348 surgeons' keports — Maryland — second district. 



tbcir old enemy, bowevor, is returning, and extending bis scepter over tbeir beautiful country, and 

 prostrating tbeir people before liiiii. 



Did tbe cause of cbolera destroj- tbe so called malarial poison 1 or did it enter into nature's 

 laboratory, and stop tbe generation of tbe first poison, so prolific of disease and deatb ^ or did it 

 cbange man's physical condition, so that he was no longer susce[»tible to its deleterious effects ? I 

 shall not undertake to answer these questions. The fact is notorious that on tbe-Upper Potoiunc, 

 lor years, bilious fever was a curiosity to the inhabitaut.s, who, previous to 1832, bad been familiar 

 with it from childhood. There had been no change in the status of tbe inhabitants, uoTie in mode 

 of living, nor any nuirUed cbauge in the system of farming; only more land bad been cleared and 

 put in cultivation. In tbe country, little attention is i)aid to drainage, even about dwellings and 

 out-bouses. A highly respectable physician of Virginia, some years ago, stated that be ordered a 

 hogshead of rain-water, which had been standing for some time, to be emptied on the grass, by 

 which tbe grass that was wetted by tliis water was entirely killed, not a root being left alive. 



As before stated, that part of the city through which Jones's Falls runs is free from malarial 

 fevers, while north of the same city, on the same falls, these fevers prevail to a great extent. 

 Attention has been called to the nudarial fevers of mouutainous regions, of districts of rolling 

 laud on running streams, and of tide-water districts. In tbe two former, these fevers prevail fully 

 as much as in the tide-water districts of the State. What cause gives rise to these fevers ? I 

 think staguant putrid water is the principal cause. Jones's Falls in the citj', the receptacle of 

 every species of filth, has no malarial disease on its borders. This part of tbe falls has stone walls 

 on each side, confining its waters to the bed of tbe stream, above the city, and to the lake. There 

 are small streams emptying into these falls, and bringing with them the exhalations from the stag- 

 uant pools along their banks into the current of air following the course of the falls; this is still 

 further increased from tbe putrid water along tbe main stream. As a necessary result, the inhab- 

 itants soon feel its deleterious influence; not nearly so much, however, when their dwellings are 

 sep.arated from those streams by forests. 



The Potomac River and its tributaries are in the same condition as Jones's Falls, with the 

 addition of many natural sinks containing stagnant water. I have gone beyond tbe second con- 

 gressional district in speaking of disease, because the same character of fever prevails throughout 

 the State ; the same cans ■ of disease must exist where the same disease prevails. lu all these 

 sections, large collections of stagnant water are to be found. The inference can, I think, be Justly 

 drawn that stagnant putrid water is tbe most prolific s»urce of nudarial fever. It is a welt-estab- 

 lished, but hitherto unexplained, fact, that from the appearance of the Asiatic cbolera, the character 

 and tyi)e aiul recuri-ence of malarial fever for years were changed, and, to a great extent, it disap- 

 peared ; and that these fevers are again slowly but surely returning to tbeir former character and 

 type, which may possibly be checked by a close and untiring attention to drainage. Clearing aiul 

 cultivating land will not i>reserve the general lu'alth, unless the beds of the streams are well open, 

 and stagnant pools cease to be seen in our miihst. This can only be accomplished by the appoint- 

 ment of capable and efficient health-oflicers. 



The iidiabitauts of this district are Americans, Germans, Irish, Jews, and negroes. In the 

 country [tortiou of this district, the jieople are mostly farmers and gardeners. Mechanics are settled 

 to a limited extent to suit tbe wants of the people. There are also cotton -factories and iron-works. 

 The inhabitants live well, are industrious, and have tbe characteristic of the American, namely, a 

 great desire to be rich. Going to school is appreciated; education is not — that is, the people think 

 going, to school is education. The State is entering upon a uew career of educating. It is hoped 

 she will do better than she has yet done. 



The seven wards of the city, being the eastern portion, are principally occupied by mechanics 

 and laborers. These classes are more liable to accidents, rheumatism, and henna. # * » 



Lpilcpsi/. — Confirmed epileptics are rarely or never under medical care. It is often impossible 

 to procure a i)liysiciau'« affidavit to the witnessing an attack within six months. A medical alfi- 

 davit that the man bad been seen in an attack, and reliable testimony that he had had au attack 

 within six mouths, would establish the fact, and entitle the man to a discharge. 



Well-ascertained organic disease of any internal organ should dis(]ualify from military service. 

 The worst cases of organic disease of the heart were fouiul in those who never complained of heart 



