Disease & Epidemic in the mid-1800s

(Image: Biohazard symbol)

A number of epidemics struck the population of the United States during the first 60 years of the  nineteenth century: Yellow Fever (1803, 1847, 1850,1852, & 1855), Cholera (1833, 1834, 1848-49, 1851), Typhus (1837 & 1847), and Influenza (1847-48,1850-51), 1858-59), There also was a Small Pox epidemic among the Native Peoples of the Great Plains, brought on in 1837 with the arrival of infected goods and people of European descent on the steamboat S.S. St. Peter. The disease killed more than 17,000 indigenous people. The disease did not abate until 1840, nearly wiping out some of the tribes.
 
It is important for us to remember that people living in the first half of the nineteenth century in America did not have antibiotics, nor did they have a clear understanding of what caused  most diseases or how to treat them. Germ theory was embryonic and personal standards of cleanliness were low. People would wash their face and hands in the morning, of course, but bathing was generally a weekly thing. Flush toilets, running water, and bathrooms were still in the future. My point is many diseases spread easily and readily.
 
During the Civil War, typhoid fever was a common disease within most communities, but especially within military regiments and camps. According to the Mayo Clinic, typhoid fever is caused by Salmonella typhi bacteria. “Typhoid fever spreads through contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include a high fever, headache, abdominal pain, and either constipation or diarrhea.” Without treatment, the disease can be life-threatening. Here’s the crucial thing: “Salmonella typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn't washed carefully after using the toilet. You can also become infected by drinking water contaminated with the bacteria.”[1]
 
When I did research for Walk by Faith and A Time to Heal, I learned that army camps were petri dishes for all kinds of disease. In fact, character Patrick McCoy, who works with the ambulance corps, comments that the fallow times were as dangerous the times the men were in battle. Typhoid fever was just one of the diseases fighting men encountered.
 
But because it was not routine for nineteenth-century food handlers to wash their hands – and they certainly did not have protective gloves – it was possible for an asymptomatic carrier like cook Mary Mallon (“Typhoid Mary,” 1869-1938) to spread the disease later in the century to 51 people, three of whom died. And Mallon was not alone in transmitting the typhoid fever through food handling. She was just the most publicized case.
 
In the Saint Maggie series, several diseases have shown up. Most notably, rheumatic fever, which Maggie says claimed the life of her husband John and their son Gideon. Rheumatic fever develops from a throat infection caused by group A streptococcus. Today we treat the infection with antibiotics. No such luck in for people in 1850. Actually, no such luck in the 1920s, either. Little Guy L. Stafford, who later became my dad, contracted the disease back then.
 
Obviously, my father didn’t die, because I’m here today. But many years later, when he was in his 60s, we learned that the disease had damaged a mitral valve in his heart. He underwent surgery for a valve replacement –but the damage turned out to be not as severe as the physicians had thought and they only needed to make a few repairs. Needless to say, my dad, who probably should have been a doctor instead of an engineer, was a bit ticked off. He really wanted that new valve!
 
I have since learned that my dad was part of a national outbreak of rheumatic fever. According to an editorial in the AHA Journals, “In the 1920s, rheumatic fever was the leading cause of death in individuals between 5 and 20 years of age and was second only to tuberculosis in those between 20 and 30.” In addition, in an era before the advent of antibiotics, “The only treatment was salicylates and bed rest. The majority remained at home for weeks, more often for months, with a smoldering illness while the sicker children were managed in foster homes. In several large cities, special institutions took over the care of the chronically ill…”[2]
 
So now we can see how Maggie’s son Gideon Blaine could have died from rheumatic fever. I suspect that his father, John, probably experienced complications, most likely due to undiagnosed, pre-existing heart disease.
 
Another disease mentioned in Walk by Faith is puerperal fever or childbed fever, a uterine infection after childbirth. It is caused by a bacterial infection. Cleanliness on the part of the person delivering the child as well as in the birthing environment dramatically reduces the incidence of this fatal disease. Germ theory was starting to come into the awareness of doctors in Europe but would blossom later in the century thanks to Joseph Lister. However, certain practices were starting to be considered helpful. In Walk by Faith, Maggie’s daughter, midwife and aspiring doctor, Lydia Lape, is fortunate to work in Gettysburg with a German midwife, Adela Edler. Adela reads medical publications from her native land and these advised her that washing hands with a chloride of lime solution before attending a woman in labor would reduce cases of puerperal fever. Adela follows these directions and most of the mothers in her care survive. Lydia then takes these practices with her when she returns to Blaineton.
 
The mysterious fever that grips the boarding house family’s children in The Christmas Eve Visitor could be anything, since childhood fevers were not uncommon. It most likely was a strain of influenza to which the adults had been exposed and had developed an immunity, but the children had not. Still, who knows? Some diseases were unidentified and classified simply as “contagions.”
 
If I decide to write about a disease hitting the town of Blaineton, it most likely will be typhoid fever. In fact, I even know where and from whom it will come! Spoilers? Maybe. But right now I’ve got two short stories that I have published online. These need to be polished and re-edited and put out in a more professional format. So a new, full-length novel might take a while.
 
Speaking of short stories, the conclusion to “The Newcomer” will be up on Wednesday!
 
Meanwhile, stay safe, my friends. Wash those hands, buy only what you need (no hoarding, please), and be healthy.
 


[1] “Typhoid Fever,” Patient Care & Health Information, Diseases & Conditions, Mayo Clinic, 31 July 2018.
https://www.mayoclinic.org/diseases-conditions/typhoid-fever/symptoms-causes/syc-20378661
 

[2] Bland, Edward F., MD, “Rheumatic fever: the way it was,” AHA Journals, Vol. 76, No. 6, December 1987, 1190.
https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.76.6.1190)