surgeons' KEPORTS — MARYLAND SECOND DISTRICT. 347 



Diiiubcr, tbiee liuiidicd ami scveutysevcn were exempted for physical disability, and four butidred 

 and thirty seveu were refused exemption. # * * 



The Seeoud Congressional Distriet of Maryland embraces the fifth, sixth, seventh, ninth, tenth, 

 eleveiill], and twellth districts of Baltimore County, the whole of Ilarford County, and the lirst 

 seven wards of the city of Baltimore. The city portion of the district is bounded by Jones's Falls on 

 the west. Tiiis stream rises in B;;ltimore County, runs partially around the north of the city, then 

 through the city, receiving into its channel the washings of many streets, the contents of sewers 

 and privies, and then empties into the Basin, so-called, which is an inlet of the Patapsco River. 

 This basin forms the southern boundary of the seveu wards of the city. On the east and north side 

 the land is high and rolling. 



The ninth district of Baltimore County is also bounded on the west by Jones's Falls. From 

 these falls the city is supplied with water by means of an artificial lake, made by the city a few 

 years ago. 



The twelfth district of Baltimore County lies, in great part, on tide-water. There are several 

 rivers running through it, which empty into the Chesapeake Bay. In this district there is much 

 low, swami>y land, a portion of Harford County lying on the Susquehanna River. Excepting this 

 part of Harford County and the twelfth district of Baltimore County, the land'in both counties is 

 rolling and well watered. The eastern section of the city, embraced in part by the first seven 

 wards,' has been represented as being most subject to intermittent fevers ; for the past two years, 

 this fever has ]irevailed to a greater extent in the western section of the city. On Jones's Falls, 

 on the north side of the city, intermittent fever prevails as much as in the twelfth district of Balti- 

 more County. Where these falls run through the city, there are no cases of intermittent fever. 

 From the aitpearance of the Asiatic cholera in 1832, until about ISui, all portions of the State 

 liable to autumnal fevers before the former period were less liable to these diseases than had ever, 

 been known before. The type of disease was as much changed as the character of these dis- 

 tricts for health was changed. In ISal, malarial diseases prevailed to a great extent in the Cham- 

 bersburgh and Shenandoah Valleys; it made its appearance before harvest, vegetation being in 

 its most luxuriant condition, and few families escaped, even when the disease had not been known 

 for many years. In some' families, scarcely any were left well enough to attend tlie sick. In tbose 

 l)laces where autumnal diseases prevailed to some little extent, the inhabitants were healthy. Since 

 liSG't, these fevers have been annua'ly becoming more prevalent, and assuming a similar type to 

 that which existed before the advent of thercholera, and they require a decided change in the mode 

 of treatment. A very intelligent and successful physician in Cecil County, Maryland, informed 

 me, in the summer of ISUl, that bilious remittent and intermittent fevers were then prevalent, and 

 that he had been very successful in their treatment, prescribing at the onset emetocathartic doses 

 of calomel and tartarized antimony. Such treatment iu this district, in 1850, would have been 

 ruinous to the patient, and would now be at war wjth modern theory. The result of actual prac- 

 tice, however, is more to be trusted than auy theosy. Country physicians are generally governed 

 bj' experience and observation more than by theoretical system. They are compelled by their iso- 

 lated situation to rely upon their own observations, and to draw their own conclusions; and their 

 exi>eiience teaches them to adapt their treatment to the actual condition and physical wants of 

 their patients. The experience of the writer corroborates the correctness of the treatment of the 

 pliysician from Cecil County. As before stated, the fever of 1854 began when harvest vegetation 

 was not even declining. What, then, was the cause of this exten.sive epidemic? What had kept 

 this malarial poison so long in abeyance"? The only difference known was that all the siuks,^which 

 are very common in limestone regions, had more or less stagnant water in them from the spring- 

 rains, which had continued late in the season. The streams were sUll well supplied with water. 

 On the first settlement of the valleys named, these fevers were unknown ; as the country was 

 cleared, they prevailed more or less every year, until occasionally tliere would be no house with- 

 out some one sick from that cause. Autumnal fevers are now as prevalent and more violent than 

 they are in the lower counties of Maryland, where, before the advent of the cholera, they were 

 expected with the fall of every year. The inhabitants of the lower counties attributed the im- 

 proved condition of their country, in regard to health, to the great quantities of lime used on- their 

 lands, and to the iuipioved system ol farming. No doubt, they are right to a considerable degree; 



