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To understand the times in which our ancestors lived, we must understand the unique selection of survival, which has allowed our existence. Along with the deaths due to natural causes, accidents, murder, war and tragedy, our ancestors had to also survive the great plagues and epidemics which signified their times. We cannot appreciate the miraculous process of selection in which survival of the seed was protected in order to allow for our existence without understanding the forces which were against this survival. Therefore, we must look into the past in order to appreciate the events which transpired, which have led to our very existence. For surely our ancestors were affected, either directly or indirectly by these events which marked their times.

"During these times (452AD) there was a pestilence, by which the whole human race came near to being annihilated... And this disease always took its start from the coast and from there went up into the interior."
Procopius History of Wars II, XXII, 1-7

Black Death- Bubonic Plague

In the 14th century, a Plague, beginning in China, swept through the world, which changed the face of every country. As the Far East suffered deaths which almost depopulated the countryside, Europe watched and waited, hoping the Spirit of death would not darken their shores. Their hopes were in vain as the Plague swept into the coastal cities and spread inland into the heart of the countries. In the years 1347-1352, Europe's population declined by 25 million people, roughly one third of the population; some areas were nearly decimated. Buildings were left empty. Famous names disappeared forever. Men, women and youths in perfect ehalth at midday were dead by nightfall... The Black Death spread through Italy to Spain, France, Switzerland and Yugoslavia in the first six months; then to Britain, Austria, Hungary and Germany; then to Ireland, Scandinavia and Russia with catastrophic results.

In England, the plague is said to have arrived in Dorsetshire in July or August of 1348. It quickly spread throughout England, Scotland and Ireland. The year 1349 was the most deadly year of the plague. In some areas, the survivors were so few that there were not enough living to bury the dead. In Norwich, with a population of 70,000 some 57,374 were said to have died of the plague. About two-thirds of all of the clergy in England were victims of the plague. Many villages and hamlets lay desolate. Fields and mills were abandoned. Livestock also fell victim to the Plague, including the prized sheep.It was recorded that in one field, 5,000 lay dead. Peasants lay dead beside the roads. Children were carried into the churches to be laid in mass graves. Dogs and cats were also affected. It seemed that no living thing was spared the horrors of the death which gripped the land. The country stood still as the hand of death lay upon it.

It was in this year that the Scots, believing that God's vengence was upon England, decided to invade England. Gathering a force of troops, the Scots marched into England only to be smitten themselves of the plague. Over 5,000 died of the plague. The remnants of the Scottish army returned home, only to carry the plague into Scotland where it spread rapidly throughout that land.

The symptoms of the Bubonic Plague were easy to determine: fever, swelling of the lymph glands in the neck, armpit and groin; red spots which eventually turned black. The lymphs would swell to the size of an egg or an apple and were often black. As the disease spread throughout the body, black boils spread across the body due to internal bleeding.The swellings would continue to grow until they burst, emitting a dreadful odor. The grotesque appearance of the victim added to the fear and horror of the disease. Death was usually within 3-5 days, though some died within 24 hours of infection.

The Bubonic Plague thrived in the months between July to October and was spread by fleas which were transported by rats. The disease affected everyone from the social rich to the reclusive pauper. No remedy seemed apparant. As people fled the cities for the countryside, so did the Plague. Causes for the plague were blamed on everything from the wells to the Jews to Spiritual retaliation. There was a widespread belief that the plague was carried by the wind, some cloud or mist. Most, however, believed that the plague was the result of God's wrath upon them. The plague's helpless victims did not know what was killing them and had no idea for a remedy. The people at the time of the plague called it "The Pestilence" or "Great Mortality".

Along with the Bubonic Plague, the population also suffered, during the winter months from a more deadly Pneumonic Plague. This plague was noted by high fever and headache followed by coughing which took on a bloody red, foamy appearance. The Plague was spread through germs transmitted by the cough or sneeze.

Everywhere people were dying. Parents abandoned their children, attorneys refused to visit the dying, monasteries were annihilated as the nuns and priests sought to care for the dying. Charity was abandoned as parents refused to visit their children and the children also refused to visit their parents for fear of contamination. The structure of society failed as chaos ran rampant. In the cities, corpses were dumped into the streets or in mass graves. Properties stood vacant, abandoned by their frightened or deceased owners. The mortality rate was 60-80 percent of those infected, dying usually within 3-5 days, though some lingered as long as a month.

"Then the grievous plague penetrated the seacoasts from Southampton, and came to Bristol, and there almost the whole strength of the town died, struck as it were by sudden death. There died at Leicester in the small parish of St. Leonard more than 380, in the parish of Holy Cross more than 400; in the parish of S. Margaret of Leicester more than 700; and so in each parish a great number. Then the bishop of Lincoln gave general power to all and every priest to hear confessions, and absolve with full and entire authority except in matters of debt, in which case the dying man, if he could, should pay the debt while he lived, or others should certainly fulfill that duty from his property after his death. In the same year there was a great plague of sheep everywhere in the realm so that in one place there died in one pasturage more than 5,000 sheep, and so rotted that neither beast nor bird would touch them. And there were small prices for everything on account of the fear of death. For there were very few who cared about riches or anything else.... Sheep and cattle went wandering over fields and through crops, and there was no one to go and drive or gather them for there was such a lack of servants that no one knew what he ought to do. Wherefore many crops perished in the fields for want of someone to gather them. The Scots, hearing of the cruel pestilence of the English, believed it had come to them from the avenging hand of God, and--as it was commonly reported in England--took their oath when they wanted to swear, "By the foul death of England."


After the pestilence, many buildings, great and small, fell into ruins in every city for lack of inhabitants, likewise many villages and hamlets became desolate, not a house being left in them, all having died who dwelt there; and it was probable that many such villages would never be inhabited. In the winter following there was such a want of servants in work of all kinds, that one would scarcely believe that in times past there had been such a lack. And so all necessities became so much dearer."
History of England by Henry Knighton, in Source Book of English History, by E.K. Kendall.

By 1350, most of the Plague's devastating effects were dissolved. The survivors believed that they had been spared by God's grace. Religious fervor rose. Society itself was changed forever. The huge reduction in the workforce hailed a change in feudalistic society which was never the same following the Plague. Those workers which had survived the plague, now in the minority, demanded higher wages and more freedom. The Catholic Church, which had been unable to control or stop the Plague, had lost its importance in the mind of the people and paved the way for the birth of the reformation movement.

Both the Bubonic Plague as well as the Pneumonic Plague recurred several times within the next centuries, each time claiming lives, though not so many as in the 1348 outbreak. The countries affected were unable to rebuild the population before the next outbreak appeared, which was devastating to the work force, the economy, the culture, politics and the arts. It was during the time of the plagues that England and France were involved in the Hundred Years War, which only further served to reduce the populations of both countries. The plague years occur from the late 14th century into the mid-17th century in England. The plague also occured in the 12th century. The Pied Piper legend arose as a result of the plague in 1284. As a result of the plague and the reduction in the work force, the plague was accompanied by famine and malnutrition. In 1625, in London alone, some 35,000 died of the plague; while in 1665 the total deaths attributed to the plague is 69,000.

Another plague was also noted during this time period of the late 14th century, which was known as The Sweat or Swat. This plague arrived in England in 1485 carried by priests from Rouen who arrived at the invitation of Henry Tudor. This insiduous plague usually claimed its victim within nine hours of infection. It was said that this plague only affected the rich and middle-aged. Outbreaks of this plague continued in 1508, 1517 and 1551.

In 1563, an outbreak of the Bubonic Plague in London killed an estimated third of the population. There were subsequent outbreaks in 1578, 1603, 1625, 1636 and 1665 in which thousands died. The epidemics took the highest toll in 1563 and 1665.

Unidentified fevers followed in 1638, 1660 and 1661. These fevers may have been due to influenza. The death rate for those exposed to Bubonic Plague was 90%. In the most severed Bubonic Plague epidemics, the plague was responsible for some two million victims a year. The worst plague epidemics were in the 6th, 14th and 17th centuries.

Ref:
The Plague
The Bubonic Plague

Smallpox

Smallpox is a deadly disease which has plagued mankind for thousands of years. Various epidemidcs of the disease have been recorded throughout history. Smallpox may be spread through direct contact or through airborne transmission. Smallpox was omnipresent, but at times reached epidemic proportions. The smallpox vaccine was developed by Edward Jenner in the 18th Century but smallpox was not eradicated until the late 20th century.

The first record of smallpox was in 189 A.D. in the Roman Empire when 2,000 people a day were claimed by the deadly disease. Mummies have been discovered bearing marks of the disease from the 18th and 20th Egyptian dynasties (1570-1085 BC). In late 9th century Europe, 400,000 died each year from smallpox and about one third of the survivors were blinded by the disease.

Smallpox symptoms include: high fever, aches, nausea and a pussy blistered rash appearing first on the face, hands and feet and then spreading throughout the body. If the victim was alive after twelve days, they usually survived only to be covered by scars which served as reminders of the terrible disease, or blinded for life. Smallpox is spread through airborne transmission. Contraction of smallpox could mean death or blindness. Many were blinded by the dreaded disease. Smallpox was primaily a fatal disease, in which death was fairly expedient. Fatality rates were higher for infants, ranging as high as 90 percent. Survivors of smallpox were marked by scars upon their face, readily distuingishable as that of smallpox. Many people in medieval England through the colonial period were marred by the disfiguring smallpox or "pox" scars. Survivors of smallpox were then immune to further contagions of the disease.

Smallpox was always present, filling the churchyard with corpses, tormenting with constant fear all whom it had not yet stricken, leaving on those whose lives it spared the hideous traces of its power, turning the babe into a changeling at which the mother shuddered, and making the eyes and cheeks of the betrothed maiden objects of horror to the lover (1).

Smallpox was prevalent in 1634-5 and was also responsible for the death of Pocahontas during her visit to England. It was this smallpox outbreak in England which was probably responsible for the deaths of the Indian natives in the American colonies as well. . First introduced into Mexico by the Spanish conquistadors, Mexico's indigenous population fell from 25 million to 1.6 million. Similar fates fell upon the Indians of Eastern North America when the English colonists introduced smallpox to the native Indians. The American Indians were particularly susceptible to the disease, having no immunity for it and suffered death rates as high as 90 percent. The slave trade added to the smallpox epidemics as the slaves came from regions of Africa where smallpox was endemic.

Smallpox had no respect for class or position and even kings and queens fell subject to its power. Queen Mary II fell to the scurge of smallpox in 1694. In 18th century Europe, some 400,000 deaths were attributed to smallpox a year while one third of the survivors were blinded for life. Macaulay described smallpox as "the most terrible of all ministers of death."

Smallpox was a feared disease in which the victimes were usually abandoned or sent to "pest" houses where they recieved little or no treatment. The dead were buried in mass, common graves. Fatalities from smallpox ranged in the 20-60 percent range of those infected. Eradication of the plague required burning all of the victim's clothes and linens as even the linen's of the infected communicated the disease to others.

Early colonial New England was ravaged by smallpox epidemics, carried in with newcomers from England, where it was rampant. Between 1617-1619, a smallpox outbreak along the northern east coast of America killed 90% of the Massachusetts Bay Indians.

In 1677-1678, one fifth of the population of Boston was killed during a smallpox epidemic. Smallpox epidemics in Boston occurred again in 1692 and 1721. There was a smallpox epidemic outbreak in Pennsylvania in 1736 and in South Carolina in 1738.

In the 18th century, the disease was known as "The Speckled Monster".

Anytime troops were gathered together, smallpox outbreaks were common. In the Revolutionary War, deadly smallpox epidemics occurred.

Smallpox was particularly devastating to the native American Indian. Whole populations of Indians throughout the colonies were wiped out by smallpox epidemics. In 1738, a smallpox epidemic killed one half of the Cherokee Indians near Charleston, striking the entire state of South Carolina.

Ref:
Smallpox

1. Armies of Pestilence: The Impact of Disease on History. R.S.Bray. Barnes & Noble. NY. 1996

Yellow Fever

Yellow fever swept through the cities and the contryside, especially in the South. The fever was carried by mosquitoes. In the summer, those who lived in the city would often spend the summer with relatives in the country in order to escape the annual infections of fevers carried by the mosquitoes.

The symptoms of a severe infection of yellow fever were: high fever, chills, headache, muscle aches, vomiting, and backache. After a brief recovery period, the infection could lead to shock, bleeding, and kidney and liver failure. Liver failure causes jaundice (yellowing of the skin and the whites of the eyes), which gave yellow fever its name.

The symptoms of the fever usually became apparant within three days of hte bite of a disease carrying mosquito.
Yellow fever was one of the most dreaded diseases in port cities of the United States from until 1822; bringing with it the spread of doom and gloom to the people. The very mention of fever led to the quick assumption that the patient would die. The ability of medicine of that period did not even include a cure for fever and the doctors had no idea what caused the yellow fever outbreaks or any medicine or treatment for it.

Yellow fever outbreaks were common in families in which members of the family had travelled to the West Indies. However, once one was exposed to yellow fever, the survivor was protected by a lifetime immunity.

The fever was especially deadly for adults, while children tended to survive the attacks. The most prone to get the disease were males between 15 and 40; thus many heads of families were victimized but the disease quickly spread to other family members, even among the blacks. Yellow fever, like the plague, typhus and malaria are not spread from person to person. Unlike other diseases, yellow fever was impartial as to social status; the disease carrying mosquito equally at home in the cistern of the wealthy.

One of the most insidious things about the yellow fever was the fact that the patient would appear to be getting better only to suffer nausea and even death two or three days later. The patients would bleed from every orifice and even through the pores of the skin. The patients suffered black vomit and constant hiccupping. The victim suffered from the constant delusion that they were improving.

One victim, an Irish woman, "suffered severe head and back pains, great thirst, offensive stools, much vomiting, delirium, red spots on her face and breast, blindness, sore throat and hiccupping."

Inspectors in all of the ports examined immigrants for signs of any infectious disease or dying passengers, in which case, the ship was quarantined.

In 1690 New York suffered from a yellow fever epidemic and in 1699 an epidemic broke out in Charleston, SC and Philadelphia.

In the late 1700's many of the ships carrying French refugees were all in ill health.

Philadelphia suffered yellow fever epidemics in 1741 and 1762. The outbreak in Philidelphia in 1762 claimed the lives of some twenty persons a day. Charleston in 1745 and Virginia in 1741. An outbreak of the fever in New York in 1791, claimed the lives of about two hundred. Between 1792-1799, yellow fever epidemics broke out in Charleston, SC; Philadelphia, PA; New Haven, CT; New York, NY; Baltimore, MD and in Washington D.C. During the summer of 1793 the worst outbreak was in Philadelphia in which ten percent of the population died, about 5,000 victims. At that time, the new capital at Washington D.C. was under construction and the government was being held in Philadelphia. The government officials fled from the city. The great epidemic broke out in 1798. In 1793, Dr.Benjamin Rush began to study yellow fever. Dr. Rush was first to recognize the disease as yellow fever. He also determined that yellow fever was endemic in the West Indies and became lethal outside the islands. Dr. Rush advised blood-letting for vicitims of the yellow fever.

Yellow fever outbreaks occurred throughout North America in 1841 but was most severe in the South. New Orleans suffered a yellow fever outbreak in 1847. North America again suffered an epidemic of yellow fever in 1850 as well as 1852-1853 and again in 1855.

A severe yellow fever epidemic broke out in the United States in 1878, claiming the lives of some 20,000 people.

Following an epidemic, it became common to publish a list of the dead and to tally the fever statistics.

Malaria

Malaria is one of the oldest diseases known to mankind. The Chinese, Indian and Egyptian manuscripts mention malaria.

Symptoms of malaria include high grade fever, shaking chills and rigors but malaria is not confined to those symptoms but rather can present itself with varied and dramatic manifestations, especially where it is endemic. These symptoms may include: low grade fever, severe head aches and body aches, weakness, vomiting and diarrhea, cough, breathlessness, chest pain, acute abdomen pain, altered behavior, convulsions, coma, hallucination or a combination of these symptoms.

Malaria is a parasite affecting the red blood cell, causing the blood cells to rupture. The parasite is introduced into the victim through a mosquito.

Jamestown, with its swamps and thick woods was particularly susceptible to outbreaks of malaria. The Southern United States saw many of the outbreaks of malaria, though northern port cities, such as Boston and New York also suffered from outbreaks. Both sides during the Civil War suffered outbreaks of malaria, especially those stationed in the South, where soldiers suffered more than 1.2 million cases.

The New England colonies did report cases of malaria but the incidence in Southern colonies was far greater.

Symptoms of malaria occur 10 days to 4 weeks following the infective bite. There was no cure for malaria and victims were treated with herbal medicines such as betony, mustard, St.John's wort, wormwood and foxglove. In England, the revival of the Roman Baths claimed to be useful for Ague (malaria) as well as black and yellow jaundice, scurvy and other diseases.

In the 1700-1800's, malaria in England was known as Ague. Areas in England, which were particularly affected were marsh areas and along the coast.

During the Civil War, malaria epidemics were common, cuased by the stagnant swamps, teeming with infected mosquitoes. The Union Army reported one million cases of the disease during the course of the War.

Victims of malaria suffered outbreaks of the disease throughout their lives and were susceptible to numerous other deadly diseases.

Scarlet Fever

Scarlet fever, also known as Scarlatina, is a disease caused by the strep bacteria. It was a very serious childhood disease prior to the development of antibiotics.

Scarlet fever typically began with a sore throat, or strep throat and developed into a fever, vomiting, a rash on the neck and chest along with a sandpaper feel to the skin and peeling on the fingertips, toes and groin, along with chills, headache, general achiness, abdominal pain and muscle aches.

Complications of scarlet fever included acute rheumatic fever, ear infection, abcesses, pneumonia, Sinusitis, Meningitis, liver damage and kidney damage.

Scarlet fever is a disease that is transmitted by contact and is highly contagious.

Scarlet fever epidemics were often accompanied with puerperal fever and infected wounds.

Scarlet fever epidemics occurred in New England between 1735-1740 in which hundreds died, primarily children. In 1764 a Scarlet fever epidemic hit Boston and in 1787 in Maine.

Typhus (Typhoid)

Typhus was the most common waterbourne disease according to Thomas Sydenham, England's first great physician of the 17th century. A disease caused by contamination from human feces.

Epidemic Typhus is carried by the body louse and is excreted in the feces. The human scratches the bite and rubs the feces into the wound and contracts the disease, which incubates 1-2 weeks. Epidemics occurred throughout Europe from the 17th-19th century. Known as "Gaol Fever" in prisons, it was very common. Widespread epidemics occurred during the Napoleonic Wars and during the Potato Famine 1846-1849.

Symptoms include a high fever, weakness, headache, lack of appetite, stomach pains, a rash of flat and rose-colored spots. Extreme symptoms of typhoid include intestinal perforation, delusions and confusion. When untreated typhoid fever persists for three weeks to a month.

During the Civil War, epidemics of dysentery, typhoid, hepatitis, malaria, smallpox, measles and venereal diseases killed three times as many soldiers as battle wounds. Perhaps one quarter of noncombatant deaths in the Confederacy were the result of typhoid fever.

It wasn't until 1837 that Typhus fever and Typhoid were differentiated. Gerhard described the more acute onset of Typhus with typical rash. In 1850, Jenner presented a detailed comparison of the two diseases based upon clinical and post-mortem appearances describing the difference in the rash and the lesions of Peyer's patches and the mesenteric glands seen in Typhoid were never seen in Typhus.

Typhoid fever is caused by various strains of Salmonella, while Typhus is caused by various Rickettsiae and is divided into endemic typhus (flea-borne) and scrub typhus (chigger-borne)

Typhoid epidemics occurred in Philadelphia, PA in 1837 and throughout the United States between 1861-1865.

Influenza

Influenza, or the flu, as it is commonly known is a viral infection of the respiratory tract. The flu is highly contagious, spreading from person to person through coughing or sneezing. It readily develops into pneumonia.

An influenza epidemic occurred throughout the world between 1732 and 1733. The influenza epidemic hit North America and the West Indies in 1761. An extremely severe epidemic occurred worldwide between 1774-1776. A "Putrid Fever" and Influenza occurred in Vermont in 1793 in which 500 died in five counties in four weeks. In 1850-1851 North America suffered another influenza outbreak and a world wide epidemic occurred 1857-1859.

A worldwide influenza epidemic in 1918-1919 resulted in the deaths of some 675,000 in the United States. Over 40 million worldwide fell victim to the influenza virus in 1918-1919.

This epidemic, known as the pandemic killed at least 25 million people in one year, perhaps as many as 37 million. This influenza epidemic, falling on the heels of WWI, began in Camp Funston in Kansas and at quickly spread world-wide.

It wasn't until 1997 that the epidemic of 1918 was identified from specimens preserved in formaldahyde from the victims of the pandemic. It was discovered that the virus spread from birds, to pigs, to humans. These viruses, mutated in pigs, are the most deadly of all viruses.

Known as the Spanish Influenze epidemic of 1918-1919, one fifth of the total world population was infected, though only 3% of those infected actually died. The age group 20-40 was the most susceptible to the disease. The disease was distince because it had a very rapid onset and the patient often died within hours. Entire families lay dying in their homes, coughing foamy, blood-tinged sputum.

At the height of the epidemic, patrols were charged with picking up and disposing of the disease's victims. The newly dead were brought out of their houses to be picked up by the patrols. The stench of death was everywhere. In Philadelphia some 7,500 fell victim to the disease in two weeks. Streetcars became hearses as the supply of coffins ran out.

Some called the pandemic Judgement, God's disgust with the human race following WWI.

The epidemic was particularly deadly in US Army training camps, where the death rate was as high as 80% in some camps.

In order to protect themselves from the disease, people stayed home. Public facilities such as churches, theaters and schools were vacant and abandoned.

Diptheria

Diptheria, a common childhood disease which was acute and highly contagious in which a thick grey membrane formed in the child's throat making it difficult for the child to breathe. This symptom was accompanied by fever and severe weakness. The disease often affected the child's heart, making it fatal.

The disease is caused by a bacteria which causes toxins that circulate through the blood stream and damage the cells of the heart.

A diptheria epidemic occurred in 1739-1740 in New England accompanied by an epidemic of Scarlet fever.

Measles

References to measles occur as early as the 7th century and in the 10th century is recorded as "more dreaded than smallpox".

Measles is caused by a virus and the primary site of the infection is the respiratory system. The disease is highly contagious. The disease can be contracted by any age group and is spread by direct contact of secretions of infected people and less frequently by airborne transmission.

Symptoms of measles occur in two stages. The first stage includes a runny nose, cough and slight fever. The eyes may become reddened and sensitive to light as the fever continues to rise. The second stage begins on the third to seventh day and is noted by a high fever and a red blotchy rash, which lasts four to seven days. The rash usually begins on the face and spreads to the entire body. Small white spots may appear on the gums and inside the cheeks.

An individual may spread the disease for five days prior and five days after the rash appears. The disease is spread through a sneeze or a cough, or even if an infected person talks to you.

Complications from measles include pneumonia and encephalitis, middle ear infection and convulsions. Measles is more severe in infants and adults. For every 1000 cases of measles, one or two will die. Pregnant women who contract measles may have a miscarriage or premature birth.

An outbreak of measles occurred in New York between 1592 and 1596 and again in Boston in 1657. In 1687 an epidemic of measles occurred in Boston, where it again occurred in 1713 and 1729 and yet again in 1739-40. In 1747 the states of CT, NY, PA and SC were all struck with a measles epidemic. In 1759 a measles epidemic struck the United States and again in 1772. Philadelphia and NY were struck in 1788.

Bloody Flux, Dystentery

The most common cause of the death of young children was bloody flux or dysentery. Death in early childhood was common. In Philadelphia, one fifth of the newborns did not reach age two.

Dysentery is one of the most dangerous types of diarrhea and is more deadly than other forms of acute diarrhea. The disease is caused by a baceria. Mortality is high among infants and the elderly.

The primary symptom is bloody diarrhea. Other symptoms may include abdominal cramps, fever and or severe pain during defectaion. Most cases last up to seven days but can be persistant for fourteen days or more. The disease may cause blood poisoning, rectal prolapse and may affect the kidneys and blood clotting system.

The disease is spread by poor sanitation, especially unwashed hands. Unlike Cholera, dysentery is not spread through contaminated food or water. Epidemics of dysentery occur during hot, humid and rainy seasons, especially in crowded areas with inadequate sanitation and poor hygiene and limited water supplies.

Dysentery was rampant in the United States during the Civil War. Disease, not battle wounds, were the biggest killer during the War. In the Union Army three of five died of disease and in the Confederate Army two of three. Half of these were due to intestinal disorders, including typhoid fever, diarrhea and dysentery. The remainder died from pneumonia and tuberculosis. The military camps introduced contagious diseases to the soldiers, many for the first time, causing outbreaks of common contagious diseases including measles, chickenpox, mumps and whooping cough. Poor camp conditions contributed to the spread of disease such as dysentery.

Bilious

A catchall phrase for stomach distress. At the time it was believed that bilious was caused by excess bile, evidenced by discolored stools or vomit. The disease created a pattern of sweats and chills, which diminished only to return with vigor the next day. In the August heat, bilious, remittent fever left the patient prostrated and peaked and sallow.

Inflammatory symptoms, flushed face, rapid pulse, over excitability were all rare in August.

Cholera

Cholera is basically a result of bad water and poor sanitation. The bacteria can live for a surprisingly long time in water. The disease is an infection of the small intestine caused by a bacteria. The disease inhibits the absorption of water and salt in the intestines. Once the symptoms of cholera set in, death can follow within hours. Most deaths are the result of severe dehydration brought on by diarrhea.

The disease began with an attack of violent diahrrea and vomiting followed by intense abdominal cramps, thirst and fever. Deprived of water, the victim's extremeties become cold and "death like in touch." Within three to twelve hours the skin became dry and a dusky blue or purple color, the eyes sank in their sockets and a pulse became imperceptible, while the voice was reduced to a faint whisper. Death often took place within a day or even within hours.

Though Cholera had first been identified in the late 1700's, it had never been seen outside of India, where it is endemic, especially in the Ganges Delta. The First Cholera Pandemic began in 1817 when the bacteria made a westward movement over the Arab-Moslem trade routes from India and affected the east coast of Arabia, Syria and southern Russia as far as the Volga. The pandemic abated in the early 1820's.

The Second Cholera Pandemic appeared in 1826, affecting all of India and much of the Far East. Travelling the trade routes, Cholera spread westward into all of Russia's main cities by 1831, contaminating all of the water sources including major rivers.

Cholera is a bacteria that can exist outside the human body. It was the arrival, into India, of Western modes of transportation: railroads, steamships and canals that transported the disease outside of India for the first time. It is often said that Cholera is a disease of the Industrial Revolution.

Cholera first appeared in England in the 19th century, with the first outbreak in October of 1831 and lasted until 1833. The disease arrived from Russia and spread rapidly with 22,000 people falling from it before June of 1832. By the end of 1832, the disease had spread throughout England. It spread quickly to Scotland and to Ireland. The speed with which it claimed its victims was the most frightening thing about it.

England, anticipating the arrival of the disease, established a National Health Board, as well as localized boards of health in eatch town and village. Temporary hospitals were established. Infected persons were to be taken to one of these hospitals as soon as the disease had been detected. Rules were established for the homes of sick people, which included "washing all the clothes and furniture, scouring the walls and ceilings with lime and the doors and windows left open."

Cholera was "perceived as a demonic, evil and foreign force".

In New York and in the United States at large, the spread of cholera was also anticipated. The New Yorkers saw the disease as the righteous consequence of God's judgment upon those who were not in God's grace. This attitude was further enhanced by the fact that the disease had affected primarily those persons who lived sinful lives, therefore it was the consequence of sin in those areas of the world least populated by Christians. There was also an attitude that those who were good, clean and temperate would escape the ravages of Cholera, as the disease was seen as a "poor man's plague".

Cholera entered Canada with a ship of Irish immigrants and quickly spread southward into New York through Albany. It also entered New York through the St.Lawrence and along the shores of Lake Ontario. The disease also was transported into New York through immigrant ships. By June of 1832, the disease appeared in New York City and by July the city saw one hundred deaths a day. By September, over 3,000 were dead. Many of the population fled the city and much of New York's businesses were closed.

With prior epidemics in the city, New York had established a Board of Health, which established a quarantine of all people and products of Europe and Asia. New York's sanitation department was reorganized and the city's streets were cleaned. Temporary hospitals were established in the city. Old banks and abandoned public buildings were transformed into Cholera hospitals. Welfare services were established and slum clearance programs, food and drug regulations were developed. Public hysteria overwhelmed the city's Board of Health following the outbreak of the disease.

Many of the immigrant ships to North America brought cholera to the United States. The ships were overcrowded and had poor sanitation and were natural habitats for the disease. Otentimes, local residents demonstrated when immigrations ships arrived, fearful that the ships might be harboring the deadly cholera. Oftentimes, even quarantining infected immigrants did not halt the spread of the disease. Irish Catholics were seen as the source of the deadly disease. As the newest immigrants, the Irish lived in the worst housing and the most crowded conditions, unable to afford good medical care, good water or flight from the epidemic.

Americans saw the Cholera epidemic as proof that the Negroes were socially and genetically inferior, as the Negroes, also living in poor sanitary conditions, died in larger numbers than the whites. It was believed that the Negroes "innate character invited Cholera." The Negro was seen as "filthy and careless in personal habits, lazy and ignorant by temperment", taking no steps to protect himself from the ravages of the disease.

An outbreak of the disease again struck Great Britain in 1848-1849, claiming the lives of perhaps 70,000 in England and Wales. The disease was spread with alarming speed, largely due to poor sanitation in large towns.

Asiatic Cholera struck North America in 1831-1832, brought by English immigrants. Asiatic Cholera was a particularly virulant strain of the disease and was usually fatal. New York City and other major cities were struck by a Cholera epidemic 1832-1834. A cholera epidemic struck North America in 1848-1849 and New York City in 1849.

Whooping Cough (Pertussis)

Whooping Cough is a bacteria that is spread by people. The bacteria is carried in the lungs, throat and nose and is spread by coughing, sneezing and spitting. The bacteria cannot live outside the human body. It is most contagious in its early stages, when the symptoms are no different than the common cold.

Early symptoms of whooping cough include a sore throat with a feeling of tiredness. In two or three days a dry, intermittent cough which persists but may wax and wane over the next 7-10 days by which time the cough becomes more productive and accompanied by occasional bouts of a choking cough. Fever is usually only noticed inthe first week and is mild. The victim may experience nasal discharge. After the initial first two weeks, attacks of a choking cough, often with vomiting and a feeling of suffocation. Between these attacks, the victim feels perfectly well. These attacks may only be a few a day or they may be as many as fifty. The whooping sound is heard as the victim intakes air during the coughing, though not all victims make the sound. The victim may stop breathing after a severe coughing spell and may even faint. Whooping cough lasts three weeks but may last as long as three months.

The primary complication is pneumonia, experienced by about 1 of 100. Deaths from the disease are primarly limited to babies due to respiratory failure. Minor complications in severe cases include bleeding over the white of the eye, blood spots on the skin, tearing at the ligiment at the base of the tongue and umblicial hernia, all caused by the severe cough.

Tuberculosis (Consumption)

One of the most common causes of death throughout the 19th century was tuberculosis. Unwittingly, entire families were wiped out by passing this disease, that consumed the body tissue, to one another.

A bacterial disease, tuberculosis is equally at home in the brain or the lung, destroying its host. Mothers with tuberculosis unknowingly gave the disease to their infants while nursing. The bacteria lived not only in mother's milk, but also in saliva and in the air as well, spread by a cough or sneeze. The bacteria survived even in the dirt, where people spat, killed only by sunlight. It became illegal to spit on the ground.

Mumps

Mumps is an acute, viral illness described by Hippocrates in the 5th century BC. Armies have been particularly susceptible to the disease. Complications from mumps led to aseptic meningitis and sensorineural deafness in children.

The virus is spread through saliva and is also found in urine, blood and the milk of infected victims. The virus spreads to multimple tissues including salivary, pancreas, testes and ovaries.

Incubation lasts 14-18 days and symptoms include achiness, anorexia, fatigue, headache and low grade fever. Swelling is the most common manifestation affecting the salivary glands, first noticable as an ear ache or tenderness on the palpatation of the angle of the jaw. Symptoms decrease after one week and are usually resolved after ten days. Some patients may experience primary respiratory symptoms.

Complications include aseptic meningitis and symptomatic meningitis. Adults are at a higher risk for this complication than are children and in children, boys are more commonly affected than girls. Encephalitis may develop but is rare. Testicular inflammation is the most common symptom in postpubertal males and may include nausea, vomiting and fever. This swelling may last a week but tenderness may last several weeks. About 50% of these patients may suffer some permanent testicular atrophy but sterility is rare. Ovarian inflammation occurs in only about 5% of postpubertal females and may mimic appendicitis but there is no relationship to infertility in females. Pancreatitis is infrequent but occasionally occurs. Permanent deafness occurs in approximately 1 in 20,000 cases. Heart attacks occur rarely and result in a few deaths.

 

References

A Short History of Yellow Fever

In Sickness

The 1832 Cholera Epidemic in New York State


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