The Heartbreaking Childhood Plagues of the 1700s and 1800s
Families decimated from New York City to Maine
In 1849, as he was writing On the Origin of Species, Charles Darwin suffered a devastating loss. Charles and Emma Darwin’s ten-year-old daughter, Annie, caught scarlet fever along with her two siblings. Some believe that she may have suffered from tuberculosis as well. Worldwide scarlet fever pandemics raged during the 1700s and again between 1820–1880 and hit children in Europe and North America especially hard.
Scarlet fever symptoms include sore throat, high fever, enlarged tonsils, headache, and a body rash. Victims sometimes died within 48 hours.
The symptoms overlap a variety of other diseases, so scarlet fever was often confused with diphtheria, during the European colonial expansion of the 1600s and 1700s. The fever sometimes led to pneumonia, kidney disease, rheumatic heart disease, arthritis or other problems. Even by the late 1800s, the mortality rate was significant.
As Annie suffered declining health, Darwin took his daughter to a Worcestershire, England spa for an innovative treatment — hydrotherapy consisting of whirlpool baths. Unfortunately, Annie Darwin passed away after suffering terribly for a week. Darwin’s tenth child, Charles, who would be born three months after Annie’s death, also died from scarlet fever.
Writing about his deceased, favorite child, Annie, a despondent Charles Darwin said,
“Beside her joyousness thus tempered, she was in her manners remarkably cordial, frank, open, straightforward, natural, and without any shade of reserve. Her whole mind was pure and transparent. One felt one knew her thoroughly and could trust her. I always thought, that come what might, we should have had in our old age at least one loving soul which nothing could have changed.”
“All her movements were vigorous, active, and usually graceful. When going round the Sand-walk with me, although I walked fast, yet she often used to go before, pirouetting in the most elegant way, her dear face bright all the time with the sweetest smiles. Occasionally she had a pretty coquettish manner towards me, the memory of which is charming. She often used exaggerated language, and when I quizzed her by exaggerating what she had said, how clearly can I now see the little toss of the head, and exclamation of ‘Oh, papa what a shame of you!’”
“In the last short illness her conduct in simple truth was angelic. She never once complained; never became fretful; was ever considerate of others, and was thankful in the most gentle, pathetic manner for everything done for her. When so exhausted that she could hardly speak, she praised everything that was given her, and said some tea ‘was beautifully good.’”
Scarlet Fever
The disease is caused by streptococcus bacteria and spreads through coughs, sneezes and contact with others. It begins with “strep throat”. The bacteria produce toxins that damage plasma membranes of blood capillaries under the skin. This produces the characteristic red rash on the body and tongue, known as strawberry tongue, that distinguish scarlet fever from other diseases.
Dr. William Douglas, a Boston physician during the 1700s, said that some victims died of sudden necrosis; but most of them by gangrenous or corrosive ulcerations in the fauces (throat), or by swelling in the neck, with strangulation occurring in a very short time.
Treatments for fevers in the 1700s included bloodletting from a vein under the tongue or in the arm, borax and honey throat wash, a “plaster” to burn the throat or create skin blisters on the body, physicks (purging the bowels), and various other remedies. The purpose of these treatments was to redirect the fever away from the brain, throat, and larynx and promote healing.
In a time when almost half the children under age five died, scarlet fever and diphtheria were the major causes of childhood death.
Throat Distemper
The symptoms of scarlet fever and diphtheria were so similar that there was no differentiation until the late 1800s. Sore throats, which were the major symptoms for both diphtheria and scarlet fever, were common and often unattributable to a specific disease. Colonial records indicate that diphtheria had many other names including cynanche, angina, canker, bladders, rattles and throat distemper and there is speculation that some victims may have suffered from both diseases at the same time.
Diphtheria was caused by a rod-shaped bacterium named Corynebacteriumdiphtheria, which infected the upper respiratory tract. A false membrane would form in the throat, which would swell and often quickly led to suffocation. The only solution to avoid suffocation would have been to perform a tracheotomy that would bypass the false membrane and allow the victim to breathe freely. This technique would not be perfected in North America until much later on in the 1900s.
John Duffy, the author of Epidemics in Colonial America, believes diphtheria was present in the early colonial days but it did not attract the attention of the medical profession until 1735–1736 during the occurrence of a virulent outbreak in New England.
By 1740, over 1,000 children had died in Connecticut alone. Such statistics led lexicographer Noah Webster to call diphtheria “the plague among children”. Families often lost half of their children to the disease. Some believed the disease was connected to a heavy infestation of black caterpillars. In the epidemic of 1735–1736, records show there were over 1,000 deaths in New Hampshire, which had a population of 23,000. And 90% of the deaths in that colony were of children under the age of 10.
Although records were not always well-kept, thousands of children died of diphtheria and scarlet fever and anecdotes show that by the 1700s people were beginning to believe the fevers were contagious. The “Yale Journal of Biology and Medicine” details primary source records from dozens of towns from Kittery, Maine to New York City. During those five years there was a devastating explosion of the epidemic and death. Although the epidemic proportions of the death tolls dropped off after 1880, these two diseases persisted for another 70 years.
Louis Pasteur was credited with linking streptococcus bacteria with scarlet fever in 1879. But antibiotics didn’t become available to combat scarlet fever and diphtheria until the twentieth century. Today there are vaccines for diphtheria to prevent the disease.
A global pandemic such as the Coronavirus with a population of seven billion people reaches different scale than the childhood plagues of the 18th and 19th centuries. But nonetheless, the two diseases infected and killed high percentages of children at a time when prevailing beliefs focused on superstitious causes. We can be grateful that horrible diseases such as diphtheria and scarlet fever are now more preventable and treatable.
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Glenn Fay is the author of Ambition: The Remarkable Family of Ethan Allen available online and in bookstores.
