332 surgeons' reports — ^Pennsylvania — fourteenth district 



PENNSYLVANIA— FOUllTBENTU DISTRICT. 

 Extracts from rcjmrt of Dr. P. K. Wagenseller. 



* . * * My experience in tbe uieilical exainiii.itiou of uien for inilitury service 



begins with tlie l.st day of January, 180.5, and extends over a period of nearly four months. Dnrin.!; 

 this time, I have examined about one tliousand five hundred and fitty men. * » * 



The Ponrteentli District of Pennsylvania is conii)o.sed of the counties of Daujihin, Juniata, 

 Northumberland, Sn.\der, and Union. Its extreme boundaries lie between latitudes 40° 10' and 41<^ 

 1(1' north, and between the meridians 45' west and 30' east from Washington, and the nuMd)ei' of 

 s(juare miles contained in the district is 1,885. The poi)ulation in 1800 was 121,815. The surface 

 of its territory is exceedingly diversified. It is traversed by numerous aiountaiu-ridges, between 

 which are valleys of great beauty and fertility, extending frequently over an area of many n)iles. 

 Large portions of the countiy, again, are of a gently undulating character; and tlieie is scarcely iiny 

 of its territory which is not highly irrigated by large rivers or their tributaries, many of which are 

 themselves of veiy respectable size. The princijial streams are the Susquehaniia, with its North and 

 West Branches, and the Juniata. These are broad and shallow, and, except when swollen by freshets, 

 have, as a general thing, a current moving with but little rapidity. 



Along the borders of these rivers, for a very great [lortion of their course, the land rises very 

 gradually on either shore, and extends back into the country many miles, forming an almost level 

 tract of territory, with but little elevation above the beds of the rivers, and scarcely to be surpassed 

 anywhere in productiveness of soil. 



Four of the counties comiaising the district border upon the Susquehanna; two, viz. Union 

 and Snyder, being situated upon its right bank, while the two larger counties of Nortliundierland 

 and Dauphin an- upon its left baidi. The county of Juniata, composing the remainder of the dis- 

 trict, is divided into two nearly equal portions by the river bearing the same name ; and the peculi- 

 arities of this county, as regards soil, cliaiate, and irrigation, resemble very much those of the 

 distiict previously described. The climate is mild and siilubrious. The mean average tenqtera-ture 

 of the year is about 49°, while the greatest difference between the hottest and coldest month of 

 any one year during the last five years (in my own county, Snyder) was 43°. The total annual fall of 

 rain for the last livi^ years was 47.30 inches. This is generally so e(jually distributed that tliereis 

 seldom any [)t'riod in the year, with the exception of a few weeks of drought during the summer, in 

 which the country is not abundantly watered by light rains and Irequent showers. 



The diseases most extensively [irevalent are those which are generally Tccognized as endemic in 

 localities similarly situated as regards climate, soil, temperature, and hydrography. These are the 

 different forais of miasmatic intermittent and remittent fevers, with dysentery, diarrha'a, &c. ; and 

 of diseases not endi inic; there are very few which, when i>re\ alent, have not in some degree blended 

 with them th(^ nuasaiatic element. (Jf late years, however, the type of miasmatic diseases has been 

 gradmdly becoanng milder, iind, while these are now also less frequent than formerly, others of 

 different origin are becoming more common. 



Typhoid fever, which was not so generally recognized until within a more recent date, is now 

 a disease; which i)revails lo a considerable extent during the whole, or a greater portion, of the 

 year. 



The causes of the prevalencie of miasmatic levers throughout the district were, no doubt, the 

 abundant foci for the generation of marsh miasmata, as jionds, stagnant water, and inqierfect 

 drainage, existing throughout a large ])orti()n of its territory. These causes, although still existing to 

 a certain degree, have been materially modified by cultivation and systems of drainage, and in ])ro- 

 portion as these liave been perfected have the diseases arising from them been rendeied milder 

 and much less frequent. Organic diseases of the liver and spleen, witlj old dyspepsias and general 

 debility, in consecpience of severe or repeated attacks of miasmatic disease, are frequently met 

 with. 



There are but few large towns in the district. A large proportion of the poi)idation is rural, 

 and is composed mostly of Germans and I heir descendants. The inhal)itants, in llieii- general 



