Ballard County is sometimes referred to as the "Kneecap of the South". Although Kentucky was neutral in the Civil war and north of the dotted Mason-Dixon line, the mile-wide Ohio River at the westerly portion of The Commonwealth formed a very real border between the Union and the Confederacy. Because the Ohio flows into the Mississippi here, the two rivers form a knee-shaped border on the North and West of the Jackson_Purchase region.

The counties along the Mississippi: Ballard, Carlisle, Hickman and Fulton form what is known as "The West Coast of Kentucky".

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