The Fatal Five

Many of the diseases that the people of Dundas experienced and feared in the 1800s are today a distant memory. With the invention of antibiotics and widely available vaccinations many of the common early childhood illnesses are no longer the serious threat they once were. In the 19th century infants and children were at terrible risk of succumbing to a wide variety of now treatable ailments. Through analysis of the 1869-1878 death records from Dundas, five of the most commonly recorded causes of death for children under seventeen were: Diarrhea, Scarlet Fever, Tuberculosis, Whooping Cough, and Bronchitis. Among the other commonly recorded causes of death were cholera infantum and dysentery.  The 3-D printed models are of the microscopic virus or bacteria responsible for each disease.

During the 1860s and 1870s the bacterial or viral causes of these diseases were not yet fully understood. Many medical practitioners still favoured the miasma and humoral theories of disease. The miasma theory held that diseases and infections such as cholera or the plague were caused by “bad air”, foul-smelling air that affected anyone in the area rather than infections being spread person to person. The humoral theory of medicine believed that people have four vital bodily fluids: blood, yellow bile, phlegm, and black bile. It was thought that in order to maintain good health these humours had to be balanced within the body and medical treatments aimed to re-balance the humours by removing the excess of whichever humor was thought to be causing the disease. This is why ‘bleeding’ was such a common treatment for many illnesses until the late 19th and early 20th centuries.

Because many of the causes of these diseases would not be discovered or understood until the end of the 19th century, the treatments used to combat them were often ineffective if not outright dangerous. Many patent medicines contained ingredients that we would recognize today as toxic. The artifacts here which are associated with a specific illness are a representation of the type of treatment that would have been used. They also would have been used in the treatment of a wide variety of symptoms and diseases. The study and practice of medicine looked very different in the 19th century and may seem obsolete and even ridiculous today, however it was the best attempt at facing deadly and unknown diseases.

Mortar and Pestle

1964.573

Small-sized marble mortar & pestle, used in the shop of E. Lesslie & Son, Dundas, 1821. Pharmaceutical medicines were not as widely available as they are today. Doctors or pharmacists would often have to mix their own medicines, rather than carry a stock of prepared mass-marketed medicines.

Aloin, Strychnine, Belladonna Pills

2012.001.219

Parke, Davis and Company was founded in Detroit, MI in 1866. The company was once the largest pharmaceutical company in the US, built the first pharmaceutical research laboratory in the US, and is credited with developing the first systematic methods for performing clinical trials of new medications.

Medicine Spoons

1959.025 and 1967.005

Silver measuring spoon and silver-plated medicine spoon for warming medicine over a candle (c.1880).

When a person contracts this illness, the individual exhibits a number of symptoms, such as watery stool, nausea, fever, and abdominal cramping. This illness is usually contracted through a viral infection connected to drinking contaminated water or infected dairy milk. Diarrhea was often fatal for those who contracted it because people became so dehydrated that their body systems failed. Some nineteenth-century treatments for diarrhea include the giving of fluids and soothing syrup.

Cholera is mainly caused by bacteria located in the fetid water by people’s stool bacteria.  In Hamilton, altogether there have been 550 cholera outbreaks. Cholera symptoms include watery diarrhea, rice water stool, fishy odor stools, vomiting, fast heart rate, dry mucus, low blood pressure.

Common treatments: Boiling drinking water.

Facts about Cholera:

• If untreated cholera can kill within hours 
• The wells at the center of Hamilton were created for safe drinking water in one of Hamilton’s two major outbreaks
• John Snow discovered the cause of cholera 
• Safe drinking water is the easiest way to prevent cholera

John Snow was born in York, England on March 15th, 1813. He grew up to become a physician and was skeptical of the miasma theory for cholera (the miasma theory was the theory that cholera was a bubonic plague transmitted through the air from pollution, etc.).  After lots of research and mapping out areas of the disease, and then after digging at a pump, Snow found stool 3 feet below the pump.  However, his point wasn’t convincing enough for a big change in medical practices, but he got the city council to disable the pump. Now we now know that he was in fact right.

Peppermint Oil

2012.001.214

Oil Menth. Pip (Peppermint Oil), is derived most often from the Mentha piperita plant, which is among one of the oldest herbs used for medicinal and culinary uses. One of the popular uses for peppermint oil is as a carminative and gastric stimulant, used in the treatment of flatulence, nausea, and abdominal pain.

Oil of Aniseed

2006.569.016

Oil of Aniseed is derived from the anise plant. In traditional European medicine, the oil was most commonly used for its carminative (gas-reducing) properties and general benefits for the gastrointestinal system. This bottle of Oil of Aniseed was produced by a wholesale drug company known as Drugs Limited, in Winnipeg, MB.

Granulated Twin Leaf Root

1969.15

Twin leaf Root was used by the Haudenosaunee and in early settler medicine to treat diarrhea. From the Parke & Parke Store in Hamilton, established in 1876 and incorporated in 1917. They grew to be one of the largest pharmaceutical manufacturers and supplies in Canada.

 

Scarlet fever was a dangerous disease that was very deadly in Dundas during the nineteenth century. When a person contracts this disease, the individual exhibits a number of symptoms, including headaches, nausea, vomiting, ‘strawberry tongue’ (a tongue that looks white with red dots), strep throat, and a sore throat with white or yellow patches. A person can contract this illness by coming into close contact with someone who has the disease.  Some common ways of contracting the illness include the sharing of towels, swimming in a pool, or sharing clothes. Scarlet fever was often fatal for those who contracted it because it could lead to other illnesses such as kidney disease or rheumatic fever. Scarlet fever often attacks people between 5 and 15 years of age. The treatments we now use to treat scarlet fever include the prescription of antibiotics. 

Some (not-so-fun) Facts:

• The bacteria that cause scarlet fever (streptococcus) is the same one that causes strep throat.      
• It takes 12 hours – 7 days for the bacteria to attack, once it has invaded a person.

In the nineteenth century, doctors tried to treat scarlet fever by:

• Quarantining people with the illness, as well as burning their possessions to stop the spread of the disease
• People with scarlet fever were put on a strict diet.
• Leeches were placed behind both ears of the patient until they turned pale or fainted
• Doctors would put a borax solution on patients’ eyes.
• Doctors would prescribe ‘Belladona’ (a toxin that would give the patient a rash) because the doctors believed it would cancel out the rash caused by scarlet fever.

Chocolate Coated Tablets

2012.001.220

Belladonna was sometimes used to prevent Scarlet Fever. A common early medical theory thought that “like cured like”. Therefore there was a belief that the rash caused by belladonna would prevent the rash from scarlet fever.

Saltpeter

2012.001.207

Emetics were a common treatment of scarlet fever. This forces the patient to vomit. Once this was given it was important to only eat things that were easy on the stomach. Saltpeter, or potassium nitrate, was sometimes added to rice water to give to patients. This jar was sold by W. N. Braund, a druggist located in Dundas.

Torch Brand Lozenges

2006.515.4

“Torch Brand Children’s Cough Pastilles” made by Allen & Hanburys Ltd. This package was found along with several other items in a warehouse in Hamilton and was originally from St. Mary’s Apothecary. Allen and Hanburys produced over 80 kinds of medicated and crystallized pastilles.

This video was created by students in the popular game “Minecraft”. They built a virtual model of a person with scarlet fever to demonstrate the symptoms of the illness in a human body.

When an individual contracts this disease, the person exhibits a number of symptoms such as chest pain, intense coughing, weakness, weight loss, chills, fever, sweating at night, and a loss of appetite. This disease is frequently contracted from bacteria that spread from person to person through coughing. Tuberculosis was often fatal in the nineteenth century for those who contracted this disease, which caused a person’s lungs to fill with blood and other fluid.

Tuberculosis has also been called “Consumption” and “Phthisis”. Today tuberculosis is treated with long courses of multiple antibiotics. Prior to antibiotics, there was no reliable treatment for tuberculosis and it usually resulted in the patient “wasting away” until death. Bleeding and purging were sometimes recommended, however, the usual treatments were rest, fresh air, and later isolation in sanatoriums.

Dr. Stafford’s Vegetable Composition

2012.001.216

“This is a prompt and most efficacious remedy for colds, coughs, horseness, summer complaints, asthma, bronchitis, incipient consumption, &c. No family in our changeable climate should be without this efficient remedy.”

When a person contracts this disease, the individual exhibits symptoms such as a fever, coughing fits, exhaustion, runny nose, apnea (pauses in breathing), vomiting, high-pitched wheezing. This disease can spread if one inhales the bacteria spread by an infected person through coughing, sneezing, or other transmissions.  People with whooping cough commonly have the bacteria found in their mouths and noses.

This disease is very serious, especially to those with weakened immune systems, such as young children or older adults.  Normally, whooping cough weakens its victims, allowing other diseases to infect and kill them by overwhelming their immune systems. Doctors presently treat whooping cough with antibiotics.

Wine Ipecac

2012.001.221

Wine ipecac was used to induce vomiting. The belief was that this would help balance the four humours. It was used in small doses as an expectorant and diaphoretic to treat colds, flus, gastro-intestinal problems, bronchitis, or pneumonia.

Ayer’s Cherry Pectoral

2012.001.208

This patent medicine created by James Cook Ayer in the 1840s was a popular remedy advertised as a cure for ‘coughs, colds, asthma, croup, laryngitis, bronchitis, whooping cough, and consumption.’ This patent medicine contained a narcotic component, an opium derivative.

Skunk Oil

1969.12

Skunk oil was used to treat people suffering from whooping cough or croup. Skunk oil could be rubbed on their chests or drank to induce vomiting, clearing the lungs, and calming their coughs. It is likely that settlers learned this remedy from Indigenous peoples in North America.

When a person contracts this disease, the individual exhibits a number of symptoms such as a cough, fever, aches, shortness of breath, discomfort in the chest, and thick mucus (that may be abnormal in colour). These symptoms usually last from seven to ten days. Individuals usually contract bronchitis when the disease gets into the body, swelling the lungs’ bronchial tubes. This illness can be exacerbated by smoking.  This illness can be very serious for those people with weakened immune systems, such as the very young or the very old, or people with pre-existing conditions, such as emphysema or other lung conditions. Some nineteenth-century treatments for bronchitis include the prescribing of garlic, cinnamon, pepper, and even coffee.

Milton Inhaler

2012.001.182 A-B

Many early inhalers for treating asthma and other lung problems used heat to vapourize active chemical ingredients for the patient to breathe in through the tube. Chemicals used in early inhalers included ammonia, chlorine, iodine, tar, balsams, turpentine camphor, and other combinations.

Aerohalor

1996.095 A-E

Glass powder inhaler inside its original package. Named the “Aerohalor,” and produced by Abbott Laboratories, Abbott’s Aerohaler was one of the first commercially successful dry powder inhalers of its time.

Chloretone Inhalant

2012.001.217

“For symptomatic relief in inflammatory and catarrhal conditions of the nose and throat. Directions – Apply 3 to 5 drops locally with droppers, spray, or swab every three or four hours.”

Antibiotic resistance is the ability of bacterial infections to resist an antibiotic that was previously effective at controlling it. Scientists are working on creating new antibiotics able to resist most bacterial infections, as well as working on treatments that help people with antibiotic allergies to existing medicines, such as penicillin. There are different antibiotics for different illnesses. Common ailments caused by bacterial infections include strep throat, pneumonia, whooping cough, and tuberculosis. There are some superbugs that can live in hot tubs and pools, or also through medical equipment that has not been completely disinfected.  People with weakened immune systems are extra vulnerable to superbugs.

One of the ways that superbugs are created is when people misuse antibiotics, either by not taking them as long as they are prescribed (even after their illness’ symptoms have stopped). Some ways to fight the spread of superbugs include washing your hands properly and often, getting vaccinated, and using antibiotics the way your doctor instructs you to.

Phenidex Lozenges

2006.515.005

A package of “Phenidex” antiseptic and antibiotic lozenges. This package was found along with several other items in a warehouse in Hamilton and was originally from St. Mary’s Apothecary.

This year I intended to use the study of public health issues to help teach my students about the history of their community, as well as the larger narratives found within the history of our country and the broader story of the impact of science and medical breakthrough on human life.

This study began with a tour of our community’s oldest cemetery with a passionate local historian, Mr. Stan Nowak, who taught the students about some of the key figures and events in our community’s past.  On the tour, Mr. Nowak had students note the number of children’s gravestones, taking the class through ‘Cholera Alley’, a section of the cemetery where victims of a cholera outbreak were buried.  This trip to the cemetery literally ‘brought home’ the topics of disease and public health for the students and parents that afternoon.

As a way of understanding the impact of disease in our community, we approached Anna Patterson, the Educational Coordinator at the Dundas Museum & Archive about our project, and she shared with the class copies of the local death records for the years 1869-1878.  Through these documents, students glimpsed the sparse, yet starkly intimate details of a person’s life as recorded in municipal death records.  It is a sobering experience for a ten- or eleven-year-old student to record the specifics of a two-year-old child who died in July 1871 of “Consumption” after being ill with the disease for one year.  In these records, one member of our class observed, the lives of children were often so brief they were recorded in hours and days.

While recording the causes of death, students frequently noted they had never heard of most of the diseases that took the lives of children in this period.  This observation led to a number of discussions about improvements in sanitation, access to clean drinking water, and, perhaps most presciently, vaccinations.  We talked about and reflected on the fact that diseases that took the lives of children who used to sit in our classroom no longer threaten us. As they collected their data, students came to see the disproportionate representation of children in our local death records from this time.  On most pages of these records, children represented between half and three-quarters of the dead.  What the archival evidence showed the class in frank and uncompromising terms was that in late nineteenth-century Dundas the most dangerous thing to be was a child.

We decided to focus on five of the most fatal diseases for children in our community at this time: diarrhea, consumption, bronchitis, scarlet fever, and whooping cough.  After compiling this list – what we named the ‘Fatal Five’ – students grouped and graphed the data by the organ system(s) most affected by each disease.  What they found was that the respiratory system was by far the most vulnerable one for children in the 1800s, markedly more than it was for adults. This information directly influenced our Science program and in particular, the Grade 5 Human Organ Systems unit. 

As part of this unit, students work with a biomedical scientist – Dr. Deborah Sloboda – from McMaster University in the dissection of different organs, including the brain, heart, and lungs.  In preparation for the lung dissection, we located several academic articles on the topic of childhood respiratory disease, and, after reading the summary section of the articles, the students found logical reasons for children’s vulnerability to respiratory diseases, and they discussed their findings with Dr. Sloboda prior to the dissection where the students saw from themselves the sections of the lung affected by the diseases they had studied.

One question that kept occurring during our primary research was that, given what we knew from our cemetery tour about the prevalence of cholera in our community during the 1800s, could doctors have mistakenly diagnosed diarrhea when patients had actually died of cholera.  To find out more about this, we reached out to a McMaster professor of biochemistry – Dr. Michael Surette – with this question, and we learned the key symptoms (i.e. the stool) of these diseases are very different from one another, making misdiagnoses unlikely.  However, Ms. Patterson noted that the contemporary fears around cholera may have led doctors to omit the actual cause of death in order to quell public anxiety.  Throughout the project, when a question arose, we did our best to find and approach people with expertise in the relevant field.  Consequently, even questions stemming from the project’s main focus led us into branches of information and ideas that stretched both the reach and depth of this project.

One of the big questions we have been chasing through a number of classroom projects is ‘When did science begin to win in the fight against disease?’  Ms. Patterson provided the students with a glimpse of the confusion that surrounded most medical attempts to address the Fatal Five diseases in our community in the nineteenth century.  Ms. Patterson showed the students a wide range of items – some effectual, most ineffectual, some harmful – prescribed for the ailments and symptoms associated with the Fatal Five.  The subsequent conversations with students led to an exploration of certain milestones in medical science and public health, such as the discovery of insulin and antibiotics, as well as modern concerns about the dangers of antibiotic resistance and the rise of ‘superbugs’.

The Fatal Five project came to straddle a range of curriculum areas, and we found that our historical project was also deeply intertwined with science.  In order to deepen our understanding of the scientific context of the five diseases we studied, we reached out to McMaster Children and Youth University (MCYU) which provided workshops with the students centering around the themes of contagion and antibiotic resistance.  Through these workshops, students came to appreciate and comprehend some of the mechanisms of infection and the efficacy of antibiotics, as well as the dangers of their overuse.  I have been struck throughout this project by the way the intertwining narratives of History and Science have mutually informed and enriched for my students the story of the Fatal Five.