When was the last time you lost someone to intestinal parasites? Thanks to the miracle
of modern science, gut worms won’t kill much more than the mood these days, but it was a completely
different story 200 years ago. Stay tuned for more ways people bit the dust in 1800s America.
So let's just start with one of the grossest items on the list — diarrhea — which today
most people tend to think of as more of a symptom than an actual disease.
Back in the 1800s, it was a general umbrella term used to describe loose,
watery stools that weren't attributed to a specific infection like dysentery.
It was a big killer, too. According to the "Mortality of the United States" census report,
diarrhea claimed the lives of 7,850 people in 1860.
In today's America, you don't often hear about people dying of diarrhea. That's primarily because
the real killer from diarrhea is the dehydration that can happen if it isn't tended to quickly.
Today, if you can't manage to replace fluids with Gatorade or Pedialyte at home,
you can always get IV fluids at the ER. Although, deaths can and do happen even now.
In fact, a study published by JAMA found there are roughly 8,000 diarrhea-related
deaths in America every year. Which, when you think about it,
does seem like a pretty high number compared to those from the 1860s.
Remember, though, that figure includes all diarrheal illnesses. And, there also are about
10 times as many people in the United States today as there were back in the 1800s,
so proportionately, the numbers aren't really that alarming.
Worldwide, though, diarrhea is still a big killer. According to the World
Health Organization, today diarrheal illnesses,
including cholera and dysentery, kill about half a million children every year.
Vaccines have made it possible for more people to survive childhood. As a result,
many of us tend to grow up completely unaware of just how bad vaccine-preventable illnesses can be.
One excellent example is pertussis, otherwise known as whooping cough.
This bacterial illness is a little bit like our dear friend COVID-19 in that it not only
spreads from person to person via respiratory droplets; it also causes a severe cough.
Once you have pertussis, symptoms progress slowly over a couple of weeks. At first you
may feel like you just have a cold and you're all, "I can totally do this pertussis thing!"
Within a couple of weeks, though, you'll progress to having coughing fits so violent that you can't
breathe through them. And, well, you'll also probably barf when they're over. Not fun.
To make it even more not fun, the CDC says symptoms can persist for up to 10 weeks,
which is why some people call pertussis the "100-day cough."
In the 1800s, pertussis was a big killer. The 1860 census counted 8,408
whooping cough victims. The disease, however, was especially fatal for children under the age of 1.
In fact, it accounted for 5% of total infant deaths that year.
Today pertussis is less of a problem in America because of both widespread
vaccination and antibiotic treatment. Still, 50% of babies who get pertussis
will need hospitalization, so it's not a completely trivial disease.
Convulsions were quite the killer in the 1800s. Data from the "Mortality of the United States"
says that convulsions killed a total of 9,077 Americans in 1860.
In those days, "convulsions," like diarrhea, was sort of an umbrella term used to describe
any disorder that caused spasms, usually in children. This could include everything
from neonatal seizures, epilepsy, or even tetanus, which causes spasms of the jaw muscles.
For children under the age of 1, convulsions were considered so universally fatal that
doctors sometimes didn't even bother to attend to patients who had this symptom. Why? Well,
because unfortunately, there wasn't anything that could be done for them.
Convulsions were especially dangerous for newborns, and today it's clear why.
Babies deprived of oxygen during birth through situations like a detached placenta or compressed
umbilical cord, could suffer brain damage, which can lead to seizures after birth.
The difference between now and the 1800s is today we have things like MRIs, CT scans, anticonvulsant
medications, and medical knowledge. Newborns still die from things like oxygen deprivation
and meningitis, but the cause is less of a mystery, and many of the conditions are treatable.
Cephalitis is encephalitis without the first two letters.
It is not a specific disease, but rather a symptom of something else.
According to Johns Hopkins Medicine, people with encephalitis have inflammation in the brain,
which can lead to a host of other symptoms including light sensitivity,
stiff neck, headache, and confusion.
It's still a big problem today, as it's affected roughly 250,000 Americans in the last decade.
Sometimes the cause is a virus like measles or chickenpox; other times an autoimmune disease
can be the causing factor. But, in up to 40% of cases, the cause is actually a mystery.
It was even worse in the 1860s. Why? Well, it's important to understand that it would still be a
couple of decades before doctors started having a good understanding of germs,
what exactly they were, and how they made people sick.
That explains why the 1860 census gave cephalitis its very own, very vague category. In fact,
the common term "brain fever" was often used to describe the condition.
Brain fever was a scary name for a mysterious illness, which according to JSTOR Daily,
sometimes found its way into classic novels like "Madame Bovary."
Some doctors even thought "brain fever" was a mental health problem.
They usually chalked it up to sufferers experiencing some kind of emotional trauma,
or maybe they were just your typical overthinker.
In 1860, 10,399 Americans died from cephalitis. Even today,
the mortality rate in hospitalized encephalitis patients is nearly 6%.
You can't say anything about dysentery without mentioning the Oregon Trail,
so let's just get that out of the way first.
"You can catch dysentery like that."
"Oh, It's spicy."
Yes, ever since the Oregon Trail made its debut in 1971, people have been dying of
dysentery from coast to coast, sometimes even a few times in a row. But, don't be fooled,
dysentery is also an actual thing that people died of in real life, and still do to this day.
Dysentery is different from diarrhea by its severity and cause. People with dysentery
have bloody diarrhea, while regular diarrhea is blissfully blood-free.
Dysentery is also caused by two specific microorganisms which we'll get into.
According to the NHS, the first is a bacteria called Shigella. People usually encounter this
while eating food that's been in contact with the stool of someone else who has
this form of dysentery, so that's a bit gross. Wash your hands, people!
The second form is amebic. This is caused by a single-celled organism,
specifically a protozoan called E. histolytica, which also spreads via poop.
10,468 people died of dysentery in the year 1860 according to the "Mortality of the United States''
report. In comparison, today, about half a million Americans get dysentery every year.
Which, when you think about it, means the message still isn't percolating the way it should be.
Though to be fair, most Americans who get dysentery today don't die from it.
You're probably thinking people in the 1800s never died from old age. No vaccines,
poor public health measures, lousy sanitation — it seems pretty obvious that some disease
or another is going to take you down before you get old enough to buy a rocking chair.
But as it turns out, a lot of people in the 1800s did live long enough to become old geezers.
The 1860 census names "old age" as the cause of death for a total of
10,887 people. It does that with some caveats, however. The author of the census wrote:
"Old age should include only those who die from exhaustion of vital force from
protracted use of life, without any disease or organic lesion."
The author then goes on to note that most of the "old age" deaths in the report
probably didn't meet that definition, since the elderly are more likely to die from
illnesses that younger people usually survive.
In fact, the author also notes that some of the people who were reported
as dying of old age were less than 50 years old. So, just in case you needed
confirmation that life in the Wild West was rough, well, there you go pard'ner.
Modern medicine describes remittent fever as a fever that fluctuates by more than a couple
degrees but is never normal. Today, doctors know this type of fever is usually caused by
some kind of infectious disease, but in the 1800s? It was just called a "fever"
because the concept of disease-causing agents was still on pretty shaky footing.
The cause of the fever wasn't always known, so the fever itself was named as the illness.
There's also some likely confusion between what the 1860s census calls "remittent fever," which
killed 11,120 people in 1860, and the less-common cause of death labeled "intermittent fever."
Doctors of the time often used both words when talking about known illnesses like malaria.
The census document doesn't go into much detail about this cause of death
other than to say it claimed about twice as many lives in the summer as in the winter.
Which, when you think about it, also points to malaria since it's mostly a summer disease.
Malaria isn't something you worry about while you're swatting mosquitoes anymore,
but it was a big problem in the United States. That is, up until the CDC launched its mostly
successful 1946 campaign to eliminate the disease. However, believe it or not,
there are still around 2,000 cases a year right here in America even today.
You also don't really hear about people dying of dropsy
anymore. Though that's not because dropsy is no longer a thing, it's
because it has a different name. Today, dropsy is called edema or more simply,
"fluid retention." Medically speaking, it's the swelling of tissues due to fluid build-up.
Fluid retention is most obvious in the ankles and feet, but it can also appear in the stomach.
It can even manifest as weight gain or, more worryingly, trouble breathing.
Just having swollen feet and ankles seems pretty benign at face value,
but when edema shows up it's often a sign of something a lot
more dangerous like heart failure, kidney failure, or lung disease.
That explains why "dropsy" was such a big killer in the 1860s. These are pretty
dangerous conditions that are hard to treat even today; so back then — they were lethal.
The 1860 "Mortality of the United States" document counts 12,090 people as victims of fatal dropsy.
To be fair, though, even in 1860 doctors were aware that
dropsy was a symptom rather than a disease.
The author of the 1860 report called it, quote, "an unsatisfactory designation of
disease or cause of death," and noted that it was usually caused by disease of the heart.
"Listen doctor, I got a boy here in cardiac crisis. You can't treat that
with coca-cola or bisquick. We're gonna have to use real medicine this time."
Typhoid fever is another illness you don't hear much about anymore, but
it is still very much a thing. You do hear about its close cousin Salmonella, which is what keeps
you within three feet of a bathroom after you foolishly ate some grocery store sushi.
Salmonella is usually not serious for healthy people, but when small children, the elderly,
and immunocompromised people come down with it, it can be life-threatening.
Typhoid fever is caused by two types of Salmonella,
specifically serotype Typhi and serotype Paratyphi.
Nowadays, Americans who come down with typhoid fever usually pick it
up while traveling to other countries. This is because health authorities in
the U.S. have solved most of the sewage problems that contribute to the disease.
According to the CDC, it can also spread person-to-person. However,
this generally only happens when someone who has the illness gives
you a soda or something after using the toilet and not washing up afterward.
In other words, if you get typhoid fever it's literally because you ate poop.
By the 1860s, people were aware that you could get typhoid fever this way.
But great sanitation systems weren't really widespread by the time of the 1860 census.
So, by that year a total of 19,236 people died from typhoid fever.
For new parents, croup is a dreaded condition and this isn't because it's fatal. Rather,
it's because it usually requires staying up all night long with a very unhappy infant.
According to Johns Hopkins Medicine, croup is usually caused by something like
influenza, a respiratory virus like RSV, or other cold viruses.
It's distinguished from other kinds of cough
because the voicebox and windpipe become swollen, which can make it hard to breathe.
This in turn causes the distinctive whistling sound that gives croup its name, meaning to cry
hoarsely or croak. Because babies have smaller airways, the swelling can become an emergency.
Today, croup is fairly easily treated with medication as long as parents seek medical care in
time. In the 1860s, though, the only way to clear a swollen airway was to perform a tracheotomy.
Unfortunately, the procedure was really just a last-ditch effort that didn't usually work.
When it did, the person would have to live with a tracheotomy tube for the long term.
For many patients, though, this radical surgery wasn't even an option.
Croup wasn't just a terrible killer in those days, it was also heartbreakingly common.
According to "Mortality of the United States," it killed
15,211 people in 1860, nearly 90% of them children under the age of 5.
If you've seen "A Million Ways to Die in the West," you know that people in 1800s
America commonly died from everything varying from gunshots, to stabbings,
wolf predation, exploding cameras, rampaging bulls,
being crushed to death by large blocks of ice, and methane poisoning from their own flatulence.
"The American West is a disgusting, awful, dirty,
dangerous place. Look around you. Everything out here, that's not you, wants to kill you."
In short, yes, it was a dangerous time.
Not only were the liability laws and safety regulations a bit lax, but medical science
didn't really know how to save people from major trauma or excessive farting back then.
Hence, the 1860 census document lumps 18,090
deaths into the "accident" category. It doesn't include flatulence or exploding cameras though.
Instead, it includes things like burns and scalds, drowning,
lightning, firearm accidents, falls, railroad accidents, strangulation, and poison.
That last category also includes snakebites and might include a
case or two of flatulence-related methane poisoning, but probably not.
There were also 4,178 "accidents not specified" and a few other accident-related causes of death
not mentioned here simply because some of them frankly didn't seem very accidental.
Still, it's obvious that it was pretty easy to die in stupid ways back then.
Especially since this particular kind of mortality is pretty high on the list of
the most common ways people died in 1800s America.
If you ever read "The Velveteen Rabbit" as a child,
you were forever traumatized by the idea of scarlet fever.
Not because you thought you were going to die from scarlet fever,
but because kids with scarlet fever had to burn all their stuff.
And well, that's really just about the worst thing that can happen to a kid.
Today, kids can — and still do — get scarlet fever. The difference is that doctors can
now prescribe antibiotics, so it's not a completely serious illness like it once was.
"It's so good to see your face."
"We're going to the sea to get you strong and well."
"The sea?"
"Mm, I want you dancing by the time Amy gets back."
Scarlet fever is caused by Group A Streptococcus, the same bacteria that causes strep throat. The
disease often begins in the throat and, in some people, develops into scarlet fever. You'll know
it when you have it because it causes a bright red rash on your skin and a bumpy, red tongue.
Like croup, it's mostly a childhood illness,
though anyone can technically come down with it if they're unlucky enough.
Today, the CDC describes scarlet fever as "a mild infection." The 1860 census document,
though, described it as the quote, "dread scourge of children." Why? Well,
the 26,402 people who died from it accounted for a full 7.41% of all deaths recorded that year.
Pneumonia is still a big killer, even today. According to the American Thoracic Society,
it's responsible for 16% of all deaths worldwide in kids under the age of 5.
Better access to healthcare makes it less deadly in America,
but it's still the leading cause of hospitalizations among children.
Pneumonia is a disease of many causes. Bacterial pneumonia is often caused by Streptococcus
pneumoniae, but there are a few other bacteria that can cause it, too. Viral pneumonia can
occur after infection with a host of different viruses, including influenza, RSV, and COVID-19.
Today, bacterial pneumonia can be treated with antibiotics,
but there are unfortunately no good treatments for viral pneumonia.
In the 1800s doctors didn't even have antibiotics, so when you got pneumonia,
all they could do was throw their hands up helplessly and tell your family to start praying.
According to "Mortality of the United States" census data,
pneumonia in 1860 was "among the most destructive diseases," claiming the lives of 27,094 people.
If you watch period films, you know what consumption is. A beloved character is
stricken by this dreadful disease and is sent off
to live in a "sanatorium," where he or she slowly wastes away and dies.
"How we feelin' today, Doc?"
"I'm dying. How are you?"
That fiction was an exact mirror of the truth, though the sanatorium wasn't even a thing in
the 1860s. The belief was that fresh air and healthy food could help you recover, though
the facilities also acted as isolation centers that prevented further spread of the disease.
Sanatoriums probably did help some rather wealthy people recover, but consumption
didn't really stop being a big killer until the antibiotic streptomycin came along in 1944.
Today, there's a different word for consumption, but it's the same illness. Modern tuberculosis
doesn't usually kill Americans, though. If you're unfortunate enough to develop it,
you take antibiotics and you recover. In other parts of the world, people aren't so lucky.
The 1860 census numbers tuberculosis deaths in the United States at 49,082,
calling it "the great destroyer here and elsewhere." It was the cause of
nearly 14% of all American deaths that year. Worldwide, things weren't much different.
According to PBS, by the early 20th-century tuberculosis had claimed the lives of one
out of seven people who had ever lived on planet Earth.
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