xt7b8g8ffq6g https://exploreuk.uky.edu/dips/xt7b8g8ffq6g/data/mets.xml Sutton, W. L. 1850  books b92-128-29187831 English Maxwell & Co., : Louisville : Contact the Special Collections Research Center for information regarding rights and use of this collection. Typhoid fever Kentucky Georgetown. History of the disease usually called typhoid fever  : as it has appeared in Georgetown and its vicinity, with some reflections as to its causes and nature / by W.L. Sutton. text History of the disease usually called typhoid fever  : as it has appeared in Georgetown and its vicinity, with some reflections as to its causes and nature / by W.L. Sutton. 1850 2002 true xt7b8g8ffq6g section xt7b8g8ffq6g 


            USUALLY CALLED








M. D.,




  Page 44, line 5, after "tibia," read "occurred."
  Page 101, line 7, for Bliss, Iii," read "'3ss, :Jii."
  Page 120, line 20, for "capsicum, eve. Medicine, c.," read -capsicum,
Eve: medicine, c."
  A few other typographical errors of little importance will be detected
by the reader.


                C O N T E N T S.

INTRODUCTION, -   -                                        I
                       CHAPTER I.
NAiE AND HISTORY,                    -                    4
   ART. 1.-Name,   -   -    -   -    -   -    -   -    - 4
   ART. 2.-History,   -   -   -    -   -    -   .   -    6
                      CHAPTER II.
CAUSES,  -   -    -   -    -   -   -    -   -    -   -    9
   ART. 1.-Age, Sex, Race, Period of Residence,  -  -    -  9
   ART. 2.-Dwellings, c.     -   -   -    -   -    -   13
   ART. 3.-Contagion,      -   -    -   -    -   -    - 17
                      CHAPTER III.
SYMPTOMS,     -   -    -   -    -                        29
   ART. 1.-Mode of Access,   -    -   -    -   -    -   29
   ART. 2.-Physiognomy and Nervous System,     -    -   - 29
       Sec. 1.-Expression of Countenance, -  -    -    -   29
       Sec. 2.-Sensations, -   -    -   -    -   -    - 30
       Sec. 3.-State of Mind,.    -   -    -   -    -   30
       Sec. 4.-Senses, -   -    -   -   -        -    -31
       Sec. 5.-Wakefulness,  -    -   -    -   -    -   31
       Sec. 6.-State of Muscles,  -   -    -     -    - 31
   ART. 3.-Sanguiferous System,   .   -    -   -   -    32
       Sec. 1.-Pulse,  -   .    -   -   -    -   .    - 32
       Sec. 2.-1pistaxis,-    -   -    -   -   -        32
       Sec. 3.-Hemorrhage from Bowels,  -    -   -   - 33
       Sec. 4.-Congestion,    -   -    -   .   -    -   33
   ART. 4.-Digestive system, - -    -   -   -    -   - 34
       Sec. 1.-Mouth and Tongue,  -   -    -   -    -   34
       Sec. 2.-Nausea and Vomiting, -   -    -   -      34
       Sec. 3.-Diarrhea, -    -   -   -    -   -    -   35
       Sec. 4.-State of Abdomen, -  -   -    -   -    - 38
   ART. 5.-The Urine,    -    .   -   -                 39
   ART. 6.-State of Skin,  -   -    -            -      40
       See 1.-Heat, dryness, c., of Skin, -  -   -   -    40
       Sec. 2.-Rose Spots, -    -   -   -    -   -    - 41
       Sec. 3.Z aSudamina,    -   -   -    -   -    -   42



       Sec. 4.-Desquamation of Cuticle,
   ART. 7.-Respiratory System,
   ART. 8.-Sequel2.   -    -   -
                     CHAPTER IV.

   ART. 1.-Duration, - - - -
   ART. 2.-Prognosis, -   -   -

                      CHAPTER V.

                     CHAPTER VI.

DIAGNOSIS AND NATURE,    -    -   -   -
   ART. 1.-General Remarks,
   ART. 2.-Diagnosis from Bilious Fever,-
   ART. 3.-Diagnosis from Typhus Fever,
   ART. 4.-Nature,  -   -    -   -
       Sec. 1.-Rose Spots,-    -   -
       Sec. i.-Sudamina,  -  -   -
       Sec. 3.-Peyer's Patches, -   -

                     CHAPTER VII.

TREATMENT,    -   -    -   -   -    -
   ART. 1.-Bloodletting,
   ART. 2.-Etnetics,  -   -    -   -
   ART. 3.-Catbartics,  -    -   -    -
   ART. 4.-Mercury,    -   -   -    -
   ART. 5-Tonics and Stimuli,  -   -    -
   ART. 6.-Appliances to Skin, -
       Sec. 1.-Blisters and Sinapisms,
       Sec. -2.-Water, to head or body,
       Sec. 3.-Pediluvia,
   ART. 7.-Diaphoretics,
   ART. 8.-Opiates, -   -    -   -    -
   ART. 9.-Expectorants,
   ART. 10.-Diet and Drinks,
       Sec. 1.-Diet,
       Sec. 2.-Drinks,
   ART. 11.-Management of Patient,
                     CHAPTER VIII.
   ART. 1.-Cases,

-   - 42
  -   43
    - 43

- 45
- 48


- 55
- 64
_- 7

          - 95
        -   95
          - 98
-   -   -  104
  -   -    106
-   -   -  106
  -   -    107
      - -  108
_   -   -  109
      - -  110
-   -      110
  -   -    110
    -i- -  111
  -   -    112





                   COMMONLY CALLED



  A report on typhoid fever made to the Scott County
Medical Society, at their annual meeting in April, 1846,
in accordance with the constitution of that Society, was
the origin of this essay. Subsequently, I reflected that
as this form of disease is at present attracting much at-
tention on the part of our profession; that if not a new
disease among us, some very important features in it have
been overlooked; that in various portions of the West
aRd South, it does not exist, or has not been detected;
that it is very important, in this transition stage of our
knowledge of this subject, that all the means which can
be made available towards forming a fixed and correct
opinion, should be within reach; and that a true delinea-
tion of this form of disease, as it appears at different
times and places, drawn by faithful observers, is very im-
portant to coming to correct notions as to its nature, cau-
ses, and treatment; I have determined to discharge what
I conceive my duty to the profession, and give an account
of it, as it appeared in Georgetown and its vicinity, for
the last six years. My remarks are not intended to ap-
ply to any other time or place. I have depended mainly
upon my own observations as to facts. I have taken con-
siderable pains to make myself acquainted with the cir-



cumstances attending these facts; so as to be better ena-
bled to judge what influence these circumstances exerted
up)on conclusions to be drawn from these facts.
  .1 have endeavored to observe correctlv, and to report
faithfully. I have no favorite theory to maintain; and if
I had, I should desire a better basis than facts badly ob-
served, or unfairly stated. I have conferred freely with
my professional brethren, and have their general concur-
rence as to the correctness of my observations. Facts,
not of my own observation, or which go to militate against
those, I have given on the authority of the parties fur-
nishing them. Of course I have introduced none which
I do not consider fully entitled to credit.
  In considering the etiology, and pathology, I have
availed myself of the labors of other men, usually in
their own words, that no change of meaning might be
given to their facts or opinions, by change of language.
  In my interpretations of those facts and opinions, I have
endeavored to follow where reason and common sense led
the way. I have not attempted to give a complete ac-
count of the history, causes, symptoms, or treatment of
the disease, or form of disease as it may be. I do not
pretend to have settled points in its etiology, pathology,
or treatment; but I have aimed to give a correct account
of its symptoms and treatment as observed here.
  Upon some points it may be thought that I have ex-
pressed myself too strongly, and it may be so. I know
that it is extremely difficult to be sure that we are in pos-
session of all the facts in any given case. I know too,
that I am as liable to overlook facts and circumstances as
others. I can only say, if I have drawn incorrect con-
clusions, no man will regret it more than myself.
  From the fact that I have quoted pretty freely from
Prof. Bartlett's work on typhus and typhoid fevers, and
in some instances have viewed his facts in a light differ-
ent from that in which he views them, it may be supposed
I take plcastire in dlitering from him. I hope the gene-



ral tenor of my remarks will show, that my object is
truth-not to agree or disagree with any one. Certain it
is, I love my profession,.and honor its members as the
benefactors of my species; and no one of them more than
Prof. Bartlett.
  The truth is, I look upon his work as an exposition of
our knowledge apon the subject; and as it is, or ought to
be in the hands of our profession generally, it is conveni-
ent as a matter of reference. Valuable as that work as-
suredly is, I do not think it an objection to the publica-
tion of observations made in the West and South, but
rather an additional reason for such publications. Dif-
fering Nidely in climate, and in the habits of the people,
as this country does, from France and New England,
even the same disease may reasonably be expected to
present modifications in symptoms, and to require cor-
responding modifications of treatment; at least observa-
tions made in those regions must be verified here, before
they can be implicitly relied on. I hope my professional
brethren will read this essay, compare the facts and opin-
ions therein contained, with what they have observed in
their own practice, and extend to me that charity which a
knowledge of the difficulty of properly executing such a
task shall suggest-and I hope (may I not be disappoint-
ed) that many of them at different points will follow the
example, and give me an opportunity of profiting by their
  To this essay it may be objected that it is unnecessa-
rily minute in some particulars, or that some porti hns are
even irrelevant to the subject. I feel the objection; but
I likewise know that in examining subjects not thoroughly
understood, it is difficult to determine the weight which
circumstances apparently minute and unimportant may
assume; or what may prove relevant or irrelevant to the
subject. Certain it is that during my researches since
beginning this essay, my views upon some important
points have been materially modified.




                     ARTICLE 1.


  It frequently happens that a name of disease, which to
one person, and in some circumstances, seems peculiarly
appropriate, to other persons and in different circumstan-
ces, appears very differently.
  Such is particularly the case with regard to the term
"Typhoid Fever," which has been applied to this affec-
tion. The term typhoid had had a signification sufficient-
ly definite, as indicating that state of the system, charac-
terised by a quick, weak pulse, a dry, black tongue, great
muscular weakness, frequently subsultus tendinum, low
delirium, petechia, c. Tmi4 signification however has
become sadly unsettled by its miew alliance. It now has
no necessary connection with any one of the group of
symptoms, which were formerly necessary to its exis-
tence. It is now applied to a state in which the pulse
may be strong or weak, quick or slow; subsultus or not,
tongue dry or moist, with or without delirium; with or
without petechia; occasional epistaxis, a meteoric state
of the abdomen; diarrhea.
  In fact many cases of typhoid fever, run their course
without a single symptom which characterises the "ty-
phoid state." Hence it has happened that two physicians
talking of typhoid fever, attached very different ideas to
the phrase; one having dothinenteritis in his mind, the
other, the typhoid state of bilious fever. I fear that am-
biguity arising from this mode of expression, has found
its way into our standard writers e. g., Prof. Bartlett



speaking of certain cases, says: "So far from being ca-
ses of typhoid fever, even the typhoid state was not pre-
sent." What meaning does he attach to the phrase here
I apprehend most persons will respond, that state indi-
cated by quick, weak pulse, c., c. Yet it seems
clearly meant to indicate something necessary to consti-
tute typhoid fever; which as before observed, is not true,
of that train of symptoms. On the other hand, to speak
of typhoid fever existing without typhoid phenomena, is
very close akin to a solicism. It is to be regretted that
a phrase of well established meaning, should have been
used in a sense materially different from that meaning.
  Our phraseology ought to be so uniform, that one man
of fair attainments in the profession, should easily under-
stand any other one, when delivering his opinions on
medical subjects. I therefore think it unfortunate that
the term typhoid fever has been appropriated to this dis-
ease. But as the professional writers seem generally to
have adopted the phrase, I must consent to the verdict.
  It is unfortunate too, that names of disease should ever
become fashionable. Some years ago, all cases of fever
were congestive-now they are all typhoid fever. I have
known cases reported as severe attacks of typhoid fever
one day, who werb walking the streets the next. I have
seen divers forms of disease, febrile, or not, called typhoid
  So that the diagnosis is not, in all cases, and to all phy.
sicians at least, as clear as noon day.
  This disease is called by various names by different
writers: as typhoid affection, dothinenteritis, entero-
mesenteric fever, follicular enteritis, typhus fever, putrid
fever, adynamic fever, ataxic fever, enteric fever, c.




                     ARTICLE 2.


  In the summer of 1841, I was desired to visit a young
lady, in whom I took much interest. Her case was quite
grave, and it appeared to differ materially from any form
of fever, with which I was acquainted.
  This difference, I was more able to feel in my judge-
ment, than to describe to others; the principal points be-
ing a greater disturbance of the nervous system, and
prostration of the muscular power. I availed myself of
the assistance of the late Prof. Richardson; but it appear-
ed to me, that the disease was new to him as well as to
myself. Two months after this attack, five other mem-
bers of the same family were seized, a good deal in the
same way. It now occurred to me, that the disease was
most likely, a form of fever, which had been very preva-
lent about Paris, Kentucky, several years before, and
which as I supposed, had been about Lexington for some
years. This I was more disposed to believe, because
there had at this time, been a good deal of sickness be-
tween the residence of this family and Lexington. Under
this view of the circumstances, I felt it my duty to re-
quest that some physician, residing in Lexington, might
see these cases with me. Dr. Holland was selected by
the family, under the belief that he had a very extensive
practice, and that he wvas very successful in the treatment
of fever. When he had examined the causes, he gave it
as his decided opinion, that it was the typhoid fever of
Louis; saying at the same time, that he was very famil-
iar with it, as it appeared about Lexington. Upon my
inquiring of him if any dissections had been made about
Lexington so as to demonstrate its identity with dothin-
enteritis, he answered in the negative. Seven cases oc




curred in that family, two of which were fatal; a third, a
lady of about forty-eight or fifty, who was not supposed
to be dangerously ill, died instantaneously without a
groan; and a fourth, the first patient taken, recovered of
the fever only to go into phthisis, of which she died six
months after. One other case occurred in that neigh-
borhood about the same time. During the ensuing win-
ter, the disease appeared in our village, and from that
time, it has rarely been altogether absent from our neigh-
borhood, although it has at no time raged to as great ex-
tent as it appears to have done in many places.
  The time just mentioned is the first, as I believe, that
I ever saw the disease. I think so, because it appeared
to me at that time, to present a phase new to me; and
carrying my remembrance back carefully as in my power,
I am not able to identify any form of fever with it. In
the winter of 1827-'8 I saw a form of fever in Union
county, Kentucky, which I thought at one time, might
have been the same; but upon referring to my notes of
that fever, taken at the time, I am satisfied that the sus-
picion is untenable. In the winter of 1837, we had a
form of fever here, which my friend Dr. Craig thinks
now, was the same fever. I am not able to identify the
two as one. I recollect very distinctly that purgatives
were very prone to run off with watery stools; and that
there was considerable disturbance of the nervous sys-
tem. But I do not remember, that there was much dis-
position to diarrhea, when no medicine had been taken;
neither can I recollect the features of that epidemic, as
those most conspicuous in typhoid fever. I have a dis-
tinct recollection too, that there was a material difference
in the general appearance of the stools. Although thin,
they were less watery than those of typhoid fever. They
were also of a decidedly green bilious character. There
was however, one exception which made a strong impres-
sion upon my mind at the time. In that case, the fecal



8                  TYPHOID FEVER.

discharges had a very striking resemblance to those at
present observed in typhoid fever. Like the latter, too,
it went on to recovery, without that change as to consis-
tence and color, which we then considered essential to
  This fever bore a considerable resemblance to that of
1827-'8 above mentioned. Dr. Gano, too, who has been
practicing here upwards of twenty years, thinks that for
a long time, he has seen this fever. He describes an
eruption as having appeared upon the neck and face, and
occasionally upon the arms and body, which corresponds
with the rose colored lenticular spotE of typhoid fever.



                     ARTICLE 1.


 Age, recency of residence and contagion are the circum-
 stances enumerated by Louis and Bartlett as of most im-
 portance as causes of typhoid fever. I shall append a
 table of cases, which I have seen during the last twelve
months, which will show age, sex, and color of each pa-
tient. It will be seen, that of forty-three cases, twenty-
six are between fifteen and thirty years; nine over thirty;
and eight under fifteen.
  The table shows twenty-seven males, and sixteen fe-
males; thirty whites; thirteen blacks. A superficial ex-
amination of this table would perhaps convey a very er-
roneous impression. It will be observed, that of the
twenty-nine cases originally mine, eighteen were whites;
eleven blacks; of these three whites and no black died.
  On the other hand, of the fourteen, whom I saw se-
condarily, twelve were whites and two blacks; of whom
five whites and both blacks died. Consultations are more
apt to be held over whites than blacks; therefore the pro-
portion of deaths amongst the whites, in the number seen
is unduly large. For the same reason, fewer blacks over
whom consultations are held recover. Thus both of
those mentioned died. For this reason, I think the cases
originally mine, are the proper basis for our estimates.
It may be proper to state, that the proportion of whites
to blacks, within the bounds of my observations, is about
108 to 100.
  I had supposed there was a majority of blacks, but



from observations made with some care, though not able
to say precisely, I am fully satisfied of the proximity to
truth in the statement above made. Our population is
stationary to a great degree. The principal ingress is
from students to our schools, male and female, and jour-
neymen mechanics
  We haye about two hundred students from a distance.
Among these, I have not known of more than eight or
ten cases of fever in the six years; and I do not know
that any one of them had been here less than a year.
Neither do I know, with the exception of four, that any
case was one of typhoid fever, I presume, however, that
some of them were. This table shows a large proportion
of cases between fifteen and thirty years-a much larger
proportion of cases over forty years than seems to be com-
mnonly found-a large majority of males-a large majori-
ty of whites-and we may say nothing respecting those
of recent residence amongst us. The field is too narrow
to found any general conclusions upon. We can only say
such has been the result of facts observed by a single in-
dividual in a certain location, during a particular year.

    NAMES.          AGE.   SEX.     COLOR.     FATE.
J. Stevens    - -------- 10  Male,  White, Recovered.
-M. Stevens .......... 8  Female,  i"
M. Daviess ........ 19  4"
Mrs. McDaniel-       45 -45                       As
Taylor -15 Male,
Reuben -14                  4"     Black,
Elijah -16                  "d
Harriet -            17  Female,    "

  Since this was written, I have seen a number of strangers with the
fever, still however, not a sufficient number to think that they are at all
more liable than permanent residents.




Sam .........
J. Wallum.....
R. Stubbs....
D. Stubbs-....
A. Stubbs......

H. Stubbs    .
Frances Stubbs-
Eliz. Stubbs - .-
J. Hall  -----
Miss Conway --
M. Johnson.
1. Bell  --
Caroline   .
J. Sutphin.
Mrs. Sutphin - -
Mrs. Brown. --
Geo. Brown- ..
Dick .....-
Julia        .

- -.20
... J 9
- ...19
.... 14
.--- 23
--- 12
-. .17
. 12
-. .25

-  .15
.... 2
  --- 21

.   ]45
...- 45

Milly --45
Lewis -25
Wrm. Buck-  .17
Browning - . 25
Bradford -   25
Johnson -18
Burgess  . -20
L. Flournoy  25
tE. Duncanson - 12
tJane -            15
M. Kershaw-   30
WVill -           30
Miss Tapp  ..... 25
Mrs. Black  _.25
James... ....   19




  I '
















  . .




Reco vered.





   ' 4

Male, Black,




   I did not see those marked with a  in the first instance,
I saw them generally during the third or fourth week; four
of them I saw only once; three thrice; the other seven I con-
tinued to attend until death or recovery. Of the last num-
ber, three died. Of the other seven, four died; being
just one half of the whole. Of the twenty-nine whom I
saw at the commencement of treatment, three died. This
great disproportion is explained by the fact, that the first
mentioned fourteen were far advanced, and bad cases at
the start. Of the twenty-nine, two were treated by diet
and regimen alone.
  Those marked t were cases which I had treated in
1843, for the same disease. To enable my readers to
give to this circumstance its proper weight, I will add two
remarks: 1st. These two are the only certain cases of a
recurrence of the disease in the same individual, within
my knowledge; but I do not now recollect any case of
fever of any kind, recurring in the same individual du-
ring the same period. 2d. This occasional recurrence
does not prove that this is not a specific disease, because
such recurrences take place occasionally in small pox,
and other analogous diseases. Wm. Buck had been here
about eighteen months. All the others were permanent
  By referring to my cases, I am enabled to make out the
following tables. It is to be remarked however, that
these tables are not to be considered altogether correct,
as many cases are not noted; and it is impossible to say

  During the present year, 1850, I have seen two cases which I con-
sider well marked, occurring in persons who had previously suffered an
attack. I have also seen some cases, which occurred in persons who
were reported to have bad the disease previously, and who probably had,
but as I did not see them in the first attack, I do not think myself ju
ified in stating them as cases of a repetition of the disease.




what proportion the omitted cases bear to those noticed
at any time, or the sex, or color of such omission.
Of the 192 patients there occurred in
Dec. Jan. Feb. Mar. Ap. May, June, July, Aug. Sept. Oct. Nov.
3   12  16   8   26   21   21   25   26    17   8    9
      Total-Winter,   Spring,   Summer,     Autumn,
             31         55         72         34
 Table of sex and color.
        Male,      Female,      White,      Black,
        104         88          i18         74
 Of the 192 nineteen were forty years old and upwards.
 I do not know that I appreciate properly the title of a
 recent residence as a cause of disease. If we consider
 typhoid fever as a specific contagious disease, to which a
 person is not usually liable a second time, we will not of
 course suppose that a person after having it once will, by
 changing his residence renew his liability. I presume
 that the activity of this cause is adventitious rather than
 necessary. I suppose that a large portion of those per-
 sons who flock to large cities are young persons, pre-
 cisely within that period of life, at which the liability to
 fever of all kinds is greatest-that the change in the mode
 of living is considerable-that there is an unwonted and
 undue excitation of the various passions-which all ac-
 ting simultaneously, have a very great tendency to dis-
 turb the regular healthy play of the functions, and of
 course to produce fever. For this reason I presume this
 cause is less influential in our rural districts.

                      ARTICLE 2.

                    DWELLINGS, ETC.

  In every case coming under my observation, where a
considerable number of cases have occurred in the same
family, there has been reason to think that something




connected with the situation of the house, may have con-
tributed to the prevalence of the disease.
  For instance, at Stubbs', the house was old, and dilapi-
dated; the windows in the upper story open, so that there
was free admission of wind, rain, and snow; the cellar,
which had usually been occupied as a kitchen and dor-
mitory for the negroes, had during the winter, lhen the
disease prevailed, been closed, and made the receptacle
of all kinds of filth, into which the water from the house
and yard found its way, for want of proper care to drain
it off. At John Laws', where the foamily suffered severely
in 1845, the house was in very much the same situation,
except there was no cellar. At all other places, where
there has been much sickness, the -houses are without
cellars, and without means of admitting air freely beneath
the floors. I have had the floor taken up to examine the
state beneath, but have found no sufficient cause.
  It is proper to add, that this condition is almost uni-
versal among the negro houses, and also among such
dwellings for whites as havte remained from the early set-
tlement of the country. It is also proper to state, that
although the statement above made is true as to those
families most afflicted, yet the disease has by no means
been confined to such houses, but has been found in new
houses of the most comfortable construction.
  Very lately I have seen a number of cases which may
be thought interesting. On the 3d of April, Mrs. C.,
about twenty-two years old, became ill of typhoid fever,
I saw her on the 10th-then no fever known any where
in the neigeborhood. She had come home, after an ab-
sence of two or three months, some time in February-
no fever known in the neighborhood from which she
came. The house in which she resided is an old brick,
built in 1794, but in a good state of repair and clean. On
the 19th Isabella, the woman who waited in the house,
sickened. May 1, Moses, Isabella's brother, sickened-




he slept in the same house, but not in the same room
with his sister-also a negro man thirty years old. About
the same time a boy two years old wvas attacked-this
child slept in another house. During the next week two
sisters of this boy, sleeping in the same house, were seiz-
ed, as also a negro girl, nine years ol0(, and daughter to
Isabella, and spending the day in the family dwelling, and
the nights with her mother. Also a negro man who slept
in the kitchen. May 10th, Mr. C., husband to the lady
first sick, and his mother, became ill. About this time,
May 20th, a brother of Mr. C. came fromn an adjoining
county, and had some chip rubbish removed from the im-
mediate vicinity of the family dwelling. He spent two
or three days at the house, returned home, and was taken
sick in ten or twvelve days. Another brother visited the
family two days after the return of the first: upon his
return home he had a severe attack. At the time of this
last visit, a brother-in-law and sister with their children
and a negro woman as a nurse, arrived on a visit from
Missouri. On the 13th of June the sister and nurse were
attacked-on the 28th and 30th two of the children be-
came considerably indisposed, remained for tvo weeks
with what seemned to be a mild attack of typhoid fever.
A negro man who spent two days there and assisted in
laying out a negro who had died sickened on the 16th of
June. And my son who had visited the family daily and
spent a week, night and day in the family, during their
greatest distress from the 16th to the 23d of May, sick
ened at the end of that time.
  A peculiar fatality seemed to attend this spot, as every
member of the family complained more or less; and of
twenty belonging to the family, eleven had serious attacks,
not counting the visitors. The houses in which the ne-
groes were sick had the floors nearly on the ground with
no chance for ventilation under them. One house af-
forded sufficient means for ventilating the rooms inhabit-




ed. In the other, consisting of two rooms, one about fif-
teen feet square, the other ten, circumstances were not sp
favorable-in the large room were two beds with cur-
tains, a bureau, table, a chest for clothes, and several
chairs, besides a truckle bed under one of the others;
this room has an outer door, a small window, and fire-
place. In the smaller, was a bed, chest, and chairs-no
outer door, one very small window near the door open-
ing into the larger room, no fireplace-the ceiling six feet
high-both closely chinked and daubed. At the corner
of the kitchen, about twenty yards south of the door of
the dwelling house most used, and about the same dis-
tance east of the negro houses, was a slop trough, which
leaked badly, and suffered the slop to accumulate in a
sort of mudhole beneath, giving rise to a very offensive
smell. These houses are situated on a bluff some forty
or fifty feet high, with a large cluster of trees between
them, and a creek which runs on the east and north,
which however, had not been sufficiently low at the out-
break of the fever to be suspected as a source of dis-
  The sickness was almost entirely confined to those per-
sons who spent their time at and about the dwellings, the
field hands being less affected. It is proper to observe
that for two weeks during Mrs. C.'s illness, her mother
remained with her continually-her father and several of
her brothers were there much of the time, but none of
them became affected with the disease.
  I may remark that this family lives about half a mile
from Downing's, and three quarters of a mile from Mrs.
Lightburn's, hereafter to be mentioned.
  In a considerable proportion of cases, it has appeared
to me that the attack was brought on by an undue ex-
posure to cold.




                      ARTICLE 3.


  Is considered by many as a potent cause of this dis-