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MEDICAL AND SURGICAL JOURNAL.
1. APRIL 1816.
Medical Topography of New-Orleans; with an Account of the principal Diseases that affected the Fleet and Army on the late Expedition against that City. Communicated by a NAVAL SURGEON.
"Ceterum antequam destinata componam, repetendum videtur qualis status urbis, quæ mens exercituum, quis habitus provinciarum; quid validum, quid ægrum fuerit; ut non modo casus eventusque rerum, qui plerumque fortuiti sunt, sed ratio etiam causæque noscantur."-TACIT. Histor.
Ev VERY lover of medical literature, and of medicine as an experimental science, must deeply regret, that, though the expeditions undertaken by Great Britain, within the last hundred years, have been both frequent and formidable, there has been such a poverty of professional communications, that a good medical history of the greater part of them is now, and ever must be, a desideratum. While the policy and execution of such armaments are discussed in hundreds of newspapers, and give birth to clamorous pamphlets without number; medical facts and observations, which, instead of a shifting and transitory interest,
VOL. XII. NO. 46.
may be of permanent importance to mankind, are allowed to float down the silent current of oblivion, till they are lost for ever. It is painful to reflect how much this supineness of professional men has cost our art, and how rich a tract, fertile with knowledge and improvements, has thus been given up, without resistance, to the inundations of the river Lethe, whose waters (in this instance it may be said, without epigrammatic quaintness) have preserved straws and trifles, while things of specific and sterling weight have sunk to the bottom without a hope of
In the late expedition against New-Orleans, what from the sword and from disease, there was such a loss of human life, as must cause the mere politician regret, and the philanthropist affliction. Such being the case, it will not, I hope, be considered as presumption in me, to attempt some account of the complaints that occurred; an attempt which, however feeble, may in some degree compensate for the want of a better. I could, indeed, have wished that some one of greater talents, and with better means of official information than myself, had executed this undertaking, and would now willingly lay aside my pen in expectation of such an event, did I not recollect that, by every individual's thus shuffling off the task of description from himself, in the vague hope that it may be performed by another, that very detriment to medical science has arisen, of which I have just complained.
New Orleans is situated in 30 degrees of north latitude, and 90 of longitude west from London. It stands on the left bank of the Mississippi, about 100 miles from its mouth, and may justly be regarded as the capital of this district of the New World, from its commerce, its opulence, and its population. It is the great emporium into which the scattered inhabitants of the upper country, and the surrounding desert, pour their cotton and their skins, receiving in return many of the necessaries of life, and some of the luxuries of refinement.
The river Mississippi forms a most august feature in the physiognomy of this country. While the majestic grandeur of its stream, and its unexampled length of course, excite the admiration of the naturalist, and its subserviency to the purposes of commerce claims the attention of the merchant, it is no less interesting to the medical philosopher, from the direct and conspicuous influence which the distribution of its waters has upon the soil and the health of the country around its mouth. This magnificent river has its source in the remote and almost unknown regions of the American continent. Slender in its origin, the infant flood is interrupted by mountains, and broken by
cataracts, until it receives the proudly independent (rather than tributary) streams of the Missouri, the Illinois, and the Ohio, when it rushes irresistibly forward to the ocean, with a current both broad and deep. Pursuing its course with innumerable sinuosities, through fertile meadows, over whose vast extent the tired eye cannot stretch,-through sequestered regions where nature has no one to witness her awful mysteries,-and through the gloom of forests coeval with the creation, it at last, after a course of three thousand miles, pours, by several mouths, the mass of its weary waters into the gulf of Mexico.
The country around New-Orleans is a perfect plain, frequently intersected by the outlets of the river, and not unfrequently, during winter and spring, watered by its inundations. Indeed, the city itself is built upon what may be called a Delta, formed by this Nile of the Western World. In a country of this description, it will easily be conceived, that marshes are very numerous and extensive; in fact, the whole country, especially in winter, is a continued marsh, with merely solid patches (very fertile indeed) here and there. The few roads, and the site of the different forts, are generally made-ground.
Even the ground on which the city stands, bears evident marks of comparatively recent formation; for, on digging a few feet under the surface, abundance of water, soft mud, and trunks of trees are met with. These last have no doubt been flooded down, and stranded by the current, where receiving hourly reinforcements of vegetable rubbish, the whole has been bound into one immoveable mass by the viscid mud of the river.
The climate, too, of New-Orleans must not be overlooked, as its peculiarity, co-operating with the above-mentioned distribution of the Mississippi and the condition of the soil, is the real and only cause of those formidable diseases to which this city and its vicinity are subject. It is one of the anomalies of the New World, not yet very satisfactorily accounted for, that the intensity of the heat in summer, and of the cold in winter, is much greater than in the Old World, on the same parallels of latitude. This difference is very obvious all along the eastern shores of the American continent, but nowhere is it so striking as at New-Orleans. From the end of November till the end of March, the weather is generally cold and rainy, with frequent hard frosts. At those times the thermometer ranges from 20° to 40° in the shade; and there are instances, I am told, even in so low a latitude as 29° north, where, in the night, it is only a few degrees above Zero. On the contrary, during summer this climate has all the characteristics of the torrid zone; the thermometer stands at 87° or 90° in the shade. At New-Or
leans, especially, the weather is close and suffocating, from its distance from the sea, and, consequently, the entire absence of that inestimable luxury of a tropical climate, the sea-breeze; from the air being loaded with watery vapours; and from the smell of the mud of the river and swamps, which is often, even in winter, very sensibly offensive.
The description here given of the climate and soil of NewOrleans will apply, almost without alteration, to the contiguous district of the Floridas. In the former, indeed, there are traces of human care and refinement; but, in the latter, Nature still pours forth her gifts in solitary and unprofitable exuberance. Never did I see a shore more inauspicious and uninviting. The whole country is a dreary flat, indented with stagnant creeks, salt-water lagoons, and muddy rivers, whose waters are concealed by the darkness of endless woods, that approach to the very brink of the sea, as if envious of its dominion. Here there is no variety,--no eminence to relieve the eye while wandering over the insipid level of dingy green,-not a single appeal to human feelings,-not one object to call forth those mixed undefined associations of interesting simplicity, domestic content, happy industry, and cheerful civilization, which constitute the charm of the rural landscape in Europe. On the contrary, the whole scene suggests vague impressions of solitary terror, and savage wildness, and presses home upon the heart the chilling ideas of dereliction and desolation.
The local peculiarities in the climate and soil of New-Orleans give rise, during winter, to epidemic dysentery, and, in summer, to marsh fevers of a very rapid and dangerous form, from which the inhabitants, but particularly strangers, suffer most severely. The occurrence of such complaints, some readers, from the above detail, will be prepared to expect as a necessary consequence. Lest others, however, should be sceptical, it shall be my business, by and bye, to make this preliminary picture of the medical topography of the country subservient to discussions of higher interest, and to prove, by facts, the reasonableness of opinions.
*I am sorry that my account of this district is so entirely opposite to the published opinions of the venerable traveller, M. Chateaubriand. In hyperbolical raptures, and in the very pith of sentimentality, has this amiable enthu siast declaimed about "the oaks of Florida,"-" the spirit of the desert," "the pleasures of an Indian camp," and all the delightful et cæteras of a savage life!! 'Tis indeed passing strange. But," De Gustibus," &c.
"Hoc opus exiguum vario sermone levemus,
About the middle of November 1814, the expeditionary force destined to act against New-Orleans arrived at Jamaica, under the command of Vice-Admiral the Honourable Sir Alexander Cochrane. That island had been pitched upon as the pivot of extensive military operations against the southern shores of the United States; and the whole fleet of ships of war and transports having rendezvoused there, took their departure from Negril Bay, at the west end of the island, about the end of November, full of health and hope.
Before the middle of December, the fleet arrived on the coast of Florida, and took steps for disembarking the troops without delay, a measure against which Nature seemed to have opposed ample and almost unsurmountable obstacles. It would have been desirable for the fleet to have proceeded up the main channel of the Mississippi, by which an approach to the town would have been secured; but, besides lesser shoals, its mouth was secured by a bar, having only 10 feet water, over which none of the frigates, and very few of the transports, could pass, however lightened. Besides, at that season of the year, the river being swollen with rains, the current was running strong down. Its tortuous course, too, would have required a great variety of winds to make good the passage of an hundred miles up; and its principal detours and elbows were defended by Port Placquemaine, and other batteries of great strength.
This point of approach being out of the question, the fleet, passing betwixt two sandy uninhabited isles, in a very intricate navigation, made its way into the gorge of one of those broad salt-water lakes (considerably to the left of the river's mouth) that runs a length of way into the country, and embraces one of the minor outlets of the Mississippi. The water, however, was so uniformly shallow, that the frigates and transports grounded in the mud, at the distance of 70 miles from the nearest point of the Delta on which New-Orleans stands; and, consequently, all disembarkation was, of necessity, conducted at this disadvantageous distance. Moreover, the passage of this lake was obstructed by five large American smacks or gun-vessels, mounting several heavy guns each, and admirably adapt ed, from their build, for operating in those shallow waters.
The latter vexatious obstacle, however, was soon conquered by our sailors, who shewed, on this occasion, all that "des tri