256 surgeons' reports— new york— tenth district. 



The two first mentioned are washed upon their western boundary by the Hudson Eiver, 

 and reach easterly to the Connecticut line. The southern portion of Westchester lies upon 

 Long Island Sound. The general surface of these two counties is mountainous and irregular ; the 

 luontitain-ranges from the Highlands running through the northerly portions, and gradually 

 bec.oiiiiiig more undulating toward the central and southern extremity. The general direction of 

 the hills is north and south, the watercourses following that conformation. The rock-formation 

 is a granitic gneiss, with the dip to the west. Bowlders of primary rock are abundant ; many 

 of large size, and some remarkable from the peculiar manner in which they have been deposited. 

 In the northern section, iron of an excellent quality abounds. In the southern section of West- 

 chester, salt-marshes of very considerable extent are formed by the tide-waters of the sound. 



Very many lakes and ponds are interspersed over the surface of this district; and the 

 Croton Eiver, rising in the upper portion, becomes a stream of .'^ome size where the aqueduct 

 receives its waters to convey them to New York. 



The county of Rockland, with the Hudson Eiver forming its eastern boundary and Orange 

 County and the State of ISIew Jersey its northern and eastern line, is mountainous and broken 

 upon its river-front, becoming more rolling and uneven toward the central and southern portions. 



Throughout the central and southern portions of Westchester, malarial and paludal fevers 

 prevail to a considerable extent, varying very much, in different years, in their frequency and 

 severity. Tliis miasmatic influence has a tendency, slowly and irregularly, to extend itself 

 northerly ; cases of malarial fever having recently been developed in localities where it was 

 unknown. This specific poison is often manifest in endemic dysentery, and even in pneumonia. 

 Typhoid fevers are more prevalent in the northern sections. Tuberculosis is of common occurrence. 



The proximity of this district to New York, with constant and easy access, both by boat and 

 rail, causes the importation of many, cases of infectious and contagious diseases. Thus, variola, 

 scarlatina, febris typhus, &c., are being constantly introduced, and act as centers from which to 

 diffuse their contagious influences. As a whole, the district has always been considered healthful, 

 and will compare very favorably with any other section of the State. 



The contiguity of the southern portion of the district to New York, its beautiful scenery and 

 healthful climate, has I'endered it a suburb of that city. The merchant and artisan, the gentleman 

 of leisure and the scholar, the artist and professional man, alike seek its abrupt shores and quiet 

 valleys for a pleasant home. With the exception of the brick and iron interests, the population of 

 the other sections of the district is chiefly devoted to a remunerative system of agriculture. 



By reference to the re[iorts from this office, it will be seen that the greatest ratios per thousand 

 exeuipted were under sections 5, 9, 20, 23, and 32, of paragraph S5, Revised Regulations ; the largest 

 being under section 23. Inasmuch as this compares with the statistical tables compiled from the 

 various offices in the States, I can give no especial reason for this greater ratio, further than the 

 general laws which affect communities and nations similar in their habits, modes of lile, and 

 occupations. 



Paragraph 85 having been carefully prepared by those whose experience and qualifications 

 entitled them to the highest respect, it is with no little diflQdence that this portion of the report is 

 entered upon. The only sections I propose to mention are Nos. 3, C, 20, and 25. 



Sections. It is a fact well known to every physician, particularly to those practicing in the 

 country, that a patient may have very nianj^ epileptic seizures without the attending physician 

 being able to see him during the paroxysm. Again, many epileptic patients, having undergone 

 treatment for a considerable length of time without apparent benefit, forego any treatment save 

 that of a domestic nature. By a strict adherence to the section, it will be impossible to exempt 

 some epileptics concerning whose iuaptitude for military service there can be no doubt. I would, 

 therefore, respectfully suggest that the section be modified so that the attested affidavit of a physi- 

 cian may be dispensed with, and other sufficient evidence be deemed satisfactory to exempt. 



Section G. There are many young men with a scrofulous diathesis strongly marked, who, with 

 the advantages of regular habits, generous diet, exercise, and habitual care, may keep tuberculosis 

 in abeyance for years. I think every examining-surgeon has had such men present themselves for 

 examination, and, in his mind, there was not a doubt but that the exposure, fatigue, and hardships 



