REPORT

ON THE

MEDICAL TOPOGRAPHY AND THE EPIDEMIC

DISEASES OF KENTUCKY.

BY

W. L. SUTTON, M.D.,

GEORGETOWN, KY.

REPORT ON THE MEDICAL TOPOGRAPHY AND THE

EPIDEMIC DISEASES OF KENTUCKY.

IN preparing myself to discharge the duties imposed upon me by the Association, I have addressed circulars to the physicians of the State freely; besides writing many letters, and, when circumstances would admit, making personal applications. I am sorry to say that my efforts have been less successful than on any former occasion. I account for this thus: In our State, there are not a great many physicians who are willing to take the pains necessary to enable them to make a satisfactory report of their cases. And some of those who have preserved records, from procrastination, press of business, or other causes, have neglected to analyze their cases and report the result. As to those who, heretofore, have so kindly given me their aid, it is fair to presume (as indeed has been stated by some), that they had nothing to add to the observations already furnished, of sufficient interest to require additional communications. Indeed, I am not aware of any epidemic having prevailed extensively in our State. Besides, it would obviously be improper to encumber the Transactions with a repetition of reports made in vol. v., vi., and vii. The only paper which I have received is one on Milk-sickness or Sick Stomach, which I have introduced entire, and to which I have added some remarks, as to causes, &c., which my reading and oral information concerning that disease, seemed to warrant.

In addition to my inquiries of the profession, I addressed to each member of the General Assembly of Kentucky queries as to the topography of their respective counties. I received answers as to some forty-five counties, which are analyzed and reduced to tabular form, as a means of convenience and of saving space.

I have introduced some tables, prepared with some care and trouble, intended to elucidate the prevalence of some of our more

common epidemic diseases, in the different counties of the State; as also the proportional prevalence in regions of different geological formations-as also others intended to manifest the natural history of certain diseases as regards their connection with color, age, and sex, of patients and the time of prevalence.

The State of Kentucky is situated between 36° 30' and 39° N. latitude, and 82° and 89° 30′ W. longitude from Greenwich. It is 400 miles long, very much varying in width, but averaging upwards of 100 miles, with an area of about 40,000 square miles. With a little fancy, one might say that its form was not much unlike a huge stomach, of which the North Bend of the Ohio Riverin which the counties of Boone, Kenton and Campbell are situated, may represent the cardiac orifice; and the space west of the eastern line of Graves and McCracken counties, continued to the Ohio River, and including Graves and McCracken, Ballard, Hickman and Fulton counties, may represent the pyloric.

As might very well be expected, this large section of country is made of different geological formations. The lowest surface rock which appears in the State is the blue limestone, which is found to commence a little above Maysville (which was long known by the name of "Limestone," from this formation); taking a circuit south by Winchester to Stanford, and then curving northwest by Springfield, it afterwards runs north to Madison, Indiana. This limestome is covered by a soil exceedingly rich and productive, known as the blue-grass section of the State. This portion of the State is in a high degree of cultivation. This blue limestone is skirted by belts of cliff limestone, and of coral limestone of narrow dimensions; at the west extending to the foot of the Falls of the Ohio. Encircling these limestone formations is the black lingula shale, also of narrow dimensions. External to this border is a belt of subcarboniferous sandstone, also of narrow extent. To the east of this belt we have a border of conglomerate, or puddingstone, made up of coarse pebbles, of quartz, and smaller grains of sand, rounded and cemented together by silicious matter. This border, crossing the Ohio River and extending from Portsmouth, Ohio, to Greenupsburg, Kentucky (about twenty miles), runs in a S. W. direction to where the Cumberland River crosses the Tennessee line. East of this range of conglomerate is the eastern coal field, which extends through the adjacent regions of Virginia and Ohio to the vicinity of Lake Erie. It is said to be the largest coal field known.

Just here, it may be well to remark on the very singular running together of the different formations of limestones, lingula shale, and sandstone, which is observable in the vicinity of Stanford. It will be observed, too, that in this neighborhood, viz., at Mount Vernon, we find the subcarboniferous or cavernous limestone emerging between the sandstone and the conglomerate. All of these formations are thinned out, and converge along the line running west of south to the Turkey Neck of the Cumberland River and Tennessee line. Here, in the deep ravines, the blue limestone still appears, overlaid by other formations, so much thinned that the whole can be crossed in a few rods. West of this line, the cavernous limestone again appears, and underlies most of the State from this to the Mississippi River.

In the northern portion of what is called the Green River country, the southern coal field is situated, surrounded by its border of conglomerate.

The cavernous limestone, mentioned above, underlies that portion of Kentucky known as the Barrens. This country originally dif fered from prairie, in having many small bushes growing upon it, intermixed here and there with a few small oaks of a peculiar kind, known as black jacks; but nothing worthy of being called timber. Large bodies of land have an exceedingly rich soil; but other portions are of inferior quality. The surface is marked in many places by sink holes, being conical depressions of from twenty or more yards in diameter, to two or three acres, and ten to thirty feet deep. These are supposed to be occasioned by subterraneous cavities, which permit the surface to sink. In this formation the Mammoth Cave is situated. Of this cave it is said "the known avenues amount to 223, the united length of the whole being estimated, by those best acquainted with the cave, at 150 miles; say that the average height and width of these passages amount to seven yards, each way, which is perhaps near the truth, this would give upwards of 12,000,000 cubic yards of cavernous space, which have been excavated by calcareous waters and atmospheric vicissitudes." (Geological Survey, vol. i. p. 81.) Truly it is difficult to conceive how this can be so. Besides this, there are many others of limited extent. In this region it frequently happens that streams of some size sink and run under ground for several miles, and then reappear at the surface.

These sink holes, caves, and subterraneous streams, however, are not confined to the regions of cavernous limestone, as they exist