TABLE I. Monthly Mortality Rates of the Armies of the United States during the Year ending June 30, 1862, expressed in ratio per thousand of mean strength. Atlantic...... Central.. Pacific........ 2.00 2.06 1.79 2.04 2.68 3.24 2.93 2.43 2.58 3.16 3.27 3.53 38.40 1.02 2.73 3.49 4.66 6.36 6.61 8.68 9.27 10.66 6.67 7.40 6.15 82.19 1.45 1.48 1.18 1.54 1.43 0.91 0.21 0.41 1.03 0.36 0.00 0.44 10.76 [Diagram I., on page 711, exhibits the monthly mortality as given in Table I. The three regions are distinguished by the direction given to the lines of shading, as explained at the foot of Diagrams I. and II. The height of the several columns in each month is drawn to a scale, and corresponds to the mortality rate of each region.] GENERAL PREVALENCE OF DISEASE. The difference between the three regions above contrasted is not so conspicuous in the general sickness rates as in the mortality; yet the whole number taken sick in the central region was greater than on the Atlantic coast, and in this, again, greater than on the Pacific. In the first, the number taken on sick report during the year was 3368.14 per thousand of mean strength, in the second, 2748.83, and in the third, 2586.00. It will thus be seen that in each of these regions a large proportion of the troops must have been taken sick several times during the year. Table II. exhibits the monthly ratio of "taken sick" for each of the three regions. It does not indicate the "constant sickness rate," but the total number taken on sick report during the month. The monthly fluctuations exhibited by this table are, of course, much less instructive than those of individual diseases; they serve, however, to indicate a gradual improvement in the sanitary condition of the army during the war. It would be exceedingly interesting were it possible to present a table representing the "constant sickness rates" for the same period; but the imperfect data in the Surgeon-General's Office for the first year of the war do not afford the means for computing such a table in a reliable manner. TABLE II. Monthly Sickness Rates of the Armies of the United States during the Year ending June 30, 1862, expressed in ratio per thousand of mean strength. Atlantic 391.35 372.18 298.26 267.14 255.90 230.99 199.92 183.33 167.25 214.52 208.45 239.75 2748.83 Central. 258.65 356.91 325.40 326.11 300.24 305.71 323.55 249.85| 252.61| 284.32 259.70 232.83 SSCS.14 Pacific... 198.91 200.37 245.27 210.19 279.39 198.84 201.13 258.27 236.67 136.08 157.47 193.61 2586.€0 [Diagram II., on page 711, illustrates this table. It is drawn on a scale different from that of the monthly rates, but is otherwise similar. The three regions are marked by the same shading as in Diagram I.] CAMP FEVER. Under the head of camp fever, all the cases reported to the Surgeon-General's Office as typhus, typhoid, common continued, and remittent fevers, are here included. Of these several categories it may well be doubted how far the cases reported as typhus were really of that character. From the details furnished by sanitary reports, it appears probable that, with perhaps rare exceptions, what was regarded as typhus was, in fact, of a very different nature; severe typhoid fever, with cerebral complications, and congestive intermittents, in scorbutic constitutions being shown, in some cases at least, to have been regarded as typhus. This error was not, however, very widely diffused, the whole number of cases reported as typhus amounting to but a few hundred. As for the cases reported as common continued fever, the vast majority appear to have been different only in degree of severity from those reported as typhoid or remittent. Moreover, while a cer tain amount of uncomplicated enteric and remittent fever certainly did occur, especially at The three regions referred to in the text are distinguished by the direction of the lines of shading, thus, Atlantic coast. Central region. 5 Pacific coast. NATIONAL ALMANAC. gion the annual ratio of cases was 319.94 per thousand, and the ratio of deaths 101.8 per thousand cases, or one in 9.8. On the Pacific coast the annual ratio of cases was only 60.95 per thouThe severity of camp fevers in these sand, and the ratio of deaths to cases 45.2, or one in 22.1. several regions is thus shown to differ as consiAn inspection of the table, or of the accompanying derably as their frequency. diagram, at once exhibits the autumnal character number of attacks steadily increased until Novemof the disease. On the Atlantic coast the monthly ber, 1861, then as steadily diminished until March, quency. In the central region the maximum was 1862; after which they once more increased in freattained in September, 1861, followed by a gradual as on the Atlantic coast. On the Pacific coast, aldiminution till March, and a subsequent increase, will be observed that October was the maximum though there is less regularity in the fluctuates, it month. The most superficial observer cannot fail to be struck with the similarity between these three waves and those of the intermittent fevers, of whose malarial nature there is no doubt, and which are illustrated in the next table and diagram. TABLE III. annual ratio was 375.34, the deaths 5.9 per thousand cases, or one to 170.0. On the Pacific coast the annual ratio was 151.68 per thousand of mean strength, and no deaths. The distinctly autumnal character of the disease is well shown in the following table, and accompanying Diagram IV. 7.87 8.43 7.00 12.01 15.25 16.88 195.94 5.47 9.53 12.46 151.68 37.27 62.80 53.62 65.27 41.49 29.73 20.94 16.98 18.63 27.41 27.86 26.02 375.34 9.46 13.27 10.70 5.08 6.65 8.68 18.69 19.80 19.21 [Diagram IV. illustrates this table.] The three regions referred to in the text are distinguished by the direction of the lines of shading REGION. 68 THE NATIONAL ALMANAC. DIARRHEA AND DYSENTERY, Diarrhoea and dysentery caused about onefourth of all the sickness reported. On the Atlantic border more than half the army suffered, and in the central region the number of cases almost equalled the mean strength. Although not nearly so fatal as camp fever, affections of this class were an important cause of the mortality of our army. In the chronic cases, though most generally called diarrhoea, and not dysentery, the colon was the seat of the chief lesion. The most characteristic post-mortem appearance was a thickened, softened condition of the mucous membrane, with pigment deposit and enlargement of the solitary follicles, frequently terminating It appears from Table V. that the annual ratio of diarrhoea and dysentery on the Atlantic coast was 646.01 cases per thousand of mean strength, in the central region 994.77 per thousand, and on the Pacific coast 319.64. The relative morthousand cases, or one in 483; in the central, 9.6 tality was, in the Atlantic region, 2.1 deaths per per thousand, or one in 103.8; on the Pacific, 0.9 per thousand, or one in 1159. [Diagram V. illustrates this table.] CATARRHAL AFFECTIONS. Catarrhal affections of every class were exceedingly common, attacking nearly one-half the forces in the field. The relative frequency in the three regions of the country appears to have been about the same:-on the Atlantic border 456.47 per thousand of mean strength, in the central region 427.20 per thousand, and on the Pacific slope 407.61. In all, the frequency of these affections increased greatly during the winter and diminished during the warmer months, the maximum month being January for the Atlantic and central, and February for the Pacific region. A large proportion of the severer catarrhal cases occurred as sequelae to camp measles. The vast majority of the simple catarrhal cases terminated in recovery, the deaths being one to every 1127.8 A cases on the Atlantic coast, one to every 560.0 cases in the central region, and no deaths occurring from this cause in the Pacific region. certain number of these catarrhal cases, however, terminated in pneumonia, and thus a part, at least, of the mortality of catarrhal affections is reported under that head. The annual rates of pneumonia for the three regions were as follows: On the Atlantic coast, 25.7 cases per thousand of mean strength, the deaths being 131.1 per thousand cases, or one death to every 7.6 cases; in the central region the cases were 64.2 per thousand of mean strength, the deaths 239.2 per thousand, or one to every 4.1; on the Pacific slope the cases were 20.9 per thousand of mean strength, the deaths 13.1 per thousand cases, or one to 76. TABLE VI. Monthly Rate of Catarrhal Affections in the Armies of the United States during the Year ending 1861. 1862. July. August. September. October. November. December. Atlantic.... 23.94 23.56 23.91 32.56 49.36 59.02 61.64 53.81 39.88 29.00 14.94 11.33 456.47 12.81 16.25 25.51 31.23 45.73 63.88 78.73 49.43 49.74 28.07 14.21 11.71 427.20 9.08 14.42 24.05 25.35 40.61 29.73 43.09 77.46 46.31 12.77 15.55 17.35 407.61 [Diagram VI. illustrates this table.] January. |