Disease & Death in Early America

     

     

     

  Death in Early America

From: Digital History Online


Increase Mather
Increase Mather

     Increase Mather, one of Puritan New England's foremost ministers and scholars, died in 1723 at his home in Boston. As he lay "feeble and sore broken" upon his death bed, he faced his life's end with desperate "fear and trembling." He was tormented by the thought that he might be bound for Hell. John Tappin died in Boston in 1673 at the age of 18. He, too, suffered bitter spiritual torment in the face of death. Although he had been a godly youth, he bemoaned "his hardness of heart and blindness of minde" and feared that he was destined for eternal damnation.
     For seventeenth century New Englanders, death was a grim and terrifying reality. Of the first 102 Pilgrims who landed at Plymouth in 1620, half died during the first winter. Death rates soon fell sharply, until they were about a third below those in England, France, or the colonial Chesapeake, but death still remained an omnipresent part of life. The tolling of church bells on the day of funerals was so common that it was legislated against as a public nuisance. It was customary in colonial New England to send a pair of gloves to friends and relatives to invite them to funerals. Andrew Eliot, minister of Boston's North Church, saved the gloves that people sent to him. In 32 years he collected 3,000 pairs.
     Death reached into all corners of life, striking people of all ages, not just the old. In the healthiest regions, one child in ten died during the first year of life. In less healthy areas, like Boston, the figure was three in ten. Cotton Mather, the famous Boston minister, had 14 children. Seven died in infancy and just one lived to the age of thirty. Bacterial stomach infections, intestinal worms, epidemic diseases, contaminated food and water, and neglect and carelessness all contributed to a society in which 40 percent of children failed to reach adulthood in the seventeenth century.
     Epidemics accounted for a large proportion of deaths sweeping thousands of people away in the course of a few months. Diphtheria, influenza, measles, pneumonia, scarlet fever, and smallpox ravaged the population, producing death rates as high as 30 per thousand. A smallpox epidemic in Boston in 1677-78 killed one-fifth of the town's population. Many of the individuals who survived a smallpox epidemic were left blind or pockmarked for life. Conflict with Indians also took many lives. One Indian war, the Pequot War of 1675, killed a larger percentage of the population than any later war in American history.
     How, then, did Puritans respond to the ever-present reality of death? A deep, underlying tension characterized the Puritan view of death. On the one hand, in line with a long Christian tradition, the Puritans viewed death as a blessed release from the trials of this world into the joys of everlasting life. At the same time, the Puritans regarded death as God's punishment for human sinfulness and on their deathbeds many New Englanders trembled with fear that they might suffer eternal damnation in Hell.
     From their earliest upbringing, Puritans were taught to fear death. Ministers terrorized young children with graphic descriptions of Hell and the horrors of eternal damnation and told them that at the Last Judgment their own parents would testify against them. Fear of death was also inculcated by showing young children corpses and public hangings.
     Puritans believed that even the youngest child was touched by original sin. As Benjamin Wadsworth put it, "their Hearts naturally, are a meer nest, root, fountain of Sin, and wickedness." Accordingly, young children were continually reminded that their probable destination was Hell. Cotton Mather put the point bluntly: "Go into Burying-Place, CHILDREN; you will there see Graves as short as your selves. Yea, you may be at Play one Hour; Dead, Dead the next." Even their schoolbooks repeatedly reminded Puritan children of the death and Hell: "Tis not likely that you will all live to grow up." "Time cuts down all/Both great and small."
     Adults, too, looked upon death with foreboding. Puritan theology denied that individuals had any assurance of salvation. God had decided their fate at the time of creation and His will was inscrutable. It was a delusion to think that God in His mercy would forgive their sins and take them to Heaven. Consequently, many Puritans like Increase Mather and John Tappin suffered desperate spiritual torment and anxiety in the face of death.
     Since there was nothing that friends or relatives could do to alter the fate of a dying Puritan, there was no place in Puritan New England for expensive and elaborate religious rites or ceremonies. Funeral sermons offered no individual eulogies for the dead and funeral monuments were kept plain and simple. The first grave markers were wooden and early grave stones contained words but no designs because the Puritans thought that the Second Commandment prohibited the use of graven images. Elaborate funerals or headstones seemed like idolatry. (The original headstones faced east, so that on the morning of the Day of Resurrection, the bodies will respectfully face their Holy Father).

Winged cherub
Flying winged cherub on a 1789 grave-
stone symbolizing the flight of the soul.


     Gradually, the stark Puritan view of death softened. After 1650 Puritan funerals became increasingly elaborate and expensive and tombstones less plain. Corpses began to be embalmed in order to allow time for families to plan funerals and for guests to gather. Especially after the Great Awakening the intense religious revival that swept the American colonies beginning in the 1720s attitudes toward death began to change. Where, in the seventeenth century, children were told to fear death, they were increasingly told in the eighteenth century look forward to death as a reunion with God and their parents. Adults, in turn, were increasingly assured that a life of active piety assured salvation.
     In cemeteries, which were now described as "dormitories," winged cherubs replaced the grisly death's heads and winged skulls that marked early Puritan graves. Republican symbols such as urns and willows began to appear in graveyards after the American revolution and the discovery of the archaeological remains at Pompeii. The wording on gravestones also changed reflecting a dramatic transformation in American views of death. Instead of saying, "Here lies buried the body of," inscriptions began to read, "here rests the soul of," suggesting that while the corporeal body might decay the soul survived. Death was increasingly regarded as merely a temporary separation of loved ones.

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  Notable Epidemics

1657 Boston: Measles
1687 Boston: Measles
1690 New York: Yellow Fever
1713 Boston: Measles
1729 Boston: Measles
1732-33 Worldwide: Influenza
1738 South Carolina: Smallpox
1739-40 Boston: Measles
1747 Connecticut, New York, Pennsylvania & South Carolina: Measles
1759 North America (areas inhabited by white people): Measles
1761-61 North America & West Indies: Influenza
1772 North America: Measles
1775 North America (especially hard in New England): Epidemic (unknown)
1775-76 Worldwide: Influenza
1778 Valley Forge, Pennsylvania: Smallpox
1781-82 Worldwide: Influenza (one of worst flu epidemics)
1788 Philadelphia & New York: Measles
1793 Vermont: Influenza and a "putrid fever"
1793 Virginia: Influenza (kills 500 people in 5 counties in 4 weeks)
1793 Philadelphia: Yellow Fever (one of worst)
1783 Delaware (Dover): "extremely fatal" bilious disorder
1793 Pennsylvania (Harrisburg & Middletown): many unexplained deaths
1794 Philadelphia: Yellow Fever
1796-97 Philadelphia: Yellow Fever
1798 Philadelphia: Yellow Fever (one of worst)
1803 New York: Yellow Fever
1820-23 Nationwide: "fever" (starts on Schuylkill River, PA & spreads)
1831-32 Nationwide: Asiatic Cholera (brought by English emigrants)
1832 New York & other major cities: Cholera
1837 Philadelphia: Typhus
1841 Nationwide: Yellow Fever (especially severe in South)
1847 New Orleans: Yellow Fever
1847-48 Worldwide: Influenza
1848-49 North America: Cholera
1850 Nationwide: Yellow Fever
1850-51 North America: Influenza
1852 Nationwide: Yellow Fever (New Orleans: 8,000 die in summer)
1855 Nationwide (many parts): Yellow Fever
1857-59 Worldwide: Influenza (one of disease's greatest epidemics)
1860-61 Pennsylvania: Smallpox
1865-73 Philadelphia, New York, Boston, New Orleans, Baltimore, Memphis, & Washington D.C.: a series of recurring epidemics of Smallpox, Cholera, Typhus, Typhoid, Scarlet Fever & Yellow Fever
1873-75 North America & Europe: Influenza
1878 New Orleans: Yellow Fever (last great epidemic of disease)
1885 Plymouth, PA: Typhoid
1886 Jacksonville, FL: Yellow Fever
1918 Worldwide: Influenza (high point year):
     More people hospitalized in World War I from Influenza than wounds.
US Army training camps became death camps with 80 percent death rate in some camps.
     Click here to go to the PBS website for an in depth look at the 1918 Influenza. It includes the documentary film, Influenza 1918 which can be seen in its entirety.
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  "Epidemics in Colonial North America, 1519-1787: A Genealogical Perspective"

by Larisa R. Schumann (taken from the Kindred Konnections newsletter).

     Perhaps you are wondering how epidemics influenced your family history. Obviously your ancestors survived, because you are alive today. For many of us deadly diseases such as typhoid, smallpox, cholera, yellow fever, measles, and polio are all diseases of the distant past. They have been eradicated or vaccinations have been found. However, our ancestors all lived with the ominous threat of disease. By understanding the diseases of their lifetimes, we will be better able to understand our ancestors and the circumstances they lived in. The repercussions of these diseases are important for family history research, especially here in the United States.
     Disease was common in the large cities of Europe, from where most early colonizers came. The Black Death, or Bubonic Plague, of Medieval Europe was still in recent memory for most immigrants. It was just accepted that disease and premature death was part of life. Europeans brought many Old World diseases like smallpox, influenza, and measles to the New World. Many of these settlers had survived outbreaks in their homelands and developed immunities. However, the native American Indians had no previous exposure and diseases decimated their populations. With their numbers weakened, Native Americas were unable to stop European immigrants from settling on their lands. Wars also decimated native populations. With Native American and European troops marching over colonial America, diseases traveled swiftly from colony to colony, country to country.

Smallpox
     The first disease that we will examine is smallpox or Variola major. The disease was called smallpox because its surviving victims often had pox marks on the face or body, but the markings were smaller than those left by syphilis, which was commonly known as the large pox or French pox. The two diseases were often mistaken for each other until the 17th century.


smallpox victim
Smallpox victim

     In her book, Pox Americana, Elizabeth Fenn describes minutely the 32-day timeline of the Variola virus. She calls it a parasitic virus that consumes its host. Introduced by either touch or inhalation, Variola usually incubates in its new victim for 10-12 days before the first symptoms present themselves. At first, the victim may feel as if they have the flu with symptoms such as backache, headache, fever, and nausea. At this stage, the victim can contaminate others, yet not even know they are seriously infected. On about the 15th day a rash and eruptions appear on the skin. They eventually burst, then scab over. Sometimes victims developed internal sores that would cause them to bleed to death from various body openings, such as the eyes and ears. The entire process is full of immense pain and suffering. By day 30, if the victim is still alive, he or she is no longer contagious, though often scarred for life. The very young and the very old were the largest group of victims. In one study that Fenn recorded, there was a 29% mortality rate for children under one year of age, 8% for children 5-14 years, and 32% for adults over 45 years. The mortality rate was highest for pregnant women: 96%. Surprisingly enough, Variola could survive for long periods outside the human body. A blanket used on a victim, unwashed and stored away for years, can still contain an active virus. With statistics such as these, it is evident why smallpox was so feared in North American colonies.

     The origin of the smallpox disease is uncertain, but John Duffy believes it came from Central Africa or India. Rhazes, a Persian scholar, who lived from 850-923 A.D, recorded the first accurately documented case. By the 15th and 16th centuries, Variola was affecting people worldwide. It reached the West Indies soon after Christopher Columbus, and in 1520 Spaniards carried it into Mexico. Duffy estimated the smallpox deaths in Latin America to be three million.

     Just as explorers from Spain were carrying Variola to Mexico, the French were carrying it into Canada, and the English to the American colonies. This time period bustled with commerce and wars, both primary causes for smallpox epidemics. Fenn's work about smallpox focuses specifically on the years of 1775-82, the time of the American Revolution. Her claim is that the many military campaigns spread smallpox and killed more people than all the battles combined. As soldiers marched from one large city to another, they took Variola along with them, and no one was safe from the virus. Oftentimes diseases like smallpox and others were imported from abroad by crowded and filthy immigrant ships sailing from London or Liverpool. Sometimes these ships would stop in the West Indies for fresh fruit to prevent scurvy, where they would also pick up yellow fever and other tropical diseases. Major seaports were the primary dissemination points for diseases, especially smallpox. Once brought on land, Variola would spread again. Fenn estimates that for big cities such as Boston and New York smallpox epidemics happened approximately every five years, making it endemic to city life.

     Lack of proper nutrition caused people to be physically weaker and more susceptible to smallpox. Duffy says malnutrition, especially scurvy, "paved the way for epidemic disorders". This is especially true for Native Americans. Fenn shows that many Native Americans died because of famine conditions and because their numbers were so decimated there were few left to care for the recovering victims of smallpox.

     Even with such terrible consequences, Stephen Kunitz points out that while many European immigrants had higher mortality rates than people born in the American colonies, they tended to have lower mortality rates than those in their countries of origin. This perhaps was due to the distances between settlements in the colonies. According to Duffy, it was the geographic remoteness and smaller urban populations that spared early North American colonies from the many epidemics that raged throughout European cities. Apparently, if one worked and lived on a family farm in a remote part of a northern New England colony, one's chances of catching and spreading diseases like smallpox were greatly reduced compared to those of slaves working on southern plantations.

     Consequently, Kunitz states that in the 17th century, life expectancy in New England was higher than in Maryland; a trend which continued into the 18th and 19th centuries. For instance, in the early 19th century, death rates in New England were 18-25 per thousand and in cities like New Orleans and Savannah, 80-90 per thousand. Kunitz does not specify the race of these groups, but it is most likely those numbers are for whites only.


Smallpox Innoculation
Smallpox innoculation in the 18th century.

     Other causes of smallpox epidemics were early attempts to inoculate or isolate people against the disease. Large cities usually quarantined ships with known carriers of disease. Eventually, quarantine laws were enacted. Sometimes a house was chosen outside of town in which infected individuals lived out their quarantine. Whole communities were often quarantined. As Fenn points out, these tactics sometimes worked. For example, in 1721, 900 of the 10,700 citizens of Boston fled to the countryside to escape the smallpox. The problem with such isolation methods was that those who fled the city often carried the disease into the countryside with them, thus spreading, rather than containing, the disease.

     Inoculation was a technique that some colonists turned to. Also known as variolation, this technique was risky. Introduced to the Colonies in the 1700s, variolation required the patient to have a live virus (usually in the form of pus from an already-infected patient) inserted into a cut in the hand or arm. The patient eventually displayed symptoms of the disease, but milder, and mortality rates were lower. Unfortunately, variolation was expensive so only the upper classes could afford the procedure. Sometimes inexperienced and unqualified doctors, who did not encourage isolation for the newly inoculated, performed the procedure. Such carelessness often started epidemics when only a few cases were originally reported.


Tombstone
Peleg Conklin who died of
smallpox innoculation in 1788.

     The consequences of such epidemics were horrifying especially for native peoples and black slaves. Daniel K. Richter claims at least "twenty-five thousand Native people died on the Pacific Coast" because of smallpox, even before Lewis and Clark's famous expedition. And east of the Mississippi River, he calculates the Plains Indians population was decimated 75-95% by 1800. The disease destroyed entire Native American Nations. Fenn tells us that more African American and black loyalists died from smallpox than in the battles of the American Revolution. She describes the devastation this way; "With its first New World landfall, Variola gained access to millions of potential victims with no acquired immunity. It was as though a spark had landed in a forest laden with thousands of years of dried timber. The results were explosive; the consequences unspeakable". Fenn gives a conservative estimate of 130,658 deaths from smallpox during the years 1775-82. And not only were many lives lost, but schools, businesses, and governments all virtually shut down during smallpox epidemics. Life came to a complete and deathly halt during these Colonial epidemics.

     Eventually Dr. Edward Jenner developed a vaccine for smallpox in 1796. Using cowpox, this procedure was much less painful and no side effects occurred. Today the World Health Organization considers the disease extinct.

     But what can we learn from smallpox that will help us in our family history research? Fenn suggests that knowing about smallpox helps us to understand the peoples of Colonial America. She states, "While the American Revolution may have defined the era for the history books, epidemic smallpox nevertheless defined it for many of the Americans who lived and died in that time".

     But more than that, we begin to understand the upheavals epidemics caused. Fenn puts it this way; "The movement of the virus from one human being to another shows us how people actually lived in the late 18th century. For despite the political, social, and racial boundaries of the day, people rubbed elbows. They lived side by side, they talked, they fought, they traveled, they traded, and in these daily transactions, they passed Variola on to one another". This virus gives us a glimpse of life in Colonial North America and we gain a better understanding of the world in which our ancestors lived.

     Small pox is considered by many to be the most horrifying epidemic of colonial times because of the terrible suffering it inflicted, the high mortality rates, and disfigurement it left behind. However, when other diseases like malaria, dysentery, diphtheria, scarlet fever, yellow fever, and even the common cold are considered, small pox may seem less ominous. Indeed, John Duffy claims, in his book Epidemics in Colonial America, that respiratory diseases weakened and eventually killed more colonists than small pox . Also, the endemic diseases of malaria and dysentery were continually present in colonial times. These diseases did not always kill people; often they were weakened enough that a mild outbreak of influenza or measles would finish them off. Children and older adults were often the first victims in any epidemic. Along with age, poor diet and hygiene also contributed to the high mortality rates in colonial North America.

Endemic Diseases: Malaria and Dysentery
     A disease is considered endemic if it is localized and recurs year after year. Malaria and dysentery were endemic for the entire colonial period. Malaria was also known as "ague", "quartan ague", "tertian ague", and "the Kentish disorder" . Passed to humans by mosquitoes, the parasites that cause malaria led to chills and fever, vomiting, and other flu-like symptoms. Eventually, victims either die because their red-blood cells are destroyed and anemia results or their capillaries, which lead to the brain or vital organs, are clogged . Either way, malaria was a horrible disease. Specific colonies-New Jersey, Pennsylvania, New York, and Delaware-were more prone to malaria because of their climate and the resident mosquitoes. The mosquito's role in transmitting the disease was not discovered until the twentieth century. Colonials believed in the miasmic theory; that breathing air near stagnant water made one sick . The term malaria itself comes from the Italian words mala and aria, which mean "bad air" .

     Malaria was so common that outbreaks often were not recorded. Indeed, Duffy says that for the colonists, "the spring and fall flare ups [of epidemic proportions] were as inevitable as the seasons themselves". In his opinion, malaria was "directly or indirectly one of the most fatal of colonial diseases". Colonists who survived malaria often developed some immunity and resistance, but often they were physically weakened and more susceptible to other diseases or another malaria outbreak. Newly arrived immigrants were often among the fatalities from the diseases. Indeed, Duffy claims that malaria was more widespread and affected more people than small pox or yellow fever and calls it a "major hurdle in the development of the American colonies". One ethnic group, however, was not as susceptible to malaria. African slaves who came from West Africa and colonies in the West Indies were genetically better equipped to ward off attacks of malaria. According to David Rosner, this resistance is due to their sickle cell trait, which "is associated with greater resistance to malaria". Duffy says this immunity "made possible the development of rice plantations in South Carolina" plantations run by African slave power because the white settlers were either constantly sick or died from diseases like malaria and yellow fever that were endemic in those regions.

     Charleston, which was often hard-hit with other diseases, was never really bothered by malaria. Duffy attributes this to the city's close proximity to salt water, an inhospitable climate for mosquitoes . New England, while troubled by malaria outbreaks during the early colonial days, had almost eradicated the disease by the American Revolutionary war. Conversely, outbreaks became more severe in the other colonies in the late 1700s.

Dysentery
     Like malaria, dysentery had devastating effects on colonists. Also known as "camp fever" and "camp disorder" the disease was spread by either a bacteria, parasitic worms, or protozoa through feces-contaminated water and food, flies, or handling of food in unsanitary conditions. A soldiers' camp or immigrant ship would be just such a place for dysentery to commence its painful course. Those with the disease usually died from dehydration because of severe diarrhea. Children are especially susceptible to the disease. Whiled today we have a better understanding of the importance of cleanliness and greater availability of antibiotics, in colonial times people just had to endure and let the disease run its course. Some people suffered for long periods before dying while others suffered for short amounts of time; there was no timeline of infection and recovery with dysentery like with small pox. Unfortunately, like malaria, dysentery often left its survivors sufficiently weakened to be susceptible to other dise ases. Duffy says it was "endemic and epidemic, recurrent, debilitating, and often fatal".

Yellow Fever
     John Duffy calls it a "strange and unaccountable pestilence that brought death in a horrible fashion to its victims". Known also as "Bilious Plague" and "Black Vomit" it was transmitted by mosquitoes and often arrived from the West Indies. The mosquitoes are thought to have survived in buckets or containers of stagnant water on board ship; and once the mosquitoes hit port cities with temperate climates-like Charleston-the yellow fever quickly spread. The virus transmitted by the mosquitoes had a quick on set and left its victims tired, feverish, jaundiced, and they often would hemorrhage. Duffy says it "was one of the most dreaded diseases in the affected regions [and had it] adapted itself to all areas in the British American colonies, yellow fever would undoubtedly have ranked with small pox as a leading cause of death". And like malaria, whites were more susceptible to the disease than blacks. Charleston was the hardest-hit, though as evidenced by the following chart, other large port cities suffered epidemics. Most outbreaks started in the tropical West Indies and Bahamas where fatalities were higher than in the American colonies. Between the years of 1760 and 1793, Duffy tells us that yellow fever disappeared from the colonies. He credits this to stronger and better-enforced quarantine laws.

Diphtheria and Scarlet Fever
     In a time when almost half the children under age five died, diphtheria and scarlet fever were major causes of childhood death. The symptoms of both diseases were so similar that they were not differentiated between until the late 1800s. Sore throats, major symptoms for both diphtheria and scarlet fever, were common and often unattributable to a specific disease. Duffy believes diphtheria was present in the early colonial days but "it did not attract the attention of the medical profession until the occurrence of a virulent outbreak in New England during 1735-36".

     Caused by bacteria, a false membrane would form in the throat, which would swell and often led to suffocation. The bacterium was contagious and "transmitted from person to person by droplet infection produced from respiratory secretions". Until a vaccination was developed the only solution was a tracheotomy that would bypass the false membrane and allow the victim to breathe freely.

     Families often lost half and sometimes all of their children to the disease. In the epidemic of 1735-36, there were over 1,000 deaths. And 90% of the deaths in New Hampshire were of children under the age of 10. By 1740, over 1,000 people had died in Connecticut alone. Such statistics led Noah Webster to call diphtheria "'the plague among children'".

Scarlet Fever
     Like diphtheria, many of this disease's victims were small children. Spread by close contact, streptococcus leads to a high fever, vomiting, sore throat, enlarged tonsils, and a red or "scarlet" rash . In severe cases, the throat enlarges and the victim suffocates similarly to diphtheria. Even though Duffy believes scarlet fever was first identified in 1675, it was often confused with small pox, measles, and diphtheria . It was called a "frontier disease" because it did not start in large urban centers like other diseases. Duffy points out that while scarlet fever was sometimes fatal, it was a minor disease of that time.

Respiratory Diseases: Influenza, Pneumonia, Pleurisy, and colds
     Duffy classes respiratory disorders among the "major causes of morbidity and mortality" in colonial America. This seems surprising when one reads about the devastation that small pox, yellow fever, and diphtheria left in their wakes. However, as pointed out earlier, in a time when diets were unhealthy, living conditions unsanitary and overcrowded, and frequent exposure to the elements weakened many colonists, "winter diseases" like the flu and a cold often proved fatal. While influenza itself caused comparatively few deaths in colonial America, complications sometimes arose and led to secondary infections, such as pneumonia.

Pneumonia
     People with low resistance, the aged or very young were especially susceptible to pneumonia. Caused by different pathogens-including bacteria or viruses-victims often developed a chill, pain in the chest, fever, headache, cough, rapid pulse and breathing . Death was not as common with pneumonia as with other diseases, but no exact statistics were kept.

Pleurisy
     A catchall term used to describe any cough or condition that restricted breathing, pleurisy was endemic, not epidemic in colonial America. Respiratory diseases were very common, and therefore, not often recorded. Duffy's research found pleurisy was usually only referred to in personal correspondence and not in the newspaper headlines.

Colds
     Sometimes described as a winter sickness or catarrh, colds were very common. However, there are no available records to measure the loss of life in colonial times. Duffy puts it as his opinion that the economic cost of respiratory illnesses far exceeds those of the more publicized epidemics. He continues, "if adequate statistics were available, respiratory diseases undoubtedly would rank high on the list of fatal sicknesses which attacked the American colonists".

Whooping Cough
     A highly communicable disease, whooping cough or pertussis, is caused by the bacterium Bordetella pertussis (1). It presents itself as an upper respiratory infection, which involves continual coughing and discharge of mucus, even vomiting. The disease gets its name from the "high-pitched crowing whoop [that develops after 14 days]. 10 to 15 coughs may follow in rapid succession before a breath is taken"(2). The disease is more serious for young children and can lead to pneumonia, asphyxia, convulsions, and brain damage (3). Today the disease can be prevented with early inoculation and treated with antibiotics. In colonial times, the disease was allowed to just run its course. According to John Duffy, whooping cough "aroused little apprehension"(4). It was not until a major outbreak in 1738 that whooping cough really was given any attention. Even though there were fatalities, they were not as numerous as with other diseases. Duffy tells us that whooping cough "can be safely relegated to a very minor role among the epidemic diseases of the period"(5).

Mumps
     Considered a child's disease, mumps was rarely fatal. Caused by the virus, epidemic parotitis, it attacks the salivary glands and causes pain and swelling (6). Victims may have a fever and general feeling of illness. Eating is often painful. The infection runs its course within three weeks. Complications may arise if adults contract the infection. According to The Expanded Columbia Electronic Encyclopedia, the heart, thyroid, brain, and reproductive organs may be affected. The cases are rare and in colonial times few records were kept on mumps. Duffy tells us the disease was "inconsequential in comparison with the more virulent epidemic sicknesses of the period"(7). Today the disease is prevented with a vaccine.

Measles
     Caused by a highly communicable virus, measles (rubeola) was much more severe and deadly than either whooping cough or mumps. Measles was often ignored because of the severity of other diseases like small pox and yellow fever. Considered a childhood disease because most of its victims were infants and young children, Duffy tells us measles was "one of the leading causes of infant mortality"(8). The disease did give survivors permanent immunity, like small pox, a person would only have the disease once. Measles was often mistaken for either small pox or scarlet fever due to similar symptoms: fever, a reddish rash, and upper respiratory infection. Measles also ran its course in twenty-one to thirty days, similar to small pox. And like small pox, regular epidemics of measles swept the colonies (9), though limited records were kept on measles epidemics in the seventeenth-century (10).

     Many people died from a weakened condition and the complications arising from measles, such as bronchial pneumonia and encephalitis (11). The Expanded Columbia Electronic Encyclopedia also showed the following complications could arise: "The measles virus has also been associated with subacute sclerosing panencephalitis (SSPE), which causes chronic brain disease in children and adolescents. After the attack of measles, it can cause intellectual deterioration, convulsive seizures, and motor abnormalities and is usually fatal." Pregnant women were also at risk to measles because the virus can pass through the placenta and infect the unborn child (12). Poor hygiene and sanitation in colonial times spread measles and Duffy considers it endemic. At a time when medical treatments included bleeding and purging, the 1713-15 epidemic of measles led to some beneficial treatments for the disease. The Puritan minister Cotton Mather advised that rest was important in recuperating from the disease and he encouraged avoidance of traditionally invasive procedures (13). He wrote his advisory tract after seeing his wife, 3 children, and a maid die from measles within a two-week period. While there is no evidence as to whether or not his congregation heeded his advice, Mather's observations about treatment are still in force today.

     Surprisingly, the 1772 epidemic left so many people immune that measles was one of the few diseases not raging at epidemic levels during the American Revolutionary War (14). Duffy tells us it was not a major killer, but when added to all the other diseases one could suffer from, measles did take its toll, especially among children.

Typhus
     While there are a variety of typhus fevers, the most common and fatal in colonial times was Rickettsia prowazeki (15). Also known as "jail fever", "prison fever", "military fever", "hospital fever", "camp fever", "putrid fever", "ship fever", and "spotted fever" it was transmitted through the feces of body lice (16). Duffy tells us typhus was more common in the filthy, poor, and overcrowded urban European communities than in the American colonies "where land was cheap and the economy predominantly agricultural"(17). Therefore, the disease was never endemic and only reached epidemic proportions either when large immigrant groups arrived in port from Europe or during wartime. There were outbreaks of the disease during battles of the American Revolutionary War. And in the eighteenth century, groups of Germans and Scotch-Irish brought the lice with them on their dirty and overcrowded immigrant ships (18). Besides these few outbreaks, typhus was rarely present in colonial America.

     When typhus first presents itself, the symptoms are similar to influenza and include headache, fever, chills, and weakening of the limbs. Eventually a rash develops and covers the body. Victims often become "deranged with fever...and death becomes a welcome release"(19). The best prevention for typhus is adequate sanitation. Pesticides are also used to kill the lice and prevent the spread of the disease.

Typhoid Fever
     Caused by poor sanitation, infected water, overcrowding, and war, typhoid fever was transmitted by the bacteria salmonella typhi in feces, vomit, and urine (20). Experts were not sure when typhoid fever first appeared in the colonies, but the "burning fevers" of the Jamestown settlers in 1607 may have been typhoid fever (21). Briggs corroborates that typhoid was "one of the first epidemics to occur in the United States [and] took place in Virginia between 1607-1624. Approximately 85% of the arrivals in James River died from disease which began as a typhoid epidemic"(22). According to The World Health Organization's website, scholars put the total number of deaths for this period at 6,000+ (23).

     Typhus was also known as "slow fever", "nervous fever", "continued fever", "burning fever", "long fever", and "bilious fever"(24). Some of the early symptoms of typhus were fever, overall pain, loss of appetite, headache, muscle pain, cough, and restlessness. Later delirium and severe constipation and dehydration occur, which lead to cardiac arrest and death. The disease runs its course in one to three weeks. At first, the disease was confused with dysentery and typhus. Typhoid was first identified in 1659 and by 1880, it had been isolated and recognized separately from typhus.

     While the epidemics of typhus in Colonial time were not as frequent as small pox and yellow fever, Duffy tells us typhus has a "high rank among destructive sicknesses...[due to] the increasing extent of the sickness and the number of deaths" from 1730-1770 (25). With increased sanitation, the epidemics began to subside. Today, along with proper sanitation, the typhoid vaccine has eradicated the disease from most developed nations.

Other diseases
     While not of major concern in colonial times, Duffy tells us hookworms and parasites were prevalent and especially dangerous for children, but never reached epidemic proportions (26).

     Women were at risk for infections-such as puerperal fever-associated with childbirth. While this topic would be better discussed in another article, it is important to note mortality rates for childbearing women were high.

     Duffy tells us there was some venereal disease in colonial America, but the outbreaks were nothing compared to those in Europe. The only recorded outbreak was of syphilis in 1773 in lower Canada (27).

Conclusion
     In this series of articles, we have covered a major component of the colonization of North America: disease. Along with famine and war, disease decided who survived and settled the colonies. Small pox, while perhaps the most feared disease, was not the major killer. Malaria took more lives than any other disease, mostly because it did not grant immunity like small pox and measles did. Dysentery was the number two killer of colonists. The next most fatal illnesses were the respiratory complaints: influenza, pneumonia, pleurisy, and colds. After that, the ranking would be small pox, yellow fever, diphtheria and scarlet fever, measles, whooping cough, mumps, typhus, and typhoid fever.

     Charleston, South Carolina had a higher mortality rate than other regions in the Colonies like New England. Mostly these statistics can be blamed on climate and migration patterns. Since Charleston was one of the biggest seaports, the Carolinas had a lot of traffic in and out and therefore more exposure to diseases from other areas. But no group suffered more than the indigenous American Indian. Small pox killed most natives, as previously shown. The fatality rate from disease in colonial times for Native Americans was 55-90%. One shocking example is the complete decimation of the Pemlico tribe in South Carolina in 1698-99 (28). Recently published research shows evidence that British commander Jeffery Amherst conspired with other leaders to end the siege of Fort Pitt in 1763 by killing off natives with "gifts" of small pox-infected blankets (29). While records show the plan was at least attempted, there are no statistics to prove how many were infected and died.

     African slaves also suffered cruelly from small pox, often bringing it with them aboard the slave ships. However, there are no concrete records available as to the total loss of life by disease for African Americans. Overall, isolation, few congested urban areas, increased immigration, and high birth rates helped the American colonies survive the devastation of epidemics.


     Article Sources:

Briggs, Elizabeth. A Family Historian's Guide to Illness, Disease, & Death Certificates (AbeBooks.com link). Winnipeg, Manitoba, Canada: Wesgarth, 1993.

Duffy, John. Epidemics in Colonial America (Amazon link). Baton Rouge, LA. Louisiana State UP, 1953.

The Expanded Columbia Electronic Encyclopedia. New York: Columbia University Press, 2003. Accessed at http://www.historychannel.com.

Kunitz, Stephen J. "Disease and Mortality in the Americas since 1700." The Cambridge World History of Human Disease (Amazon link). Ed. Kenneth F. Kiple. New York: Cambridge University Press, 1993. pgs 328-334.

MyTrees.com Chart on Smallpox Epidemics in Colonial North America, 1519-1787

Sofge, Christine Whittaker. "Microbe Wars" History Magazine. April/May 2003: 49-51 (Amazon link).

World Health Organization, "Fact Sheet N149: Typhoid Fever" March 1997.

Reference Numbers in Article:
(1-3, 6, 11, 15, 16) - The Expanded Columbia Electronic Encyclopedia
(4-5, 7-8, 10, 13-14) - Duffy p. 165-183
(17-18, 21, 24-28) - Duffy p. 223-244
(9) Kunitz - p. 331
(12, 19, 20, 22) - Briggs p. 52-69
(23) - WHO Fact Sheet
(29) - Sofge Article p. 50

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  Sources for Further Reading

Books:

Bray, R.S. Armies of Pestilence: The Impact of Disease on History. Barnes & Noble: New York, 2000. This book is a survey of disease and war from Ancient Rome to modern Africa. Bray, a biologist, looks at diseases such as plague, malaria, yellow fever, typhus, cholera, and influenza. Click HERE to see the book on Amazon.com.

Chambers, J.S. The Conquest of Cholera: America's Greatest Scourge. Macmillan: New York, 1938. Asiatic cholera originated in India, but was always confined to that continent and its environs. But the British colonization of India soon spread the disease outside the country. An outbreak in 1826 led to the U.S. outbreak in 1832. Carried by traders and travelers alike, cholera encircled Europe. In 1831 many Irish immigrants fleeing the epidemic at home carried it to the U.S. on filthy and crowded ships. Chambers discusses the spread of the disease on the east coast and Canada and its slow progress across the continent to the California gold fields. He also looks at medical contributions toward eradication of the disease. Outbreaks of cholera in 1866 and 1873 are also examined. The book contains an index and bibliography, also numbers illustrations and maps. Originally published in 1938, Chambers language is a bit extravagant, but easy for any reader to follow. He was a medical doctor and professor at the University of Kentucky when the book was published.

Chase, Marilyn. The Barbary Plague: The Black Death in Victorian San Francisco. New York: Random House, 2003. Chase's work traces the 1900 plague in San Francisco and discusses the two men assigned to handle the crisis; Drs. Joseph Kinyoun and Rupert Blue. She also looks at how the Chinese in San Francisco were discriminated against during the 1900 outbreak. Chase also looks at the 1906 earthquake and its influence on the spread of disease in San Francisco. Includes endnotes, extensive bibliography, and index. Click HERE to see the book on Amazon.com.

Duffy, John. Sword of Pestilence: The New Orleans Fever Epidemic of 1853. Baton Rouge, LA: Louisiana State UP, 1966. Discusses what Duffy calls "probably the worst single epidemic ever to strike a major American city"-since over forty percent of the population contracted the disease and a tenth died. Includes endnotes, bibliography, and index.

Rothman, Sheila M. Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History. New York: BasicBooks, 1994. This text looks at specific cases for New England men between 1810-60; the individual case of Deborah Vinal Fiske, 1806-44; and cases of people who went west between 1840-90. The last chapter is about cases between the years of 1882-1940. Includes endnotes and index. Click HERE to see the book on Amazon.com.

Websites:

1918 Influenza Timeline. This fascinating website was created by PBS. Along with the timeline, it has an interactive map which shows how fast influenza spread in 1918. There is also a graph with U.S. death rates by month. You can also purchase "Influenza 1918" (part of the American Experience series) on DVD at the PBS website HERE.

World Health Organization While the WHO website does not offer a historical perspective, it is searchable for diseases still present today.

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  Old-time Medical Terms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Ablepsy - Blindness
Ague - Malarial Fever
American plague - Yellow fever
Anasarca - Generalized massive edema
Aphonia - Laryngitis
Aphtha - The infant disease "thrush"
Apoplexy - Paralysis due to stroke
Asphycsia/Asphicsia - Cyanotic and lack of oxygen
Atrophy - Wasting away or diminishing in size.

B

Bad Blood - Syphilis
Bilious fever - Typhoid, malaria, hepatitis or elevated temperature and bile emesis
Biliousness - Jaundice associated with liver disease
Black plague or death - Bubonic plague
Black fever - Acute infection with high temperature and dark red skin lesions and high mortality rate
Black pox - Black Small pox
Black vomit - Vomiting old black blood due to ulcers or yellow fever
Blackwater fever - Dark urine associated with high temperature
Bladder in throat - Diphtheria (Seen on death certificates)
Blood poisoning - Bacterial infection; septicemia
Bloody flux - Bloody stools
Bloody sweat - Sweating sickness
Bone shave - Sciatica
Brain fever - Meningitis
Breakbone - Dengue fever
Bright's disease - Chronic inflammatory disease of kidneys
Bronze John - Yellow fever
Bule - Boil, tumor or swelling.

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C

Cachexy - Malnutrition
Cacogastric - Upset stomach
Cacospysy - Irregular pulse
Caduceus - Subject to falling sickness or epilepsy
Camp fever - Typhus; aka Camp diarrhea
Canine madness - Rabies, hydrophobia
Canker - Ulceration of mouth or lips or herpes simplex
Catalepsy - Seizures / trances
Catarrhal - Nose and throat discharge from cold or allergy
Cerebritis - Inflammation of cerebrum or lead poisoning
Chilblain - Swelling of extremities caused by exposure to cold
Child bed fever - Infection following birth of a child
Chin cough - Whooping cough
Chlorosis - Iron deficiency anemia
Cholera - Acute severe contagious diarrhea with intestinal lining sloughing
Cholera morbus - Characterized by nausea, vomiting, abdominal cramps,elevated temperature, etc. Could be appendicitis
Cholecystitus - Inflammation of the gall bladder
Cholelithiasis - Gall stones
Chorea - Disease characterized by convulsions, contortions and dancing
Cold plague - Ague which is characterized by chills
Colic - An abdominal pain and cramping
Congestive chills - Malaria
Consumption - Tuberculosis
Congestion - Any collection of fluid in an organ, like the lungs
Congestive chills - Malaria with diarrhea
Congestive fever - Malaria
Corruption - Infection
Coryza - A cold
Costiveness - Constipation
Cramp colic - Appendicitis
Crop sickness - Overextended stomach
Croup - Laryngitis, diphtheria, or strep throat
Cyanosis - Dark skin color from lack of oxygen in blood
Cynanche - Diseases of throat
Cystitis - Inflammation of the bladder

D

Day fever - Fever lasting one day; sweating sickness
Debility - Lack of movement or staying in bed
Decrepitude - Feebleness due to old age
Delirium tremens - Hallucinations due to alcoholism
Dengue - Infectious fever endemic to East Africa
Dentition - Cutting of teeth
Deplumation - Tumor of the eyelids which causes hair loss
Diary fever - A fever that lasts one day
Diptheria - Contagious disease of the throat
Distemper - Usually animal disease with malaise, discharge from nose and throat, anorexia
Dock fever - Yellow fever
Dropsy - Edema (swelling), often caused by kidney or heart disease
Dropsy of the Brain - Encephalitis
Dry Bellyache - Lead poisoning
Dyscrasy - An abnormal body condition
Dysentery - Inflammation of colon with frequent passage of mucous and blood
Dysorexy - Reduced appetite
Dyspepsia - Indigestion and heartburn. Heart attack symptoms
Dysury - Difficulty in urination

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E

Eclampsy - Symptoms of epilepsy, convulsions during labor
Ecstasy - A form of catalepsy characterized by loss of reason
Edema - Nephrosis; swelling of tissues
Edema of lungs - Congestive heart failure, a form of dropsy
Eel thing - Erysipelas
Elephantiasis - A form of leprosy
Encephalitis - Swelling of brain; aka sleeping sickness
Enteric fever - Typhoid fever
Enterocolitis - Inflammation of the intestines
Enteritis - Inflations of the bowels
Epitaxis - Nose bleed
Erysipelas - Contagious skin disease, due to Streptococci with vesicular and bulbous lesions
Extravasted blood - Rupture of a blood vessel

F

Falling sickness - Epilepsy
Fatty Liver - Cirrhosis of liver
Fits - Sudden attack or seizure of muscle activity
Flux - An excessive flow or discharge of fluid like hemorrhage or diarrhea
Flux of humour - Circulation
French pox - Syphilis

G

Gathering - A collection of pus
Glandular fever - Mononucleosis
Great pox - Syphilis
Green fever / sickness - Anemia
Grippe/grip - Influenza like symptoms
Grocer's itch - Skin disease caused by mites in sugar or flour

H

Heart sickness - Condition caused by loss of salt from body
Heat stroke - Body temperature elevates because of surrounding environment temperature and body does not perspire to reduce temperature. Coma and death result if not reversed
Hectical complaint - Recurrent fever
Hematemesis - Vomiting blood
Hematuria - Bloody urine
Hemiplegy - Paralysis of one side of body
Hip gout - Osteomylitis
Horrors - Delirium tremens
Hydrocephalus - Enlarged head, water on the brain
Hydropericardium - Heart dropsy
Hydrophobia - Rabies
Hydrothroax - Dropsy in chest
Hypertrophic - Enlargement of organ, like the heart

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I

Impetigo - Contagious skin disease characterized by pustules
Inanition - Physical condition resulting from lack of food
Infantile paralysis - Polio
Intestinal colic - Abdominal pain due to improper diet

J

Jail fever - Typhus
Jaundice - Condition caused by blockage of intestines

K

King's evil - Tuberculosis of neck and lymph glands
Kruchhusten - Whooping cough

L

Lagrippe - Influenza
Lockjaw - Tetanus or infectious disease affecting the muscles of the neck and jaw. Untreated, it is fatal in 8 days
Long sickness - Tuberculosis
Lues disease - Syphilis
Lues venera - Venereal disease
Lumbago - Back pain
Lung fever - Pneumonia
Lung sickness - Tuberculosis
Lying in - Time of delivery of infant

M

Malignant sore throat - Diphtheria
Mania - Insanity
Marasmus - Progressive wasting away of body, like malnutrition
Membranous Croup - Diphtheria
Meningitis - Inflations of brain or spinal cord
Metritis - Inflammation of uterus or purulent vaginal discharge
Miasma - Poisonous vapors thought to infect the air
Milk fever - Disease from drinking contaminated milk, like undulant fever or brucellosis
Milk leg - Post partum thrombophlebitis
Milk sickness - Disease from milk of cattle which had eaten poisonous weeds
Mormal - Gangrene
Morphew - Scurvy blisters on the body
Mortification - Gangrene of necrotic tissue
Myelitis - Inflammation of the spine
Myocarditis - Inflammation of heart muscles

N

Necrosis - Mortification of bones or tissue
Nephrosis - Kidney degeneration
Nepritis - Inflammation of kidneys
Nervous prostration - Extreme exhaustion from inability to control physical and mental activities
Neuralgia - Described as discomfort, such as "Headache" was neuralgia in head
Nostalgia - Homesickness

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P

Palsy - Paralysis or uncontrolled movement of controlled muscles. It was listed as "Cause of death"
Paroxysm - Convulsion
Pemphigus - Skin disease of watery blisters
Pericarditis - Inflammation of heart
Peripneumonia - Inflammation of lungs
Peritonotis - Inflammation of abdominal area
Petechial Fever - Fever characterized by skin spotting
Puerperal exhaustion - Death due to child birth
Phthiriasis - Lice infestation
Phthisis - Chronic wasting away or a name for tuberculosis
Plague - An acute febrile highly infectious disease with a high fatality rate
Pleurisy - Any pain in the chest area with each breath
Podagra - Gout
Poliomyelitis - PolioPotter's asthma - Fibroid pthisis
Pott's disease - Tuberculosis of spine
Puerperal exhaustion - Death due to childbirth
Puerperal fever - Elevated temperature after giving birth to an infant
Puking fever - Milk sickness
Putrid fever - Diphtheria.

Q

Quinsy - Tonsillitis.

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R

Remitting fever - Malaria
Rheumatism - Any disorder associated with pain in joints
Rickets - Disease of skeletal system
Rose cold - Hay fever or nasal symptoms of an allergy
Rotanny fever - (Child's disease) ???
Rubeola - German measles

S

Sanguineous crust - Scab
Scarlatina - Scarlet fever
Scarlet fever - A disease characterized by red rash
Scarlet rash - Roseola
Sciatica - Rheumatism in the hips
Scirrhus - Cancerous tumors
Scotomy - Dizziness, nausea and dimness of sight
Scrivener's palsy - Writer's cramp
Screws - Rheumatism
Scrofula - Tuberculosis of neck lymph glands. Progresses slowly with abscesses and pistulas develop. Young person's disease
Scrumpox - Skin disease, impetigo
Scurvy - Lack of vitamin C. Symptoms of weakness, spongy gums and hemorrhages under skin
Septicemia - Blood poisoning
Shakes - Delirium tremens
Shaking - Chills, ague
Shingles - Viral disease with skin blisters
Ship fever - Typhus
Siriasis - Inflammation of the brain due to sun exposure
Sloes - Milk sickness
Small pox - Contagious disease with fever and blisters
Softening of brain - Result of stroke or hemorrhage in the brain, with an end result of the tissue softening in that area
Sore throat distemper - Diphtheria or quinsy
Spanish Disease - Syphilis
Spanish influenza - Epidemic influenza
Spasms - Sudden involuntary contraction of muscle or group of muscles,like a convulsion
Spina bifida - Deformity of spine
Spotted fever - Either typhus or meningitis
Sprue - Tropical disease characterized by intestinal disorders and sore throat
St. Anthony's fire - Also erysipelas, but named so because of affected skin areas are bright red in appearance
St. Vitas dance - Ceaseless occurrence of rapid complex jerking movements performed involuntary
Stomatitis - Inflammation of the mouth
Stranger's fever - Yellow fever
Strangery - Rupture
Sudor anglicus - Sweating sickness
Summer complaint - Diarrhea, usually in infants caused by spoiled milk
Sunstroke - Uncontrolled elevation of body temperature due to environment heat. Lack of sodium in the body is a predisposing cause
Swamp sickness - Could be malaria, typhoid or encephalitis
Sweating sickness - Infectious and fatal disease common to UK in 15th century

T

Tetanus - Infectious fever characterized by high fever, headache and dizziness
Thrombosis - Blood clot inside blood vessel
Thrush - Childhood disease characterized by spots on mouth, lips and throat
Tick fever - Rocky mountain spotted fever
Toxemia of pregnancy - Eclampsia
Trench mouth - Painful ulcers found along gum line, Caused by poor nutrition and poor hygiene
Tussis convulsiva - Whooping cough
Typhus - Infectious fever characterized high fever, headache, and dizziness

V

Variola - Smallpox
Venesection - Bleeding
Viper's dance - St. Vitus Dance

W

Water on brain - Enlarged head
White swelling - Tuberculosis of the bone
Winter fever - Pneumonia
Womb fever - Infection of the uterus.
Worm fit - Convulsions associated with teething, worms, elevated temperature or diarrhea

Y

Yellowjacket - Yellow fever.

See Also:

Latin/English Glossary of Causes of Death and other Archaic Medical Terms
Ridiculous Vintage Quack Medical Devices
Old Time Cures & Remedies (Some of these are really horrible!)

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  Vintage Medicinal Ads

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