48 MEDICAL HISTORY QUARTERLY

caught in traps. They were shooed from the tables of the well-to-do with big fans or tufts of paper strips on the ends of poles. Mosquitoes were numerous everywhere till the land was brought under cultivation and drained. Bed bugs could not be ousted from a log cabin without burning it down. They infested taverns and steam­ boats. The death rate of infants and children was very high, and the average length of life before 1850 was probably not over 40 years. We must not conclude from this, however, that many of our ancestors failed to reach old age. The great increase in the average length of life, which has occurred in the last few decades, is due in great part to the conquest of diseases of childhood. This conquest, unfortunately, has increased the frequency of cancer and vascular disease. For the children we save from tuberculosis and diarrhea live to die of cancer, or heart disease, or apoplexy. A man aged 40 in 1820 had almost as good a chance of living to be 80 as a man aged 40 has today. The chief diseases of pioneer Indiana were malaria, typhoid fever, tuberculosis, dysentery, and milk sickness. Epidemics of Asiatic Cholera are said to have occurred in Indiana before the Civil War, but I doubt that proof of this exists. Malaria was endemic in all parts of Indiana. It was probably the most common cause of illness and a frequent cause of death during the first quarter of the Nine­ teenth Century. The great grandparents of a man I know died about 1810 in south­ ern Indiana of a very severe form of malaria called black water fever. Every house­ hold had a solution of quinine in whiskey on its mantlepiece. The disease was thought to be due to noxious vapors emanating from swampy grounds. This is one reason why the uplands of southern Indiana were settled before the more fertile low­ lands. The incidence of malaria decreased as the land was brought under cultivation and drained. Typhoid fever was extremely common and so remained till the second decade of the present century. This is no cause for wonder when we consider the bad sani­ tary conditions I have mentioned. The drinking water in towns was unbelievably bad. Thus the people of Cincinnati drank raw water from the River, the mud from which would settle to the bottom of drinking glasses. This was true up until about the end of the last century when a filtration plant was installed. The victims of typhoid fever were starved and given but little water. This made the disease much more dangerous to life. Tuberculosis was common. It not infrequently destroyed entire families. Crowded living quarters, poor ventilation, and spitting spread the disease. No one thought of isolating the sufferers. Epidemics of dysentery were frequent. Our forefathers called it the flux and one form of it the bloody flux. It was often rapidly fatal. The unsanitary conditions which favored the spread of typhoid favored that of dysentery. These diseases were the chief enemies of armies. If we can believe contemporary writers, milk sickness was one of the chief causes of death among pioneers. Other names for it were the “puking sickness,” the “staggers,” the “trembles,” and the “slows.” In Dubois County in Indiana half the deaths occurring in 1815 were said to have been caused by this disease. In 1819 it was common around Vincennes. We know now that it was caused by a poison found in the leaves of the white snake root. When these were eaten by the cow the poison was excreted in her milk, which in turn poisoned humans. The symptoms of the disease were fever, muscular weakness, tremors, vomiting, collapse and death. Nancy Hanks is believed by some to have died of milk sickness at the youthful age of 35 on the seventh day after she had taken sick. The prevalence of this disease may have caused the Lincoln family to move to . I have already mentioned that the highlands of southern Indiana were settled before the lowlands. Milk sick­

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