SURGEONS REPORTS IOWA — FIRST DISTRICT. 453 



^' Prevalent diseases, and cmises condiicire thereto.^'' — In the entire State of Iowa, between June 1, 

 1859, and May."!, ISOO, there were G,!)4;i (leath.s. The lblk)\vins are the |)rinci|)al disease.s reported 

 iu the United States census as the cause of death : Consumption, 748; diarrhoea, 224 ; dysentery, 

 2G4; intermittent fever, 2oG; remittent fever, 235 ; tyiihoid fever, 413; pneumonia, 581 ; scarlet 

 fever, 337 ; crou)), 4G0. 



At Fairfield, Iowa, during ten years, between May 12, 1852, and same date, 18G2, jny private 

 record (preserved witii great care, and compared with tiie sexton's boolis) shows that there were 

 368 interments. The principal causes of death in these cases were as follows: Dysentery, 3G; con- 

 sumption, 33; pneumonia, 24; croup, 19: typhoid fever, 18; remittent fever, 17; diarrhoea, 18; scar- 

 let fever, 7; congestive fever, 5; &c. 



The term remittent fever is understood to be synonymous with the common expression bilious 

 fever. The word typhoid is extremely indefinite, and should not be apjtlied to any cases but the 

 true enteric fever, so graidiically described by Dr. George B. Wood, of Philadeli)hia. Enteric fever 

 is a very rare disease liere. 



Even a casual glance at the figures from the United States census, compared with those front 

 my own record, will illustrate the idea that tliere is litthi dilference between the prevailing diseases 

 of the first district and those which are set down generally as the cause of death throughout the 

 West. Dysentery, bilious and intermittent fevers, and generally diseases supjiosed to depend ujion 

 miasmatic origin, are more common and more fatal than any other class of maladies. In the eaily 

 spring and late winter months, when the snows are disajjpearing and the weather is variable, alter- 

 nating from great heat to sudden cold, when the winds change rapidly from south to north, and 

 there are rapid changes in the hygrometrical condition of the atmosphere, there is the usual 

 tendency to pulmonary diseases. Occasionally, an epidemic of pneumonia at this season has seized 

 the inhabitants, and has been found quite intractable. Bronchitis, called in adults " a bad cold," 

 and in children catarrh or catarrhal fever, is an extremely common affection at such times. The 

 causes which contribute to these diseases — in one word, checked perspiration — are not different 

 from those found in other localities similarly situated. 



The idea at one time extensively prevailed that this region was peculiarly exempt from con- 

 sumption ; and some persons affected with the disease, in every stage of its development, escaped 

 from their homes and sought this climate with hope of allex iation, and possibly of cure. Travel, 

 the excitement incident to novel scenes, the whole routine of treatment under the comprehensive 

 title "change," perhaps, accomplished as much good as if a consumptive i>atieut liad removed 

 from Iowa to Alabama, but not a particle more. There is no reason why a greater or less develoi)- 

 ment of tuberculosis should occur here than elsewhere discoverable in the present state of our 

 knowledge as to proximate cause and intimate pathology of the disease. 



Dysentery, remittent and intermittent fevers, are the scourge of the late summer and 

 early fall months. All these are supposed to de])end upon miasmatic origin. In fact, it may be 

 said in passing, that many ordinary distempers assume a distinctly intermittent or remittent char- 

 acter, indicating miasma as their cau.se, or at least as modifying their cause. Thus, pneumonia, 

 dysentery, diarrhoea, neuralgia in protean shape, &c., freciuently become intermittent; in other 

 words, there is an aggravation of all the symi)toms, lecurring at regular intervals, with other 

 symptoms of bilious disorder and origin; and though the cases are essentially different, being 

 inflammation of different tissues and of different grades of severity, ulceration, spasm, or mere 

 nervous pain, the cases happily yield to the administration of antiperiodic remedies. 



In some instances, during a widespread epidemic of dysentery, where the symptoms put on this 

 character, suli)hate of quinia was an infallible remedy. The same may be said of i>neumonia. In 

 short, this region is no exception to the rule that heat, moisture, and vegetable decomposition 

 develop miasma, and that these poison the blood and induce bilious diseases. This locality is not 

 exempt from the ordinary epidemics that claim their victims iu the whole civilized world, and there 

 is no reason why it should be, or why their essential nature or character should be modified. 



General character of inhabitants. — Says General W. Diiane Wilson, in his excellent hand book, 

 "Iowa and its Resources," just published, speaking of the first district, "Its population is intelligent, 

 moral, and industrious, and in the cities highly intellectual and cultivated." It may be superfluous 

 to enlarge upon this statement, but a few figures and (acts are added to illustrate it. In 1861, 



