experi-
ment perseveringly with the means science now furnishes her votaries.
  In  relation to  our  great Western disease, yellow fever, early history
has not furnished us with many  more valuable  facts, as to its causation,
than it has of the plague.  If yellow  fever is an American disease,  it was
not found here on the discovery of the country, it was only developed as
a climatic influence on  European constitutions;  it was only after these
Western  regions were occupied for more than a century, that it  began to
prevail;  when the settlements became more or less dense, and men con-
gregated  in  cities, population became  crowded, the habits of colder
regions were transplanted where they were  so unsuitable, and tropical
hygiene not understood, that  it had its birth.
  But science has dawned in the West in the awaking of the mind due
to a new era: the spirit of the  age  now expects to know  the cause of 
Supplement.
279
every thing, secondary agencies are the  hand-maids, the  interpreters of
the will of Deity ; it is only upon this foundation can the  true principles
of prevention (or sanitary laws) be based.  It is  a law  to  which all that
is dear to man is subject, that  as there is no fixed, stationary position for
man or for science, the moment we stop advancing we  are retrogressing.
Let us, then, fully advised, use all the means which science, still in her
infancy, has amply supplied her votaries, and interrogate nature with the
honest and sincere desire to arrive at the truth, instead  of  speculating
with a prurient imagination upon the half-stated  and the  false facts with
which imperfect tradition furnishes us, and we shall  thus  sooner unravel
the mysteries which environ this hitherto dark subject.
   Scientific investigation  has  furnished  us  valuable data to  begin with.
I have just stated why yellow  fever never occurs in the Pontine marshes,
and was unknown in all the ravages at Walcheren, the average tempera-
ture  being under 80 degrees, below which,  it  is  now  known, yellow
fever cannot originate.   It has been  shown  that  a summer temperature
 of 60 degrees is necessary for  the production of fever,  and that it  never
 appears as an epidemic, unless  the temperature  reaches  65 degrees.
 These temperatures are reached at Walcheren and the Pontine marshes,
 but not 80 degrees, and for the existence of  yellow fever, this temperature
 must not only be reached but  endured weeks if not months.  So precise
 has science now extended its investigations, but we trust,  it is only at the
 threshold.   We now  know  why  yellow  fever would  not spread  in
 Charleston* when carried there in May and October last,  and why, being
 taken to Aiken and Columbia,f at a more advanced period of the sum-
 mer it would  not  spread either, and that  when taken to Blackville and
 Augusta,;), it did spread.   In  the first cases there was a deficiency of heat
 and humidity, etc., while  in the  latter  they existed.   The  condition of
 Augusta  has been noted in  the " Introduction" to the Report, that of
 Blackville is  low,  with  a pond  in  its midst imperfectly filled, swamps
 surround it, and the irregularities of the ground have been filled up with
 offensive putrifiable materials.  Of the various  occurrences of  the many
 " spontaneous cases," mentioned  with  such emphasis in  the Report—in
* Temperature too low.
t Temperature and hygrometer too low, and particularly the latter, and the places clean.
$ Temperature and hygrometer very high, with abundant filth, etc. 
280                         Supplement.
tho  absence of precese observations  with the thermometer, there  are
other proofs mentioned, of the existence of, at least, these two agents, as
well as others, and  I  refer, as ample proof of it, to the many " sponta-
neous cases " of the fever mentioned in the Sanitary  Report.
   And, again,  I repeat the fact, which defies contradiction, that when
the  temperature  and humidity are  lowered to a certain degree, (stated)
yellow fever, as an epidemic ceases in this latitude.   These are,  I believe,
irrefutable truths, constituting  the laws  of the disease.   Another is no
less certain, that without the concurrence of the two agencies mentioned
in the Report—no yellow fever has  ever occurred, nor, by sequence, ever
can occur !   No amount of heat and moisture alone has ever or can ever
produce it.   No amount of filth alone, can effect it;  when concentrated,
it may produce  asphyxia and death ;—when  less, with defective ventila-
tion, crowding  and  a  low temperature, it may produce the worst forms
of typhus and other fevers, but never yellow fever.
   I  have  said that two conditions are required to  coalesce or combine,
in order to produce the alleged effect—the  meteorological and the ter-
rene—and  that  this latter  consists of filth  or decomposable organic
matter of all kinds—of which  I consider fresh rich original soil to be an
equivalent.   I have  never said or believed that one alone was sufficient—
yet against one alone has all the force of opposition been expended !
   We think, then, that the following propositions have  been clearly de-
monstrated, from the facts, by experimental observation and  by every
principle of fair analogy, viz.:
   1st. That ordinary mud—consisting of the  clay and sand  deposit of
the River Mississippi—is different from the "original soil" referred to in
the Report, in this, that one has organic  matter in it, and the other has
not, and  that it  is  farther mixed with  every species of decomposition,
and particularly,  with  the  offals of  society; that personal excreta, of all
kinds, constitute  the worst forms of organic  matter; that  yellow fever
results from these, in combination with the meteorological ingredient, and
that hence, it is the highest form of fever, and occurs mostly where these
exist, in greatest excess, as in the  filthiest parts of crowded cities.
   2d.  That yellow  and bilious fevers proceed from the same  causes,
although  differing in degree and amount.
   3d. That these causes,  acting  upon individuals of different suscepti-
bilities, (as the acclimated or native and  the acclimated,) produce these 
Supplement.                         281
different effects — in the first,  developing a  milder grade of periodic
fever, and in the second, the aggravated form, or yellow fever.
   4th.  That the main pathological cause of the difference  in  the  phe-
nomena exhibited  in  yellow fever  from  bilious fever, arises from the
difference in the rank  and  importance of the organs attacked in each
case respectively—in the first it is on organs whose integrity is more im-
mediately essential to  life, as the nervous and sanguiferous systems, or
those of cerebral life ; and in the second developing its influence on sub-
sidiary  organs, or those of rather secondary importance—those of animal
life, as the liver, spleen, stomach, etc.
   5th.  That these  causes proceed from all the circumstances that impair
the  purity of the  air,  which is essential to healthy existence, proceeding
from vegetable and animal decomposition of all kinds, and  disturbances
of the original soil—that these, in the aggregate, constitute MALARIA,
together with certain meteorological conditions, which are indispensable,
to give it activity.
   6th.  That all we know of contagion, is, that being a specific virus, the
product of secretory action, it must be,  in  its very  nature,  independent
of all these circumstances and conditions; the existence and the spread
 of these  can necessarily have no connection  with  it.  But, as  all the
 condition s productive  of vitiated or bad air must  tend to extend the
 above influences, within the  area of that impure air, and in proportion to
 that impurity and  the  meteorological condition, so  the susceptibility to
 the spread of  these diseases will exist.
    7th. The final proof of all these  propositions is, that when the condi-
 tions above  pointed  out are removed,  or no  longer exist, the  effects
 cease, causa sublata tollitur effectus.
   Throughout this paper I have endeavored to impress the reader with
 the firm belief which has pervaded  my own mind—that as there can be
 no effect without an adequate cause—so all  fevers, and at the head of
 them particularly, yellow fever, must have  some adequate  cause for its
 production, and I solemnly entertain  the firm and abiding conviction,
 that we are not ignorant of that cause.   Our author attributes  yellow
 fever to " accident or specific  causes."   The  term  " accident"  may be
 applicable  to man's action—but not  to the Creator's—with him, be it
 reverently spoken, there can be no " accident."   In  its reference to us, it 
282
Supplement.
only means our ignorance of a cause.  But  herein  I  have shown that
this is a most  egregious error, and that we know as much of the cause
of yellow fever, as we do  of any other ailment  with which  man is
afflicted,  and that, moreover, there is nothing " specific " about it.  Nay,
it is not too much to hope, with the better understanding of climatology,
with the clear proof, now well known to every well read medical man,
that fevers of every class and type have  their geographical limits, and
this will  be the more  precise, as both of these are better understood,
(i. e., fevers and climate,) that the great mystery of the proximate cause
of fever, that is, the ipse  morbus, will be,  ere long, unravelled.  To
hasten that long coveted period, to make this of real practical value, (its
only use) we must push on anew in our studies  of climate and  its rela-
tions, for it is upon a thorough understanding of all these, as a founda-
tion, that we can erect any rational structure of sanitary and preventive
measures.  This  study must enter into medical education in the legitimate
orthodox way, through a proper system in the schools.  Let it receive its
earliest impulse from this first Sanitary Commission ever instituted in Amer-
ica to investigate the origin of epidemic diseases, and if we  shall have suc-
ceeded " in establishing a single principle in our science "—we shall, in the
language of our eminent countryman. Dr. Rush," have done that  which
will lead to more truth in one year, than whole volumes of uncombined
facts will do in a century." 
 
 
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