374 surgeons' reports — Kentucky — sixth district. 



organic disease of the heart. No doubt, one great cause conducive to consum])tioi» and scrofula is 

 the character of the climate. Here the cold of the north and warmth of the south meet in con- 

 tinual conUict, one prevailing for a short time and then the other. As a rule, not more than 

 thiee or four days at a time of either very cold or moderately warm weather are ever witnessed 

 here in thi' winter-season. The changes are sudden and violent; the difference in temperature occa- 

 sionally amounting to thirty and forty degrees between one day and another. The thermometer 

 frequently indicates sixty-live, seventy, and eighty degrees ; then the mercury is down to zero, 

 sometimes ten and twelve degrees below, and at times fifteen, twenty, and even twenty-four. 

 These constant changes during one-half at least of each year must necessarily affect all who are 

 delicate and feeble, or who are predisposed to chest-diseases; hence consumption is developed out- 

 right, if such a thing is possible, the result of cold, pneumonia, or ])leurisy, acting as exciting causes 

 upon a constitution already predisposed. 



The people almost universally eat hot bread at every meal, lightened or raised with soda or 

 "baking-powders," drink hot tea or coffee morning and night, together with copious draughts of cold 

 water at intervals. Supper is as hearty a meal with them as dinner, at which they eat as much 

 meat, which is nearly always hot fried pork or ham. They retire to sleep early, with their stomachs 

 filled with ill-masticated and indigestible food; hence dysi)epsia. Thousands also bring the disease 

 upon themselves by the vicious and constant habit of chewing and smoliing tobacco. 



Functional disease of the heart exists largely in conjunction with tubercular deposits, curvature 

 of the spine, indigestion, habitual constipation of the bowels, irritation in the biliary organs, and 

 internal disorders. It is also caused in many cases by the influence of tobacco chewing and smok- 

 ing, and by the constant habit of drinking mean whisky. Tea and coffee, on some constitutions, 

 have the same effect, especially if strong. The surgeon should bear all these things closely iu 

 mind, or he will sometimes be misled, and conclude upon organic mischief where there is nothing 

 but functional disorder. 



Organic disease of the heart is more frequently the result of rheumatism than of any other cause 

 known to me. When this cannot be traced, the affection is often produced by constant heavy lift- 

 ing, by labors that require an incessant hurry, by occupations that put a continued strain upon all 

 the physical energies. In some cases, no cause whatever can be assigned. 



Diarrhoea, cholera morbus, and dysentery are quite prevalent from about the first of June until 

 decided frosts come in the fall. 



Diarrhoea is caused by eating immature vegetables, unripe fruits, especially those of strong 

 acid qualities, (such as cherries,) fresh pork, and by heat. 



Cholera morbus can nearly always be traced to the eating of cherries, young potatoes, green corn, 

 fresh shote, or to overwhelming heat. 



Dysentery does not prevail except during intensely hot weather, and then any of the causes 

 mentioned as producing diarrhoea and cholera morbus act as exciting causes iu the production of 

 the disease. It is occasionally endemic and sometimes epidemic. 



The people are iudustrious, energetic, intelligent, and, inx^eaceful times, remarkably hospitable, 

 social, kindly, and generous. They are managing, thrifty, and money-making. Since the war 

 commenced, however, a majority of them have been rebels of the genus Diabolus ; such is their 

 general character. 



The occupation of the people is almost universally that of farming. jNIuch attention is 

 paid to the breeding of fine horses and cattle, and to the rearing of mules. Large profits 

 are realized from the production of tliese animals. The vine has been introduced to some extent 

 iu two or three counties, and the cultivation of the peach in its finest varieties has received much 

 attention of late years. 



There are large iron-manufactories in the counties of Kenton and Campbell. Immense quan- 

 tities of tobacco are manufactured iu the city of Covington by twenty-five or thirty different estab- 

 lishments— more, perhaps, than in half the State besides. Such are the "modes of life and occu- 

 jiations of the peo[)le." 



The parti(;ular diseases and disabilities that have disqualified a greater ratio per thousand of 

 men from military service than others are hernias, fractures, wounds, organic disease of internal 

 organs, developetl tuberculosis, loss of teeth, and varicose veins. A considerable proportion of 



