On the Causes of the Epidemic

Several large ponds of water, interspersed with the spontaneous growth of dock and other weeds, exist in a direct line between the Lazaretto and Pitt-street, Fell’s Point. These ponds are of large size, and contain vegetable matter sufficient, one would suppose, to poison the atmosphere at any season. The water contained in them, is green; and from these ponds arises a mist, forming a cloud of great extent, which may be seen at any time from May to November, early in the morning. The smell issuing from these ponds is fœtid beyond description, at any season of the year; but in the summer months it is almost insupportable. Now it is known to all who made observations on the weather, that for several days before and after the commencement of the disease on Fell’s Point that the wind blew from an easterly direction, which I conceive was the manner, by which the poison was conveyed to the Point.

The cause existing in a concentrated condition upon the surface of these ponds, was wafted by this easterly breeze to the place, where it first produced its visible effects, in Pitt-street, Fell’s Point. Here it met with an atmosphere nearly allied to its own nature, from the causes before mentioned. These uniting produced a concentration almost equal to that existing at the place, where the poison was generated in such quantities.

The peculiar manner of its action on the system, I shall not here examine; but will only state, that although it is what is called by the profession, the remote cause, and an exciting cause, is thought to be necessary to produce the disease; yet if continued it will produce the disease, without any other agent, by acting both as a remote and exciting cause. This explanation I deem important to state, to give the reader a more explicit view of the subject, and to enable him to understand these terms, whenever I shall have occasion to use them.

The disease for some time was local, and its circuit circumscribed within very narrow limits; but soon it began to creep, and presently, to use the language of one of the medical gentlemen, in his report, it commenced jumping, proceeding along the course of the wharves. This, to a superficial observer, would seem to indicate, that the causes existed on the wharves; but I attribute it to the continuance of the easterly wind, which lasted some days. The streets principally affected, were Pitt, Wolf, Ann, George, Fells, Thames, Philpot, Fleet, and Alisanna-streets, nearly in the order in which the are mentioned; and towards the conclusion of the disease, new cases occurred in Wilk, Bank, Bond, Carolina, and Gough-streets, which last street constituted the boundary line, beyond which it did not pass, as far as my information extends, so as to become prevalent.

Having Thus briefly enumerated what I conceive to be the causes of the disease, it is distinctly perceptible, that I am decidedly of the opinion, that it is of local origin.

It might now be expected, that I should point out some means of prevention of future repetitions of this calamity; but even if I were competent to this task, it does not comport with my design. I have stated as my belief, that the construction of our docks, and the condition of our basin, in relation to the Patapsco, from which it chiefly derives its contents, will always expose our city to disease, without active and energetic exertions on the part of the Board of Health. I have also pointed out nuisances in the eastern district of our city, which call for speedy removal. If it shall be found that my hints are at all worthy of consideration, proper measures will no doubt be taken to remove every cause of disease, before another season shall inflict a similar calamity. These hints are the result of much thinking and careful observation, they have cost the author some pains, and if they shall in any degree be useful, his design will be accomplished, and he will be fully remunerated for his time and trouble, in making the investigation.

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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