Tuesday 23 June 2015

The Scourge of Phthisis (Tuberculosis)

Neither my wife nor I have to go back very far in our family trees to find direct ancestors who died of Phthisis, more commonly known as tuberculosis: Mary Elizabeth (Pearson) Shepheard, my great-grandmother, died in 1891; and Elizabeth (Walker) Cooper, my wife’s grandmother, in 1922. The dates are far removed and the origins of the disease are quite disparate. Both left young children behind, though, as well as husbands who I believe had difficulty coping with the care of those children in addition to the loss of their partners.

Tuberculosis is one of those diseases that have been around the world for a very long time. There is probably not a family that has not had someone afflicted and/or died because of it. One can find a great deal of information on tuberculosis on the Internet, starting with Wikipedia, which notes that it has gone by names, consumption, phthisis, scrofula, Pott's disease and the White Plague at various times in history. The disease appears to go back thousands of years, to the Neolithic period. It was certainly around in Greece in the 5th century, apparently one of the most common causes of death there. It was present in India in 1500 BC, Egypt in 2000 BC and possibly in China in 4500 BC. Europe was plagued by the disease for hundreds of years. It was present there during the Middle Ages and as widespread epidemics (the Great White Plague) into the 19th century. Some researchers have estimated that tuberculosis in all of its forms have killed over a billion people around the globe over the last two hundred years. In 2013, according to the World Health Organization, 9 million people fell ill with it and 1.5 million died.

The first record in Cornwood parish, Devon, (which parish I look after as on Online Parish Clerk) burial records was in 1770. That was a period when the then vicar made an effort to record causes of death. Not all ministers did so in the past so the record is incomplete. In that year and the two following there were also many deaths from small pox. Adjacent parishes do not have this kind of detail however statistics show there was a substantial increase in the number of burials during this time period; so there must also have had many residents die of consumption as well. The disease hit all ages and all socio-economic groups.

I do not know how My Great-grandmother contracted TB. It was certainly easily spread by contact with others who had it, primarily through the air. She was probably already in the early stages when my grandfather was born, seven months prior to her death. She may have caught it in a medical ward, a crowded tramcar or even at church. We won’t likely ever know.

The manner in which my wife’s grandmother was affected is a bit clearer. She was admitted to an asylum just a couple of years after the birth of her last child. At the time she was suffering from what was described as “a state of wild maniacal excitement” and “hallucinations of hearing” (possibly schizophrenia?). Asylums in Scotland through the early 20th century were also places where people sick with tuberculosis were confined. In the less-than-hygienic conditions, highly contagious diseases like tuberculosis spread rapidly. Many patients, originally hospitalized for mental illness actually died of other causes such as phthisis.

Phthisis is a particularly nasty sickness, originally defined by Aelius Galenus, a prominent Greek physician, as the "ulceration of the lungs, thorax or throat, accompanied by a cough, fever, and consumption of the body by pus."

Effective treatment of consumption was virtually unavailable well into the 20th century, until the discovery of Streptomycin which came into use in the 1940s and isoniazid in the early 1950s. The antibiotic drugs offered hope that the disease could be eradicated. That did begin to happen within a few decades – cases in Britain dropped from around 117,000 in 1913 to about 5,000 in 1987. With the emergence of other diseases which impaired the immune system, the appearance of more drug-resistant strains and the reduction in public health services, the number of reported cases rose again. In the undeveloped world, the contagion is still widespread.

There may have been many more family members who became sick with and even died of tuberculosis. The lack of records prevents us knowing for sure. We might be able to track outbreaks of the disease in certain areas and see if any deaths in the family corresponded with times of outbreaks. That might tell us whether tuberculosis might have been a cause.

Wayne Shepheard is a volunteer with the Online Parish Clerk program in England, handling four parishes in Devon, England. He has published a number of articles about various aspects of genealogy and is a past Editor of Chinook, the quarterly journal of the Alberta Family Histories Society. Wayne also provides genealogical consulting services through his business, Family History Facilitated