Data from 500 death certificates of Washtenaw County residents reveal that causes of death in the late 19th century differ drastically from today. They also suggest a frightening vulnerability to disease without recourse to medicines or, sometimes, competant doctors. When the afflictions are sorted and ranked, the top 10 causes of death emerge.
1. Consumption (Tuberculosis)
Consumption is by far the most common cause of death for late 19th-century local residents, accounting for a staggering 15% of all deaths. Once recognized by Hippocrates as the most prevalent disease in his day, TB had a 40% mortality rate. The respiratory disease was so widely feared that when German doctor Robert Koch isolated the bacterium responsible for the disease, he won a 1905 Nobel Prize. In local death records, TB strikes all age groups from late teens to age 75 equally, with the striking exception of many children. Tragically, probably almost none of these victims, or their caregivers, knew that the disease was contagious. But they all probably did know at least one Ypsi friend, neighbor, or family member who died from the disease. Henry David Thoreau died from TB in 1862 at age 44.
2. Scarlet Fever/Scarletina
Although TB did not seem to cause many local childrens' death, scarlet fever preyed on local children exclusively: all of its victims were between the ages of 1 and 14, with only one older death at age 60. Named for the red body and facial rash and the "strawberry tongue" it creates, the disease is caused by a strep bacterium and today treated with antibiotics--a scarlet fever vaccine wasn't discovered until the 1920s. Helen Keller, who had perfect sight and hearing at birth, lost both to scarlet fever in 1881, before age 2.
3. Heart Disease
One local teen death from heart disease is listed in local records, but most of the victims were in their 30s through their 80s, with the majority in their 60s and 70s. Given the primitive nature of 19th-century diagnostic tools, one wonders if the term refers not to disease but to actual heart attacks.
4. Inflammation of the Lungs
This is one of those slippery 19th-century medical terms that seems much more like a symptom than an identifiable disease. It would seem to be a symptom of many common 19th-century diseases, does it not--pleurisy, pneumonia, whooping cough? This diagnosis suggests the limits of the age's medical knowledge.
5. Typhoid Fever
This is a nasty one, spread by food or water contaminated by feces and common in the days when people often had sewers directly under their houses or wells and yard privies not too far separate. It can also be spread by asymptomatic carriers. Untreated with modern antibiotics, it has a mortality rate of 10-30%. The prevalence of this disease suggests a level of hygiene and sanitation far lower than today.
6. Dropsy
Dropsy is another 19th-century term that refers to a symptom, not a disease. It refers to edema, or a swelling of accumulated fluid in some part of the body. It's hard to pinpoint which body part was affected unless the coroner included such terms as "dropsy of the brain," which might refer to encephalitis. In the county records, there are mentions of plain dropsy, "dropsy of the brain" and "dropsy of the heart," the latter of which might be rheumatic heart disease or congestive heart failure.
7. Cholera Infantum/Summer Complaint
This deadly bacterial disease of hot, moist months struck the tiniest children. All of its local victims were under 2 years old. The gastrointestinal disease which could spike fevers up to 104 degrees, was often fatal in 24 hours. Pepto Bismol was originally concocted in the early 20th century as a medicine--it was originally called Mixture Cholera Infantum. The early ad at left touts Pepto-Bismol as "An Ideal Mixture for Cholera Infantum and Summer Complaint."
8. Paralysis
Now, Dusty D has noticed the prevalence of this unusual cause of death before, and as a nonmedical person, I've developed a theory. Paralysis is a side effect of botulism poisoning. I wonder if all these deaths from paralysis were from the effects of undiagnosed botulism poisoning from improperly home-canned food. Likely nearly every home in Ypsi and the Township had home-canned food in it--and it's darn hard to do it right even with modern equipment. Also, the "open kettle" canning technique was common back then, which is no longer recommended, as it is too dangerous and unsanitary. But it wasn't until the early 20th century that people began to warn home canners about the danger of "open kettle"-canned foods. How widespread was undiagnosed botulism in Ypsilanti?
9. Dysentery
Another digestive system illness, dysentery seems to have struck local victims only from either end of the age spectrum. It also affects victims at either end of their bodies, in a manner better imagined than described. Usually fatal if untreated, it can be spread via contact with public toilets combined with lack of hand-washing.
10. Inflammation of Bowels
This is yet another hazy diagnosis that sounds more like a symptom than a disease. Could it have been appendicitis? Or perhaps it was just another permutation of the gastrointestinal diseases that plagued former residents. Or a misdiagnosis of a different digestive disease--maybe even a euphemism.
Local late-19th-century residents bore much in their everyday lives that now are just half-forgotten medical terms. Without antibiotics, many surgical procedures, or much understanding of contagion, they were targets for terrible diseases.
But many led long and healthy lives. Aside from these top 10 diseases, the second leading cause of death was simply...old age.
Life is so hard, is surprising anyone gets through it alive. This is useful information, as the terms today are hard to understand. Thank you for your hard work in making this clear.
ReplyDeleteOh, my pleasure. I myself did not know what "dropsy" meant and had to look it up. I'd thought it was some sort of fainting disease that caused people to weaken and drop...had no idea it was about edema.
ReplyDeleteI just wonder if some of these conditions will be back and with a vengeance as they become resistant to antibiotics. I also wonder about the role of family in surviving illnesses in those days. Were these conditions survivable with appropriate care from family members? I mean, compare it to the way the poor die today of preventable and treatable diseases in the absence of money to pay for care. I wonder if the person who headed to the frontier alone, or who didn't have caregivers surrounding him, tended to die of otherwise less than fatal illnesses.
ReplyDeleteThose are very interesting questions. We have already seen the rise of "superbug" antibiotic-resistant MRSA.
ReplyDeleteI think in some cases, the role of family in surviving illness sometimes made things far worse. There seems to be almost no idea at the time of how many of these diseases are communicable, and many caretakers likely caught diseases that they otherwise would not.
I was taking pictures of headstones in an old graveyard. Over 100 pictures were of headstones for children who died between 1885 - 1895. I wondered why until I saw this site. I'm surprised humanity continues.
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