The White Plague

                                                                   Photo by Henry Peach Robinson 1858

     It was spoken of in hushed tones, and certainly never outside the family circle, a certain stigma attached.  Whatever name you knew it by, be it phthisis, king's evil, consumption, the euphemistic "decline", or tuberculosis, it was usually a sentence of death; sometimes quickly, other times only after decades of suffering.  The first symptoms were fatigue, weight loss, and the cough. Later stages were characterized by pallor, sunken yet luminous eyes, night sweats and the horrifying expectoration of blood.  Death came when the infected lungs became so ravaged they could no longer perform their job, though this could be a long process.

      No one knew why whole families were sometimes afflicted, and it was once believed to be hereditary.  Not until 1882 would the responsible bacillus be discovered, but it would be over a decade longer before the medical community accepted that TB was a communicable disease caused by a specific bacteria.  Of course finding the cause was not the same as finding a cure, and with the knowledge that a contagious agent was behind the deadly illness, sufferers lives became that much worse.  They found themselves shunned and sometimes even wrenched from their homes and families and forced into public institutions.

     Several of my ancestors died of tuberculosis, four that I'm aware of, but I'd be willing to bet there were others.  It's been estimated that by the 19th century, TB had killed one in seven of all people who had ever lived.  That's an astounding number.  One particularly heartbreaking case was that of my third great-grandmother Sarah Charlotte Fowler Vincent.  Sarah lived with her family in the rural community of Butler, New York.  She died at her home in the summer of 1883 when she was fifty years of age, eleven days after the death of her twenty year old daughter Mary Ann from the same disease.  Sarah left a husband and three other children none of whom, to my knowledge, ever developed TB.

       Another was the equally sad case of my great-grandmother Ellen White O'Hora's sister Julia Sullivan. Julia, who had lost her husband years earlier to nephritis, died in Rochester, New York in 1917 at fifty-three, leaving an orphaned son of thirteen.  He doesn't appear to have contracted the illness either.  I found it puzzling that individuals living in close contact with, and caring for TB victims somehow escaped it's clutches.  So I did some research on tuberculosis.  

     After much reading, I learned that TB is spread when a person with an active case coughs, sneezes, or even talks thereby spreading droplets that can be inhaled by others.  Once that happens, several different things can occur.  The person can develop a TB infection themselves, but surprisingly,  in the majority of cases that does not happen.  Their immune system is usually able to overcome the bacteria, only one in ten of those exposed to TB will go on to develop the disease; usually those with weakened immune systems.  A third possibility is the person's immune system does not destroy the bacteria, but is able to keep it inactive.  Known as latent TB, this stage is not contagious; but if the immune system should weaken, an active case could result many years after the initial infection.

     The fourth known case in my family happened in Ballyraggan, County Kildare, Ireland in 1866; and was that of yet another third great-grandmother of mine, Anne Donahoe McGarr.  Anne's death certificate says she died of phthisis at the age of sixty six, after an eighteen month illness.  The book, "Medicine, Disease and the State in Ireland", by Greta Jones states that at the time of Anne's passing, tuberculosis was the leading cause of death in Ireland, just as it was in America, killing many more people than smallpox, typhus and cholera combined.  The last-named diseases however, had more dramatic onsets, tended to occur in epidemics and caused death in a much shorter period, so they received more attention in the 19th century than the easier to hide (up to a point) TB.  

     Anne's case fascinates me because the story in our family is that she was a folk doctor specializing in the treatment of skin cancer.  From what I've read of the old healers, they were often believers in the "fairy faith".  This may or may not have been true of Grandma Anne, but I'm quite curious as to how her illness was perceived.  A stroke of bad luck or a fairy stroke?

     The discovery of streptomycin in 1943, followed by numerous other drugs finally put an end to this scourge that had plagued mankind since the time of the pharaohs.  While there have been recent outbreaks of drug-resistant strains, tuberculosis is no longer the menace so feared by our ancestors.  After all the articles I've read, and my new understanding of how prevalent TB was in the 19th and early 20th centuries, I have to wonder who else in my family may have been it's victim.