Semi-Monthly Medical News. VOL. I. LOUISVILLE, KY., NOVEMBER 15, 1859. NO. 22. Report on Epidemics of Kentucky, presented to the State Medical Society, in 1859. By W. L. SUTTON, M.D., of Georgetown, Ky. NOTES AS TO THE TABLES. Table I. contains a statement of the number of acres of land, compiled from the report of the Auditor of Kentucky, the number of improved and unimproved acres, compiled from the U. S. Census of 1850 (the Auditor's report gives 6,000,000 acres as the area of the State more than the Census-that amount possibly being held by non-residents-but does not give the quantity of improved and unimproved land, each of which also is doubtless more than stated in Census); the number of acres to each inhabitant; the average number of those dying annually, of each of the diseases named, and the proportion of deaths to the population of each county. But, in a few counties, but one or two had died of a particular disease, in five years. In such cases, one is put down as the annual average. In all other cases, the nearest number is used to avoid fractions. In Table II. the annual average mortality of each county of the limestone regions is shown, and the average number of deaths from each disease, and the proportion of each to the whole number of deaths from ascertained causes. Table III. shows the same facts in the coal regions. It must be observed, however, that in these, the springs and wells furnish, in some places, hard, and in some soft water; to what extent is unknown. In these two tables, the very large number of zymotics to the whole number of deaths, has induced me to carry the number to two decimals. Then follows a series of tables, intended to elucidate the natural history of individual diseases, as cholera, dysentery, etc. In these, the influence of disease upon color, age, and sex, is indicated, as also the relative influence of each month on the disease. These tables are to be read thus: The first line of VOL. 1, NO. 22-43 white males refers to the year 1852, the second to '53, and so on to '56. The other divisions are similarly constructed. It is thus easy to compare the entire white, with the entire colored mortality, or the mortality of the sexes of either race. In estimating the relative mortality among the white and colored races, it is important to remember that in Ketucky there are about seven whites to two colored. In noticing and comparing the Tables II. and III., we shall be sensible of some marked differences in the proportion of deaths from special diseases to the whole number of deaths from all causes. Thus, the mortality from cholera in the whole limestone region was 1 in 22, of all specified causes. Again, in the blue and coral limestone, it was 1 in 18, while in the cavernous limestone, it was 1 in 34, indicating that this disease caused a much larger proportion of all, in the blue limestone, than in the cavernous region. Again, the mortality from this disease in the coal regions was 1 in 32. But, when we compare the two coal fields, we see a mortality of 1 in 26 of specified deaths in the southern field, and 1 in 56 in the eastern, and a mortality in the limestone much greater than in the coal regions. Again, if we take up dysentery, we shall find in the lime, stone regions a mortality of 1 in 7; in the blue, 1 in 10; and in the cavernous, 1 in 6. Here, the preponderance is in favor of the blue limestone. Again, when we go to the coal fields, we have a mortality of 1 in 5; in the southern, I in 6, and in the eastern, 1 in 4. Here, the mortality is greater in the coal region. If we look to fevers-which include all fevers except scarlet and puerperal--we have, in the limestone counties, the proportion of 1 in 7; in the blue, 1 in 9; in the cavernous, 1 in 6. Again, in the coal fields, 1 in 6, the southern and eastern being equal. Again, a slight difference against the cavernous limestone, and also against the coal regions. Again, if we investigate the ravages of scarlatina, we shall find the proportion of deaths from it in the limestone regions to be 1 in 27; in the blue, 1 in 22-and in the cavernous, 1 in 39; being quite an odds in favor of the cavernous, Again, if we turn to the coal fields, we shall find an average of 1 in 19being 1 in 47 in the southern, and 1 in 10 in the eastern field. This is a very startling disproportion. This disproportion seems to have been occasioned by a severe epidemic of scarlatina, in a number of the mountain counties. It will be seen that in Knox county, the average number of deaths from scarlatina was 21, whilst the average number from specified causes was but 48. Again, in 1854, of 131 deaths from all causes, 98 were from scarlatina-these deaths from it being an excess over all the deaths in ordinary years. In the same year, the mortality in the adjoining county of Laurel was very heavy, one-half of which was from scarlatina. When we turn our eyes to the whole class of zymoties, and compare the different regions with each other, and the different counties with each other, we shall be struck at once with the very large number dying of this class of diseases, in proportion to the whole number of deaths; one death from this class to 2.15 from all causes being the most favorable proportion for any division, and 1 to 4.44 for any single county. We dare not depend on our returns as giving anything like the number of deaths in the State, or from any county, or we might claim our State to be peculiarly healthy, and especially free from all other forms of disease, except those of this class. But even that view would show us to be great sufferers from zymotics. As it is, we must keep our judgment in abeyance untill we have more reliable returns. In the blue limestone, 1 in every 2.15 died of the diseases belonging to this class; in the cavernous, 1 in 1.87, giving an average of 1 in 2.01 for the whole limestone counties. In the coal fields, the proportion was 1 in 1.67; 1 to 1.85 in the southern, and 1 to 1.47 in the eastern. The eastern coal field is mountainous, a large portion very much so. Here, too, of necessity, the country is less cultivated, and the state of society less advanced; and here we find the largest proportion of deaths from zymotics. It may be, that this is largely attributable to the extensive prevalence of scarlatina in some of the counties. It is a fact, however, that the proportion of zymotic deaths is as large in counties where there was little or no scarlatina, as in those where it prevailed. Another feature in these tables is the great uniformity of propor tion in the counties in each formation. It may be well to remark that, in Table VII., under the head of continued fever, are included such deaths as were ascribed to typus, typhoid, and winter fever; and in Table VIII. are included all that were thus returned, and that, doubtless, a large proportion properly belonged to Table VII. I will add that, although I do not look upon croup as properly included in the zymotic class, yet as it is so placed, and as it is charged with a heavy mortality in Kentucky, I have been willing to take the pains necessary to construct the table. In making out the first five registration reports for Kentucky, "Winter Fever" was considered synonymous with Typhoid Fever, but it has been ascertained that in the southern part of the State (whence those cases come), that the name is equivalent to Typhoid Pneumonia." COUNTIES. Population. TABLE I. Showing the population, the area, the number of acres of improved and unimproved land (digested from the Auditor's Report and the U. S. Census), the average number of acres to each inhabitant, the number of those dying of certain diseases, and of the class Zymotic, and the proportion of those deaths to the population of each county. Adair. 9,898 243,068 63,746 145,395 25 Allen. 8,742 198,531 46,188 105,913 23 53 Anderson. 6,260 106,383 43,208 35,303 17 6 1,043 6 1,043 15 417 6 1,043 44 142 Ballard. 5,496 231,933 20,876 87,976, 42 2,748 4 1,374 3 1,832 18 305 Barren....... 20,240 378.757 117,604 204,564 19 3,373 35 578 45 450 5,060 126 161 Bath...... 12,115 255,723 108,170 54,783 211 12,115 28 433 81 1,514 2,019 53 228 Boone ..... 11,185 154,984 92,910 65,369 14 2,237 12 932 201 559 2,796 50 224 Bourbon. 14,466 168,118 168,891 1,111 12 12 1,205 33 438 19 761 3,616 82 176 Boyle. 9,116 107,905 53,717 43,151 14 2 4,558 8 1,139 6 1,519 9,116 20 456 Bracken. 8,903 139,144 41,196 48,436 16 5 1,781 5 1,781 12 742 4,452 35 254 Breathitt.. 3,785 224,601 13,517| 274,043 59 1 3,785 6 631 10 378 3,785 24 158 Breckinridge...... 10,593 328,038 67,822 181,745 31 4 2,648 9 1,177 15 706 1 10,593 59 179 Bullitt 6,774 171,490 50,144 111,734 25 13 521 5 1,355 15 452 3 2,258 42 167 Butler..... 5,755 222,018 26,272 112,896 39 1,151 10 575 18 319 1,151 50 115 Caldwell.... 13,048 190,863 69,713 182,549 15 Calloway.... 8,096 247,351 48,164 184,409 30 Campbell. 13,127 87,876 27.009 33,111 7 Carroll.... 5,526 74,109 30,663 36,601 13 5,526 4 1,381 11 5021 5,526 20 276 Carter Casey. 6,241 308,3631 28,234 218,630 49 6,241 22 284 891 0,241 39 160 6,556 207,241 49,594 140,339 31 1 6,556 8 819 1,311 6,556 19 345 Christian........... 19,580 389,370 105,670 171,260 20 24 816 25 783 33 593 2,797 122 160 Clarke...... ....... 12,683 187,331 153,096 17,056 14 3 4,228 11 1,153 11 1,153 4 3,171 39 325 Clay 5,4211 235,008! 137,006 25 19,186 6021 81 678 2 2,710 261 208 |
