ON THE DISTRIBUTION OF CERTAIN DISEASES, ETC. O 



in the extreme north to one in the extreme south. The same result is arrived at if we com- 

 pare the number of persons living to one death from consumption. The variations from this 

 direct and uniform decrease are very slight. For instance, in the District of Columbia, the 

 proportion was considerably greater than in other places of the same latitude, owing probably 

 to the mixed population, derived as it is from all sections of the land; while in Minnesota and 

 Iowa it is less dominant, owing, as there is reason to believe, to the remarkably equable and 

 dry climate. Again, some allowance must be made for the newly settled territories which are 

 mainly populated by young and vigorous men, with a dearth of females, a class in which the 

 disease would not be expected to prevail. 



The general law that liability to consumption in the United States decreases as we pass 

 from north to south must be considered as definitively settled. Whatever the minor errors in 

 diagnosis or in registration may have been, and considering the uniform time and method in 

 which the data were obtained, they would weigh little against the uniform rate and direction 

 of the variation exhibited. 



Now in addition to the fact that consumption is so much more fatal at the north than at 

 the south, it is also a fact that the mortality from all diseases is greater at the south than at 

 the north. If we take the three northernmost States, Maine, Vermont, and New Hampshire, 

 the mortality to every one hundred persons is 1.25, or one person to every 81 living; while if 

 we take the southern States, South Carolina, Georgia, and Texas, the mortality is 1.41 to one 

 hundred, or one death to every 71 living. It then becomes a question, what disease, or what 

 class of diseases at the south compensates for the fatality of consumption at the north. The 

 miasmatic diseases, developing fevers of various types, are well known to be very fatal at the 

 south. If we tabulate the fevers in the same way as we have done consumption, (and this is 

 also exhibited in the table,) we find the order of the States nearly reversed, the proportion of 

 deaths being very small in the northern and large in the southern States. Indeed, if we add 

 together the percentage of deaths from consumption and fever in each of the States, their 

 sum is nearly equal for all the States; and the extremes of variation for the States, instead of 

 one to ten, become as one to two. 



It is thus evident that there are regions more favored than others in respect to exemption 

 from certain diseases, and consequently more favorable to recovery from those diseases; and 

 that this preference is much more strong than has been supposed — certainly more strong than 

 has ever before been proved. What is true in regard to the two diseases in question is true 

 to a certain extent of other diseases. 



The idea, therefore, of establishing sanitaria for different diseases in parts of the country 

 best suited to their cure, sending patients north or south, east or west, to the sea-shore or 

 upon the mountains, as the case maybe, is a most important one. Infirmaries established, 

 with this idea in view must be attended with a far greater degree of success than can be 

 obtained from the old system of mingling together invalids laboring under all sorts of 

 infirmities, as has been the case heretofore in all countries. 



An English writer has maintained that the idea that consumption and ague are antago- 



(2S9) 



