Saturday, October 21, 2017

The Strangling Angel of Children

Quarantine poster from the 1880's
Disease and mishaps that cut lives short, often in terrible ways, dogged our ancestors' footsteps. Family historians are familiar with high rate of children's mortality before the 20th Century. Federal censuses of the 1800's "record" the sad loss. A child born in one decade but absent in the next almost always means death occurred between the ages of newborn infant and 10 years. A host of frightening diseases for which no treatment or cure had yet been found attacked people of any age, but were especially virulent in the very young and very old.

Charles Hergesheimer, my grandmother's older brother, contracted diphtheria in July, 1878 and died. He was just seven years old. I can imagine the shock and fear my great-grandparents must have felt when Charles' diagnosis was pronounced. They had two small daughters, aged 5 and 3, who certainly had been exposed to the disease, so my great-grandparents faced the terrifying possibility of losing all three of their young children.

Diphtheria, like so many of the diseases feared by our ancestors, is barely known about today. But from the 1600's, when its symptoms were first recorded, until the development of an effective vaccine in the 1920's, diphtheria was a deadly bacterial disease. Highly contagious, it was spread by coughed or sneezed droplets, close contact with an infected person, or touching objects contaminated by the infected person.

Diphtheria's onset was gradual, mimicking a cold. First there was a sore throat, and maybe a cough, but then hoarseness set it, and a fever began, accompanied by severe headache. Within a day or two, a leathery pseudo-membrane began to form at the back of the throat. Swallowing and breathing became difficult. The breath took on a putrid odor so peculiar as to be instantly recognizable as a diphtheria symptom. Attempts to remove the thick false membrane were unsuccessful; not only did the removal cause extreme rawness and bleeding, the membrane grew back at an alarming rate. The neck and face swelled, and the child eventually suffocated, hence the characterization of diphtheria as "the strangling angel of children."

Bottles of homeopathic remedies
The mortality rate for diphtheria was very high. Today, when it does occur, the mortality rate is 5-10%, but at the time my great-uncle contracted it, mortality among children is thought to have been 50-80%. Our Family Physician*, a popular book of treatments found in many late 19th and early 20th Century American homes, says of diphtheria: "In strong constitutions, the chances for recovery are favorable, if treatment is begun at an early period. If, however, the treatment has been delayed for a day or two after the symptoms show themselves, the chances are very much lessened....The longer the false membrane is in forming, the more unfavorable the results to be feared." Death occurred within 2-7 days.

My great-grandmother helplessly watched
the "strangling angel" take her eldest child
Immediate isolation in a well-ventilated room was the first measure taken for treating diphtheria. Our Family Physician offers four pages of suggested homeopathic, allopathic, and herbal treatments. Recommended remedies to relieve the patient's suffering could only have made matters worse: the poisons belladonna, aconite, mercury iodide, or creosote oil were mixed with benign substances and ingested; the throat was painted with dilutions of poisonous and tissue-burning muriatic (hydrochloric) acid or silver nitrate; a mixture including poisonous turpentine oil was used to gargle. Hot ashes and salt wrapped in a flannel were applied to the swollen neck. Fortunately for the suffering patient, the mixture of sodium sulfite and quassia oil, claimed to be "an excellent remedy to destroy the membrane", was relatively benign, but couldn't prevent the damage done by the other medicinal remedies.

If the child were strong enough to survive both the disease and the treatments, recovery took months, and was often never complete. Our Family Physician notes: "Several disorders are likely to follow diphtheria, the most alarming of which is Paralysis." Myocarditis, inflammation and damage of the heart muscle, was the most common complication of diphtheria, but other organs, especially the kidneys, could be left impaired. I don't know if my grandmother contracted the disease, but her sister probably did. When my great-aunt died at 72, the primary cause of death was "chronic myocarditis".

*A pdf of Our Family Physician by Henry Rice Stout, M. D. (Boston: George Smith & Co., 1885) can be downloaded for free at

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