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The insalubrity of Carthagena varies with the state of the great marshes that surround the town on the east and north. The Cienega de Tesca is more than fifteen miles long; it communicates with the ocean where it approaches the village of Guayeper.
When, in years of drought, the heaped-up earth prevents the salt water from covering the whole plain, the emanations that rise during the heat of the day when the thermometer stands between 28 and 32 degrees are very pernicious to the health of the inhabitants. A small portion of hilly land separates the town of Carthagena and the islet of Manga from the Cienega de Tesca.
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