USA > New York > Monroe County > Rochester > Settlement in the West : sketches of Rochester with incidental notices of western New-York > Part 9
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" On the 7th of June, 1792," says Dr. Coventry, " I ar- rived with my family at my former residence near the outlet of Seneca Lake, opposite to the village of Geneva. The seasons of 1793 and 1794 were very sickly in the Gen- esee country in proportion to the population. There was a much greater number of cases of fever than in the cities, although they were not so fatal in their termination. I re- member a time when, in the village of Geneva, there was but a single individual who could leave her bed, and for sev- eral days she alone, like a ministering angel, went from house to house, bestowing on the sick the greatest of all boons-a drink of cold water. During the season last men-
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tioned, dysenteries occasionally appeared, preceding or fol- lowing, and sometimes alternating with the fever. In 1795 no rain fell either in June or July-the waters in the lakes lowered more than a foot-every little inlet became a seat of putrefaction-the heavens seemed on fire, the earth scorched, and the air saturated with pestilence-the hogs were found dead in the woods, the flies swelled and turned white, and lay in handfuls on the floors of our rooms. On the 18th of August I was called to visit Judge P. at Aurora, on the east side of the Cayuga, whose house, I believe, was the first one that had been built on the Military Tract : one apartment contained the corpse of his wife, who had expired a few hours before my arrival, with every symptom attend- ant on malignant or yellow fever ; in another apartment the judge and two children lay with very threatening symptoms. While attending here on the night of the 22d, I heard the pleasant sound of thunder, and soon after the more delight- ful noise of the rain pattering on the roof, with which our ears had not been regaled for the last two months. A change of at least twenty degrees of temperature followed, together with a copious fall of water. The patients labouring under fever seemed to be immediately benefited, and the new cases decreased. But dysentery soon made its appearance in the most appalling and fatal form-occasioned, without doubt, by this sudden change of temperature, causing a checked perspiration in persons fully prepared. On my re- turn I found that three persons had died of dysentery on the preceding day in the village of Geneva, and was informed that several others lay at the point of death. * * In the summer of 1796 I settled in Utica. In the autumn of that year dysentery was very prevalent, and, as I was informed, proved fatal in many instances on the north side of the river Mohawk. In the extent of four miles along a road at that time thinly inhabited, I was told that twenty-four deaths had taken place from dysentery. Although I had lived several years in Glasgow, accounted the second city in point of pop- ulation in the British dominions, yet neither there nor while attending the Edinburgh hospitals, where three or four hun- dred persons are annually admitted, had I, in public or pri- vate practice, an opportunity of seeing a single case of dys- entery, nor was I more fortunate as to this during a resi- dence of five or six years on the Hudson river, previous to my removal into the western part of the State of New-York."
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" Genesee is an Indian term signifying pleasant valley, given to the country near the river of the same name : its bounds are not very clearly defined, being sometimes ex- tended to all that part of the State of New-York lying west of Utica, but more generally restricted to that portion west of a meridian passing through the northwest corner of Seneca Lake. The country lying west of Utica is, in its general character and most prominent features, so much identified as to admit of being taken under one review, and therefore the whole will be considered under the following brief notice," says Dr. Ludlow, in his essay on the diseases of the Genesee country.
" The settlement of this section of the State of New- York," he continues, " began in 1791, and was principally completed in 1804 [but the settlement of Rochester was not commenced till 1812]. For the few first years, the settlers were scattered over such an extent of country, that an at- tempt to characterize the prevalent diseases would be fruit- less. I have therefore commenced at a period when they had developed themselves sufficiently to attract the notice of the medical practitioner. 'The summer of 1801 was warm, with frequent showers ; the days were excessively hot, but the nights very chilly. In September and October there was less rain ; the days were mild and pleasant, but the nights continued cool. The diseases of the spring and sum- mer months were principally intermittent fevers, which pre- vailed throughout the country ; they were of the tertian type, and frequently complicated with visceral obstructions, and attended with violent inflammatory action : none were ex- empt from them except those who had undergone many pre- vious attacks, without having taken any measures to inter- rupt their course. A strong prejudice existing against all remedies which check the paroxysms : the consequence of this was, that the disease laid the foundation of many in- curable chronic affections.
" Peruvian bark was then rarely used ; though, when properly employed, generally successful. It was given without any previous depletion, even in cases where visceral obstruction existed ; it is, therefore, not extraordinary that doubts of its efficacy should have arisen.
" In September and October, remittents of a mild form ap- peared, which continued through November, growing more severe as the season advanced. For the first two or three
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paroxysms, it was difficult to distinguish intermittents from remittents : the patient was attacked with languor, pain in the head and back, and alternate fits of heat and cold. These symptoms lasted four or five days, about which time a remis- sion commonly took place, often without the aid of medicine. Intermittents and remittents often occurred in the same fam- ily, and required similar treatment ; an obstinate case of the former being more dreaded than a mild case of the latter. Venesection, an emetic, and cathartic, followed by a few doses of bark, usually subdued the disease by the fifth or ninth day. Occasionally, though rarely, it was more violent, the patient being attacked with a severe cold fit, violent pain in the head and back, delirium, full hard pulse, increased heat, and difficult breathing. These cases, however, were seldom fatal, when depletion, according to the exigencies of the case, was premised. When left to nature, the symptoms became typhoid, and a recovery of the patient uncertain. There were also a few cases of dysentery, but not of a ma- lignant character. The smallpox occasionally appeared, but was seldom fatal. The vaccine virus had been intro- duced, but was considered more dangerous than the former. All fevers, except fever and ague, were called by the people Lake or Genesee fevers. After November, the country was remarkably healthy, and continued so during the winter.
" During the summer and fall of 1802, the diseases were similar to those of the preceding year : the winter was mild and healthy.
" 1803. As the country became more settled, new dis- eases appeared, and the preceding ones did not retain their former characteristics. Intermittents, from being simple, became complicated with other diseases, so as to render it difficult to determine their nosological character.
" In each succeeding year, it became apparent that inter- mittents were declining, and continued fevers becoming more prevalent. Diarrhea was the prevailing disease of the spring. During the summer, there were many cases of dysentery ; the symptoms were, however, mild, and none terminated fatally. In autumn, remittents and continued fevers were general, but yielded readily to the usual rem- edies.
" 1804. The summer of this year was but moderately warm; the winter was intensely cold for an unusual length of time. A greater quantity of snow fell, and laid longer
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than had ever been known. Fevers, during the summer of this year, were less frequent than the last. The new settle- ments, where intermittents and remittents had prevailed the preceding season, were remarkably healthy. In the old settlements, during the fall, there were many cases of re- mittent. The winter diseases were purely inflammatory, which is generally the case in this country. Cynanche ton- sillaris, pleuritis, and enteritis, were prevalent, making the season more than usually unhealthy.
" 1805. From the equable temperature of the last year, it was expected that the present warm season would be less sickly than those which succeeded open winters, but it was otherwise. The spring commenced with fevers of an in- flammatory nature, which continued until cold weather. The intermittents were complicated with enlargements of the liver and spleen ; in most instances, these were sequelæ of the fever ; but in others, these organs were primarily affected.
" About this time mercury came into fashion ; and in all forms of fever, whether intermittent, remittent, or typhus, without reference to the diathesis, the patients were indis- criminately salivated. In those cases where the liver was diseased, it proved serviceable ; but to its abuse numbers were sacrificed.
" 1806. There was much rain and warm weather during this summer. The diseases resembled those of the last year, except at Palmyra, where a fever of a typhoid charac- ter prevailed. It commenced in December ; the symptoms were, great prostration at the commencement of the disease, succeeded by coma, subsultus tendinum, and hiccough. Dissolution generally took place in three or four days, unless the system was supported by powerful tonics. It proved fatal to many. Whoopingcough was also epidemic through- out the country.
" 1807. The spring was ushered in by wet weather, which continued during the summer with alternations of great heat. The fevers of this year, during the summer months, were purely inflammatory. In September and Oc- tober, typhoid symptoms supervened early in the disease. The character of the fever varied, however, with its local- ities. Near streams, and where the current had been ob- structed by dams, its symptoms were strongly marked on the attack ; whereas in high grounds, its approach was insidi-
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ous, the patient feeling but slightly indisposed for some days previously ; after this the disease suddenly developed itself. These cases were more unmanageable than when the attack was sudden. In July and August a severe ophthalmia pre- vailed. In September influenza was epidemic throughout the country : few escaped an attack, as neither previous nor existing diseases were preventives. It was attended with acute pain in the head and eyes, and sometimes terminated in abscesses in the frontal sinuses. It proved fatal to many elderly people, and soon terminated the sufferings of those who were in the advanced stage of plithisis pulmonalis, of which it became the exciting cause where a predisposition existed. It also frequently terminated in typhus. The treatment generally pursued was depletion, antimonials, and mucilaginous drinks. Measles, whoopingcough, and chick- enpox were prevalent during the winter.
" 1808. 'This season much resembled the last. Fevers of a continued type prevailed during the summer, but gen- erally terminated favourably. In the month of January a typhoid fever appeared, which continued till May. It was confined to particular sections of the country, and as fre- quently originated in situations proverbially healthy as in those of a different character. In many instances it ter- minated fatally. Different plans of treatment were pursued, of which none proved uniformly successful. Those who hitherto considered mercury as infallible in all fevers were now compelled to acknowledge their error. Some adminis- tered bark early in the disease ; others wine, brandy, and opium. The most successful treatment was early, though careful depletion, followed by stimuli, judiciously adminis- tered. The sudden prostration of strength, the small fre- quent pulse, brown tongue, and cold extremities, all indicated a disease of a different character from the inflammatory fevers which formerly prevailed.
" 1809. The summer was unusually cool, and the fevers of this season were of a less inflammatory character than common, readily assuming the form of a mild typhus. In- termittents seldom appeared.
" 1810. The spring commenced early, and the weather was less variable than the last season. The summer was hot and dry, and during the winter there was much snow and cold weather. The diseases of this year were similar to those of the last, though less numerous.
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" 1811. Bilious fevers, with visceral obstructions, pre- vailed during this summer, which was extremely warm and dry. There were also many cases of diarrhea. The winter months were excessively cold, with alternations of pleasant days. Pneumonia, measles, and rheumatism were the pre- vailing affections.
" 1812. In March of this year there were frequent cases of pleuritis, with great diversity of symptoms. In some cases, copious bleeding was required, with a strict antiphlo- gistic regimen, while in others an opposite course of treat- ment was indicated. The weather had been variable, with southerly winds. In April and May were noticed for the first time a few sporadic cases of pneumonia typhoides, a disease until then unknown, and which, during the ensuing winter, became the most formidable epidemic which had ever appeared in this country. In the first cases, the local affection was principally confined to the throat, and these were more fatal than those which succeeded them, in which the lungs and brain were principally affected. The summer months were extremely warm and dry. Diarrhea, dysen- tery, and the usual fevers were prevalent, without anything remarkable in their symptoms. During the autumn, pneu- monia typhoides again prevailed in different parts of the country, particularly among the soldiers at Lewiston, on the Niagara frontier.
" 1813. In January and February the weather was very variable, being alternately cold and humid ; the epidemic pneumonia typhoides now became general, and caused great mortality. There were two forms of the disease : sthenic and asthenic ; the greater portion, however, were of the lat- ter kind. It differed from preceding epidemics by its local determination to different parts of the system, particularly the brain and lungs. Its varied symptoms in different sub- jects gave it a plurality of names, and occasioned a diver- sity of treatment. Some were attacked with violence, and died in a few hours, while others were but slightly indis- posed. The disease was ushered in with severe cold chills, continuing several hours ; pain in the head, back, loins, and side ; cough, with expectoration of a frothy mucus, tinged with blood. The respiration was difficult, the extremities cold, and the pulse exhibited every variety ; sometimes natural, again very slow or quick ; but, in most instances, the artery was weak and easily compressible. The morbid
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action was frequently translated from one part of the system to the other ; thus, in one case, the patient was seized with a violent pain in the head, which continued several hours ; on the subsidence of this, his legs became painful, and ex- tensive inflammation and suppuration supervened. In other instances, the diseased action suddenly left the lungs, and inflammation and suppuration of the upper extremities fol- lowed. Such a multiplicity of symptoms occasioned a great contrariety of treatment : some depleted, others stim- ulated. On its first appearance, large bleedings were em- ployed, but with temporary relief ; in most cases the patient sinking on the third or fourth day. In other sections of the country, this mode of treatment was more successful. Those who were opposed to the lancet trusted exclusively to opium, a practice equally fatal. The most successful treatment was restoring warmth during the cold stage by different stimuli, followed by moderate bleeding and evacu- ants ; the skin being kept free, and blisters and tonics early employed. The epidemic ceased on the return of warm weather. In the spring there were a few cases of pleurisy. The summer was unusually healthy.
" In the winter of 1814, the destructive disease of the pre- ceding year returned, though it was not so malignant as it had proved during the last season. Depleting remedies generally produced a favourable termination. In the spring it wholly disappeared. There were fewer fevers this sum- mer than usual. In the autumn, catarrhal complaints were very prevalent.
" 1815. The fevers of this year were generally inflam- matory, and easily subdued. In July, dysentery prevailed as an epidemic, but admitted of free depletion. In some cases it was accompanied by external inflammation and tumefaction of the face, neck, and joints ; in others the throat and fauces were affected ; in some few instances the inflam- mation of the face terminated in gangrene. The fatality was greatest among children.
" 1816. Every part of the country was this year unusu- ally free from fevers. Intermittents rarely occurred, except in new settlements, and continued fevers were very mild.
" 1817. There was nothing remarkable in the diseases of this year, except in September and October, when a fever with typhoid symptoms prevailed to a limited extent.
" 1818. In December, a fever similar to the last ap-
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peared. In most cases typhoid symptoms supervened early in the disease, requiring the free use of tonics, which treat- ment was generally successful.
" 1819, 20. Both of these years were generally free from fevers ; but rheumatism, pleurisy, measles, whooping- cough, and dysentery were constant visiters.
" 1821. Intermittents and remittents were more frequent this year, and were particularly malignant in different parts of the country. At Syracuse, a small village near Salina, many died suddenly. Whoopingcough, cynanche trachealis, cholera infantum, and measles also prevailed.
" 1822. In the winter and spring of this year, the usual inflammatory diseases prevailed. During the summer, dys- entery was epidemic, and many deaths occurred. Bowel complaints proved fatal to a number of children. Intermit- tents were more prevalent in old settlements than they had been for ten years previous ; also remittents, with unusual determination to the head. In some instances they were complicated with dysentery, the patient discharging large quantities of blood before death. At Salina and its vicinity, there were a few cases of a highly malignant character.
" Calculous diseases are almost unknown, which is in op- position to the prevailing opinion that they are peculiar to limestone countries. Goitre, or chronic inflammation of the thyroid gland, is a very common appearance-[now, 1837, the reverse]. I have hitherto purposely avoided mentioning phthisis pulmonalis among the diseases of the country, with a view of giving it a particular notice.
" Since the time of Hippocrates, it has been a received opinion that intermittents have great agency in the removal of other diseases. Boerhaave, in speaking of them, ob- serves, ' that unless they are malignant, they dispose a body to longevity, and purge it from inveterate disorders.' By the moderns this idea has been carried still further, and con- sumptions have been said to be almost unknown in those countries where intermittents prevail : the fens of Lincoln- shire and the inland parts of Holland have been cited as examples. To a certain extent, this is the case in the Gen- esee country-pulmonary affections, as idiopathic diseases, being rarely met with [even as recently as 1823,] although they are frequently the sequelæ of protracted intermittents. This has been accounted for on the supposition that the im-
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pure air of marshes is particularly favourable to the lungs of those who are predisposed to these complaints.
" In the management of consumption, the main object is to translate the disease from the lungs, and to sustain it per- manently in some other part without injury to the constitu- tion, until the primary affection is removed. We see this effected in various ways. The action of mercury, by pro- ducing salivation, frequently arrests the disease in its earliest stages ; the same effect is produced by the irritation of preg- nancy ; and, as soon as the woman ceases to bear children, it invariably returns. In what way are these changes effected in marshy countries ? Probably by the increased action of the liver, and particularly of the stomach and intestines. In this country, and I believe it to be the case in all marshy countries, there is a general bilious diathesis, and a continual current to the bowels. Intestinal diseases prevail more or less throughout the whole year, accompanied frequently with hemorrhagic discharges." Thus far, Dr. Ludlow in 1823.
The contrast between the past and the present may be shown most forcibly by quoting the language of President DWIGHT (respecting the condition of the country about thirty years ago) in juxtaposition with some facts concerning the present diseases and mortality of the country.
In the seventh letter detailing his observations on a jour- ney to Niagara in 1804, President Dwight says, with refer- ence to the Genesee country-
" The diseases which principally prevail here are the fever and ague, intermittents without ague, and bilious re- mittents. Fever and ague may be considered as nearly uni- versal, almost all the inhabitants being sooner or later seized by it within a few years after their emigration. This disease, from the violence of its affections, its long contin- uance, its return at the same season for several years, and the lasting impression which it often leaves on the constitu- tion, is regarded by the people of New-England with a kind of horror. The other two diseases, though common to most parts of the country, are yet much more predominant in par- ticular places. Along the Genesee they all abound. They are also frequent, as I was informed, on the southern shores of Lake Ontario, and in spots around the outlets of most of the smaller lakes, and in various others. A tract around the Onondaga salt-springs is still more sickly and fatal.
" The tract of country which I am now considering has
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thus far been unhealthy. How far this fact is owing to the present stage in the progress of its settlement, it is [now in 1804] impossible to determine. Most regions on this side of the Atlantic have been subjected to some peculiarities of disease during the progress of population, of which many have vanished when they had reached the state of complete settlement. While the country is entirely forested, it is ordinarily healthy. While it is passing from this state into that of general cultivation, it is usually less healthy. This arises partly from the hardships suffered by the planters, and partly from the situation of the lands. *
" From the pulmonary consumption, so frequent else- where, they are in a great measure exempted. Dr. W., of Canandaigua, a physician in extensive practice, informed me that, during the ten years of his residence there, only three persons within his knowledge had died of the consumption in that township and its neighbourhood. He also observed that most of the diseases found on the seacoast were un- known there, and that he believed the fever and ague to be not improbably the cause of this exemption. As I passed through Sheffield, in Massachusetts, I was informed, in a manner which could not be rationally questioned, that the consumption is also very rare in that town. Should there be no error in this account, it will deserve inquiry whether the infrequency of this disease in the Southern states is not owing more to the fever and ague than to the warmth of the climate ; or perhaps, in better words, whether the tendencies to disease in the human frame do not, in particular tracts, flow in this single channel ? Should the result of this in- quiry be an affirmative answer, Canandaigua may hereafter become a more convenient retreat for persons subject to pul- monic affections than the Southern states."
Such were some of the concurring remarks of President Dwight and Dr. Ludlow upon the medical topography of Western New-York at periods about twenty years apart. They were generally applicable even recently ; but now the scene is almost wholly changed throughout this region, The condition of Rochester-a city distant twenty-eight miles from Canandaigua, though not in existence when President Dwight travelled through the region-may be cited now as furnishing, in the present health of its citizens, the strongest contrast to the medical statistics of an earlier period in the settlement of the country.
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