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It seems proper in this the first report on State Medicine from Nebraska, to give some slight description of location and climatology.

Nebraska, though one of the youngest States in the Union, bids fair to be one of the most flourishing, owing to the extreme salubrity of her climate, her geographical position, and medical topography. She took her start in 1864, at the commencement of that great enterprise the Union Pacific Railroad, which unites with its bands of iron the Atlantic and the Pacific, thus the whole world pouring into America the rich commerce of China, Japan, and the Indies.

By a glance at the map it can be seen that the State lies in that belt which, from the Atlantic to the Missouri, teems with the greatest number of inhabitants. Her soil is such that for three hundred miles to the west of the Missouri, it must soon be peopled as thickly as Indiana or Illinois. Lying between latitude 40° and 43° north, embracing a breadth of two hundred and eighty miles, and longitude 95° to 104° west, four hundred and twelve miles, with a rich loamy soil, Nebraska is destined to be one of the wealthiest agricultural States in the Union. Its lovely undulating prairies, with an elevation of from 900 to 6000 feet above the sea, susceptible of affording the richest crops even from the highest hills, scarcely an acre of marsh land in the whole State, an abundance of pure water supplied by perennial springs, with its invigorating climate, offer every inducement for rapid settle. ment.

There have been no epidemic diseases in the State as yet. The climate is perfectly exhilarating, and, as far as my observation, covering a period of over ten years, goes, excellent for incipient phthisis, the air being generally so dry that, notwithstanding the

sometimes rapid changes in temperature, the consumptive is not nearly so much affected as in a much warmer and more equable climate, where the air is more saturated with moisture.

I append hereto a list of some cases collected from hospital and private practice; from them a slight idea of the prevailing diseases may be obtained. I regret that they are not more full, but in the absence of any law, they are all I have been able to collect. You will observe, that, with the exception of a slight catarrhal fever or ordinary cold hardly deserving a place among the zymotic diseases, the percentage of such to the whole is very slight. Typhoid fever is scarcely ever seen, only seven cases occurring, out of three thousand of various diseases collected. The remittents are also of a very light grade, yielding to proper treatment in ninety-nine cases out of a hundred, or even more, as you will observe from the ratio of mortality, only one death occurring in one hundred and eleven cases. Diarrhoea and dysentery, also, are far less fatal than in more thickly settled communities, only four deaths occurring out of two hundred and eleven cases. Scarlet fever has generally been of short duration, but frequently malignant; occurring among the children of emigrants just coming to the State from the crowded .communities of the East, worn out and exposed to severe weather, the mortality has been considerable.

Diphtheria I have never seen in the State. Pneumonia and bronchitis prevail during the spring, and are sometimes quite severe.

The percentage of consumption requiring any treatment is very light compared to the whole number, only thirty-one cases occurring out of nearly three thousand of various diseases treated. It is unnecessary to occupy time by comment, as any one interested can refer to the tables hereto appended.

Like California we have our season of rain commencing in March and ending in June. The rain comes in heavy showers, rarely lasting more than a few hours, giving way to a bright and beautiful sky, thus continuing for two or three months at the time most needed by the husbandman. The heat of the summer is not excessive, and the constant prairie winds make the nights cool and delightful. Our autumn is perfectly exhilarating, being a long continued Indian summer, extending some years away into December.

The winters, though sometimes cold, are scarcely felt, owing to the dryness of the air. Of course it is impossible as yet to tell in


so sparsely settled a State what its eventual standard of health may be, for as yet it is almost in its virgin condition, only having a population of some three hundred thousand. What the effect of the rapid settlement now going on may be, the rapid turning up of thousands of acres of the rich soil to the sun may produce, remains for future statistics to show.

It does no harm to speculate, although many difficulties lie in the way of a definite solution of the question of climatology and epidemic diseases.

The rapid pouring in to our cities and counties of emigrants from the East, must bring more or less of smallpox, measles, and scarlatina, but so far these diseases have failed to spread, the extreme dryness of our climate serving to check them.

At the risk of being accused of repetition, I will again say that the influence of our climate on strumous diseases will ever be for good; the weather allowing of out-door exercise for eight or nine months in the year, certainly must have the effect to prevent the development of tubercle.

The almost entire exemption from all paludal matter is another high recommendation, for every one who has paid attention to the subject must know that this is a great cause of consumption.

The only objection to the climate is its occasionally severe days in winter, the thermometer sometimes for a few days ranging from ten to fifteen below zero. In my desire to have a complete report for the whole State, I addressed letters to all regular physicians whose names I could find, but am sorry to say only received replies from three, whose remarks are herewith submitted; they uniformly agree with me in regard to the facts set forth.

Dr. GEORGE TILDEN, of Omaha, writes as follows:

In a new State the subject of malarial diseases is one of vital importance. Prominent among the causes and conditions of this class of affections may be mentioned: a fertile soil; luxuriant vegetation, and poor drainage. Our soil is exceedingly rich, and our vegetation most abundant, but the other condition, poor drain. age, is not present; on the contrary, we have in this State a most perfect system of natural drainage. The natural slope of the coun. try towards the Missouri River, for a distance of four hundred miles, is about eight feet to the mile. The banks of the rivers and creeks are generally high and well defined, rarely overflow, and even when they do, no ill effects whatever follow, owing to the porosity of the soil (no hardpan near the surface to hold the water), and the rapid evaporation.

Again, the atmosphere is very pure and dry, preventing the pernicious miasmatic effects which usually result from decaying animal and vegetable matter.

No lakes, ponds, swamps, morasses, or stagnant water are to be found in the State. The above are only a few of the conditions which both explain and confirm the indisputably established fact that Nebraska has less malarial disease than any Western or Southern State. Cases of this class of disease are very rare, and when they do occur are mild in character, yielding very readily to simple treatment.

In regard to epidemics, I think it may be safely asserted that there has never been one in this State. Scarlet fever, measles, or smallpox have never appeared here epidemically.

You are anxious to have me state, as fully as possible under the circumstances, the influence of this climate on consumption. The vital statistics of the United States for 1870, set forth a fact of the highest importance to us, relative to this deadly enemy of mankind; one which is extremely gratifying and encouraging to the inhabitants of the State, and to those who may contemplate a residence here. These statistics, together with our own, show with mathematical certainty that Nebraska is the most favorable State in the Union for the prevention and control of this great scourge.' Here, in proportion to the population, consumption carries her smallest bills of mortality. But this authoritative statement will not surprise in the least those who have resided here for the last ten or fifteen years, and have given any attention whatever to this subject. They have stoutly contended that this is a most favored spot for those predisposed or suffering from this malady.

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In speaking of malarial diseases, I showed that we have no soil moisture, properly or medically so called, and the tables of Doctor Bowditch, of Boston, which are based on the observations and statements of physicians, show that the chief cause of consumption is soil moisture.

1 Inasmuch as in the statistics of the U.S. Census the subjects of age and sex of inhabitants are not considered in connection with the death-rate from consumption, or other diseases, and as these are controlling elements, no such comparison as is here presented can be properly made. By direction of the Section, these comparisons by States are, for this reason, omitted in publishing this paper. Stars are inserted to show where such omissions occur.


Secretary of the Section.

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Another fact well worthy of notice is, that we have very little skin disease; the cases are few and the type mild, the cure easy and speedy.




Too much importance can hardly be attached to our astonishing immunity from bronchitis and consumption. Our winds change with the seasons; the prevailing winds in winter are uniformly from the north and northwest; in the spring, east and northeast ; summer, south and southwest, and in the fall, southwest. At long intervals they attain considerable velocity, and in the winter they are sometimes violent from the north and northwest. The air is dry and pure, and contains on an average less than half the amount of moisture necessary for complete saturation. It is extremely rare for the humidity to reach one hundred per cent.

Our climate has many most excellent features that I should be pleased to notice in detail, but it is not necessary to occupy the space. I will, however, before closing, mention one of them, namely, the peculiar character of the nights of the summer months. It matters not how warm or oppressive the day may be, the nights are uniformly cool and delightful. Sleep, the great restorer of the mental and physical energies, is never disturbed by an oppressively warm atmosphere. Those who have lived here for fifteen

years declare this to be true. This may help explain why even in the summer months our people can toil so hard, endure so much, enjoy such remarkable health, and are so elastic in spirit. This is in strong contrast with the facts in most other States. I merely mention the fact; it deserves to be dilated upon at length. In fine, the atmosphere of Nebraska is very pure, clear, dry, elastic, and bracing, and promotes in a high degree, mental and physical activity and development. Take the seasons as they come and go, and average them, and no State can make such goodly promises as this for health, development, and longevity.



Dr. VAN BUREN, of Fremont, writes as follows:

Fremont, May 1, 1874. DEAR SIR: In answer to your inquiry for statistics or observations on medical topography, climatology, epidemic or other dis


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