These anticipations have not been realized; but, on the contrary, Consumption has become the prevailing disease of our city. The causes of this increase of the disease are numerous. We are told by Dr. Rush, that it is unknown among the Indians of North America; that it is scarcely known by those citizens of the United States who live in the first stage of civilized life, and are generally called the first settlers; that it is less common in country places than in cities, and increases in both, with intemperance and sedentary modes of life; that ship and house-carpenters, smiths, and all those artificers, whose business requires great exertion of strength in the open air, in all seasons of the year, are less subject to this disease than men who work under cover, and at occupations which do not require the constant action of their lungs. By applying these facts to the situation of this city, the causes which have produced the increased mortality from consumption, become evident. 1. The growth of the city, and consequent state of the atmosphere, most distant from that of the pure air of the country. 2. The increase of all those causes which have enervated the bodies of men, and rendered them more susceptible to the influence of a variable climate. Among these are, augmentation of wealth, and consequently, luxury; increased dissipation, with its accompaniment, imprudence in dress; and extension of manufactures, affording greater opportunity for sedentary employments, and exposure to an insalubrious atmosphere. In general, the causes are, all those circumstances which tend to remove man farthest from that situation, in which the body is possessed of the greatest vigour, and of course, least subject to disease, that of the savage. In proportion as the city has enlarged, these causes have continued to increase, and probably still will do so. But in Great Britain, they appear already to have attained their acme, and as a consequence of the improvements in medicine, the causes not increasing, the disease is on the decline.[2] The following statement will show the proportion, which the number of those who die from consumption, bears to the whole number of deaths, in this city, during the last twelve years. In 1804, 499 persons died from Consumption, and were to the whole number of deaths, 2125 as 1 to 4.25. In 1805 462 2352 1 5.09 1806 354 2225 1 6.28 1807 464 2312 1 4.94 1808 429 2014 1 4.69 1809 413 2108 1 5.1 1810 569 2158 1 3.79 1811 595 2524 1 4.24 1812 669 2553 1 3.81 1813 562 2229 1 3.96 1814 618 2507 1 4.04 1815 572 1974 1 3.8