The Archives and Rare Books Library at the University of Cincinnati houses a collection of more than 528,000 records of births and deaths in the city of Cincinnati from 1865 to 1912, when the collection of such vital records was transferred to the State of Ohio. The old index card records were compiled by the Cincinnati Health Department several decades ago and are considered the official and legal records of births and deaths for this time period. Among the death records are some archaic terms unfamiliar to today’s researcher.
Among the most common causes of death among adults in Cincinnati, the Health Department records show 3,616 deaths by apoplexy from 1865 to 1912. These days, we use this old-fashioned term metaphorically, especially as an adjective: apoplectic. It was once the preferred term to describe the incapacity caused by a stroke or cerebral hemorrhage.
Intestinal distress killed many, many Cincinnatians over the years. The major epidemics wandering through the region, often spawned by nonexistent hygiene, usually included various intensities of diarrhea; dysentery, cholera, and malaria all involved some degree of “flux” or bowel incontinence. If the usual fecal flow contained visible amounts of blood, it was known as the bloody flux and was commonly fatal. They didn’t know from electrolytes in those days.
Today, malaria is almost unheard of in Cincinnati and any local cases are almost certainly traced to foreign travel. Time was, however, when malaria was not uncommon in the Queen City. Few medical authorities in the 1800s connected the disease to a parasite transmitted by mosquitoes. Congestive chills was the term applied to cases eventually identified as malaria, especially if accompanied by diarrhea. “Malaria” is an Italian word meaning “bad air,” and our ancestors believed malaria (or congestive chills) were caused by repulsive smells. In Cincinnati, around twice as many deaths were diagnosed as malaria compared to congestive chills.
The physicians of the Victorian era found themselves in a linguistic quandary. Over the 19th Century, medical doctors gradually accumulated professional respect, chased charlatans from their ranks, and sought to standardize clinical education and practice. This included renaming every disease with an appropriately scholarly Greek or Latin designation. Unfortunately, their patients understood only the ancient names for diseases passed down through the centuries. Cincinnati recorded more than 2,000 deaths from dropsy (a word dating to the 1300s), but just 298 from ascites, 169 from anasarca, and 61 from edema, all related terms for the buildup of fluid in bodily tissues. In all cases, whether the patient’s death was blamed on dropsy, ascites, anasarca, or edema, the true cause was undoubtedly an undetected organ failure—usually the heart, kidneys, or liver.
Although they understood little about bacteria, our ancestors knew many diseases caused by streptococcal bacteria. Erysipelas was one such malady. Similar to cellulitis, it’s generally confined to the uppermost layers of skin, while cellulitis infects deeper tissues as well. Even today, it can be difficult to identify whether erysipelas or cellulitis is the cause of a fiery red rash. Nearly 1,000 Cincinnatians died from erysipelas in the days before antibiotics.
Excessive Use of Chloroform
While not a common cause of death in old Cincinnati, overdoses of chloroform were not unheard of. Well into the 1900s, anyone could walk into the pharmacy and purchase opium, cyanide, cannabis, strychnine, and a whole formulary of chemicals now restricted by prescription or law. Abuse and misuse were inevitable in such an environment, and several dozen Cincinnatians met their demise sniffing chloroform-laced handkerchiefs. This was almost equal to the number dying from opium or laudanum overdoses.
Back in the 1800s, people who believed in microbes were thought to be insane. In such an environment, understanding seizures or convulsions—whether caused by epilepsy or other conditions—was essentially impossible. Consequently, seizures were described with all sorts of names, from folk maladies like “fits” to attempts at modern nomenclature like “paroxysms.” Whether the attending physician or the coroner opted for the traditional term or the new-fangled option, either conveyed clearly that no one really knew what the poor soul died from.
Goring by an Ox
It’s often forgotten just how many more animals lived in Cincinnati in the late 1800s compared to today. The city’s transportation system was based on horses. People kept cows, chickens, and pigs in their backyards. Businesses relied on mules and oxen for heavy-duty jobs. On a fairly regular basis, one or another of these beasts decided it had endured quite enough, thank you very much. The same coroner’s report [January 7, 1868] reporting death by ox-goring recorded another victim “killed by a vicious mule.” Mad dogs, irascible hogs, and runaway horses took their toll, not to mention poisonous snakes down by the canal.
Also known as “Painter’s Colic,” lead colic was an often fatal condition of “obstinate constipation” caused by lead poisoning. All the best paints in Old Cincinnati incorporated lead compounds for bright and durable colors. In fact, lead was among the more benign pigments soaking into a painter’s intestines. The fashionable Paris Green shade was so chock-full of arsenic that the pigment itself was used to kill rats and insects and sometimes ingested for suicide or murder.
Poverty, ignorance, and a host of societal abuses created an epidemic of malnutrition in Cincinnati. Marasmus was just a fancy medical term for starvation, and hundreds of Cincinnati children died with this ailment listed on their death certificate. Inevitably, some other undiagnosed condition was the real culprit, whether diarrhea, scurvy, rickets, pellagra, or another deficiency.
Known as “hip-joint disease,” morbus coxarius was just one of many manifestations of tuberculosis in Cincinnati. In this case, the bacterial microbes consume the bones of the hip and upper leg, eventually causing a fatal infection. Among the other terms employed to describe diseases caused by tubercular bacteria were scrofula, phthisis, tabes mesenterica, and consumption.
Yes, people in Cincinnati, even in the 19th Century, did survive into advanced senescence. In such cases, it was quite common—nearly 3,200 records between 1865 and 1912—for the cause of death to be listed simply as “old age.” Most patients who earned that cause of death were 80 years old or more. There are a few examples in which the attending doctor (obviously a young whipper-snapper) listed “old age” as the cause of death for a patient barely 60 years old. Back then, living until 60 was a rare and wonderful thing, but still…
Few diseases generate more anger among modern researchers than puerperal fever. Throughout the 1800s, giving birth in a hospital frequently resulted in the mother’s death from puerperal fever as doctors glided from autopsy to delivery without washing their hands. Even in an age when bacteria and viruses were unknown, European doctors, notably Ignaz Semmelweis, recognized that physicians needed to disinfect their hands before attending pregnant women. Despite ever-increasing evidence that Semmelweis was correct, many doctors refused to comply. One pig-headed traditionalist, Charles Meigs of Philadelphia’s Jefferson Medical College, insisted, “Doctors are gentlemen and a gentleman’s hands are clean,” while thousands of Cincinnati women died. A related uterine infection was known as metritis.
It was only gradually, after the discoveries of Louis Pasteur in the 1870s, that medical doctors agreed diseases could be caused by microbes. The “germ theory” wasn’t fully accepted until after 1900, though, so Cincinnatians died by the thousands from infection. Pyaemia is just one of the common names for various forms of sepsis or “blood poisoning” including septicemia, toxemia, and sepsis. Stomatitis refers to an infection of the interior of the mouth and killed more than 100 Cincinnatians.
The name of this disease conjures visions of some overly dressed Victorian croaking “It’s too darn hot!” and then keeling over. Unfortunately, the reality was far more serious. Summer complaint killed nearly 300 Cincinnati children in the last half of the 1800s. The disease manifested as acute diarrhea, usually caused by unhygienic conditions, especially food contamination.
Between 1865 and 1912, the Cincinnati Health Department recorded 742 deaths of young children attributed to teething. Any parent who has endured a child suffering through this developmental landmark may be forgiven for believing that a lot of our ancestors just lost patience. That isn’t the case. It appears that, in those days when the germ theory of illness was just catching on, teething caught the blame for deaths caused by simultaneous infections, dehydration, cholera, typhus, and so on.
Affecting newborns, trismus neonatorum was a stiffening of the jaw, often indicating a fatal tetanus infection. Childhood in 1800s Cincinnati was fraught, with more than half the deaths reported each year involving children under 10 years old. Every disease now avoided through childhood vaccination killed thousands of Cincinnati children, especially diphtheria, pertussis, measles, mumps, rubella, and tetanus. Cincinnati children commonly died from smallpox, scarlet fever, and the deadly duo of debility and inanition, collectively known as “failure to thrive.”