On the Causes of the Epidemic

By David M. Reese

In entering upon a field so vast in extent, so unlimited in the considerations which it embraces, and so important to the interests of our city, I am not a little disconcerted at the undertaking. Unaccustomed to the cultivation of hypothetical speculation, I feel as though entering upon strange ground. Opposed to that blind pursuit of theory, which some profess to observe, I have always avoided laboured hypotheses as dangerous in medicine. If, however, the sentiments of a celebrated writer be correct, that “to think is to theorize,” then am I a theorist.

But not yet having strayed from the secure walks of private life; being without the commendation of great names, or the patronage of the learned; unknown, except in a very limited circle; and but entering on the threshold of science; it is a task of no small magnitude, for me to attempt to account for the causes of a disease, about which the “literati” have so materially differed. Certain it is, however, that there are physical causes for every physical effect, and although these causes may remain for a time concealed, yet they only require industry and research to effect their discovery. I have, therefore, thrown together some reflections on this important subject, and shall give my opinions with all that diffidence which becomes me; but I will not resign those opinions to any authority but a conviction of their fallacy. If I shall not cause another ray of light to penetrate the cloud, in which this subject is involved, yet I trust I shall not act the part of an ignis fatuus, by misleading the votaries of science from the true path. If, however, I shall do no more than point out the road to the temple of Truth, I shall consider my part performed, at least my fondest expectations will then be realized.

The city of Baltimore affords one of the most secure harbours of any of the cities of the United States; but that harbour is of artificial construction. It is familiarly denominated a basin, upon the border of which the city is built. Ships of the largest size come as far as Fell’s Point, while for vessels of two hundred tons, it is navigable to its extremity. From this basin, the water passes up into docks, which are intended for the convenience of the bay craft, and other small vessels.

These docks are of various dimensions, perhaps from two hundred to five hundred yards in length. Of this character is that upon which the disease first appeared, or rather to which it was first attributed, viz: Smith’s Dock. The water in these docks, seldom or never changes, except by a strong south-easterly wind, to blow up the mass of water, and a strong north-westerly wind to force it back again, occurring the one soon after the other.

A piece of wood or other light body, has been observed to float on the water in these docks for weeks together, without any perceptible change in its position, until an occurrence like that above hinted at, produced a circulation in the water. And, indeed, seeing that they are situated so far from the Patapsco river, nearly two miles, which is the principal source from which they derive their contents, it is not at all extraordinary, that the ebbing and flowing of the tides should only in a very trivial degree affect these docks. And it is important to state, that these docks are resorted to by vessels of small size, many of which contain fruit, grain, and other vegetable substances, the refuse of which is frequently thrown overboard, in defiance of the laws, which adds to the stock of like substances, necessarily accumulating from unavoidable sources. These docks, therefore, generate and evolve the miasma already spoken of, in large quantities every summer.

But although the cause exists, other collateral circumstances not concurring, the effect has not been extensively produced; yet this argues not at all the absence of the cause, even although no effects were evident. This, however, is not the fact; for, as has already been stated, this same disease, which this season has become epidemic, has appeared sporadically every season for some years; and what is very remarkable, one or more cases has been traced to this self same spot, Smith’s Dock, each season for several years past. The condition of the docks then may be considered the cause of the disease, as originating west of the Falls.

Some peculiarities in the structure of Smith’s wharf, as differing from other wharves, have been supposed to have contributed to the production of the malady, by a very worthy and enlightened professor of our city, but not yet having been published, they are private property; and I shall not trespass upon the rules of etiquette by canvassing his opinions. And, indeed, as they are not yet before the world, they do not admit of criticism. If he shall hereafter present them to the public from his own pen, they will be clothed in language and manner, before which my attempts to delineate them would sink into insignificance. I will, therefore, be excused from thus committing myself, since I am informed that it is his intention to publish his opinions himself. It is my duty to give my own sentiments, and my reasons for those sentiments, without having a reference to the doctrines of any man. I am decided in the belief, that the condition of the wharves, the construction of the docks, and the want of a proper circulation in the water contained in them, are the sole causes of the disease originating in the city, properly so called.

The next inquiry which naturally arises upon this subject is, to what causes are we to attribute the appearance and continuance of the fever on the Point? This is an important inquiry, and to give it a correct solution, will require attention commensurate with its importance. I have given the subject some scrutiny, and will state the result of my investigations, upon the merits of which the public are to decide. “I speak as unto wise men, judge ye what I say.”

It is ascertained by actual demonstration, that in filling up the wharves, and making the streets at the east end of Fell’s Point, vast quantities of wood have been made use of instead of earth. This may be considered to be one of the causes of the malady; for this wood is now undergoing putrefactive decomposition, as may be easily proven to any one, who will take the trouble to examine. He will find upon digging down two or even three feet into the earth, at the lower end of Wolf-street, (in the vicinity which first afforded evidences of the epidemic,) a mass of chips, shavings, &c. which from putrefaction have become perfectly black and fœtid; and from this mass may be distinctly seen bubbles filled with noxious gas continually evolving.

This experiment was performed in the presence of a number of professional gentlemen, and other respectable citizens, with the above mentioned result. This, however, in my opinion, would not have excited the disease of itself, although I believe it greatly aggravated it, and increased its malignancy. It is certain that it could not have been the only cause, since it raged at the Lazaretto, two miles from this accumulation of ligneous matter, as soon as it prevailed on the Point, and was equally malignant and fatal in proportion to the number diseased.

Fort McHenry, situate immediately opposite the Lazaretto, became so much affected, that it was deemed expedient to remove the troops stationed there, which was accordingly done. Hence it is evident, that the nuisance in Wolf and Pitt-streets, at Fell’s Point, already spoken of, could not have been the sole cause of our calamity. We are, therefore, to look for some other source for the poisonous agent; and to those who are acquainted with the relative situation of Pitt-street, Fell’s Point, to the Lazaretto, and the nuisances existing between them, it is by no means difficult to see the principal, if not the whole cause of our epidemic.

From Observations on the epidemic of 1819, as it prevailed in a part of the city of Baltimore by David M. Reese, M. D.
Baltimore: published by the author, 1819.

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