Introduction

 

The following article, published in the Medical Repository, pertains to Saratoga County medical geography.

A Topographical Description of the County of  Saratoga, (N. Y.) with an account of the origin and treatment of some of its endemic diseases: communicated by Dr. John Stearns, of Waterford, to the Medical Society of the State of New-York; and presented to the editors by Dr. Romayne, President of said Society.

The county of Saratoga is bounded on the south by the Mohawk river, which divides it from the county of Albany ; on the east and north by the counties of Washington and Rensselaer, from which it is separated by the Hudson river ; on the west by the county of Montgomery. It is about forty five miles long, and thirty wide, containing 32,000 inhabitants. The land which extends along the Hudson is level, consisting chiefly of clay, excepting that part of it which lies in Stillwater, which is generally composed of slate. As it extends towards the interior, it is found to consist of sand, loam, and clay, alternating with each other, and is generally fertile. The north western part is mountainous, and some part of it unsusceptible of complete cultivation. Near the centre of the county are situated the celebrated Ballston and Saratoga medicinal waters. As the analysis of these waters is in the possession of the public, and as a minute detail of their various operations and virtues would exceed the limits prescribed tor this report, I shall therefore defer for the present, their further consideration. Within a few miles of these springs, to the eastward, are situated three large lakes, one of which is about nine miles long and three wide ; it is called Saratoga lake : the other two lie south and west. A considerable extent of marshy land lies contiguous to Ballston lake, from which it is overflown in high water. The Kaydeross creek, which is astream of considerable size, runs from west to east nearly through the middle of the county, and empties into the Hudson at Saratoga. On this creek are situated a number of mills, the dams of which so obstructed the water as to overflow the adjacent ground for a considerable distance. The luxuriant vegetation on each side of this creek, in the warm months, of course became subject to the process of putrefaction. From the deleterious gas which this gave out, were supposed to originate fevers of a peculiar malignity. It was not uncommon to see families, consisting of ten persons, lose three or four of their members in the course of one warm season. This alarming mortality excited the attention of all classes of people: they found that the origin of these fevers could be traced to the erection of the mill-dams, and that their deadly influence was every year increasing with an alarming rapidity, so that at some part of the season there were scarcely well persons sufficient to nurse the sick. The menaces of the people finally induced the owners to open their dams and draw off the water during the sickly months.[1] The consequence was a restoration of health to the inhabitants. The logs with which the creek was generally filled have since been removed, and the land on each side in a great measure cleared up. This source of fever therefore being diminished, the owners were again permitted to resume their business. Although intermitting and remitting fevers do still prevail; they are not marked with their former malignity. Living remote from the places where these fevers prevailed, I have had no opportunity to observe their characteristic symptoms, nor the mode of treatment that was pursued.

[1] I have been lately informed that the owners of the mills were indicted and consequently obliged to open their dams.

I shall now proceed to give a concise history of some fevers that have occurred under my particular observation.

The village of Waterford is situated at the confluence of the Hudson and Mohawk rivers, on a flat which terminates about 150 rods west of the Hudson, in a rise of ground that runs parallel with that river to the north. The soil near the river is a black loam which is changed for clay at the distance of about forty rods, and about 200 rods further west is converted to light sandy loam, which extends several miles in that direction. A slate rock underlays the eastern part of the village. The water from this part is universally bad, in which soap is insoluble. The village is regularly laid out into streets and alleys which intersect each other at right angles. It consists of about 1000 inhabitants and has generally been remarkable for its salubrity.[2]  In the summer of 1805, a small quantity of water had been suffered to collect and stagnate in the centre of the village ; an accumulation of filth of various kinds had prevented it from being drained as usual from the ground. Towards the latter part of summer it assumed a green aspect and emitted effluvia that were extremely offensive. As the Fall months advanced, this green colour appeared to be gradually converted to a reddish hue : this was its situation when it was by the severe frosts converted to ice. Early in the month of September, 1805, Amos Porter was occupied for several days near the verge of this stagnant water. On the tenth, he was assailed with violent febrile symptoms, his face bloated, eyes swelled, and their vessels extremely turgid with blood, accompanied with a yellow aspect ; pulse at 100, tense, and full ; complained of a nausea, and extreme pain in his head and back ; with a universal prostration of strength. His symptoms continued with very little variation till the next day, when a subsultus tendinum commenced and increased with violent rapidity, till his body was universally agitated with perpetual convulsions. He continued in this situation twenty four hours, when he expired on the third day from the attack. Six persons occupied stores within two rods of this stagnant water, on the north. The south wind, of course, wafted the effluvia through those buildings ; one of these occupants was soon after seized with symptoms similar to Porter’s, excepting that they were less violent, and the disorder more lingering; he died on the ninth day from the attack. The other persons were not so much confined to the stores. They enjoyed a more salubrious atmosphere, and of course were not so much affected by this deleterious gas: they were however all sick, but recovered.

[2] Not one adult has died in this village since the 1oth of Feb. 1807, and but three infants.

There was scarcely a person who was in the habit of frequenting the vicinity of this pond, but was in some degree affected by its exhalations. About twenty persons were violently seized with fevers similar to the above, all of which could be traced to this source. All recovered but the two first cited cases.

My treatment of this fever was ;

  • 1st. Venesection. This I generally repeated from two to four or five times, according to the inflammatory action of the system. In one case where the pulse was too frequent to be numbered, it rendered it slower and much more distinct.
  • 2nd. Emetics. These I seldom exhibited unless they were indicated by a nausea or vomiting.
  • 3d. Cathartics. These I administered very liberally, generally consisting of calomel, or calomel combined with jalap ; or with tartarised antimony. They were administered every day at first, and every other day afterwards, or oftener if evacuations were indicated.
  • 4th. Epispastics. These were generally applied after the second bleeding, and sooner if a stupor, delirium, or subsultus tendinum was threatened ; or when the vomiting proved obstinate.
  • 5th. Alkalies. Soda was generally preferred where the stomach would receive it; otherwise the aqua ammonite acetatae, or in a state of effervescence.
  • 6th. Febrifuges, consisting of nitrous powders combined with soda and tartarised antimony, given so as to dissolve in the stomach.
  • 7th. Calomel. Whenever the symptoms were alarming, I always gave calomel in small doses to produce an affection of the salivary glands. Though I must confess I always gave it with reluctance, and not till the state of my patient rendered it absolutely necessary.
  • 8th. Lavations. I made it a constant rule to have my patients thoroughly washed with strong soap-suds, or a solution of pearl-ash, twice a day and sometimes oftener.
  • 9th. Cold. When the feverish heat was great, I generally applied cold water, or vinegar and water, to the body generally.

All these cases of fever had completely subsided in January, 1806; and no new case occurred till the summer following, when it returned with redoubled force, and in a much greater variety of instances. It was now evidently traced to a new source. In the summer of 1804, a mill dam had been erected across the northern branch of the Mohawk river adjoining the village. This dam set the water back into a creek which in the summer had always been dry. The trees and a luxuriant vegetation completely excluded the rays of the sun from this creek through the summer following. In the winter of 1805 and 6, all these trees were cut down for fire-wood. Nothing any longer excluded the solar rays, they burst with full force upon the creek, into which a profusion of vegetables andthe offals of animals had been thrown. The process of putrefaction now commenced and evolved an exhalation of deleterious gas that soon affected the inhabitants in its vicinity. About fifty persons resided near the bank of this creek: not one ot these escaped an attack of a bilious remitting or typhous fever, and most of them were sick, during the whole season. They uniformly complained of the fetid effluvia which emanated from this creek ; which were most offensive early in the morning. The fever gradually progressed to persons more remote, till it arrived at Broad street, which runs east and west through the centre of the village. North of this line, very few cases occurred during the whole season, while in the south, I have enumerated 150, and most of these in the immediate neighbourhood of the creek. The symptoms were very similar to those I have described for the preceding year, excepting the liver and alimentary canal, which were now more particularly the seats of disease. In one case an abscess that had formed in the liver discharged large quantities of pus through the intestines per anum.

A copious discharge also issued from the cavity of the abdomen, through the right iliac region, and also through the scrotum. These discharges continued with great profusion till the patient expired. The cases continued to increase during the latter part of June and July with astonishing rapidity. The mortality, however, was not proportioned to the menacing attitude which the fever assumed. Of two hundred cases during the months of June, July and August, but one proved mortal. The treatment was so nearly similar to that which I have already detailed, that I conceive an account of it here to be entirely superfluous. As the summer declined, the remitting type gradually yielded to the quotidian intermittent. A few cases of dysentery appeared with some symptoms of malignity. They were however soon cured by the same treatment that had been used for the fever. This is a corroborative proof of the Febris introversa of the illustrious Sydenham. Women and children, who were confined generally to their houses, and lived within the influence of their exhalations, were subject to frequent relapses, which proved extremely obstinate, while those persons whose occupations led them to the healthy part of the village, generally enjoyed good health, after they had completely recovered from the first attack.

I could observe no uniform regularity in the different crises of those fevers. They variously occurred on every day from the ninth to the twenty first.

During the month of September, the fever was entirely of the intermitting type, and it had totally ceased by the last of October. As it declined, the dysentery returned in a variety of cases, accompanied with a few instances of pertussis.

It may be proper to remark, that during the months of June, July, and August, I never found a single case of” intermitting or remitting fever in which the exhibition of the bark was not succeeded by manifest injury. After the first of September, when the intermissions became distinct, and depletion, and the usual evacuations had been premised, the bark was administered with the most complete success; very few cases, however, now occurred that required bleeding.

TANNER, (B.?). BALLSTON AND SARATOGA SPRINGS, CITY OF ALBANY, AND ADJACENT COUNTRY.  Engraved For J. Melish’s Description Of The United States. J. MELISH. PHILADELPHIA. 1822. COPPER ENGRAVING

 

Map of Saratoga County, New York.  New Topographical Atlas of Saratoga County, New York.  Stone & Stewart Publ., Philadelphia, 1866

 

NOTES

http://www.saratogaspastatepark.org/history.html

The two most important contributions Saratoga County made to medicine prior to 1850 are related to Ballston and Saratoga Springs and the important work of John C. Stearns. 

The story of Reverend Eliphalet Ball and his move to Ballston rather than remain active with the Protestant churches down near Westchester, is a story told numerous times in the history of mineral springs. 

The story of Dr. John Stearns is scarcely presented in any of the local history writings and so deserves some brief coverage. 

A number of professional and political differences prevented progress in the attempts to form a stable medical society in New York.  A significant amount of work was done in the 1790s to set up some a group in order better manage those who were professionally trained and/or mentored prior to  practicing  versus those who were not.   This even led to the successful passage of New York legislation assisting in the monitoring, licensure and control of physicians in New York State, which from its year of passage 1797 to 1805 have managed to officially certify at least a few local practitioners.  In April 1806, an article written by Stearns was published entitled “An Account of the Origin of the Law, ‘to Incorporate Medical Societies for the purpose of Regulating the Practice of Physic and Surgery in this State’; passed 4th of April, 1806.”  In this article, Stearns tell us how he was able to form a solid, stable Committee of Correspondence along with Doctors Grant Powell and William Patrick, Stearns on November 9, 1805. After submitting this for consideration by the Legislature,  a committee of three was established consisting of Dr. Asa Fitch, of Washington, Dr. John Stearns, of Saratoga, and Alexander Sheldon, of Montgomery.   This legislation would only apply to the three counties.  Due to several minor differences in opinion, this law was not passed until the following year.  It became active on April 3, 1807.

Dr. Stearns played a pivotal role in determining whether or not the State would establish a medical society during this period in New York medical history.  From 1806 to 1810, Stearns work along with the efforts of individuals from Montgomery, Washington and Albany Counties making  headway in the development of this society designed to manage the professional and legal duties of this increasingly important field during the years ahead.  Not known at the time, the War of 1812 was just a few years away and the state had enacted a law requiring physicians and surgeons to provide their professional services to the military.  Although the examples impacts of  the efforts of Stearn and others on this law is uncertain, their impacts became most noticeable as the years progressed.  

Since the official close of the Revolutionary War in 1787, medical training could be obtained in a variety of ways.  One could still learn as an apprentice, or by learning as part of your military service provided as a surgeon’s mate or assistant.  Those who received their training by neither of these methods could still move into the region to practice without much fear of the local government.  Due to schools ‘like those in New York and Philadelphia, some many have attended a series of lectures just to practice medicine, or they could have been poorly managed during their years of apprenticeship or military work.  One did not need any certificate of any type back then to prove that he was a doctor.  One only had to be able to perform your skills at work as if you were authentic.    Between 1790 and 1800, the most common training methods was to serve as a mate and then a Surgeon, afterwhich you could go on your way to treat people.  This latter method of training had its critics to content within as evidence by the minutes of the first meeting of the Saratoga group.   As a result one of the first issues taken up by the new medical committee was the requirement of serving in the militia:

Dr. Sheldon, from the committee to whom were referred the communications from the county medical societies of New York, Saratoga, and Montgomery, reported the following resolution; That the section of Militia Law which compels physicians and surgeons to do military duty, is contrary to their ancient rights and privileges, and that a committee be appointed to wait upon Dr. Mitchell, and other members of the Legislature, to represent the same and to request their friendly aid to effect the repeal of the said section. Whereupon Drs. Stearns, Comstock and Romayne were appointed a committee for that purpose.

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For more of Stearns see the following, at this site in the section on Medical Legislation, or via Google books:

James J. Walsh.  History of the Medical Society of the State of New York.  New York State Journal of Medicine, Volume 6 By New York State Medical Association, Medical Society of the State of New York (1807-[1811])  pages 291-3, 325-7, 361-3, 400-3, 432-5.

 

For more on the medicine, health and Saratoga Springs see Valentine Seaman’s A Dissertation on the Mineral Waters of Saratoga, Including an Account of the Waters of Ballston.  2ed. 1809.