Category Archives: cholera

Disease and Discrimination in Colonial Atlantic America

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Reviewed by Michelle Ziegler

Dale Hutchinson. Disease and Discrimination: Poverty and Pestilence in Colonial Atlantic America. University of Florida Press, 2016. $85

Dale Hutchinson’s latest book fits into a recent trend of a more critical analysis of the role disease played in the demographic collapse of Native Americans in the Colonial period. After spending most of his career working on the Spanish Colonial system in Florida,  in Disease and Discrimination, he discusses the English and French colonies along the Atlantic seaboard.

By his own description, “this book is a series of narratives about changing landscapes of America — not only the natural landscapes, but the social, political and economic landscapes — and how they all contributed to the nutrition and health of natives and newcomers in the Atlantic coastal colonies” (p. 10) He goes on to warn the reader that landscapes he intends to paint are “neither exhaustive nor completely factual representations”; he has “chosen what to accentuate” (p.11).   In painting his landscapes he chose to use an informal, conversational tone that should make it the science easier to understand but also leads to a somewhat rambling style that sometimes lacks structure and yields uneven coverage. Disease and Discrimination is divided into four sections: ‘Of Apples and Edens’,  ‘Natives and Newcomers’, and Planters and Pestilence, and ‘Measuring the Lands’.

In the first section, he discusses landscapes and disease processes.  He opens the second chapter with a nice introduction to disease ecology and terminology but then moves on build off of McNeill’s “civilized disease pools”, which is now quite outdated. This would have been an ideal place to discuss syndemics, but he does not apply syndemic theory anywhere in the book. From here he moves into a rather free flowing discussion of plague pandemics. To be honest, I felt this discussion was out of place in a book that does not otherwise discuss bubonic plague. If he wanted to discuss the Old World origins of New World epidemics, then wouldn’t it have been better to discuss the disease ecology of an organism that made the ‘Columbian exchange’?

Opening with a discussion of syphilis, the next chapter discusses historical epidemiology and then the virgin soil epidemic hypothesis. As he notes, attenuation (weakening over time) is a core principle of the virgin soil hypothesis that lacks pervasive scientific evidence. It is not always in the best interest of a pathogen to become less virulent. Indeed, some times it’s quite the opposite.  Hutchison correctly points out that many of the examples of virgin soil epidemics were more likely to be caused by environmental contingencies like over crowding and poor sanitation on Indian reservations. Consulting David Jones (2003) work on refuting the virgin soil hypothesis would have been helpful here.

In the second section, Hutchinson reviews the European settlement, resource extraction and interactions with the Native tribes. He pays particular attention to the interactions between the French, Dutch and English colonists with the tribes, providing a handy table of seventeenth-century epidemics (table 4.1). It is interesting that all but one of these epidemics are credited to viruses (smallpox, measles, and influenza). Just over half of these epidemics were recorded by the Jesuits working in the French colonies. The 1630s were a particularly bad time for the colonies with measles, smallpox and other poorly recognized diseases impacted both the colonists and the Native American tribes in the Northeast. Hutchinson spends some valuable time discussing the differential impacts of the French and English interests in resource extraction, how that affected the landscape, and how the tribes moved, mixed and formed new entities due to attrition. Despite the reputation of epidemics among native tribes, the Europeans and Africans were ravaged by smallpox and measles as well.  Children born to both Europeans and Africans would have been as immunologically naive as the Native Americans (although variolation would have protected the few who received it from smallpox). Malnutrition affected all three groups but in different circumstances and to different degrees, as did the effects of war. A key difference between natives and newcomers is that more Europeans and Africans could arrive to bolster their numbers, while Native Americans were still being enslaved or facing hostile encounters.

As the English began to attempt to transform the landscape, to ‘improve’ it, they built plantations, essentially recreating English manors in the New World. The New World landscapes did not yield easily and it dragged out long enough to spawn its own pestilence, known by contemporaries as ‘the seasoning’.  Hutchinson discusses the ecological causes including rice farming, deforestation, and diseases clusters (primarily typhoid and malaria).  The ‘seasoning’ is discussed in terms of immunology but it would have been helpful to consider the seasoning as a type of syndemic. In addition to gaining some immunological protection, the mortality rate was often very high in the first few years after arriving on the frontier.  In the Carolinas, rice farming learned from West African slaves quickly went from sustenance to export along with indigo and timber, taken for lumber and pine tar. The radical changes to the Carolina landscape primed it for its own blend of ‘seasoning’ microbes led by malaria.  The production environment of the Carolinas stimulated the import of African slaves who brought more malaria and were vulnerable to infections primed by enslavement conditions.

As the plantation landscape developed beyond the coast the stratification of society became extreme enough to be detected in osteological assessments of their health. Indentured servants and slaves both show evidence of a very hard life with overdeveloped muscle attachments on their bone indicating hard labor and evidence of malnutrition including signs of rickets, scurvy, and protein malnutrition. Corn (maize) replaced European grains, especially for servants and slaves. The caloric intake may be similar but the nutritional value is not. The typical diet of cornmeal, fatback, molasses, and an assortment of vegetables given to slaves is not a balanced diet. Fatback is a slice of pork from under the back skin containing hard fat with little or no muscle. It was often left to slaves and indentured servants to hunt or fish for most of their protein. Protein malnutrition is particularly evident in the remains of children who got the proportionally worst diet.  Through at least the early seventeenth century Native Americans continued to be a significant percentage of slaves, 20% in one Carolina census, and when census are compared, proportionally more Native American slaves were added than African. It was not until the end of the seventeenth century that the birth rate exceeded the death rate in Chesapeake, and even then, parents “were about as likely to die before their children reached their teens as their children were to reach maturity” (p. 137). Many children would be forced into early hard labor to survive. Although Hutchison does not discuss infection and nutrition as a syndemic, he does recognize the “synergistic relationship between nutrition and infectious disease” (p. 139). He notes that slave owners treated infectious disease but tended to ignore chronic or nutritional disorders that made the slaves more prone to serious infectious disease. I do wonder if this was not the attitude of most people except the richest families. It is unclear if they understood the nature of their malnutrition.

In the last section, Hutchinson turns more toward the first cities and urban life. In the last full chapter, he discusses the rapid development of New York City from the original Dutch colony to New York City on the verge of the Civil War. Early New York did not have a sanitary infrastructure so that it quickly became an extremely contaminated environment that was unhealthy for all of its inhabitants. Poverty was an issue for the inhabitants of New York from its earliest days. A constant stream of new poor immigrants meant that the labor market always had access to laborers for less than a living wage. Crowd diseases like smallpox and measles and filth diseases like dysentery always had a constant supply of vulnerable people to prey upon. The city streets were a zoo of animals that contributed to its disease ecology: hogs roamed the street eating refuse, mice and rats multiplied along with stray dogs and constant horse traffic. The city buzzed with urban mosquitoes and New York fell victim to Yellow fever 19 times between 1702 and 1822, but it still did not suffer as much or as often as Philadelphia or Charlestown (p. 166). By 1760 Beloe Island in New York Bay hosted a pesthouse for smallpox and yellow fever; fifty years later the island was ceded to the federal government for the construction of Fort Wood, now the foundation for the base of the Statue of Liberty. A sewage and water system was not installed in New York City until 1850.  As with other large cities in the more distant past, New York’s high mortality rate was offset by an even higher immigration rate into the city.

Hutchinson accomplished his goal of painting a very complex landscape of disease in Colonial America. To gain a more complete picture of the causes and effects of malnutrition and disease, social, cultural and economic factors have to be brought into play along with biological and ecological conditions.

It seems that this book overlapped in the publication process with the collected study Beyond Germs: Native Depopulation in North America, published in 2015. These two books complement each other even though there does not seem to be any contact between the authors. It seems we are on the verge of a new era of Native American studies that will be very welcome.


References

Jones, D. S. (2003). Virgin soils revisited. The William and Mary Quarterly, 60(4), 703–742. http://doi.org/10.2307/3491697

Catherine Cameron, Paul Kelton, Alan Swedlund, Eds. Beyond Germs: Native Depopulation in North America. University of Arizona Press, 2015.

 

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Personal ties to Cholera, 1833

Tanner-Cholera1832
Map created by Henry S Tanner of the 1832 Cholera pandemic

What a strange feeling looking at this map of the 1832 cholera pandemic.  It looks like a blotchy bruise on the country. A little surprise at how restricted the pandemic was in America. As it turns out this map is incomplete, ending in October 1832;  cholera eventually traveled down the Mississippi to reach New Orleans and stops along the way.  One of my first experiences with history of medicine discovered in my own research occurred while doing some family genealogy. Cholera is often depicted among the poor in crowded, old cities like London. For me though, cholera is a disease of the American frontier.

My ancestor John Biggs Moore died of cholera on July 4th, 1833. John Moore was the patriarch of a large family in frontier Illinois on the Mississippi River. He came to Kaskaskia Illinois with his parents in 1781 in the last years of the Revolutionary war. His father James Moore had first seen the Illinois country in the militia of George Rogers Clark when they took the area from English control during the Revolution. John Moore was teenager listed among the men on the first census of Americans in the Illinois country in 1787 used in part to prove that Americans were settled as far west as the Mississippi River to Congress. When American territorial boundaries were established, the Mississippi River was set as the western border, putting them on the furthest edge of the American frontier. (The Louisiana Purchase would extend the frontier in 1804.) The Moore family started the American settlement at Bellefontaine (present city of Waterloo), at the site of a big well-known spring,  on the trail between Kaskaskia and Cahokia in 1782.

John Moore’s death on July 4th tells us something about its circumstances. July 4th was the biggest community celebration held on the frontier. John Moore was the son, son-in-law, and nephew of Revolutionary war soldiers and a former War of 1812 soldier. There is little doubt that he would have been part of the independence day celebrations. Cholera came to Illinois the previous summer with Gen. Scott’s arrival with federal soldiers to take charge of the Black Hawk War.  They arrived at Fort Dearborn (modern Chicago) on the shore of Lake Michigan and the disease traveled with the troops down the Illinois and Mississippi rivers fading out in the fall. When cholera re-emerged the following summer it is recorded in Belleville in July of 1833, claiming the life of former Governor Ninian Edwards on July 20, 1833. John Moore died of it over two weeks earlier 20 miles from Belleville. Most of the men in John Moore’s extended family where in the Illinois militia on campaign under his step-brother Gen. Samuel Whiteside during the Black Hawk War. So the community gathering for independence day celebrations the summer after the war, that could have went on for days, is the context of his death.

The arrival of the first steamship in Illinois brought with it the double-edged sword of connection with ‘civilization’. Most of the early Illinois pioneers did not come with grand visions of living in an isolated primitive wilderness.  They were very focused on land ‘improvements’ and recreating a Virginia-style plantation landscape. Steam ships would have been heralded as a sign of progress since river trade was vital to their economy until the railroad arrived. The cholera brought to the frontier by the federal troops killed more people than the Black Hawk War.

Historic Meanings of “Cholera”

Today the term cholera is restricted to suspected infections caused by Vibrio cholerae, sometimes called Asiatic cholera. Vibrio cholerae produces a very characteristic watery diarrhea sometimes described as ‘rice water’. This narrow definition wasn’t always so.

Since antiquity, cholera could refer to any diarrhea or dysentery. The term cholera comes from the Greek word cholē meaning bile. Cholera then was a flushing of bile from the body in an attempt to rebalance Galen’s four humors of the body (blood, bile, black bile, and phlegm) [1].

In 19th century American medical records,  it is common to see three types of cholera reported: cholera morbus, cholera infantum, and Asiatic cholera. Cholera morbus and cholera infantum were both terms for non-specific diarrhea and/or dysentery in adults and children under age five respectively.  Cholera morbus was sometimes called the summer complaint and was usually found in older children and adults from July to September [2]. It was caused by a variety of gastrointestinal pathogens with a significant contribution from contaminated food. Cholera infantum was given as the primary cause of death in children under age five in 19th century Illinois [2]. Physicians specifically associated it with the ages of teething and finger foods. Even given its non-specific definition, it was still probably over diagnosed due to paradigms of childhood illness. For example, early Illinois physicians  did not believe that children could contract malaria, then endemic in Illinois. Asiatic cholera is caused by Vibrio cholerae, epidemic in Illinois in 1832-1834, 1838, 1849-1852, 1866-1867, and 1892 [2]. Apart from discrete epidemic waves, Asiatic cholera was uncommon in America.

References:

[1] Männikkö, N. (Ed) (2011). Etymologia: Cholera. Emerging Infectious Disease, 17 (11) http://dx.doi.org/10.3201/eid1711.ET1711

[2]  Rawlings, Issac D. et al. (1927).The Rise and Fall of Disease in Illinois. State Department of Health.