Sift 
 
COL. GEORGE WASHINGTON FLOWERS 
 MEMORIAL COLLECTION 
 
 DUKE UNIVERSITY LIBRARY 
 DURHAM, N. C. 
 
 PRESENTED BY 
 
 W. W. FLOWERS 
 
Digitized by the Internet Archive 
 in 2013 
 
 http://archive.org/details/annualreportofciOOchar 
 
ANNUAL REPORT 
 
 OF THE 
 
 CITY REGISTRAR, 
 
 COMPRISING 
 
 RETURN OF DEATHS, 
 
 WITH A CLASSIFICATION OF THE DISEASE, AGE, SEX, 
 STATUS AND NATIVITY OF EACH CASE, 
 
 FOR SHE YEAR ENDING 
 
 DECEMBER 31st, 18(57. 
 
 CHARLESTON. 
 Joseph walker, agt., stationer and printer 
 
 No. 3 Broad Street. 
 
 1868. 
 
ANNUAL REPORT 
 
 I 
 
 OF THE 
 
 CITY REGISTRAR, 
 
 COMPRISING 
 
 RETURN OF DEATHS, 
 
 WITH A CLASSIFICATION OF THE DISEASE, AGE, SEX, 
 STATUS AND NATIVITY OF EACH CASE, 
 
 FOR THE YEAR ENDING 
 DECEMBER 31st, 18G7. 
 
 CHARLESTON. 
 JOSEPH WALKER, Act., STATIONER AND PRINTER, 
 No. 3 Broad Strbbt. 
 
 1868. 
 
■V 
 
mm\ §qm1 of the $itj> fjUjjisita. 
 
 o 
 
 OFFICE OF CITY REGISTRAR, ) 
 Charleston, S. C, March 30th, 1868. j 
 
 To the Hon. the Mayor and Aldermen of Charleston, S. C: 
 
 Gentlemen : The subjoined " Reports," comprising Mortuary 
 and Meteorological Tables for the year ending 31st of December, 
 1867, are herewith respectfully submitted for 3-our consideration 
 and approval. 
 
 These statistics embrace a classification of the Causes of 
 Death, Age, Sex, Status and Nativity, of each case ; together 
 with Abstracts of the Barometer, Thermometer, Dew Point, 
 Winds and Weather, at Charleston, for the same period, and 
 also, the accompanying "Health Department Tables." 
 
 The statistics of the operations of the Health Department, 
 herewith presented for your consideration, will be found highly 
 interesting, as exhibits of the work done during the past year. 
 These comprise. Tables, showing the number of cases treated, 
 and Deaths in each Health District and Hospital, during each 
 month and the year, with a classification of Age, Sex and Status, 
 the number and kind of surgical operations, and the diseases 
 treated in the Health Department, during each month and the 
 year, with the number of deaths from each disease; and the 
 Reports of the Health District Physicians upon the Sanitary 
 condition of the Districts of the City, of which they have had 
 charge during the same period. 
 
 The Health Department bas now been in operation during 
 two years, and the United States Government has continued to 
 furnish all the Medical and Hospital Supplies used for the treat- 
 ment of the poor of the City, of all classes, both in Hospital and 
 at the Dispensaries, together with Rations for the Hospitals, 
 Fuel, Transportation, &c, in accordance with the agreement 
 
4 
 
 between the Surgeon in Chief of the Bureau, R. F. and A. L., 
 and the City Council, in December, 1865. 
 
 The advantages to the City of this arrangement, have been 
 obviously great, as the City lias been saved a large outlay for 
 the articles so supplied. 
 
 The following is a summary of the Cases treated and Deaths: 
 
 Total number of Cases treated in the Department dur- 
 ing the year 1867, all classes 11,116 
 
 Of this number (4,803) four thousand eight hundred and 
 three were Whites; and (6,313) six thousand three 
 hundred and thirteen were Blacks and Colored, as fol- 
 lows : 
 
 In the City Hospital, Mazyck St., Whites, 180, Blacks & Col'd, G80 
 
 " Hampstcad, " 300, " « 8 
 
 " Small Pox Hospital, " 0, " 3 
 
 " Six Health Districts, " 4,314, » » 5,622 
 
 Totals, 4.803 (5,313 
 
 Grand Total, 11,116 
 
 Total number of Deaths in the Department during the 
 
 year 1867, all classes 371 
 
 Of this number, (89) eighty-nine were Whites, and (282) 
 two hundred and eighty-two were Blacks and Colored, 
 as follows : 
 
 In the City Hospital, Mazyck St., Whites, 12, Blacks & Col'd, 120 
 
 '< » Hampstcad, " 16, " « " 1 
 
 " Six Health Districts, « 61, " " 161 
 
 Totals, 89 282 
 Grand Total, 371 
 
 The Total number of Prescriptions prepared and administered 
 in the Department, during the year, was about (56,400) fifty- 
 six thousand four hundred. 
 
 Respectfully submitted, 
 
 GEOEGE S. PELZER, M.D., 
 
 City Registrar. 
 
W II I T E S . 
 
 DISEASES. 
 CLASS No. 1. 
 
 /jinixQiic Jjiseascs. 
 
 u 
 
 February. j| 
 
 March. 
 
 April. 
 
 May. || 
 
 June. 
 
 July. 
 
 August. 
 September. | 
 
 October. 
 
 November. 
 
 December. 
 
 
 
 
 
 1 
 
 2 
 
 '*5 
 
 "2 
 
 *2 
 1 
 
 2 
 2 
 2 
 2 
 2 
 5 
 
 1 
 1 
 1 
 1 
 
 2 
 
 1 
 
 *2 
 
 1 
 
 3 
 
 *2 
 
 2 
 
 2 
 
 15 
 4 
 
 20 
 8 
 
 10 
 2 
 4 
 2 
 5 
 
 22 
 I 
 1 
 1 
 6 
 1 
 4 
 
 11 
 2 
 
 1 
 1 
 1 
 4 
 1 
 4 
 1 
 8 
 8 
 1 
 14 
 1 
 i 
 
 12 
 10 
 3 
 1 
 22 
 4 
 3 
 1 
 2 
 
 
 
 
 
 
 7 
 2 
 2 
 
 3 
 3 
 
 
 
 
 
 1 
 
 
 2 
 1 
 
 1 
 
 1 
 
 
 
 
 
 1 
 
 1 
 
 1 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 3 
 7 
 1 
 
 "4 
 
 i 
 
 
 
 
 
 
 
 
 3 
 
 2 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 1 
 1 
 1 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 2 
 
 
 2 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 2 
 1 
 
 2 
 i 
 
 "3 
 
 
 
 
 
 
 
 1 
 1 
 
 2 
 1 
 
 1 
 1 
 
 1 
 
 
 
 
 
 
 CLASS No. 2. 
 
 Diseases of a General or uncertain Scat, 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 1 
 
 
 1 
 
 
 
 1 
 
 *i 
 
 
 
 
 
 
 
 
 1 
 
 1 
 
 
 
 
 
 1 
 
 1 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 3 
 1 
 
 
 ■ 1 
 
 2 
 
 1 
 1 
 
 "i 
 
 "1 
 
 1 
 1 
 
 i 
 
 
 
 
 
 
 
 
 
 
 i 
 
 
 
 al 9 
 
 
 1 
 
 3 
 
 
 3 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 ".3 
 
 
 
 
 
 
 
 CLASS No. 3. 
 
 Diseases of the Nervous System. 
 
 1 
 2 
 
 1 
 
 
 "i 
 
 2 
 
 "l 
 
 2 
 1 
 
 1 
 1 
 
 6 
 
 4 
 
 "i 
 
 "2 
 1 
 
 "2 
 
 "i 
 3 
 1 
 
 1 
 1 
 
 ' 1 
 
 1 
 
 3 
 1 
 
 "2 
 
 1 
 
 "2 
 "2 
 
 
 
 
 
 
 
 
 
 
 1 
 
 "i 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 
 
 
 1 
 
 
6 
 
 W 11 1 T E 8 . 
 
 DISEASES. 
 CLASS No. 3— Continued. 
 
 1 January. 1 
 
 February. 
 
 | March. || 
 
 April. 
 
 May. 
 
 June. 
 
 i-: 
 
 August. 
 
 Z 
 
 £ 
 
 October. || 
 
 November.] 
 
 December. 
 
 Totals. II 
 
 
 
 
 
 
 
 
 
 
 1 
 
 i 
 l 
 
 1 
 
 1 
 4 
 1 
 1 
 1 
 Hi 
 
 1 
 
 3 
 2 
 i 
 
 
 
 
 
 1 
 
 
 
 
 1 
 
 i 
 
 
 
 
 
 
 
 
 
 ...I... 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 2 
 
 1 
 
 3 
 
 1 
 
 2 
 
 2 
 
 4 
 
 
 2 
 
 
 
 CLASS No. 4, 
 
 Diseases of the Respiratory System. 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 2 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 i 
 
 
 1 
 
 7 
 
 
 
 
 
 
 
 
 
 
 
 5 
 
 2 
 
 3 
 
 5 
 
 2 
 
 1 
 
 4 
 
 4 
 1 
 
 4 
 1 
 
 2 
 
 5 44 
 ... 2 
 i ! i 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 i 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 i 
 
 5 
 2 
 9 
 1 
 
 13 
 1 
 1 
 
 1 
 
 8 
 1 
 1 
 
 3 
 
 1 
 
 6 
 4 
 7 
 4 
 2 
 
 
 i 
 
 
 
 i 
 
 1 
 
 
 1 
 
 
 1 
 
 i 
 
 2 
 
 1 
 
 
 
 
 
 
 1 
 
 4 
 
 1 
 
 V 
 
 
 
 
 
 
 
 
 
 
 
 
 5 
 
 2 
 
 3 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 
 
 
 
 1 
 
 
 1 
 
 
 
 
 
 
 CLASS No. 5. 
 
 Diseases of the Circulatory System. 
 
 
 
 
 
 
 
 
 
 1 
 2 
 
 i 
 
 
 
 1 
 
 
 1 
 
 .... 
 
 1 
 
 
 
 1 
 1 
 
 
 
 
 1 
 1 
 
 1 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 1 
 
 
 
 
 
 CLASS No. 6. 
 
 Diseases of the Digestive System. 
 
 
 
 
 
 
 
 
 
 
 
 ■ 
 
 
 
 
 
 
 
 
 
 
 2 
 
 2 
 
 1 
 1 
 
 2 
 
 i L. 
 
 2 
 
 
 1 
 
 
 1 
 
 1 
 1 
 
 2 
 
 
 2 
 
 
 
 
 
 
 
 2 
 
 
 
 
 
 i-7 
 
 
 
VV I I I T E S 
 
 DISEASES. 
 
 PJ.ASS Nn R — finntinued. 
 
 January. 
 
 M 
 
 99 
 
 Ih 
 
 X> 
 
 <D 
 ft 
 
 March. 
 
 April. 
 
 May. 
 
 June. 
 
 1 July- 
 
 [ August. 1 
 
 September. 
 
 October. 
 
 November. 
 
 December. 
 
 1 
 
 
 ...I... 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 "i 
 
 1 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 t • J /nr^ „ i „ / ^ • 1»— — 
 
 
 
 
 
 
 
 1 
 J 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 
 
 
 
 Stomach and Intestines, Aphthus Ul- 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 l 
 
 
 
 
 
 
 
 
 
 
 1 
 
 3 
 
 
 
 
 
 
 
 
 2 
 
 '2 
 
 3 
 2 
 
 
 
 
 .... 1 
 
 
 
 
 
 
 
 
 
 
 CLASS No, 7. 
 
 Diseases of the Urinary System. 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 i 
 
 1 
 1 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 IT) 
 
 1 
 
 
 CLASS No. 8. 
 
 Diseases of the Generative System. 
 
 
 
 
 
 
 
 Cancer Uteri 
 
 
 
 
 2 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 l 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 
 1 
 
 
 
 
 
 
 
 
 Peritonitis, Puerperal 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 CLASS No. 10. 
 
 Diseases of the Locomotive System. 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 CLASS No. 11. 
 
 External Causes. 
 
 
 
 
 
 1 
 
 
 
 
 
 j 
 1 
 
 
WHITES. 
 
 
 
 
 
 
 
 
 
 
 u 
 
 
 
 
 
 DISEASES. 
 
 CLASS Nn 11--Continued. 
 
 anuary. 
 
 ebruar 
 
 [arch. 
 
 pril. 
 
 
 une. 
 
 
 ugust. 
 
 3ptemb< 
 
 ctober. 
 
 ovemb( 
 
 >ecemb( 
 
 OTAL. 
 
 
 
 
 
 *^ 
 
 * 
 
 
 
 
 
 C 
 
 £< 
 
 H 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 1 
 
 
 
 1 
 
 2 
 
 
 
 
 
 
 
 
 1 
 
 4 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 / 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 
 
 
 
 
 1 
 
 
 
 1 
 
 CLASS No. 12. 
 
 
 
 
 
 
 
 .... 
 
 
 
 
 
 
 
 
 3 
 
 
 
 1 
 
 1 
 
 2 
 
 
 1 
 
 1 
 
 1 
 
 2 
 
 
 12 
 
 CLASS No. 13. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 1 
 
 CLASS No. 14. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 1 
 
 
 2 
 
 1 
 
 1 
 
 3 
 
 
 4 
 
 2 
 
 1 
 
 1 
 
 1G 
 
 
 84 
 
 2G 
 
 23 
 
 30 
 
 48 
 
 36 
 
 45 
 
 G8 
 
 47 
 
 4G 
 
 29 
 
 30 
 
 462 
 
9 
 
 BLACKS AND COLORED 
 
 DISEAS E S. 
 
 CLASS No, 1. 
 
 Zymotic Diseases. 
 
 Chill, Congestive 
 
 ( Miolera Infantum 
 
 Cholera Morbus 
 
 Diarrhoea 
 
 Diphtheria 
 
 Dysentery 
 
 Erysipelas 
 
 Fever, Bilious 
 
 Fever, Bilious Eemittent.... 
 
 Fever, Congestive 
 
 Fever, Enteric 
 
 Fever, Infantile Remittent. 
 
 Fever, Intermittent 
 
 Fever, Pernicious 
 
 Fever, Remittent 
 
 Fever, Typhoid 
 
 Fever, Typhus 
 
 Hooping Cough 
 
 Pyaemia 
 
 Syphilis 
 
 CLASS No, 2, 
 
 Diseases of a General or Uncertain Seat. 
 
 Atrophy 
 
 Cancer 
 
 Debility 
 
 Dropsy 
 
 Dropsy from Heart Disease.... 
 Dropsy from Hepatic Disease. 
 
 Gangrene 
 
 Hemorrhage 
 
 Marasmus 
 
 Melanaemia 
 
 Scrofula 
 
 Scurvy 
 
 Tuberculosis 
 
 Tumor 
 
 CLASS No. 3. 
 
 Diseases of the Nervous System, 
 
 Apoplexy 
 
 Brain, Disease of. 
 
 Cerebritis 
 
 Convulsions 
 
 Epilepsy 
 
 Hydrocephalus 
 
 2 
 
 1 ... 
 
 1 2 
 
 Z\"i 
 
 2 1 
 
 If... 
 H 1 
 
 10 
 
 12 
 
 1 1 
 .. 1 
 
 2 
 
 oi 2 
 1 1 
 4 1 
 
10 
 
 BLACKS AND COLO E ED. 
 
 DISEASES. 
 CLASS No, 3-Continued. 
 
 Insanity 
 
 Meningitis 
 
 Nervous Prostration. 
 
 Paralysis 
 
 Tetanus 
 
 Trismus Nascentium. 
 
 CLASS No. 4. 
 
 Diseases of the Respiratory System. 
 
 Asthma 
 
 Bronchitis 
 
 Consumption 
 
 Croup 
 
 Hydrothorax... 
 
 Laryngitis 
 
 Lungs, Congestion of.. 
 
 Lungs, Disease of 
 
 Pneumonia 
 
 Pneumonia, Typhoid.. 
 
 CLASS No. 5. 
 
 Diseases of the Circulatory System. 
 
 Anaemia 
 
 Carditis, Rheumatic 
 
 Cyanosis 
 
 Empyema 
 
 Heart, Disease of 
 
 Heart, Dropsy of 
 
 Heart, Hypertrophy of 
 
 Heart, Valvular, Disease of. 
 Hemorrhage, Umbilical 
 
 E5 U2 
 
 4k 
 
 CLASS No. 6. 
 
 Diseases of the Digestive System. 
 
 Abscess, Retro Pharyngeal. 
 
 Ascites 
 
 Bowels, Inflammation of.... 
 
 Colic , 
 
 Enteritis 
 
 Gastritis 
 
 Gastro Enteritis 
 
 Hsematemesis 
 
 Hepatitis 
 
 Indigestion 
 
 1 ... 
 .. 2 
 
 11 
 
 12 
 
 1 1 
 
 2 2 
 1 
 
 1 .... 
 
 1 ■ 
 
 1 ... 
 
 1 ... .... 
 
 1 ... 
 
 lL, . 
 
 .1 1 
 
11 
 
 BLACKS AND CO LOU ED 
 
 DISEASES. 
 
 GLASS No, 6— Continued, 
 
 Jaundice 
 
 Mesenteric (Hands, Disease of. 
 
 Perineum, Ulceration of. 
 
 Peritonitis 
 
 Stomach, Cancer of 
 
 Tabes Mesenteric® 
 
 Teething 
 
 Thrush.'. 
 
 Worms 
 
 CLASS No. 7. 
 
 Diseases of the Urinary System. 
 Kidneys, Brights Disease of. 
 
 CLASS No, 8, 
 
 Diseases of the Generative System. 
 
 Birth, Premature 
 
 Cancer Uteri 
 
 Child Bed 
 
 Convulsions, Puerperal. 
 
 Fever, Puerperal 
 
 Hemorrhage, Puerperal. 
 Hemorrhage, Uterine — 
 
 Metritis 
 
 Ovaries, Disease of 
 
 Uterus, Disease of 
 
 CLASS No. 10. 
 
 Diseases of the Locomotive System. 
 Rheumatism 
 
 CLASS No. 11. 
 
 External Causes. 
 
 Accident 
 
 Asphyxia 
 
 Coup de Soleil 
 
 Drowning 
 
 Execution of sentence 
 
 Exposure 
 
 Intemperance , 
 
 Neglect 
 
 Suicide 
 
 Wound, Lacerated.... 
 
 2 
 
 • rO 
 
 a a 
 
 1 1 
 
 ± 
 
 ...... 
 
 
 5 
 
 
 1 
 
 
 2 
 
 
 3 
 
 
 1 
 
 1 
 
 2 
 
 
 1 
 
 i 
 
 10 
 
 
 1 
 
 
 
12 
 
 BLACKS AND COLORED. 
 
 DISEASES. 
 CLASS No. 12. 
 
 Old Ago. 
 
 CLASS No. 13. 
 
 Unknown . 
 
 CLASS No. 14. 
 
 Inanition and Want of Vitality.. 
 
 Imperfect Development 
 
 Overlaid 
 
 "Want of Maternal Nourishment. 
 
 Totals 
 
 as n 
 
 * IS I* 
 
 ° a 
 
 |kl l I t 
 
 71 53 62 
 
 65 
 
 77 
 
 K2 
 
 21 9 
 
 2 ... 
 
 2 ... 
 
 4 1 
 
 841103 79 79 70 54 879 
 
 :; 4-". 
 
 1 5 
 
 22 
 1 
 
 „.i i 
 
13 
 
 ilumbfr oi §tntU t with &p#, in mix gfoiitfc, and 
 
 t\xt far. 
 
 WHITES. 
 
 AGES. 
 
 I -I 111 
 
 -r &« ~- < 
 
 £3 1 s 
 
 3 i 
 
 < f & - 
 
 Under 1 year . 
 
 I to 5 years 
 
 5 to 10 years 
 
 10 to 20 years 
 
 20 to 80 years 
 
 30 to 40 years 
 
 40 to 50 years 
 
 50 to GO years 
 
 00 to 70 years 
 
 70 to 80 years 
 
 80 to 90 years 
 
 «J0 to 100 rears 
 
 Over 100 years 
 
 Totals, — 
 Total... 
 
 34 26 
 
 23 
 
 22 12 
 
 8 
 
 2 1 
 31 
 
 i 
 
 2 
 
 2 
 2 
 
 
 
 
 30 48 3G 
 
 I I 
 
 15 8 
 9 4 
 
 2 
 7 
 
 9 
 6 7 
 
 5 G 
 
 14' G 
 
 6| 7 
 
 1 
 
 3! 
 
 3 8 
 
 7 
 
 5 3 
 2 
 
 K 
 
 45 Os 
 
 47,46 
 
 o 
 1 
 1 
 
 
 
 29 30 
 
 124 
 61 
 14 
 17 
 45 
 42 
 43 
 44 
 34 
 24 
 14 
 
 
 
 462 
 
 BLACKS AND COLORED. 
 
 AGES. 
 
 1 year.. 
 5 years., 
 10 years. 
 20 years. 
 30 years . 
 40 years 
 50 years. 
 60 years. 
 70 years. 
 80 years. 
 90 years. 
 90 to 100 years. 
 Over 100 years 
 
 Under 
 1 to 
 5 to 
 10 to 
 20 to 
 30 to 
 40 to 
 50 to 
 60 to 
 70 to 
 80 to 
 
 Totals .. 
 Total. 
 
 January. 
 
 [February. 
 
 March. 
 April. 
 
 
 [June. 
 
 1 
 
 1 . 
 .11 
 
 £w 
 
 — 
 
 a 
 
 © 
 
 ( October, 
 
 November. 
 
 December. 
 
 Total. 
 
 24(24 
 
 21 24 
 
 27 
 
 28 
 
 19 
 
 24 
 
 22 
 
 19 
 
 23 
 
 11 
 
 261 
 
 1 
 
 2 
 
 2 
 
 7 
 
 16 
 
 
 19 
 
 9 
 
 12 
 
 6 
 
 5 
 
 101 
 
 1 
 
 
 
 s 
 
 
 
 1 
 
 3 
 
 1 
 
 5 
 
 1 
 
 2 
 
 3 
 
 1 
 
 20 
 
 3 
 
 1 
 
 
 5 
 
 6 
 
 2 
 
 6 
 
 11 
 
 
 4 
 
 7 
 
 3 
 
 57 
 
 7 
 
 3 
 
 ? 
 
 8 
 
 10 
 
 13 
 
 11 
 
 12 
 
 11 
 
 9 
 
 8 
 
 
 
 106 
 
 4 
 
 4 
 
 
 8 
 
 5 
 
 7 
 
 
 5 
 
 6 
 
 7 
 
 4 
 
 6 
 
 68 
 
 3 
 
 2 
 
 2 3 
 
 3 
 
 3 
 
 8 
 
 12 
 
 5 
 
 2 
 
 3 
 
 3 
 
 49 
 
 8 
 
 5 
 
 4 
 
 2 
 
 5 
 
 4 
 
 1 
 
 1 
 
 4 
 
 8 
 
 5 
 
 3 
 
 8 
 
 50 
 
 5 
 
 4 
 
 6 
 
 6 
 
 5 
 
 G 
 
 4 
 
 6 
 
 7 
 
 5 
 
 3 
 
 65 
 
 9 
 
 3 
 
 G 
 
 5 
 
 5 
 
 2 
 
 4 
 
 2 
 
 5 
 
 5 
 
 2 
 
 7 
 
 55 
 
 4 
 
 4 
 
 3 
 
 1 
 
 1 
 
 2 
 
 1 
 
 4 
 
 1 
 
 5 
 
 3 
 
 1 
 
 30 
 
 2 
 
 1 
 
 1 
 
 1 
 
 2 
 
 1 
 
 
 
 2 
 
 1 
 
 1 
 
 2 
 
 
 
 14 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 1 
 
 
 
 8 
 
 71 
 
 53 
 
 02 
 
 65 
 
 77 
 
 82 84 
 
 103 
 
 70 
 
 [79 
 
 TO 
 
 54 
 
 
 
 
 1 
 
 
 
 
 
 
 
 1 
 
 
 
 879 
 
RECAPITULATION. 
 
 o 
 
 (Total numbfr t»f §!*Jrtftg Anting the % m. 
 
 CLASSES. 
 
 Male Whites 257 
 
 Female Whites 205 
 
 Total Whites 462 
 
 Male Blacks and Colored 423 
 
 Female Blacks and Colored 456 
 
 Total Blacks and Colored 879 
 
 Grand total 1,341 
 
 NATIVITIES. 
 
 Natives of Charleston, 1)13 
 
 Natives of South Carolina 249 
 
 Natives of the United States , 60 
 
 Foreigners 119 
 
 Total 1,341 
 
 Proportional Mortality to population 1 in 26,099 
 
 The entire population being estimated at 35.000 
 
 Respectfully submitted, 
 
 GEOEGE s. pelzer, m, jd., 
 
 City Registrar. 
 
METEORLOGICAL ABSTRACT of the Barometer, Thermometer, Due Point, Winds and Weather, at Charleston, S. C, for the Year ending December 31st, 1867. 
 
 By GEORGE S. PELZER. M. I >., City Registrar. 
 
 Months. 
 
 Barometer. 
 
 Thermometer 
 Attached. 
 
 HOTTEST DAY. 
 
 COLDEST DAY. 
 
 Thermomett 
 
 Mean Tcmpure. 
 
 r Detached. 
 
 Max'm.j Min'm. 
 
 Register 
 Thermom'r. 
 
 Dew 
 
 Point 
 
 
 
 Course of Winds at 
 Sunrise. 
 
 g 
 
 ? 
 ? 
 
 Course of Winds at 
 4 P. M. 
 
 g 
 
 w 
 
 pq 
 
 Weather 
 
 Quantity 
 of Rain. 
 
 Prevailing Weather. 
 
 1867. 
 
 B 
 
 g 
 
 1 
 
 « 
 
 < 
 
 a 
 
 Mean, 2 p. M. 
 
 • 
 
 2 
 
 a> 
 c" 
 
 S) 
 
 •k 
 
 l- 
 
 ea 
 
 a 
 
 ts Is s a Is 
 
 i- |m |oi Jt- |e4 
 
 - 
 
 % 
 
 | Mean Day. 
 
 S 
 
 
 S 
 
 CO 
 
 
 to 
 j£ 
 
 
 09 
 
 W 
 
 
 
 1 Northeast. 
 
 | 
 
 o 
 
 X 
 
 i 
 t» 
 
 i 
 
 o 
 
 X 
 
 3 
 H 
 
 i 
 
 £ 
 
 o 
 
 -~ 
 
 « 
 
 j 
 J 
 | 
 
 January 
 
 30.468 
 
 29.620 
 
 .848 
 
 4261 
 
 48.90 
 
 47.29 
 
 14th 
 
 18th 
 
 
 19.19 
 
 17.29 
 
 J 6 LLL 
 
 
 40.16 
 
 50.13 
 
 
 10 
 
 16 
 
 17 
 
 
 
 
 
 
 
 N W 
 
 
 15 
 
 
 
 3 
 
 8 
 
 22 
 
 
 
 
 20 
 
 6 
 
 5 
 
 
 Pair. 
 
 30.794 
 
 29.0.30 
 
 1.164 
 
 .')4.2r) 
 
 61.21 
 
 58.50 
 
 24th 
 
 10th 
 
 
 62.1 1 
 
 
 
 
 51.10 
 
 
 
 
 
 
 
 
 
 1 
 
 4 
 
 n.e' 
 
 2 IS 
 
 5 
 
 9 
 
 G 
 
 26 
 
 5 
 
 
 
 13 
 
 8 
 
 7 
 
 2!60 
 6.59 
 
 Fair. 
 
 February 
 
 March 
 
 30.360 
 
 29.850 
 
 .510 
 
 
 59.48 
 
 57.29 
 
 13th 
 
 16th 
 
 
 
 
 
 
 51.03 
 
 
 
 
 
 
 
 
 11 
 
 
 
 
 N. E. 
 
 29 
 
 6 
 
 2 
 
 
 24 
 
 5 
 
 
 
 N. E. 
 
 15 
 
 7 
 
 9 
 
 Pair. 
 Pair. 
 
 April 
 
 30.436 
 
 29.824 
 
 612 
 
 
 09.73 
 
 
 24th 
 
 13th 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 N. W. 
 
 4 
 
 7 
 
 9 
 
 11 
 
 12 
 
 20 
 
 8 
 
 
 
 S. W. 
 
 19 
 
 5 
 
 6 
 
 2.08 
 
 May 
 
 30370 
 
 29.404 
 
 
 
 
 71. 9i; 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 
 
 N. K. 
 
 2 
 
 11 
 
 15 
 
 11 
 
 10 
 
 23 
 
 7 
 
 
 
 S. W. 
 
 
 4 
 
 5 
 
 4.16 
 
 Pair. 
 
 Juno 
 
 30.362 
 
 29.810 
 
 
 
 
 77.40 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 N. B. .t K. 
 
 
 
 14 
 
 5 
 
 2 
 
 8 
 
 31 
 
 in 
 
 
 
 S. W. 
 
 1 1 
 
 5 
 
 11 
 
 13.22 
 
 Pair. 
 
 .Inly 
 
 30.364 
 
 30.06 1 
 
 "••'iH 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 16 
 
 N.E.S.ftW. 
 
 
 
 15 
 
 o 16 
 
 4 
 
 36 
 
 6 
 
 o 
 
 S. W. 
 
 20 
 
 5 
 
 6 
 
 4.93 
 
 
 August 
 
 ::n :;:>ii 
 
 29.98(1 
 
 .304 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 12 
 
 14 
 
 in 
 
 E. 
 
 o 
 
 3 
 
 4 
 
 o 
 
 8 
 
 11 
 
 
 6 
 
 S. W. 
 
 16 
 
 8 
 
 7 
 
 9.89 
 
 Pair. 
 
 September 
 
 30.446 
 
 29.88s 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 14 
 
 
 
 
 
 
 2 
 
 E. 
 
 2 
 
 11 
 
 3 
 
 5 
 
 5 
 
 9 
 
 34 
 
 2 
 
 E. 
 
 17 
 
 7 
 
 6 
 
 4.58 
 
 Pair. 
 
 
 1 30.451 
 
 29.870 
 
 .580 
 
 
 
 
 
 
 
 
 
 
 
 
 71 II 
 
 
 
 
 14 
 
 
 
 
 
 2 
 
 N. E. 
 
 
 
 39 
 
 20 
 
 
 
 
 
 12 
 
 2 
 
 
 
 N. E. 
 
 25 
 
 4 
 
 
 5.62 
 
 Fair. 
 
 November....!!!! 
 
 30.548 
 
 29.934 
 
 .614 
 
 r>6.7o 
 
 
 
 
 
 50. 00 
 
 65.(16 
 
 59.93 
 
 71 75 69 42 50 
 
 
 54.40 
 
 65.06 
 
 
 1 
 
 
 1 1 
 
 
 
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 December 
 
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 29.628 
 
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 Fair, 
 
 GEORGE S. PELZER, M.D., City Registrar. 
 
ANNUAL REPORT 
 
 OF THE 
 
 HEALTH DEPARTMENT, 
 
 For the Year ending on the 31st clay of December, 1867. 
 
 Showing the number of Cases Treated, and Deaths, in each 
 Health District, Hospital, and the Health Department, 
 during each Month, with Status as to color, Sex, 
 of each Case, and the total number of Cases 
 treated, and Deaths, in each Health Dis- 
 trict, Hospital, and the Health De- 
 partment, during the Year, 
 etc., etc. 
 
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Annual ilcport of f Mjj putrid gto. 3. 
 
 Charleston, S. C. April 15th, 1868. 
 7b Dr. Geo. 8. Pelzer, City Registrar. 
 
 Dear Sir: — In reply to your several inquiries concerning cer- 
 tain hygienic conditions relating to the Health District of winch 
 1 have had charge for the past two years, I would remark first. 
 Upon the statistical evidence furnished by the Register of my 
 office. By comparison of the past with the previous year of 1866, 
 it appears that the number of patients registered, is nearly one- 
 fourth greater for the year ending December 31st, 1867. From 
 general observation, and the mortuary reports of the City Regis- 
 trar, it must be conceded, that the health of the city was certainly 
 no worse — if it was not very much better, than in past years, 
 and therefore, we must look to some other sources for the cause 
 of this increase on our dispensaries. With regard to the whites, 
 they are but a little in excess of the previous year, and this 
 might naturally have been inferred, from the fact, that there has 
 been no imigration, and consequently no foreigners to be acclim- 
 atized. The freedmen who have nocked from the surrounding 
 country, have gradually driven that class of persons who form- 
 erly occupied them, from those low, filthy and insalubrious 
 portions of the city, which was always a favorable nidus for 
 epidemics, and a fertile source of innumerable diseases; and we 
 find them now occupying more healthful situations, with more 
 room}' and comfortable habitations, generally pursuing some 
 occupation, sufficient to afford them at least, the necessaries of 
 life. 
 
 With the freedmen, man}' causes have combined to increase 
 their number. In the early part of 1866, the Health Depart- 
 ment was in its infancy, and had not reached the perfection of 
 its present operations; its very existence was unknown to them 
 for many months, and consequently, we were often not called 
 upon by them, when most needed. At present, the length and 
 breadth of each Health District, is known to the fraction of an 
 inch, and all its workings in its minutest ramifications more 
 familiar to them than their prayers. The earliest accents 
 
62 
 
 infant tongues arc taught to lisp, is the "Poor Doctor's ' name, 
 and their tottering steps are trained toward the fountains, 
 whence they hope forever to draw their Paregoric and Castor 
 Oil. 
 
 The spasmodic efforts at a new life of a disorganized and 
 ruined commerce, gave temporary employment at this time, to 
 a large laboring class, and together with the large amounts of 
 money paid to disbanded troops, which was immediately dis- 
 tributed among the freedmen, enabled them in most cases, to 
 procure their medicine, and pay for medical attendance. 
 
 The Medical profession at large, had not yet been through 
 the bitter school of experience, and been taught what a princi- 
 pled disregard the free dm an has for Doctor's bills when he is 
 well, however faithfully he may have promised when suffering 
 trom disease, and now (with rare exceptions,) they cannot pro- 
 cure the services of a Physician with any claims to respectabili- 
 ty, except in most urgent cases, consequently, they are univer- 
 sally driven to the dispensaries. Unquestionably however, 
 pauperism will continue to increase; the successive failure of 
 the planting interests, the disregard of contracts and moral 
 obligations, the absence of foresight and forethought to impress 
 upon them the necessity of continuous application; their natu- 
 rally prodigal and improvident nature, and their restless migra- 
 tory habits, has impoverished and rendered homeless, many 
 hundreds, who have herded hither, where already the amount 
 of laborers are far in excess of the demand; the result is, that 
 the majority of them cannot procure (even if so disposed.) em- 
 ployment sufficiently continuous or remunerative to do more 
 than furnish them a bare subsistence while in health, when sick 
 they suffer for the absolute necessaries of life, and though the 
 Hospitals are ample and ready to provide for them, yet so gen- 
 eral is their superstitious aversion to them, that the greater 
 portion prefer to endure their discomfort, neglect and want, at 
 home, rather than be cared for there. Could any system be 
 devised by which the sick would be enabled to draw from the 
 Hospitals daily, such suitable diet as might be prescribed by the 
 attending Health Physicians,, it would no doubt relieve the Hos- 
 pital of many of its inmates, be not more expensive to the city, 
 and alleviate much of the suffering which now exists. The 
 most stringent •• vagrant laws " should also be enforced, with a 
 
»;:; 
 
 view to driving the unemployed back to the country, where 
 alone it is possible for them to make a support or be otherwise 
 than consumers and non-producers of society. 
 
 Another cause of the large numbers on our dispensaries 
 exists in the impossibility of clearly defining who is and who is 
 not properly entitled to its benefits ; and tho anomalous position 
 we occupy of serving two masters — the City as representing 
 one, and the Freedman's Bureau the other. 
 
 The freedmen having been clothed and fed and educated for 
 the last three or four years to the belief that he is the especial 
 ward of the Government, very naturally imagines that his color 
 alone entitles him, without question as to his necessities, capa- 
 cities, or pecuniary condition, to the unrestricted services of 
 what he denominates as the " Poor," the '-State," or "Spensary" 
 Doctor, and to an unlimited supply of any and every kind of 
 medicine which he desires, and I feel convinced that all of the 
 Health Physicians for fear of being accused of negligence in 
 their duties, (especially to this favored class,) have rather erred 
 on the other side, and been much too ready with their services, 
 and much too liberal with the government medicines; for these 
 reasons we have had with very rare exceptions, (and these in- 
 variably on the most unjustifiable grounds,) little or no com- 
 plaint made against us. It is certain, that just so long as medi- 
 cine and the services of a Physician can be indiscriminately 
 obtained merely for the asking, just so long will we have large 
 dispensary lists. It certainly would be as well to require appli- 
 cants to be endorsed by the Alderman of their respective wards, 
 or some other responsible person, (as is done with all other 
 public charities,) as throw the entire onus upon the Physician. 
 
 Public Hygiene. — I know not that this has been influenced 
 specially, (at least in my District,) by any particular system of 
 art or science, and if it has proved better, (as I believe it has 
 done,) than in past years, it can as readily be accounted for 
 upon the fortuitous circumstances of climactic changes, as upon 
 any hypothesis of an acquired or artificial nature. Our very 
 efficient City Surveyor, and energetic Mayor, appear to have 
 recognized in the last few weeks, the imperative necessity of 
 certain improvements in my division of the city, and much has 
 been done in the way of drainage filling, &c; much more re- 
 mains in particular locations, (which I shall point out under the 
 
04 
 
 head of •• Habitations/') which is quite susceptible of improve- 
 ment also, and which 1 hope will receive the consideration of 
 I hose whose especial duty it is to take cognisance of these mat- 
 ters. The universally acknowledged benefits to be derived 
 from a scrupulous cleanliness of the streets as well as private 
 habitations and thorough drainage of vacant lots and cellars, 
 need not be impressed upon those concerned; how far this can 
 practically be carried out, remains to be seen. No doubt the 
 entire portion of the city lying between Laurens and Calhoun 
 Streets, and east of the Bay, has been much neglected for many 
 years, indeed it does not appear ever to have had any very effec- 
 tive efforts made for its hygienic improvement, and the wonder 
 is not that there arc so many sick in this locality, but rather 
 that there should be any who are well. 
 
 Private Hygiene — Is a matter that so little disturbs the 
 mind of this class of people, that it were scarcely worth while 
 to remark upon it. Poverty and filth, always twin sisters, with 
 them are synonymous, and doubtless very favorable to the 
 development and propagation of disease. It is sufficient to say, 
 that their personal hygienic condition is almost invariably essen- 
 tially bad, but how and where the remedy is to be applied I 
 regret to say I am at a loss to suggest. 
 
 Dwellings. — Possibly the majority of the habitations of these 
 people are sufficiently roomy, dry, and well enough ventilated : 
 a very considerable portion, however, are perfectly execrable. 
 In certain parts of Laurens, Washington, Marsh, Concord and 
 Calhoun Streets, the lots are below tide water level and the 
 streets around ; inundated by every showier and spring tide, and 
 a receptacle for all the debris from surrounding yards, they are 
 almost always in a slough, and in warm weather, emit the most 
 disgusting and offensive odors ; upon these arc crowded small, 
 ill ventilated, filthy, dilapidated hovels, the basement floors of 
 many of which 1 have seen floating or submerged by the rains 
 or tide for weeks at a time. Formerly, these were occupied by 
 the lower classes of foreigners, and were always the dens of vice 
 and depravity, and fertile sources of disease; the gradual en- 
 croachments of the freedmen have entirely displaced the original 
 occupants, who are no doubt vastly benefitted by the change, 
 w hile they in a measure have fallen heirs to their many misfor- 
 
65 
 
 tunes. Into these places the freedmen crowd in incalculable 
 numbers. I have not infrequently seen ten or twelve grown 
 persons of both sexes, occupying a single room not more than 
 ten or twelve feet square. How it is that Diarrhoea. Dysentery, 
 Typhoid Fever, Cholera, and all the zymotic diseases that flesh is 
 heir to, has not prevailed here and swept them all away, is only 
 explicable on the fact that such is the peculiar strength of the 
 vital principle in their physiological organism, and the total 
 absence of those psycological influences which have so important 
 a bearing in the development of disease in the higher classes, 
 that it is only when extraneous causes of disease are acting with 
 extremcst intensity, and for very continuous periods, that they 
 appear at all to be affected by them, and these causes are con- 
 stantly counterbalanced by their restless and changeable habits, 
 seldom or ever remaining in one place longer than a month or 
 six weeks. Where all is so bad, it is hard to make any special 
 distinction, but I would here take occasion to call attention 
 more particularly to lots corner of Washington and Laurens 
 Streets. No. 10 Washington Street, No. 14 Washington, "Peney's 
 Row," Vernon Street, No. 6 Marsh Street, all the lower part of 
 Concord Street, several lots directly opposite Anson Street in 
 Calhoun Street, and various others lying between this and 
 Washington Street, on the north side of Calhoun. Lots on the 
 north side of Chapel Street, between Elizabeth and Alexander, 
 and also on the east side of Alexander near Chapel Street. In- 
 spection Street, on both sides between Washington and Marsh, 
 Wharf Street, almost throughout its entire length, and various 
 others of minor import in the same vicinity. 
 
 Food. — This is ordinarily of the simplest and coarsest nature, 
 wheat bread, corn meal, fish, and occasionally a little bacon, 
 forming the staple articles. Fish, both salt and fresh, supplies 
 almost exclusively (from their natural fondness for it and its 
 comparative cheapness) the place of all other azotized substan- 
 ces, and when fresh, being of an easily digestible and nourishing 
 character, is a very excellent and suitable form of diet, seldom 
 or ever becoming a cause of disease except when used in an 
 unsound state, and even then, causing seldom more than a tem- 
 porary indisposition. 
 
 Occupations. — With them, as a mass, occupation is so infre- 
 quent and multifarious, that it can have no possible influence 
 9 
 
upon their discuses; they do not, with but extremely rare excep- 
 tions, pursue any arts or trades as a business, that are in them- 
 selves del el t noun, but for the most part are engaged in ordinary 
 out-door labor. and this usually in such homoeopathic proportions, 
 as rather to be conducive than otherwise to a perfect state of 
 health. 
 
 Prevalence of Disease. — If we except intermittent fever, 
 no particular disease can properly be said to have prevailed, 
 other than those incident to certain seasons of the year, as 
 Cholera Infantum, Diarrhoea, Dysentery, &c, usual in the 
 early summer, and all the varieties of Pneumonic disease during 
 the winter months, interspersed with such accidental and spo- 
 radic cases as must necessarily be anticipated under any circum- 
 stances, but none of these have been more general, more serious 
 or less amenable to treatment, than in former years. Indeed, 
 reference to my visiting list shows that although the total 
 number registered is considerably larger than last year, yet the 
 actual labor has not been greater, as a much larger proportion 
 have been office patients,"' and their diseases of that trivial, 
 or benign character, which docs not usually entail any consider- 
 able amount of work. 
 
 With regard to the endemic of Intermittent Fever, which was 
 so universal and wide spread, could any plausible theory of its 
 origin here and any reasonable propositions for its prevention 
 be ottered, it might well engage the serious attention of us all, 
 but unfortunately, what the essence of this thing which we call 
 miasma, is, what produces it, where it comes from, and how to 
 counteract its baneful influences, are questions of which there 
 has been no certain solution given yet. 
 
 Superficial observation will readily accord to "burnt districts" 
 "stagnated cisterns," "open cess pools," '-decaying vegetable 
 matter" and frequent rains, the self apparent cause of these mias- 
 matic fevers, but let us inquire if such an hypothesis is supported 
 by facts. The river Tagus at Lisbon, Dr. AVatson informs us, 
 separates a healthy from a most pestiferous district ; on one side 
 is a barren hilly country, the foundation of the soil and the beds 
 of the river-courses being of rock with tree open water-courses 
 among the hills, this is the healthy side ; on the Alentejo land 
 on the other side, being perfectly dry and sandy, is most unheal- 
 thy. Moreover, in and near Lisbon there arc numerous gardens 
 
where they keep water, during the three months absolute 
 drought of the summer season, in stone reservoirs ; these reser- 
 voirs containing water in the most concentrated state of foul news 
 and putridity are placed close to the houses and sleeping rooms, 
 the inhabitants literally live and breathe in their atmosphere. 
 Yet no one ever heard or dreamt of lever being generated 
 amongst them from such a source, though the most ignorant 
 native is well aware that to cross the river and sleep on the 
 Alentejo side, where a particle of water had not been seen for 
 months and where water was never known to be putrid, he 
 would run the risk of being seized with fever. 
 
 In the Dutch Brabant in Holland, intermittent levers became 
 epidemie when the British army encamped upon its arid plains 
 of sand where no moisture could exist and where vegetation 
 was perfectly extinct. After the battle of Talavera the army 
 retreating along the course of the Guadiana river into the plains 
 of Estremadura where the country was so dry for want of rain 
 that the Guadiana itself and all the smaller streams had, in 
 fact, ceased to be streams, the troops suffered from remittent 
 fevers of such malignity that the enemy and all Europe believed 
 that the Britisb host was extirpated. At Cividid Bodrigo, on 
 the rocky bank of the river Agueda, a remarkably clear stream, 
 the country around which had become as hard and dry as a 
 brick ground and every vestige of vegetation utterly burned up, 
 the levers were only equalled in malignity to those of the 
 Guadiana. Dr. Ferguson farther tells us that in Spain (unques- 
 tionably one of the dryest countries in Europe and quite as 
 prolific of malarial fever) towards the end of summer you may 
 look in vain for lakes, marshes, ditches, pools or even vegeta- 
 tion, and it is not until it has again been made one of the 
 wettest by the periodical rains, with its vegetation and aquatic 
 weeds restored, that it can be called health}' or even habitable 
 with any degree of safety. The rotting cabbage leaves of 
 Covent Garden and those which taint the air of the Btreetsfrom 
 the neglected dust holes of London during the hot weather of 
 summer give rise to no ague. In the immediate, vicinity of the 
 Dismal Swamp and in the lower Bayous of Louisiana teeming 
 with the rankest aud most luxurious vegetation, we have no 
 intermittent fevers, while the country around and the banks of 
 
68 
 
 the Mississippi abound with it. On the banks of the Indian 
 rivers in Biirmah and Siam it is said those have the best chances 
 of escape from fevers who live in houses built upon piles in the 
 water and only approachable in boats. 
 
 In our own State it is neither those places situated on elevated 
 hills nor in the valleys, upon the rivers or away from them, 
 those in the neighborhood of stagnant mill ponds and marshes, 
 nor those surrounded by cultivated fields or barren pine lands, 
 that suffer immunity, but here a village and there a town, 
 regardless of topographical considerations, that is comparatively 
 exempt from miasmatic fevers, the causes of this exemption at 
 present are inexplicable. 
 
 But to return to the city. If burnt districts, stagnant cisterns, 
 rank vegetation, &c, <fcc, had aught to do with the last epidemic, 
 why, when these causes have been in operation since December, 
 1861, (date of the fire) have we only witnessed its effects during 
 the last summer ? Up to this time, I believe it will not be disputed 
 intermittent fever has not been more frequent than in former 
 years. Moreover, is it not likely that if these were the causes 
 its effects would first have been seen in and around these infec- 
 tious centres, and afterward spreading itself outward and out- 
 ward to undefined limits ; but on the contrary, these portions of 
 the city were comparatively exempt, at least until very late in 
 the season ; the first mutte rings of* the storm were heard miles 
 away from us, in the distant hills and in the pincy woods, in 
 the surrounding islands and the country villages where it was 
 never heard or seen before ; finally, from the suburbs it gradually 
 rolled itself in and upon us, and sweeping onward to the North 
 passed far in advance of its ancient landmarks. Of late years 
 many of the suburban residences of Philadelphia and neigh- 
 boring cities have been abandoned in consequence, and Massa- 
 chusetts and Connecticut physicians tell us of the gradual 
 encroachment of Periodic fevers which were formerly unknown 
 to them. To residents of the city it may not be so apparent, 
 but by planters and countrymen it is very generally conceded 
 that the character of our seasons have undergone a very con- 
 siderable change in the last half century. Certain it is that 
 malarial fevers commence earlier are more general and more 
 obstinate now in the spring than formerly. A strong proof 
 of this we have in the fact derived from circumstantial cvi- 
 
69 
 
 dcnco in reading the histories of Colonial times. Then and for 
 many years after, planters remained invariably on their planta- 
 tions (chiefly rice plantations and generally considered as most 
 unhealthy) until the latter part of June, and they returned to 
 them in the early fall without an idea of running any risk of 
 malarial fever ; we know that at present it is thought madness 
 to remain even on the most salubrious places beyond the first of 
 May. It is not presumable these men, fresh from foreign coun- 
 tries or but a generation removed, were less susceptible to this 
 disease than the present generation, born, raised and inured to 
 the insalubrious clime. No one who has travelled much through 
 the lower section of our country (I doubt not) but has stopped 
 at some fallen gate or perhaps a solitary gate post, and as he 
 gazed through the long vista of overreaching moss-covered 
 oaks and seen beyond the fallen shutters, the grass-grown roof, 
 and dilapidated stairway of some grand old mansion, with its 
 decaying outbuildings, broken terrace, neglected garden, stagnant 
 fish pond and all the accompanying evidences of departed grand- 
 eur, but has dropped the silent tear, or at least, heaved a heart- 
 felt sigh as he wondered where all was so lovely, so beautiful 
 and so attractive that there should be no living being there now 
 to enjoy it ; sterility of the soil has probably occurred to most 
 observers as the most reasonable cause of its desertion, we know 
 the contrary to be the fact ; the lands arc as productive and 
 remunerative as any in the State, and in many cases are still 
 cultivated to advantage, but obviously the length of term for 
 the enjoyment of the pleasures of plantation life has been 
 shortened by the encroachment of malarial fevers, and for this 
 reason so many in the lower and middle sections of our State 
 have been abandoned and left to gradual decay. Four ele- 
 ments alone seem necessary for the development of this 
 febrific poison : earth, air, heat and moisture, and only so far 
 as artificial means can modify the two latter may we hope 
 to have any influence upon its deprecating effects. Time and the 
 limits of this paper does not permit me to pursue this subject 
 farther, I have already transgressed upon both ; only one other 
 remark I Avould make in connection with this subject regarding 
 the susceptibility of the negro race to the contagion of this 
 fever which has been rather singular and contrary to precon- 
 ceived ideas and what from experience might reasonably have 
 
To 
 
 been anticipated. Born and raised in the most malarious 
 sections of our country, laboring under the burning rays of the 
 summer sun and constantly breathing the foulest and most 
 pestiferous atmosphere, whose every zephyr bears the elements 
 of d isease and death to the white man, he has enjoyed almost 
 perfect immunity from fever and reached the highest grade of 
 physical development ; but here, removed to the city, so far 
 from being exempt, he has suffered much more not only than 
 the white man, but than those of his own race who are natives, 
 proving, however strong and perfect his physical organization 
 and power of resistance to this noxious element in fixed loca- 
 tions, his total inaptitude for any change, however slight. 
 
 in conclusion, my experience in Dispensary practice (and it 
 has not been a recent one) leads me to believe that too many 
 ollices is as great an evil as too few; the characteristic of human 
 nature is the same in every department of life ; unless tborc is a 
 strong motive for action it usually lapses into careless indiffer- 
 ence or total negligence. 
 
 The common dictates of humanity would make it appear to be 
 imperative that ample public provision should be made to meet 
 the misfortunes of those whose greatest crime is poverty, but 
 the question arises, are the worthy, honest and industrious poor 
 commonly the recipients of this charity ? In some cases they are, 
 in the majority they are not ; it is the worthless, vagabond, idle, 
 dishonest, improvident drones of society, who arc either too 
 lazy to earn a living by honest labor, or who squander their 
 daily gains in the pursuit of vice and debauchery, who crowd 
 up our Dispensary registers. There is no really honest, hard- 
 working upright person in the community who would not be 
 able to procure the services of almost any physician when their 
 circumstances were property represented, and such upon close 
 examination will be found to be the case with nearly all this 
 class of persons. Doubtless many physicians now throw 
 patients upon the Dispensary who would not otherwise do it 
 but from the fact of the multiplicity and accessibility of these 
 offices. It would be much better to pay a few trustworthy, 
 efficient officers a reasonable salary, making the tenure of office 
 more secure, and require them to use a severe discriminating 
 power towards the applicants rather than have a larger number 
 who, conscientiously performing their duties, extend the chari- 
 
71 
 
 ties too far, (fostering a feeling of.general dependence) from fear 
 that an accusation of negligence of duty might be brought 
 against them if they refuse the application of any one, and 
 being unwilling to appear to receive remuneration for an insuf- 
 ficiency of work. J would farther suggest that the Dispensaries 
 could, in the depressed condition of the city finances, be readily 
 made self-supporting by the requirement of a merely nominal 
 registration fee, say 50 cents to be paid as each patient is regis- 
 tered. Calculating the number registered last year this would 
 more than pay the salary of the officers. 
 
 Respectfully, your obedient Servant, 
 
 JOHN L. AKOBUM, M . D, 
 
|tnmal it r port of fealty district Ho. 4. 
 
 Charleston, S. C, April 15th, 1808. 
 
 To Dr. (iEo. S. Pelzer, 
 
 City Registrar and Chief of the Health Department : 
 
 Doctor ; — Your circular of date April 13th, 1868, requesting a 
 "Sanitary lleport," embracing the Hygeine, public and private, 
 of the Health District I have had the supervision of during the 
 past year, 1867, the origin, maintenance and propagation of 
 disease, the causes originating the same, and the suggestions 
 remedying the above, is at hand; and I have the honor to submit 
 the following report, regretting that the time allowed and the 
 circumstances are such as to prevent the investigation and eluci- 
 dation of the subject, which the material and observation at my 
 command would justify. 
 
 REPOKT. 
 
 The vast importance of a correct understanding of the laws 
 regulating Hygiene, the means of preventing the origin of 
 disease, and its propagation, can only be acquired by the closest 
 observation and an intimate and daily contact with the effects 
 resulting from the operation of causes which by the proper 
 application of remedies can prevent the spread of disease, and 
 secure, at least, comparative health or an absolute immunity 
 from malignant and unmanagable complaints, having as they 
 always do, a tendency to epidemic or edemic propagation. 
 During the past year the Health Physician has had unusual 
 facilities for observation, resulting from the large increase in the 
 number of patients brought under his care, their character and 
 customs, habitations, mode of living, as influenced by race, occu- 
 pation and diversity of interest, the withering effects of poverty 
 producing necessarily a lack of moral restraint, resulting in 
 debauchery and vice, laying where numbers are congregated, 
 the seeds of disease, and putting at naught the means of cure. 
 It will be observed that our remarks are predicated upon an 
 
7:; 
 
 intiimite knowledge of the poor and not of the rich, whom 
 instruction and education prompt to observance of the laws of 
 health, which only law and force can compel in the destitute. 
 
 1 would notice then 1st. The public hygiene of the Health 
 District. 2d. The private hygcine. 3d. The character of the 
 dwellings. 4th. The various occupations and their influence 
 upon the spread of disease. 5th, Particular diseases, their cause 
 and origin. Gth. Suggestions for the relief and prevention of 
 evils which would probably arise, particularising such localities 
 as judgment and experience would dictate. 
 
 1st. public hygiene. 
 
 Having jurisdiction of perhaps the healthiest and best provided 
 section of the eity, at the same time largely populated and 
 extending over a large area, yet there are certain sections and 
 localities which may safely be considered as legitimate subjects 
 of comment, and suggest greater vigilance of execution of the 
 means in our power provided to prevent the evils arising from 
 their presence in our midst. 
 
 As a rule, general cleanliness of the streets has been observed, 
 garbage and detrutus from the yards promptly removed, drains 
 kept free of stoppage where they existed, and at least, in outward 
 appearance, general care was instituted. It is particularly to 
 the existence of low, damp and undrained localities, several of 
 which exist in this district, that I would call especial attention. 
 1st. Among these is the section extending from Cannon 
 street On the north to Badcliffe on the south, and bounded by 
 Coming on the east and Rutledo-e on the west. It is here that 
 after each heavy fall of rain the water accumulates, and not 
 having sufficient draining, remains, saturating the earth fre- 
 quently for days, subject to the influence of the hot summer 
 suns, remaining stagnant or else evaporating so quickly as to 
 produce very serious effects, added to which, there being no 
 outlet to that in yards and cellars, it frequently remains unat- 
 tended to until, compelled by the report of "n uisances ," steps are 
 taken to remedy the evil. Though there is sewerage in this 
 vicinity yet from the nature of the locality, and the general char- 
 acter of the inhabitants, it seems that it is not sufficient. 
 
 It was in this section of the city that the burden of the Health 
 Physician's labors resided during the past summer. Malarial 
 10 
 
74 
 
 fever abounded, attacking indiscriminately both whites and 
 blades, of all ages and sex, originating clearly in some peculiarity 
 of locality, and although the endemic may have been considered 
 general upon the Neck, yet it certainly increased in certain 
 situations, influenced, no doubt, by causes operating in a silent 
 but sure manner, and which could be palliated if not entirely 
 remedied. 
 
 2d. The section known as the Palmetto street lots and Lucas 
 street shanties, built upon stilts, the surface of the yards below 
 that of the streets, when, upon every spring tide they arc sub- 
 merged, no outlet being secured, no drainage executed, and 
 inhabited by large numbers of negroes and poor whites, huddled 
 together and living in filth. The water accumulates in large 
 quantities and the earth is in a perpetual state of saturation. 
 
 3d. Gadsden street and its vicinity very nearly of the same 
 class, and producing the same injurious effects. These are the 
 principal sections that need attention, and though there are 
 others which, to a medical eye, could be improved, yet they are 
 not of a sufficient gravity to merit attention. 
 
 An efficient system of sewerage by a well connected system 
 of sewers, with the main trunk on Coming street, properly built 
 with sufficient grade; the strict enforcement of the law requiring 
 the proper drainage and filling of private lots, the elevation of 
 open lots above that of the streets, with proper vent to the 
 accumulated water, not to speak of the commencement of 1 lie 
 initiation of a system of paving the streets, gradually and 
 efficiently executed, and the benefit of which, if the nature of 
 this report permitted, could be demonstrated by comparison and 
 hygienic statistics, are the means which readily suggest them- 
 selves to the mind of the Health Physician as proper and expe- 
 dient to correct the evil. 
 
 2d. private hygiene. 
 
 Under this head will be noticed the cleanliness of yards, 
 proper disposition for ventilation and the procurement of light, 
 the disposition of the contents of privies and drainage. 
 
 Three of the great requisites for the healthy existence of 
 human beings are due supplies of pure air, light and water, and 
 it is strange that among the poor so little attention is paid to 
 either. In looking for the origin of disease in a community, it is 
 
7.") 
 
 important that every possible contingency should be investi- 
 gated as from the accumulation of small causes are generated 
 effects which are extremely detrimental. Among the colored 
 population especially are these neglected. Frequently are they 
 found located in houses and rooms so dark as to require lights 
 in the mid-day, no ventilation, improper food and complete 
 listless indifference. As a rule no attention is paid to the above 
 and frequently we can trace serious disease to this cause. 
 
 The yards of this class arc generally kept and allowed to 
 remain dirty. Filth accumulates in large masses around the 
 houses, drains are allowed to he, and remain stopped up; stag- 
 nant water settles in the lots and yards, and beneath their 
 houses ; large numbers are congregated together, and with 
 carelessness, idleness and indifference, there is laid the founda- 
 tion of Typhoid Fever, and other kindred affections. There are 
 exceptions to these among this class, however. Stringent 
 rules requiring the closest attention to the correction of the 
 above, with surety of punishment for their non-observance, 
 are the means to be adopted to modify the evil. I call the 
 attention of the .Registrar to the principal localities referred 
 to by the above, viz: McBride's Lane, Moses' Lots Beau fain 
 Street, Lots on Coming, Kadcliffe, Morris, Palmetto, Lucas 
 and Duncan Streets, and Hargrave Court. 
 
 3rd, Character of the dwellings. Sufficient has been said to 
 show that they arc of the worst sort and class. Generally old, 
 poorly constructed, badty ventilated, needing repairs, and in some 
 few instances completely uninhabitable. Among the better class 
 ofpoorthisis not the case. Frequently they are found provi- 
 dent, industrious, clean, contented and comfortable, and in neat, 
 well protected houses. It would be impossible to particularise any 
 special position where these "Evils" exist, as the various grades 
 arc so closely drawn as to prevent any close discrimination. 
 It is to the crowding in of large numbers in small houses, the 
 consequently limited space, below that necessary to healthy 
 existence, that I would note as a frequent source of trouble. 
 
 This exists as much among the lower class of whites as with 
 the colored. How it is to be corrected we cannot say. Pover- 
 ty has no choice in the selection of its abode, and we can only 
 wait for improved educational facilities, and a keener sense of 
 the value of life to correct the evil. 
 
7(5 
 
 4 th". The various occupations, and their influences upon the 
 spread of <liaea.se. 
 
 It would be impracticable to delineate at length, from among 
 the vast numbers of applicants for aid to this Dispensary, 
 the various and multifarious occupations which arc pursued, 
 as in a large number of cases pauperism and extreme des- 
 titution are the rule. The laboring classes, embracing the 
 mechanic, artizan, and day laborer, who are exposed alike 
 to the hot suns and the cold rains; the poor female, white and 
 colored, who eke out an existence by hard and constant labor ; 
 the destitute, and those whose daily return but affords means 
 for the purchase of bread and shelter, modified by every grade 
 and character of employment, constitute the principal occu- 
 pations of the destitute poor. 
 
 It will be easily seen how influences, arising from these cau- 
 ses, can originate disease. Poorly housed, poorly clad and 
 poorly fed, being among dirt and filth, wearied by long and 
 constant labor, exposed to the temptation of drinking aleholie 
 poison to drown care, and to all kinds and conditions of 
 weather, without means of suitable protection, these subjects 
 arc and become fit food for the spread of disease, and but keep 
 alive a dcliterious poison, which by the exercise of a little caution 
 and discretion could be easily avoided. 
 
 5th. Particular diseases, their cause and origin. In selecting 
 from the large, excessive and varied character of* disease brought 
 under the care of the Health Physician, it will be but necessary 
 to refer to but one class, as being of interest, for the vast major- 
 ity are of that nature which are incidental to any and every com- 
 munity, and which arc only aggravated by change of season and 
 temperature. 
 
 Malarial fere)-, as it existed in its various forms in the year 
 18G7, and as coming under the observation of the Health 
 Physician. 
 
 There were treated from about the 1st of June, 18G7, to the 1st 
 of January 1868, (37G) three hundred and seventy-six cases of 
 Malarial fever : of this number the mortality was very small 
 not exceeding from 11 to 2 per cent. Most of the cases were 
 slight, principally of the 'Tertian Type, attacking whites and 
 blacks indiscriminately, and not confined to any particular 
 locality. Many of the cases can be referred to temporary 
 
sojourn in the country, or proverbially known malarial districts, 
 but the large majority originated in the District and from 
 poison emanating from its midst. It is impossible, in a paper 
 of the limited nature of this, to enter fully into the discussion 
 of the various merits and arguments, pro and eon of the 
 cause of malaria, its spread and effects. Limited as we are, we 
 can only look at facts and simply draw our deductions from 
 them. In the months of May and June, the city was visited by, 
 perhaps, the largest fall of rain that lias occurcd for many years. 
 The streets Avere saturated, and outside of the main system of 
 drainage, the rain accumulated in large quantities, and remained 
 in particularly low places for a long time, undrained and upon the 
 surface. Yards were filled, cellars overrun, and notwithstanding 
 every effort to effect complete drainage of the water it remain- 
 ed. The hot suns of the summer soon dried the surface, while 
 beneath it was still wet. damp and with no means or vent for 
 the accumulated water which necessarily percolates through, to 
 the surface ; giving rise to that noxious confined effluvia 
 which wc all feel is sickening, and detrimental to health. It 
 would, perhaps, be outside of my jurisdiction to speak of the ex- 
 tended influence of the over-grown and sunken lots in the Burnt 
 District of the city, where decayed vegetation and stagnant 
 water, added their quota to originate, propagate and increase 
 Malarial poisoning. All of these causes must operate to produce 
 Malaria. It has been truly said that fever lives on the banks of 
 rivers, the borders of marshes, the edges of stagnant pools, it 
 no less makes itself at home in the neighborhood of such pools and 
 badly constructed drains, and takes delight in the incense of 
 gull) r holes. 
 
 I am firmly convinced that it is to the operation of the 
 causes above alluded to, that wc may trace the existence of ma- 
 larial fever in our midst during the past season. Other consid- 
 erations may have served to influence, modify, or increase the 
 endemic, such as the character of the habitations, customs and 
 mode of living, of the poorer classes, exposure, etc., but as the 
 guardians of the public health we must not loose sight of the 
 main causes, and the remedies to prevent them. Estimating 
 from observation of the past two years, that Malarial fever is 
 and will be in future, one of the principal diseases which 
 our community, especially the section of the Neck, will be liable 
 
78 
 
 to, such steps should be taken as to endeavor to attain eventu- 
 ally complete immunity; and temporarily, partial mitigation, 
 of the evil. Drainage, complete and thorough, based upon well 
 known, scientific laws and knowledge of loeal peculiarities, the 
 enforcement of ordinances, looking to the management of Pri- 
 vate Hygiene, a system of complete inspections to see them 
 executed ; and above all. as it is known that fever of a periodical 
 nature will be prevented from showing itself by its favorite 
 haunts being covered with a good pavement, so as to separate 
 at once and permanently from the sun and air, the bed of moist 
 putrefied materials, which ferment and give rise to the contin- 
 ual evolution of noxious gasses, a system of shelling or pave- 
 ing the streets, should be commenced and pushed through with 
 all diligence and dispatch, consistent with economy and pru- 
 dencc. But even after this, unless there be enforcement of a 
 regular system of scouring, their surface will soon be covered 
 with semi-fluid mud, offal and vegetable refuse, which will 
 represent faithfully a marsh on the edge of ponds, or the con- 
 tents of cess pools and gullies. 
 
 The suggestions above arc offered with all due deference, as 
 apparent and needed, after careful observation and conviction, 
 that in a city liable (and situated as ours is) to these peri- 
 odical invasions, active and energetic steps should be taken to 
 correct the evil. 
 
 J. SOMERS BUI ST, M. D. 
 
 City Physician, 
 in Charge Jfth Health District. 
 
Annual JJcpovt of health gistrid 5. 
 
 Charleston, S. C. April 20(1), 1868. 
 George S. Pelzer, M.D.. City Registrar, &c: 
 
 Sir: — I have the honor to acknowledge the receipt of your 
 communication of the 13th April, requesting a Report upon the 
 sanitary condition of that portion of the City, over which, for 
 the last year, I have acted as Health Officer, and for such sug- 
 gestions for its improvement as I may deem fit to make. 
 
 Restricting myself as much as possible, avoiding all discussions 
 upon sanitary principles, and assuming the correctness of those 
 usually recognized, such as relate to Drainage. Sewerage, Water, 
 &e., I will attempt to be as practical as possible, confining 
 myself within the most narrow limits. I fear that the principles 
 governing the health of cities has been very much neglected by 
 us ; not because we have been unacquainted with them, or that 
 we have been indifferent, but simply because we occupy one of 
 the most salubrious cities upon the American Continent, for 
 with us but four months during the year is the climate injurious 
 to the Caucasian. Our apparent indifference has also arisen 
 from another cause. Our attention has been concentrated upon 
 the eradication of our great scourge, the Yellow Fever, and in 
 attempting the solution of problems connected with its origin 
 and propagation, much research and expense has been in- 
 curred. Fortunately for us, the attempt at the prevention of 
 this our terrible enemy, if not efficacious in the direction aimed 
 at, has been at least beneficial in the removal of the causes of 
 some other diseases. Most of the sanitary measures have thus 
 been carried out in the lower portions of the city, at those points 
 which observation has taught that such epidemics take their 
 origin, whilst no action of this kind has been attempted in 
 the upper Wards. 
 
 Time and space will not allow an analysis of the geological 
 formation upon which the city is built, or its meteorological 
 condition ; these both bear upon its diseases. J can only speak 
 
80 
 
 in a cursory manner of the surface condition of that portion 
 over which tin's District extends. 
 
 District ~No. 5 is embraced in that portion of the city which 
 is Bituated north of John street, and its continuation Chapel, 
 west of Town Creek, a branch of Cooper river, south of the 
 City boundary, near the junction of the Meeting street and 
 King street roads, and east of King street ; a space of about 
 one mile and a half in length, and half a mile in width, exclu- 
 ding the mud flats which lie to the east. Prior to the city ex- 
 tending its boundary to its present limits, portions of these flats 
 ran inwards, but as necessity required, from time to time, in 
 detached spots, some of these low places were filled up and built 
 upon. This continues still, as at the termination of Aiken, 
 Judith, and America streets, and along the eastern border of 
 the District, the filling being only sufficient to be above the tide. 
 The material was usually rubbish and the scavenger's offal. 
 The decomposition of such material requires several years, and 
 must more or less effect health by the continual escape of gases. 
 Nearly one-half of the District has been built upon ; the re- 
 mainder, although laid out in streets, continues to be used as 
 farms. Its surface is composed of a stratum of yellow sandy loam, 
 whose depth is but three or four feet; below which lies a thicker 
 bed of fine white sand, which occasionally crops out at the sur- 
 face. This bed is so saturated with water as to make it resem- 
 ble quicksand, by which term it has been described. Below 
 this again lies a dense stratum of shells, (post pleiocene,) imper- 
 vious, and keeping the water of the beds above from sinking, 
 so that the sand beds are constantly giving up, by capillary 
 action and an evaporation, a large amount of moisture. 
 The elevation of the surface is but by a few feet above 
 high water. At two or three points, small sandy ridges run 
 in a transverse direction, from east to west, the highest ele- 
 vation of which does not exceed eighteen feet ; about six feet 
 would be the average height ; its greater portion is but a few 
 inches ; particularly is this the case along America, Bay, Aiken, 
 John and Judith streets. Between these extremes the surface 
 is very irregular, few lots possessing the same height, and man}' 
 of them changing from year to year, as the materials by which 
 they had been originally filled undergo decomposition, or time 
 and the fall of rain renders the soil more compact. These lots 
 
SI 
 
 require constant work, and either become bottoms, or must be 
 tilled frequently to shed the ruin which lulls upon them. 
 This constant variation of surface interferes materially with 
 t lie surface drainage, as that adapted for one year is not avail- 
 able in the next, the fall of rain being turned in one direction or 
 another, as neighboring lots sink or arc raised. Thus stagnant 
 water collects, and health suffers. A fixed level should be 
 authorized for the sidewalk of each street, and the surface of 
 all lots required to be kept up to this grade, so that the water 
 should be thrown upon the streets, to be drained from there. 
 
 The District, consisting almost of suburbs, has been very 
 much neglected. Its drainage, the most important of all sani- 
 tary measures, is very defective. It may be said to have no 
 subsoil drainage at all. Its surface is always damp, and the 
 edges of the streets near the wooden curbing has almost always 
 water lying upon it. 
 
 Within the last year much has been done in the way of sur- 
 face drainage, for the removal of stagnant water ; long wooden 
 drains have been sunk through Aiken, Columbus, Hanover, John 
 and Judith streets. Xo sj^stematic level has been adopted ; 
 they seem intended but for local purposes. It is more than 
 probable that the benefit of these drains, even as imperfect as 
 they are, will be felt this coming summer. Above Line street, 
 which may be taken as the dividing line between the farms and 
 the city proper, very little even of surface drainage has been 
 accomplished. A few ditches have been sunk along the sides of 
 the most important roads, more for the purpose of keeping them 
 in repair than for any other object, and a few to enable the 
 farms to be cultivated. This deficiency is evinced by the 
 fact that during the winter months these farms are very healthy, 
 and arc the resort of many families for health and recreation ; 
 but as soon as the hot season comes on, the most severe types 
 of Malarial Fever attack those who are exposed upon them. 
 The white laborer suffers each season ; and the negro, whose 
 constitution is not as susceptible to the influence of this poison, 
 does not escape with impunity. In but one small part of the 
 District has any attempt been made for thorough drainage. In 
 the year 1857, the city authorities, impressed with this neces- 
 sity, inaugurated a plan for drainage and sewerage: at that 
 time some drains were sunk', and others were to be constructed 
 11 
 
as soon as convenient ; so that ultimately the entire city was to 
 be intersected by a network of underground canals, having 
 streams of water running below the streets. These drains were 
 to be kept clean by flushing. Those constructed in District l$o. 
 5 run below Meeting street, from about Columbus, southward, 
 and from Meeting, through Spring street, westward, connecting 
 at Meeting. At intervals they were provided with sinks or 
 sand pits, depressions below their bottoms. Above these sinks, 
 for the purpose of removing the materials which would collect, 
 were manholes, communicating with the surface, and covered 
 by large iron trap doors; culverts near the curbing of the side- 
 walks give passage to the sewerage and the rain. For subsoil 
 drainage this system has not answered as well as desired, or as 
 it first promised. The amount of water required to be with- 
 drawn had been under-estimated. An immense amount is 
 retained in the bed of quicksand, extending as the bed does 
 far into the interior of the State. The source of water by 
 which this bed is supplied, is from the rainfall of many miles. 
 Xot being able to sink through the shell bed below, the water 
 cannot be carried downwards, and is retained. The attempt to 
 remove all the water from one small portion of such a receptacle 
 must be futile, as it will again be supplied from other portions 
 of the bed. Temporarily the drains exhausted the water from 
 their neighborhood, as was observed in the wells, but as soon 
 as percolation became entirely re-established it was renewed. To 
 illustrate the immense quantity of water which is retained under 
 the city, it is only necessary to refer to the tubel wells, which 
 have recently been introduced in different streets ; by them it 
 is shown, that by driving a pipe down and pumping out the 
 sand, any amount of water could be obtained from this bed. 
 To ensure thorough subsoil drainage, it will be necessary to 
 dissever the city portion of this bed from that of the country. 
 For sewerage, these drains answer somewhat better. A defect 
 seems to be in the sand pits ; for even should the bottoms of the 
 drains be kept clean, all vegetable and animal offal whose specific 
 gravity exceeds that of water, must be caught in them, there to 
 undergo putrefaction, discharging their gases at first into the 
 drains, and through them into the culverts at the edges of the side- 
 walks. Disinfectants may destroy the smell, but can only render 
 these agents more injurious from their remaining undetected. 
 
83 
 
 These sinks are more pernicious, inasmuch as they are only 
 cleansed during the cool months; during the summer, at which 
 time putrefaction is more active, the drains are kept closed. The 
 large amount of sewerage removed from the manholes proves 
 the inadequacy of the flushing to keep the drains cleansed. 
 ^N"o cellars should be constructed, and all that have formerly heen 
 built should be filled up with fresh soil from the country. The 
 importance of paving t he streets and yards should not be over- 
 looked. This sanitary measure has not escaped the attention of 
 this and other cities. Its advantages have been exhibited upon 
 the health of certain streets of London, and elsewhere. The ben- 
 efit of having some material of a non-porous nature interposed be- 
 tween the heat of the summer sun and the moisture of the soil, 
 in the prevention of disease, has proved very decided. Meeting 
 is the only street in the District which has been partially 
 paved. 
 
 The streets have been kept as well cleansed by the scavenger 
 as it has been possible. At best this is but an imperfect 
 means of cleanliness, especially where the refuse of yards, sta- 
 bles and kitchens are deposited upon the surface of a sandy 
 street. Some portion of the offal will escape the spade of the 
 scavenger, and other portions of the semi-fluid mass Will be ab- 
 sorbed and incorporate itself with the soil. 
 
 The character of the water consumed by the poorer classes is 
 a matter of grave importance to the community. If san- 
 itary science has established any one fact, it is, that there 
 is no agent so pernicious to health as impure water. If it is 
 true, that those localities in which the water is impure 
 have always suffered most severely from epidemics of zymotic- 
 disorders, particularly from Cholera, Charleston has very 
 much to dread. The water used, both for drinking and do- 
 mestic purposes, in this District, is as impure as it can be. It 
 is derived from the numerous shallow wells sunk in the yards. 
 The appearance of this water is clear and pclucid, but the taste, 
 and the slightest chemical analysis, proves it to contain a large 
 amount of foreign ingredients, both organic and inorganic. The 
 wcils do not average twelve feet in depth, frequently only four 
 or five. Salts from the harbor pass through the loose porous 
 soil to them. Their supply Vicing from the surface, the rains 
 bear along with it the washings from the yards and the fluids 
 
&4 
 
 which arc thrown out. Yet. as had as this is. the greater im- 
 purity is from the proximity of the privies, a few feet of soil 
 being only interposed between these two kinds of excavations, 
 sufficient to remove, by its filtering action, only the most noxious 
 portions. Such wells should be filled up as soon as a good sup- 
 ply of water can be obtained. The Ashley, the Pee Dee, and the 
 San tee. have each at different times been recommended for this 
 purpose. But it should he borne in mind, that although the sources 
 of these rivers are in high, healthy, sandy localities, yet the}' flow 
 through malarial flats before reaching points at which it is desi- 
 rable to tap them ; these waters are all, more or less, tinged 
 with soluble vegetable matter, and probably certain malarial 
 poisons. Particularly is this likely to be the case, if malaria has 
 a cryptogamic origin, as Dr. Salsbury asserts, and Dr. ITannor. 
 Professor of Botany in Brussels, seems to confirm. These plants 
 arc readily wafted along by water, depending upon moisture for 
 their production and support. The rainfall of the city is more 
 than enough to supply the wants of the inhabitants, if each 
 residence was provided with a cistern, as avcII as the public 
 buildings; the very best water could be obtained at a minimum 
 expense. Eacb privy sunk should be walled in, and the walls 
 and bottoms encased with hydraulic cement, so as to prevent per- 
 colation. They should be required to be cleansed once a year, at 
 least until a system of tubel drains could be constructed, con- 
 necting them with the harbor; night soil is remarkable for its 
 solubility, and the presence of the water twice a day would keep 
 them pure. 
 
 There are several burial grounds now in use in this District : 
 interments should be stopped in them. The recent Report to 
 the City Council upon this subject exhibits the danger of allow- 
 ing them to be used. Junk shops should be banished to the 
 city boundary; the large quantities of rags collected in them 
 must contain the fomites of disease, and the piles of bones must 
 be injurious. Butcher pens, candle and soap factories, and the 
 like, should only be permitted on the outskirts, and over 
 streams. 
 
 The dwellings of the poor, as in the suburbs of most Ameri- 
 can cities, consist mostly of wooden buildings, loosely and 
 imperfectly built. The manner of their construction, and 
 the wanl of repair in which they are kept, ensures their 
 
85 
 
 ventilation. It is very rare that crowding is observed. 
 There is a disposition to dose up the chambers of the very sick 
 among the uninformed, but there is no difficulty in persuading 
 the friends of such persons to permit a freer supply of air to 
 them. The occupations of the poor is generally that of out-door 
 work, and such as not to interfere with health. The neglect of 
 the sick among the uneducated is too glaring to be overlooked* 
 Medical aid is frequently not requested until too late. 
 
 Some means should he employed to provide a better class, of mid- 
 wives, and to restrain someof'thepresent ones from acting. Every 
 old colored woman thinks herself sufficiently educated to act in 
 this capacity, and physicians are called upon to relieve accidents 
 which should never have occurred, to say nothing of the risk of 
 infantile life, and that of the mothers which such want of 
 knowledge entails. 
 
 It is also desirable that the office of Coroner should he filled 
 from the medical profession* The advantages have been ac- 
 knowledged where this plan lias been adopted, tending to pre- 
 vent crime, &c, &c; indeed the benefits to the community are 
 so numerous and obvious that it is not necessary to dwell upon 
 them. 
 
 It w^ould also benefit the health of the city if the grass, weeds. 
 &c, which grow along our sidewalks be allowed to remain until 
 the cold weather takes place; the practice hitherto has been to 
 cut them up during our hottest months ; and although the ap- 
 pearance of the streets are improved thereby, the effects of the 
 exposure of a new surface, and the decomposition of the weeds, 
 must be injurious. A much larger number of trees should be 
 planted, as tending by their shade to modify the severe heat of 
 the summer, and purify the atmosphere by the chemical change 
 which growing vegetations produces. 
 
 The only epidemic which prevailed last year, took place du- 
 ring the summer and autumnal months. It was of malarious 
 character, presenting all the varieties of this disease — two or 
 three cases of so severe a type as to resemble yellow fever. 
 The immediate origin of this epidemic I am at a loss to locate ; 
 whether it arose from causes within the District, or from the 
 neighboring farms. I am unable to say. Diseases of this class 
 have prevailed in this neighborhood every summer. 
 
80 
 
 Id concluding this hastily written Report, J would direct at- 
 tention to the fact, an instance of which was exhibited last year 
 in this epidemic, that the mortuary returns are no criterion of 
 the health of a city ; a period may be very unhealthy, and ye< 
 these tables present no record of the same. The number of 
 deaths arc but an index of the nature and severity of disease, 
 and to adopt the words of Mr. Rumsey, as quoted in the Amer- 
 ican Journal of Medical Science, July, 18G1, "a diminution in 
 the rate of mortality will be found to co-exist generally with an 
 augmentation of the rate of sickness.*' "The total sick time 
 measures the amount of disease. Medical records display its 
 nature and cause. The number of deaths, according to sex and 
 age, determine its intensity.*' Now, as a necessary result of 
 improvement in domestic management and medical treatment, 
 and owing to the removal of those more virulent agents of 
 destruction, which, by sharp and decisive strokes, prematurely 
 sever the thread of life, its duration has been lengthened in our 
 great cities. But, at the same time, the sickly and infirm pe- 
 riods of existence has been prolonged, probably, in a greater 
 degree than even life itself. Chronic diseases, or at least func - 
 tional disorders, have increased. Vital force is lowered, man's 
 work is arrested, his duties are unperformed, his purposes fail, 
 though he still lives. Weakly, diseased children, are now more 
 mercifully helped, as they never were in olden time, to grow np 
 into weakly, ailing adults, who in their turn propagate with 
 abnormal fecundity and unsound progeny.*' 
 
 Tt is from epidemics such as that through which we have just 
 passed that this personal diminution of vitality is engendered. 
 Few agents so productive of impairment of constitution as 
 that of malaria, are recognized — exhibiting its depressing influ- 
 ence even for years after its first effects have passed away ; and 
 no agent is so easily removed by sanitary precautions. 
 
 (Signed) J. FORD PRIOLEAU, M.I). 
 
City Hospital for Refugees and Seamen, Hampstead, ) 
 
 Charleston. January^ 1868. * ) 
 
 Dr, GrEO. S. PeLZER, Chief Of Health Department: 
 
 Sir: — In forwarding to you the annua) statement of the 
 diseases treated in this Hospital. I append a classified list of the 
 same, including those of Seamen.* Of the last mentioned, 
 eighty-one have been received and treated. It will be observed 
 that there has been but one death in this number, which was 
 from yellow fever. This case was admitted in December, and 
 occurred in a seaman just arrived from Cuba. He survived only 
 twenty hours after admission. The character presented by this 
 ease, the existence of black-vomit, and the autopsy, left no 
 doubt as to the nature of the disease; and there is every reason 
 to believe that it was the only case which occurred in Charleston 
 during the past season. 
 
 There was an unusual prevalence of malarial diseases, many 
 of them of severe grade. The numbers were, one hundred and 
 eighteen cases of intermittents, twenty-four of remittent, and 
 nine of the congestive form ; total, 151. Of these there were 
 three deaths, which were confined to the congestive cases. Two 
 of the three survived but a few hours after entering the Hos- 
 pital. 
 
 An accurate and full record, in detail, in a case book, is 
 kept of all the cases treated in the Institution. 
 
 It will be observed that I have only reported the work per- 
 formed by me since the Hospital was removed to the Tucker 
 House in June last. The cases treated by me during the pre- 
 vious six months, whilst in charge of the Mazyck street Hospi- 
 tal, will be embraced in the report of Dr. S. Chatburn Brown, 
 in charge of that Institution, now reserved for the reception of 
 Freed men. 
 
 The Hampstead Hospital is well located, in a healthy neigh- 
 borhood, and the hygienic influences are highly favorable. The 
 
 * The Diseases embraced in the Tabular list referred to are included in 
 the Health Department Report, without the Seamen's, which have n<>t been 
 published. 
 
88 
 
 Wards appropriated, both to mules and females, are airy, well 
 ventilated, neatly kept, and afford as great a degree of comfort 
 as could be desired. 
 
 [ beg to state that my Apothecary, Dr. T. Grange Simons, 
 who also performed the duties of House Physician, has given 
 his earnest and zealous attention to the work entrusted to him, 
 and lias efficiently seconded me in the effort made for the relief 
 and comfort of the inmates. 
 
 I cannot conclude my Report without also commending the 
 assiduous and diligent manner in which my Steward, Mr. Tor- 
 la)', and his assistants, have performed their various duties. 
 Very respectfully, 
 
 F. PBYEE POECHEE, M.D., 
 Surg con in Charge. 
 
City Hospital. Mazyck Street, ) 
 Charleston, January 1, 18GS. j 
 
 Dr. George S. Pelzer, City Registrar, &c., of H. I). 
 
 Sir: — Until last May. the City Hospital, Mazyck street, re- 
 mained as at date of my last Report, January 1st, 18G7 — the 
 Refugees under the care of Dr. F. Peyre Porcher, the Freedmen 
 and Insane under my charge, in separate and distinct apart- 
 ments. 
 
 A necessity having arisen for increased accommodations, from 
 the crowded state of the Wards, and tjie great number of appli- 
 cations for Hospital relief, a suitable building was leased, and 
 the Refugees moved, thus leaving the apartments formerly oc- 
 cupied by them, having first undergone extensive alterations 
 and improvements under your immediate direction, for the 
 Freedmen. 
 
 As will be seen by reference to the accompanying Report, 
 there have been six hundred and eighty (G80) Freedmen, and 
 one hundred and eighty (180) Refugees admitted and treated 
 during the past twelve (12) months, involving almost eveiy 
 variety of case. Medical, Surgical, and Obstetrical ; the mortality 
 among the Freedmen being one in five and two-thirds, (5f,) 
 whilst among the Refugees but one in fifteen (15.) This com- 
 pares favorably with that of the previous year. 
 
 It should be borne in mind that many cases reported as hav- 
 ing died in the Hospital were in a moribund condition, when 
 admitted ; some were not even taken to the Wards. The pa- 
 tients usually received, are those who have been most neglected, 
 deprived not only of food, but of shelter; and where shelter may 
 have been afforded, it was in ill ventilated and crowded apart- 
 ments. 
 
 The very large proportion and increase in the number of 
 cases of Struma and Tubercle among the Freedmen, is a matter, 
 I think, worthy of remark, confirmatory of the experience of 
 Dr. McGuire, Professor of Surgery of Virginia Medical College, 
 and Physician in charge of Freednien's Hospital at Richmond. 
 
90 
 
 Scrofulous Ulcers, Scrofulous Abscess, Tuberculosis of Joints, 
 Tuberculous Deposits in the Lungs, or other Organs, Scrofulous 
 swelling of the Glands, &c, are so general, that more than 
 ninety-five hundredths (95-100) of the patients admitted to this 
 Hospital are more or less thus affected, and every autopsy that 
 has been performed has confirmed most strikingly this truth. 
 
 Quite a large number have been admitted to the Insane De- 
 partment from time to time, beingtransferred to the Asylum at 
 Columbia as the necessities of the case required. Though the 
 stay of such cases at this Hospital is usually very short, it is 
 greatly to be regretted that the conveniences for treatment, and 
 the arrangements of this special apartment, are from necessity 
 so imperfect. 
 
 The number of patients daily under my care has averaged 
 over one hundred and thirty (130.) 
 
 It affords me much pleasure to bear testimony to the prompt 
 and faithful manner in which the officers and attendants at this 
 Hospital have discharged their duties. To Dr. C. W. Horsey 
 and Mr. Andrew Yates, Apothecary and House Physician, as 
 well as Mr. Arthur Fairley, Steward, I am particularly indebted 
 for valuable assistance, which they have at all times so cheer- 
 fully rendered. 
 
 Very respectfully, 
 
 S. CHATBUEX BPvOWN. M.D., 
 
 City Physician in Charge. 
 
Date Due 
 
 — Anu ' -v^ft t 1 
 
 Z OO j ( 
 
 
 
 
 577: — — - — rrn 
 
 JUL 2 5 W 
 
 
 
 
 mti 1 5 '4& 
 
 
 
 
 
 
 
 
 CM 
 
 
 
 
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 T^- 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Form 335 — 35M — 9-34— C, P.. Co. 
 
36 
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 97 5.7 Z99C 1860-79 v. 3 no. 43-60 
 
 32)5521 
 
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