426 surgeons' eepokts — Indiana — fourth district. 



and in Ensh County the soil is mucb deeper, and the water sooner disappears from the surface. 

 In Ohio, Dearborn, aud Frankliu Counties the bottoms and river-hills have a rich mold and allu- 

 vial soil. The uplands in the eastern part of Franklin County are good. The water in this entire 

 section is hard, being impregnated with lime, as the stone is generally of this character. 



It is conjectured that, at an early period of the earth's history, this region was greatly elevated, 

 and afterward washed off to correspond with sections east and west; and that, though now rela- 

 tively as high as adjacent parts of the country; we are below the coal-formation. 



The coal-strata crop out on the Ohio Eiver about a hundred miles above us, and nearly one 

 hundred and fifty miles below. This is not a mineral region. There were found near the rivers 

 some small licks from which the early settlers succeeded in making salt. 



The country is heavily timbered ; oak, beech, sugar-maple, ash, poplar, walnut, hickory, and 

 elm are the principal growths. The first settlements in the district were eflected in or about the 

 year 1800. These settlements were confined for a time principally to the borders of the White- 

 water and Ohio Elvers. The early settlers were mostly from Ohio, Keutuckj', and Pennsylvania. 



Of the present inhabitants, those not to the manor born are from almost every civilized nation 

 and state. The preponderating foreign element is from Germany. The Germans compose prob- 

 ably one-fourth of the population. Tlie Yankee element from the Eastern States is not large. The 

 immigration has been mostly from the Middle and from the Southern border States. 



lu the early settlement of the country the prevailing diseases were bilious fever, and chill and 

 fever or ague. These forms of disease are not now so frequent ; but cases of typhoid and conges- 

 tive fever, pneumonia, and phthisis pulmonj.lis are more numerous. Some forms' of bronchial or 

 lung disease are quite prevalent; as bronchitis, haemoptysis, asthma, &c. Quite a numbeV are 

 afflicted with. inflammatory and chronic rheumatism and neuralgia. Cases of dysentery and diar- 

 rhoea are not numerous ia adults, except when the first ])revails in an epidemic form, and the latter 

 is brought from the Army. 



Ui])htheritis of the throat has prevailed to some extent, and receutly in some localities, mostly 

 I think in the cold wet lands, there have been some cases of spino-cerebral meningitis. Tonsilitis, 

 early loss of teeth, disease of the joints and bones, dyspepsia, scrofulous developments, and the 

 results of diatetic and other forms of abuse, exposure, and neglect prevail to a considerable extent. 



Chronic ulcers and varicose veins are not uncommon, especially among the beer-drinking por- 

 tion of the Germans. Hernia and sarcocele I think are more frequently met with iu that class of 

 our population. 



We have also the ordinary amount of inflammatory disease to which flesh is heir in a variable 

 climate at 39 degrees north latitude. Injuries, cuts, wounds, sjirains, and fractures are quite 

 numerous. 



Many of the causes conducing are suggested by the geography aud history of this district. The 

 newness of the country, the rich alluvial and wet soil, the heavy timber, the luxuriant under- 

 growth, the decay of vegetable matter, the arising miasmata, the laborious and exposed life of the 

 early settlers, all tended to produce biliary derangement and nervous depression or exhaustion, 

 resulting in bilious fever and ague of every type. 



There is now a modification of these causes aud iuflueuces, and in some parts almost an exemp- 

 tion from some of them. 



There is not ouly an abatement of some of the sources of disease, but a modification bv the intro- 

 duction of new causes of disease. The earth is not so fully protected by forests ttud their fallen 

 foliage ; the earth's temperature is diminished. * # # 



We have, to a considerable extent, an active, enterprising people. They are mostly laborious 

 and much exposed, as the leading occupation is that of farming. Agricultiu'eis still pursued under 

 many difficulties. Much laud is still in the process of clearing. Drainage is imperfect, or is only 

 just commenced. The benefits of the system of tile-drainage, which depends upon the principle 

 that nature abhors a vacuum, is just beginning to be appreciated. 



(Jurpcoi)learenotonly industrious, but restless, careless of health. Manyof them drink toomuch 

 of ardent .spirits and of beer. They are not sufliciently careful in their diet. They use too much 

 hot bread, witli grease and saleratus. Probably they use too much animal food, especially pork. 

 Many of them, I can but think from experience in exnmining, are too careless of their persons. The 



