1 20 1 https://d1y502jg6fpugt.cloudfront.net/34455/archive/files/96e2aeee46c7534e9d177687fb4f8956.pdf?Expires=1779926400&Signature=WBS6rXthj25jzIOiwO99MA0yMVwG%7EXUCRRDOMvztMom5JFNPYmOOp24eYnWZBcLklp7%7EJnwrWz7oJ%7E3Nr343BSvnwHrf%7EtORPdk00SUl-fIVfH2Z79%7EegHqdnHe9aKrkqmagXq2s2DLjU7xMXbuIUt%7EmTo4l9DMnuJD4JL5BiIirw95Lr8jqSLvDykSD6-ht1KjFI16g2C0HY9xS-dB5zaH5uwM0M7ZFXipMwGp1FPu69PIcu7SlUutxvzQadbdSuYxGfoIDe%7EpjjHQW8wtf56ZAbE8VrktlDalJYGThSN%7E00pEqNyS9C89LMLCbGn1C6wa91y5wXIbK8DbXXs2LXA__&Key-Pair-Id=K6UGZS9ZTDSZM 740ef930e64ce13a26a87d736b7f5a5e PDF Text Text MEDICAL TOPOGRAPHY LEXINGTON AND ITS VICINITY: • ;·:...;EJNC AN INAUGURAJ.. DISSERTATION, SUBMITTED TO 'l'HE EXAMI NA 'l'ION 01' 'l'HE REV. JOHN ANDREWS, D. D. PROVOST ~- ..... " (PRO TEMPORE), THE • TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA, ON THE 2 1ST DAY OF APRIL, 1 8 06, FOR THE DEGREE OF.DOCTOR OF MEDICINE. BY BENJAMIN W. DUDLEY, OF LEXI N GT ON , KENTU CKY, MEl,l:BER OF THE LEXI N GT,O N A N D PHILADELPlllA MEDICA L ' SOCIETIES. PHILADELPHIA, PRINTED BY THOMAS ANP GEORG E P,).LMER , 116, HIGH-STREET. 1806. �TO DOCTOR JAMES 'FISHBACI-t, OF LEXINGTON, KENTUCKY. DEAR srn, A PUPIL is no doubt most .indebted to his first preceptors in medicine. Having commenced under the care of yourself and Dr. F . Ridgely, when I was entirely ignorant of the nature of my object, it wis the 'Pleasure of each to inspire me with industry and confidence, to remove my difficulties, and to elucidate many obscu: rities in medicine, all of which had a tendency to enhance my medical acquisitions. Those considerations· alone are sufficient to create • the purest se~~e of regard. May you long continue the exercise of those talents, which, with ordinary attention, cannot but exhibit genius and judgment._ As a testimony of friendship, please to receive this i~perfect es~ay from Your most obedient friend and pupil, THE AUTHOR. ., �TO BENJ.{\.MIN SMITH BART_ON, M. o: DEAR SIR, THE ingenious and useful manner you have pursued in your lectures, has not ~nly convinced those gentlemen who have had the· pleasure of attending them of their great utility, but it has created a desire in many of us to be present, and share in the advantages of future seasons. Your unparalleled industl'.y in the arrangement and delivery ,of useful matter is the means of contracting the warmest regard of all you_r pupils ; but, independent of tl~is, sir, I am dbligated to you for the particular attention bestowed on me since my first visit to the city. Please, -sir, accept this my first and imperfect production; ~s atestimony of the high sense I entertai1_1 of superior talents ; and, with the greatest respect for your good qualifications as a gentleman, f have the honour to be Your most obliged, And very humble servant, I . , THE AUTHOR. �A SKETCH OF THE MEDICAI.: TOPOGRAPHY, &c. THE Ohio R~ver, which serves as the great outlet to the production~ of the western country, for1!1s the boundary of the state of Kentucky to the north and west, the Virginia line bounds it on the east, and the state of Tennessee on the south. The soil of Kentucky, and particularly of Lexington and its vicipity, is so well described by geographical authors on this subject, that it appears almost superfluous to enter ,into a minute detail. It i;nay, however, be observed, that the state throughout is remarka,ble for the universality of limestone. Different districts put on very different appearances in respect to soil: some parts are of a sal\dY nature, some of a poor and light description, while other parts are of a dark, rich, and most luxuriant kind. It will be sufficient to observe, that, very generally, the soil is so favourable to the growth of all those vegetables which exist under the influence of the climate, and which do not require peculiar local • circumstances for their growth and perfection, that one of the greatest evils accruing ·to the ·a griculturist is the growth of foreign vegetables • in his tillage fields. The great variety of vegetable productions of this part of America acquire a degree of perfectio~ and magnitude, which are un- �I' 8 giyes known on the eastern side of the ' mountains ; but whethe r it obthe' all From . rmine~. unde"te yet birth ,to many new sp~cie_s is , Mr. of remark the believe I make, servations I have been able to • -< on m kingdo le vegetab the Eilico,t t is just, relative to the identity of species, the east and west sides of the Allegany mountains. - Some canacladus however, as the Aesculus flava, or Buck.:e ye, the Gynino dye ant densis, or Coffee-tree, and a species of Sophora, an , imp9rt the To article, appear to flourish more· par-t-icularly in this state. attachfirst of thos e vegetables the citizens appear to have but little of its e equenc i12,cons and, season, the in : earl}' lls ment. Its fruit_fa gia, paraple fO'-a s'ubject ate tliey cattle, tn:e excessive~ 'se a's food oy powers the to relative doubts have who and frequently death. Those give of the Aesculus in produc ing this ,affectio~ among cattle, mµst have effects same the that ~ their ass,e nt to it when they are assured the arisen from its use in a girl, who took a large quantity, with was n affectio This hope of _its curing an obstinate intermi ttent. soon relieved by. the free use of drastic purgatives".· tffe Many valuable med1cines can, be obtained' in differen t pa:t-t'i fof a ir~' -tlie-S'p state, such as the Podoph r llum pel~atu m, or May--apple, owntrifoliata, or Indian-phy_sic, th~e Datura stramo nium·, or Jamest or weed, the Liri~e ndron tulipifera, or Poplilr-, the Cornus- florida, cineDogwood, the Prunus virginiana, or Wild-c herry, the J\:tglaris Oak. or s, Quercµ of s ·specie various and rea, or Buttei;.iut-walnut, all ~ As the so il of this country is not favourable to the growth o£ . • lt whit fruits, s deliciou those of vegetables, we are d~prived of many barrenthe for able remark grow in great plenty in situations more ness of the soil. ' The town of Lexing toh: situated- neat the middle of' Fay'ette By' the county, sixtycfou~ miles from Ohio River, and half encil'cie~ is miles, , Kc;ntucky River, at the distance of ten; fifteen, and twenty . all of erected within oi:i,e mile-of the most elevated piece of ground ce the adjacen t country. As the -rivers Missisipp~ and St. Lauren ns, have almost a commo n source;' and pursue rectang ular directio w'a"of s stream t differen four to birth gi".e L exin gton and jts ".icinity a norter, whi6h pursue almost opposite coui<ses. Lexing ton has is 85 London f westco 1 de longitu the ' 'thcrly position of 38° ;:J0 , and1 ' ,,-. �10', or of Philadel_phia about 9~. ,;'he· town runs in a north-,Yest direction mile, and is 1about half a mile broad. , three qu~rters· of a_, ' Lexington in,cludes a small stream of water, running in ,v atertr.!;!et, into which allJthe water of pumps, wells, and springs, with the offal m.,ttters of the/ town, empty themselves, either directly, or thrqugh the! medium of sewers for .t hat purpose. Lexington, which • could only • boast of a few• houses and one solitary carriage in the I year I 79 I, is now composed of qear five hundred houses, a very , great part of which have been, erected of elegan~ brick; within the last ten years. The streets are laid out to form squares, which are. not so large ·as those of Philadelphia. Luxlll'y and gaiety have k'ept pace with the rapid growth of the town and the increase ofpoptilation.' The public buildings consist of·a uni~ersity, a court-house, a bank, a market-house', and four churches: Within the last two pr three • ye~rs, the citizens have made handsome progress in •paving· the streets 'w1th excellent limestone. 1 The soil of th~ town, excepti.1!f~ • .-·• the changes produced by manure, is in no respec:t different fromth~C "· of tl1e adjacent country. In common with all other rich lands.; the mud of the lanes<and streets renders walking very disagreeable ·iQ. • wet weather ; but the great porosity of the earth, together with solar influence, and an elevated situation very soon dis;ipate excessi~e ~ moisture. In describmg the, ,-faters of L~xington, I am sure I shall not be-' • extravagant in the assertion, that few situations are better supplied with this great i'iecessary of life. There is some smaU variition in the sensible .qualities of the . different sp~ings and pump ~vater, bu't ' the difference is so inconsiderable, that all are capable of answering . every domestic purpose.,., The ·water•from an excellent source is conveyed to some parts of the town by pipes, but having been· placed near 'the s~1rface of the earth, the wate~ is influencedi>y the sun, ancl :rendered too warm to drink. There is a very considerabie difference in the temperature ;f the different'waters~ and,1his le~ds to a useful practical ii;fere~ce respecting their use in the warmer seasons pf the year. Sal;ine, sulphur, and chalybeite waters· are ~ommon in different 1 Atthe state, but none suc,h 'ha ve been dis.covered in Lexington.. . • B �ro it!l'any bato•,I am SOl'l"Y that! have not b-een ab elo'fur nishm yseifw rlo firtUll l of know I as but· ; ton Lexing t a_ " ,'metrical observations t!1ken presheric atmosp ~n rity regula to tend stance whatever which would ent,_contin on.tl"\e on situati other any sure in Lexing ton more than jti er· weath of s change iate - arid as we are liable to as great and immed t;hein on variati the that , de· as any other situation, I am led to c'?nclu n so remot e harorrieter would be equally great. Placed .in a situatio antages. disadv the from ' the focus of philosophy' ·an.cl.labouring under ations observ c ountry , our opportunities for philosophic 1 ·Qf an infant _ on ambiti the have been on a very limited :scale ; but we hope, from. be in posses ~ - ~f t'bo~e in tl1e pursui t of science, that w~ shall soon occasions. •sioJ of observations which will s~rve· us on many future. .no Jess re~ is ton Lexing of tion popula the of The rapid increase since, years few A s. perilou was ent marka ?ie than its first settlem d hundre en eighte or een sevent t of'abou the popuiation consisted only four d excee must tants inhabi of r souls, wfole the presen t numbe tetl in i great • thousand. This rapid. increase is no doubt to be attribu of the nat11re nt innoc~ the degree to migrat ion ; at the same time, ry ordina with which, climate is such, that there are but few infants, • attention, canllot be brough t to years of maturi ty. their pat" The constit~tions of the citizens are much modified by ts of the ticular modes of life. The ·seven different tempe ramen be applied professor of.ti.re institutes can, with peculiar propri ety, more despeak to but, ; y vi<,init its and ton to the citizens of Lexing tic, ancl energe and robust more utions finitely, !her1; are few constit The r. ,veathe i:he of es chang the fe~v expose themselves mor<; to all nic, mecha the and ant, merch delicate female, the lawyer, the uence conseq in ication, m_?dif give their constitutions a very material d · by di•of their difl'er~nt pursui ts i_n life; and this is always followe cause., same the ·versified s.tates of morbid excitement, arising from of want from , The fe~ale s suffer a Joss of appetite and· health e improp . regula r and proper ly. accomll).odated exercise, and from of stjong use the from t, alimen little too or much too diet, from taking take them of Few food. l anima much too tea and, coffee, and of year, the of s season w~rm the .in , health sufficient e~ercise retain .... her indispo in consequence of which, a· iady not unfrequently dates . . . �n sition 'from ·the ~xercise of a p.articular party, or from the·dampnesl ,and disagreeable n_ature of the evening. , The sedentary life pursued by many- of them is, no douht, . one great ·cause of hysteria, !TT alrits differen~ grades, from an unBieasant state o f th~ mind to a .gen~ ~ . ''? convulsion. cold" that " chair, •clinical the from -..The ·observation which fell , proves-,tht greatest enemy to which mankind ru~ exposed," is ~~t • too frequently verified in the western country. The citizen of Lex.i ingtcin, and the a~jacent farmer, having been '!ccustomed to receive n~:serious injuries to their constitutions by such negligence, in the earlier part of their lives, they frequently discontinue· it only after ' 'they have sustained so great a loss of health, as to be almost useless, • i~ their families, and even ,; -burthen to s5>ciety. -• natut e· ·.•· innocent and salutary the of -sensible is who far.tn_er_, The requiare which autfons c pr~· those .exercises seldom of his climate, ealth;. h · his retain to weath~r, the of cha~ges site, under the sudden by which means he contracts ,those diseases -only, which are the . consequence of ;luf:lden transitions from a comfortable room into the cold and disagreeable air. I_n the summer _season, w)l.en _he h~s_no vegetable putrefaction and stagnai1t water to produce disease, . he. frequently s~bjects himself to the most disagreeable consequenc~s, by the excessive use of cold _spring wate;;r, both internally and externally, by drawing off Ifis clothes, and receiving -the cool ·breezes in scime delightful shade, and sometimes by making so free use of spirits as to derange the animal functions, which frequently tenninates in disease._ By unwarranted industry, in exposi~g themselves too eaiily in the morhing and too late 'at night,, no citi~ens, under -circnm&tances equally favourable, are more subject to disease •than t.he~farmers nea1~ L e_x ington ; .ai:rd, •ignorant or negligent of the proper p;·ecautions, they only make application after the disease has made considerabl~ inroad on lheir 'constifotions. But although ~ charg;e them ,, -ivit!i ignorance as it respects medicine (which tli~st be the casti even . with the learned professional characters · who have not m ade it a study), y~t it is but justice to obser--ve, that they are more fond of Q'_btai11ing useful .inf~rmation, and exe,rcise tlJeir ewn reaSO!) on sub..,,- - �jects of _e very description, ·than many of their brethren in situations more favourable to mental improvemt,rit in the 'united States. The practice of dram drihking, which crept into society soon after . the extensive erection of distilleries in Kentucky, proves a fruitful source 0£ disease•; and its patrons, who cannot ~fiord to make use of liquors of, a superior and more innocent nature, ,con_sume large •quantities of peach brandy and whiske.y,1 ,vhich are manufactured at \ • • home. Spirit, like opium, when taken in proper time _and quantity, constitutes one of the first articles of the materia mediea; ·but, Ii.kc opium with the "Turks, it is ·too frequently , converted to . those purposes, which prove a"degradation,to mankind, an? conv~rt them into beings but little superior to the beasts of the forest. ~ Those, who are t!:ie least conversant with medical science, will ' easily ~s_c ertain the diseases which are the consequence of excessive / spirituous potation; but what is still mpre pleasant to be known ·is, hat the best remedy for thes~ diseases seems to be gaining ground in many places; where it could have been but little expected~ this . is, abstinence from the cause. The blacks in this, as_well as in every other country, are tl1e ~ost • i:ubject to thos_e diseases which are the consequence of exposure to the ,?'Cather, of an insufficiency in clothi ng, _and of scanty and improper aliment. Even if t_hey become the property of some humane master, who takes all the hec~ssary precaution; to avoid either of the causes above~mentioned in prod_ucing disease, the human mind, in state of subserviency, cannot, or does not, bring its faculties into play, so as either to exhibit them as descendants from the sa_me source with the whites, or to make the necessary provision ·for their own comfort in Iife. Being deprived of the advantages of their own labour, and looking to their masters for support, they almost look to them tor health and· life also; ; amblmg, afte1' night, from place to place, for the prospects either of amusement or adva~tage, and open.• ing their bosoms to' the prey of causes, which, should th~y not pro• duce immediate disease, will eff~ct such a derangement in some of the functions, as to· bring on fatal ' affections. Many of them, and sometimes _a great part of a famUy, become ,t he subjects of a consumption, which, {{om its frequent oc1;:uri'encc, and its variation .in a ,,·. ,t 1 j. , ,· • �appearance from the disease as it appears in the ·whites, nas .con~· tracted their name. In treating of the diseases of Lexington an~ _·its vicihily,-I shall again notice thisnegro•cons~mption. • I have now examined some of the most promine~t circumsfi!pcti!lf ' rel~tive'to the constitutions of the :citizens ; hilt it is cer.taiI1tliat 1}1~ manner by which tlie country was settled -has a tendency to assimilate to each other th~ constitutions and :diseases ~f those who suffered the hard~hips of the Indian·w:ats; and, for tlie last ten years; · • the migration from different parts~ of the world h~ii prodt~cecl so_ great variety in the citizens, that it w<'luld appear prominently erro• neous to specify their constitutions. , In ,0rder that we may com<; ·at a just ·knowledge- of the incident diseases of Lexingtoh and its •vicinity, it is ne.cessary that ,v.e should take notice of circumstances ofa more-foreign nature/inrtsm.uch ,as they have an· influence on this part of the country;· and, fo_cloing this, I believe it wil.l be th~-natural inference, tnat the f:vJu~-ibie ch·cuin-,. • sta~ces for healtl! are mo~e prominent in Lexingtortthtn -i_h almost , ' any other habitable. situation. The ~xcellent tract of land -on which Lexington·is ~ihiated extends to a Yery considerable distance in different directions, forming ... the fir~t, most: interestiiig,: and most impol'taht 6ody of good land which is known in; the western country. • This feftile and leyei pa-rt of the country is furnished with -innumeraole streams of greater or I . • • - , ".. . less size, which pursue.different directions. From t;he great deposition of rain, which sometimes occurs· in the-spring seasol}; these . ' . . '\ waters become so numerous arid extensive, as not m:rly- to answer a1l domestic purposes, but they frequently inundate tJ{e fatm~ ' of ~p~ -'country, ·and pro~e ' considerably inconvenient to the agricJiit,,.u'rist-; . while the only vestiges of their remains in the latter summer and• fall season are' th.e damages .sustained b'y the farmer, arid the effects ~fa rapid and momentary cmrent on its own' bed. •No sooner does- ,", 'the cause of thoi,e inundations cease_ to. operate, than the· streams·· begi1;1 to fa~lter-in their boldness: the nature of the 'soiJ is such as to absorb large qua11tities 'of water ; ithe numero\}s. rnverns 'i,erve the office o( r~ceptacles ; the elevated situation of the c0unt1:v fa~'ot~rs ·a ' , -· • ~ ' I , ◄•., • { I+ • .. �14 raquick descen t of water into rivers,; and ~olar influence~is conside soil. a dark so on runs which ''6le in evaporatt'ng water. of the The .state of Kentucky-is visited with as sudden 'ti;arisitions contithe o~ otiier any as , e to another . r, from one extrem weathe ,. I I o ·~ust~h ry bounda The uncultivated state of its northe rn neut. local other any doubt influence the weather, but whethe r there are uncercircum stances which can also influence the temper ature is e the tain. TheI ve1:y , dark nature of the soil w-0uld seem to incre;i.s surface , warmth of the climate ; but the great evaporation from the th~ of the earth appear s to counterbalance this effect, arfd renders black a for able remack so not es countri temper ature similar with in some soil. Some facts tend to ·prove thaf tlje dimate has been dent of indepen back, es centuri few d'egree revolutionized iwithin •a . tion a cultiv. by ed • any influence which could have been produc been . T)1e two species .of elephant, the skeletons of which have· bones 'the with i• discovei·ed within the limits of the state, togethe inhaof some other animals, prove that this country was brigina1ly nt, contine bited by animal s ~hich at presen t do ·~ot belong to oiJr~ . yet as are unles·s they hav_e passed into t:h~·se western r egions which unkno\vn. of Before enterin g on· ~he diseases of Kentuc ky generally; and to er improp be not nfay it larly, particu Lexing ton and its vicinity tioh of .consider the nature of many causes which -act in the produc of talked much SC? are ction puti;efa disease. Anima l and vegetab le our direct scarce we that es, as the causes productive of sickly countri with attention to any other_source for , an explan ation. W ~ I))ay, inwith r togethe . • propriety., confine our attention fo those causes, d, ,1m;1dr'e the tempe; ance, in the explanation 9f ninety diseases ?f are which s Fhich os,cur in the western country . All those 'disease vegetat he consequence -of the influence of the sun in decomposing part ' ble and animal ·substances, m~ke 'their appearance in the latter t 'when of the ,su~m er season, when the heat of the sun is gr~ates of surface the on basons natural in d collecte runnin g Waters have c• • . ptJtrefa for situated bly favoura are les tl~e earth;' and when vegetab tioµ. �15 l am in,duced, from several circumstances, to conclude, that Ken--· tucky is riot so liable to those. malignant forms of autumnal disease ~s the adjacent state, phio . .''Kentucky _has a Jess numb~r of large currents of ,y~ter, its subterranean ca;erns are more nu,mero~s; its §oil is not df that m~rshy and moist description, it has fewer ponds of water, and it is I!J.Or~ remarkabJ~ for the regulfr appe~rance of • limestone. _ It is justly observed by the professor o( the institute~ that there , is a particular point in the progress of cultivadon, which peculiarly _ ~isposes to the pre~ alence of intermittents, where moist lands are ~he- S}1bject ?f cultivation. He ve.rifies his position by. calling t~ aid that portion o~ land included in the junction of the rivers Schl~ylkill •and Delaware. In 'its original uncultivated state, Dr. Rush ob- ·• serves, thatintermitte~ts were then scarcely.: known; that ,vhen the J3ritish were stationed in Philad~phia, in the time' of the Ameri~an ;evolution, they destroyed great part of the timqer, ~<l exposed this ,, land to solar influence, sooh after ' which intermittents were preval~nt, and ~o~ti~ued annu;lly, ~ntil, by cultivation, its moisture was clissipated. This has ~een so _freguehtly verified in the W<cster~ country, and. the reason is so obvious, as to preclude tlie neceS"sitv • ~f an explanation. The pleasant and elevate£]. situation of Lexin~- • ton will operate as an eternal bar,rier against disease fr~m this J-,.,. ' ,_ . cause, while lower situations of ·the state will be troubled with its • • . ~ ' ~equen~ recurrence. • , 1 1 ~ I have now said as much as I thought necessary, in order to rend_~r the account of the diseases of Lexington and its ,•iGjnity as $Im-:._ pie as I could. The nature 0£ the -climate is such, that it is impracticabie to establish any rule 1·elative to the appearance 'of au'y form ,:.I of disease, as belonging to paf tic~lar seaso~s of the year. There is •• n_o dise:,ise, whether pleurisy or typhus fever, which does rtot make · ~ its appearance occasionally in every month of the year. In 1Janu- · ary, 1?05, the only disease in Lexi!lgton ~nd its vicinity was typhus, , in'its worst forms. : It is ceriain that p_artic~lar month's favour the prevalence 'o f some diseases .n wre than others; but .a particular rule- would be so very exceptionable, that it v,:ould be improper to ~ay ~ • - - I . �/ 16 that .a pleurisy is the disease of ~pring, and aff inteqnittent the dis~ ease of fall months. • The diseasi s, •generally speaking, throughout the \ tate, appear • to ~carry ·with them no peculiarities, which are not common with other states of the union; and, as a minute description of the diseas~· e's of Lexington would be uninteresting, in so far as-they are" co~mon with the diseases o(the continen~, I shall m:erely consider them; gene'rally. The ten forms of autumnal fever arising from ve.g etable and animal putrefaction, the different state~ of pulmonary feve1\ · from ; catarrh to a cons1{mption, diabetes, hepatitis, ent~:re~is, gastritis, dropsies, i:hellrnatism, venereal, &c. are the diseases_ most' ' ~ommon .i n Kentucky. It may inrur the dispieasure of some -~fthe citizens,_to observe yellow fever arran ged among the· diseases· 1 - of paftic~lar situations in the state ; but the ·tempest should soon.cease, when they are assured, that it is nothing more than a high . I • grade of bilious fe:,,er, ~nd that it is mo1:e serious both 'in i,ts attack. ana consequences, and req1;1ires the more prompt attention to m_edicine and diet . . A great part _of t_h e dise-ases of the' western country are frequently concentrated in particular situations. The towp of Frankfort is an unfortunate instance of the kind; instead of being the fine' mea--,., dow of an adjacent farmer, -it is the seat of government for tbe· state. It is' impossible in the naeure of things for this place to eii- • joy health, ·so long ~s the b~ttom remains favourable for th e production of, and the high hills continue to confine, its putrid 'exhalations. , The worst states of autumnal fever have prevai!C'd, and - . / ! proved fatal to many .~ of the inhabitants for the last . few years. I _ , . feel. much at a loss in confining myself to the diseases of Lexing."" •ton aria its vicinity, aS I believe it is practicable, whether we ard i,ige' them according to the nosological doctrine ,of Cullen, or the • • more :modern unity of our own professor, to exhibit as many· various • •st!\tes of morbid excitement, as in any • town, viliage, or •~ountry: ' • situation, ·the history of ~hich has been recorded. The diseases ofJ he country have undergone considerable change ~ since the cqmf!leticement of agriculture. , · Pleurisies are much less ~ �1-7 common and· Iess ·violent in their.attacks, than they were while the • citizens, from the infancy of the country, were obliged· to live the lives in some.degree of the original inhabitants. Rheumatic affections of the acute and chronic kind are Jess frequent than they ori,ginally were, and the suppurated liver is scarcely_known until we approach some -of the larger waters or ·stagnating ponds. The small quantity of stif} water near Lexington precludes a possibility of intermittellts becoming prevalent, except immediately on the south ' sid~- pf some few mill-ponds. The few .cases of scrophtlla which oc~ cur, -seem, many of them, to be of V irginia extract ; but from some predisposition, together with the improper management of negro children, its occurrence as an indigenous disease ~annot be doubt• ed. H itherto it has been but seldom cured, from our ignorance of its nature ; but from the progress of our great professors of materia 'm edica, and the practice of medicine towards the true nature of me•dicines, and the cure o( diseases, we may now anticipate some degree of success. We must either prescribe some medicine, which a~ts specifically on the glandular and lymphatic systems, as mercury, &c. 91.' \Ve must restore the harmony of the different systems of vessels by tonics, if too Jittle action prevails, or by evacuants, if the -patient-can bear this mode of treatment. • It has been suggest~d to me; by an intimate friend and corres. pondent, that there is a11 ophthalmi~ peculiar to the state of Kep.tucky ; he supposes the affect10n to be the consequence of the 'use of lime stolle water, aµ.d that tr,msieµt vj.sitors. to this country only are the subjects of the disease. My ingenious friend ~ay be in possession of facts, which, to him may render the idea conclusive ; but, judging from what I have r ead and heard q.elivered on this subject, by the different professors of the institution, I am disposed, if not to rejec;t the idea altogether, at least to i:;uspend an opinion, · which requires time and pr9bably minute chemical knowledge to determine. Ophthalmia, in all its grades, is one of_ the most common forms of disease in countries exposed to vegetable and aJJimal , putrefaction; and as this state has stagnant waters, standing in great plenty in different parts, may not the most natural solution of this qisagreeable affection be the same with that of intermittent fever.s t C ; �18 causes which That ophth almia is frequently produ ced by the same by us all known we}l too is , fevers opera te in produ cing autum nal_ y of debilit us previo of e to be doubted ; we suppose, in consequenc exdte (l m-;.,~bi . the ata the eyes, that on the application of miasm ,. no ple, princi This ment is invited to (those) the weakest parts. ine, medic in _rts doubt, constitutes one of the most impor tant suppo r .to the presimila on occasi _ every on pplied a · y happil and can be sent. ' .n eyer been I regret , that the lime stone waters of the state have w.ou.!4 be one subjected to a minut e chemi cal examination, as this My friend mena. pheno re obscu step towards .accounting for those almia , ophth with c,l affecte not , observes, that ,when the foreig ner is e~above the If e. quenc that diarrhrea is almos~ always the conse tends oi;ily stance circum planation I have given be admitted, this last that instead' o_f to substantiate the opinion, as it shows, in this case, consequently, and the eyes, the bowels are most subject to deb_ili~y, ~iasmat;i. i~ conthe morbid action arising from t):ie application of centra ted on those parts. appea red ) n The singu lar· natur.e of a consumption, :Vhich has has attrac ted the and near Lexin gton, in some families of negro es, nt fro~ the disease notice of some of our physicians, as being as differe of existence are modes their as , whites the as it generally appears in' amon g ~e native a be to ularly partic dissimilar. It appea rs more . Kentu cky in ce n re. occur its hard_faring negro es of Virgin ia ; but dis.cov• ers It . nation exami -~ is so frequent, as to solicit a minut . e ar.te.both y, deb,ilit scarce any other premo nitory signs than _g eneral ¥no imes sqmeJ and . rial and mu~cular_; it is attended ·with very lit!le, .is :bu.t sed, encrea cough ; the bronchial and trache al mucu s may be js U~ P , of toration not always an . attend ant; suppu ration and expec of no pain, s9,1nei ains compl t patien the ; rence a very rare occur the transi ent vi~ times a heaviness in the chest. In a state of rest, tio~, :aind will sitar would suppose he had been exerci sing decep ,t at a Pll-~ presen is he u.nJess ry, contra the hardly be rnnvinced to whi,c h lll;St ' p,ul~eJ the nes exami or ation; roxysm of convulsive respir e 11,ss1,111,1es diseas No y. deb.ilit st is always indicative of the greate ~ -- •• ~. �9 :nore flattering appearances, for a speedy recovery of the patient, than this frequently does; for several days at a time, he may enjoy a perfect remission of convulsive breathing, may obtain a good _a ppetite, and may be rapidly recovering his ·s trength, when, on a sudden, a paroxysm of dyspncea comes· on, and threatens_instant suffocation. This disease 'is rapid in its progress, ahd has alway§ terminated fatally to the patient. Throughout its whole course the only -regular attendant symptom is extreme ~ebility ; some are tortured with laborious breathing, much more than others, when no perceptible cause can be assigned ; various other symptoms, more numerous and novel than occurs in almost any other disease, are frequently complained of by the patient. On dissection, we find the lungs nearly . of the consistence of the liver throughout their whole extent ; rarely any other-morbid appearance than that of increased solidity. This at once leads us to the knowledge of a disease, which by many of the sup-erstitiotls class of people has been attributed to poison, and have accordingly sent the poor, and almost breathless consumptive patient, to some old witch woman, to have the poison extracted from his body. Does not the graduar'exclusion of oxygen, by the increase in solidity of the lungs, account for the gradual debility induced? Is not too little morbid action present to be followed by suppuration, at the same time it is sufficiently great to extend the vessels, and almost obliterate the cavities of the bronchial ramifications? The h,m gs are passive organs, and in a state of health, while the muscles of respiration are performing their office with ease, they at the s~me tune conduce to effect other purposes of a very different kind, without dis-· ordering respiration ;~but when the cavities of some of the bronchial vessels are obliterateq, and many of them obstructed, do we not require more prompt ahd invariable exertion in the· respiratory muscles ? and should the action of any of them be obstructed either by exercise or an unnatural position of the body, or should an ufl• usual quantity of blood be carried to the lungs, an inca~W.,~ ,q xy .: genation of it, and, consequently, convulsive i:espiration ,viil be tbe • . 1:1;-,, . . ·,' consequence. �20 The difficulty of curing this disease is easily foreseen ; we must direct our attention more particularly to the removal of its ca~ses. Improp~r aliment, scanty clothing, exposure at_ night to co1d in_ -rambling about from place to place, filthiness, &c. must be the. causes productive of this disease. The diseases of females ·constitute a very great pa!'l of the mala"'. dies with which physicians ha~e to contend in Kentucky. The many ignorant oid women of the country, who pretend to a knowledge of a particular department in surgery, and who are called on more from a delicacy of the patient's feelings, than from a convictio~ of tlieir qualifications to perform the duties of a surgeon, leave but too m apy- proofs of the impropriety of their whisky st~vs, th~ir other ' nQstrums, and their precipitate conduct in relieving the sick ; ~d so long as the female class of the citizens refuse to adopt the customs of populous countries and large cities, so long must they be the prey of many distressing complaints, which by prope.r attention might have been avoided. It ~1ay be proper in this place to make a distinction between those diseases which unquestionably have their origin in the country, and those which appear to have been introduced from abroad. _l}ndes the former head, consumptions, pleurisies, catarrhs, ~ilious fevers, dysenteries, hepatitis, dropsies, rheumatism s, &c. may with propriety be arranged; while under the latter may be arranged small-pox, measles, hooping-cough, influenza, syphilis, &c. In the year 1783, when the residence -o f the citizens was confined to the different forts of the state, small-pox seems first to have been introduced .. t Lo_uisville: and from thence to the other forts. ,AboutJen or twelve years ago, it was again prevalent throughout great part of the state, and proved fatal to many of the citizens: like many other diseases, when trusted to the operations of nature. • We are fortunately but little influenced by the efforts of nature in curing diseases at the present day. But although _we are generally believers in the theory of the ,forced state of life, still even many, of those who are its warm supP-Qrters are but too frequently disturbing the tombstone of the operations of nature, and dragging out some of her blind laws, which, blended :wJ,th modern-theory, only serves to reduce our ideas of life �• / 21 . down to that chaotic st~te from which they were delivered by some late philosop_her. If life is a forced state, as we believe, I see no necessity for resorting to nature in the explanation or in the cure of one single disease. The true principle will serve us, on one occasion as well as another; if there are any diseases which disappear without the use of calomel, bark, ipecac,uanha, or opium, we are not to conclude that nature performed the cure, as it depends as much on the operation of stimulus, as the cure of syphilis does ·on the operation of mercu, • ry. The food we consume is an effectual medicinf in all those diseases which it can transcend in action. In retaining or estaglish)ng any principle of a physiological nature, it is presumable that it is with the intent.only of extending our ideas of the theory and prac~ tice of medicine. Could the operations of nature, the vitality of the blood, and the stimulant powers of cold, be establish_e d as-truths (which I a~ sure will pever be the c~se), it would be natural to conclude, that many phenomena would be rendei:ed simple and plain ; but as we cannot discover the smalle.st connectiop. whiC:h: subsists between the one and the other, I see no use in admitting them .in obtaining an education, Principles which appear in tt1emselves so doubtful, and whic,h explain nothing, should no longer burthen IJ1edical science. As I have given so minute a description o'f all those circumstances which would favour the production of disease in Lexington and its vicinity, both as it respects the particular situation of the country and the constitutions of its citizens, I think it unnecessary to protract the subject any farther. But I cannot conclude without discharging a duty, so necessarily incumbent upon me as a pupil: to acknow. ledge the very great advantages I have,experienced by attending the lectures of, six ingenious and well-qualified teachers of medicine: ancl may tlie professors individually. enjoy a, share of that happiness in life, which they have so studioualy laboured to bestow on their • fellow-citizens. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource First American West, 1750-1820 Description An account of the resource Drawing from many historical collections at the Filson Historical Society, First American West incorporates maps, diaries, letters, ledgers, and objects. The collection documents the travels of the first Europeans to enter the trans-Appalachian West, the maps tracing their explorations, their relations with Native Americans, and their theories about the region's mounds and other ancient earthworks. Naturalists and other scientists describe Western bird life and bones of prehistoric animals. Books and letters document the new settlers' migration and acquisition of land, navigation down the Ohio River, planting of crops, and trade in tobacco, horses, and whiskey.<br /><br />The First American West: The Ohio River Valley, 1750-1820 consists of 15,000 pages of original historical material documenting the land, peoples, exploration, and transformation of the trans-Appalachian West from the mid-eighteenth to the early nineteenth century.<br /><br /><p></p> <table border="0" style="width:99.7863%;border-collapse:collapse;border-style:hidden;background-color:rgba(255,255,255,0.5);float:left;" cellpadding="25"><tbody><tr><td style="width:40%;"><a href="https://www.neh.gov/" target="_blank" rel="noreferrer noopener"><img src="https://www.neh.gov/sites/default/files/styles/medium/public/2019-08/NEH-Preferred-Seal820.jpg?itok=VyHHX8pd" width="328" height="149" alt="NEH Preferred Seal" /></a></td> <td style="text-align:left;"> <h5>First American West was generously funded by the National Endowment for the Humanities.</h5> </td> </tr></tbody></table> Source A related resource from which the described resource is derived Corlis-Respess Family Papers (1698-1984), The Filson Historical Society, Louisville, Kentucky Joseph Hamilton Daveiss Papers (1780-1800), The Filson Historical Society, Louisville, Kentucky Foote Family Papers (1759-1987), The Filson Historical Society, Louisville, Kentucky Henry Family Papers (1773-1864), The Filson Historical Society, Louisville, Kentucky John Wesley Hunt Papers (1792-1849), The Filson Historical Society, Louisville, Kentucky Harry Innes Papers (1792-1849), The Filson Historical Society, Louisville, Kentucky John Jeremiah Jacob Papers (1806-1851), The Filson Historical Society, Louisville, Kentucky Meriwether William and George Wood Papers (1780-1831), The Filson Historical Society, Louisville, Kentucky Nall Family Papers (1797-1945), The Filson Historical Society, Louisville, Kentucky Pirtle-Rogers Family Papers (1797-1875), The Filson Historical Society, Louisville, Kentucky Pottinger Family Papers (1631-1932), The Filson Historical Society, Louisville, Kentucky Rogers-Woodson Family Papers (1789-1890), The Filson Historical Society, Louisville, Kentucky Isaac Shelby papers (1760-1839), The Filson Historical Society, Louisville, Kentucky Shelby-Bruen Family Papers (1761-1916), The Filson Historical Society, Louisville, Kentucky Charles Wilkins Short Papers (1802-1869), The Filson Historical Society, Louisville, Kentucky Museum Collection, The Filson Historical Society, Louisville, Kentucky Type The nature or genre of the resource Collection Identifier An unambiguous reference to the resource within a given context FAW Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant 18th century 19th century Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document Text Original Format The type of object, such as painting, sculpture, paper, photo, and additional data dissertation Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource A sketch of the medical topography of Lexington and its vicinity, 1806 Source A related resource from which the described resource is derived Library Collection, Filson Historical Society Rights Information about rights held in and over the resource The organization that has made the Item available believes that the Item is in the Public Domain under the laws of the United States, but a determination was not made as to its copyright status under the copyright laws of other countries. The Item may not be in the Public Domain under the laws of other countries. Please refer to the organization that has made the Item available for more information. https://rightsstatements.org/page/NoC-US/1.0/?language=en For reproduction inquiries, please visit https://filsonhistorical.org/special-collections/rights-and-reproductions/ Identifier An unambiguous reference to the resource within a given context RB Closet 973.4 W637 No.2 1806 bbf0079 Subject The topic of the resource University of Pennsylvania Geography Lexington (Ky.) Philadelphia (Pa.) Dissertations, Academic Kentucky--Lexington Climate Health Description An account of the resource A sketch of the medical topography of Lexington and its vicinity: being an inaugural dissertation, submitted to the examination of the Rev. John Andrews, D.D. Provost (pro tempore), the trustees, and medical faculty of the University of Pennsylvania, on the 21st day of April, 1806 for the degree of Doctor of Medicine. Creator An entity primarily responsible for making the resource Dudley, Benjamin W. Date A point or period of time associated with an event in the lifecycle of the resource 1806 Format The file format, physical medium, or dimensions of the resource dissertation Language A language of the resource en Type The nature or genre of the resource Text Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant 19th century 1800s Academia Dissertation Geography Medical geography Medical topography medicine science Topography University