tice of simply dragging a carcass into the nearest river, however, was hardly
unknown. Also not unknown in such urban environments were disease and
disability.^12
tClimates largely free of freezing temperatures encourage pests and
pathogens, and urban places where strangers come and go facilitate ex-
change and spread of illness. Southern cities are properly associated with
disease, then. The mountain South, rural and urban, is an exception, its
higher elevations yielding ice and snow, and in tidewater and piedmont
landscapes north ofzone , brief (at least) periods of winter freezing
are common. Generally, however, its warmer climate has fated the South to
distinctively pernicious afflictions. Europeans’ insidiously invisible annihi-
lators of native southerners we have observed more than once already.
Many immigrants from Europe arrived already ill with endemic diseases
brought from home. Seventeenth-century Anglo-Virginians may well have
suffered from nonlethal malaria, common in Yorkshire and Essex, before
they were reinfected in America. They were also poisoned by drinking from
wells contaminated by saltwater. Many apparently were afflicted by typhoid
fever. Then immigrants from Africa brought such tropical diseases as yaws,
yellow fever, elephantiasis (caused by the imported filarial roundworm), the
malignant form of malaria, and hookworm and dengue fever.^13
All these save yellow fever are typically (and rightly) associated with rural
areas. Certainly standing water in towns in summertime nursed mosqui-
toes that might afflict humans with both kinds of malaria. Cholera plagued
country and city folk alike. And once hookworm was diagnosed and its eti-
ology understood, during the s, this ill was recognized among the bare-
footed in towns as well as in farm country. Elemental hygiene was lacking
everywhere. Yet altogether, southern urban places, being warm and having
greater concentrations of humans and animals—with all their wastes and
parasites—must have been sicklier than the sickly countryside. No won-
der that nineteenth-century southern white people, probably townspeople
most of all (although not certainly, evidence being incomplete), suffered
higher rates of addiction to opiates than other Americans and, according
to one medical historian, rivaled the Chinese.^14 How else, one might ask by
way of expiation, was one to endure life in alluring but dangerous places?
tCuriously, one of the antebellum South’s premier advocates for urban
public health was none other than its premier ‘‘agriculturist,’’ Edmund Ruf-
fin (–). Already weary of farming by the time he founded his news-