What may appear on the death certificate: consumption, marasmus, phthisis, lung sickness, scrofula or King's evil (TB of the lymphatic glands), white swelling (TB of the bone), Pott's Disease (TB of the spine)
When it was prevalent: Constantly
TB is caused by the Mycobacterium tuberculosis bacteria, which usually attack the lungs, but can affect almost any part of the body. According to the U.S. Center for Disease Control (CDC), TB was once the leading cause of death in the United States. By the early 1900s, it killed one out of every seven Americans and Europeans. Readers of the children's classic Anne of Green Gables, set in the 19th century, will remember a populace where the "galloping consumption" spirited away many youths.
In the 1940s, anti-TB drugs were developed which severely curtailed the disease's power. According to the CDC, there was an increase in TB between 1985 and 1992, but redoubled TB eradication efforts have slowed the disease again. Current estimates of TB are 10 per 100,000 people, but many TB cases are concentrated among homeless, AIDS-affected and foreign-born populations.
What may appear on the death certificate: typhus fever, malignant fever, jail fever (endemic typhus), hospital fever, ship fever, Irish fever, putrid fever, brain fever, bilious fever, spotted fever, petechial fever, camp fever.
When it was prevalent: Epidemics in Philadelphia 1836, Memphis, Baltimore, Washington DC between 1865-1873. Epidemics in Ireland 1816-1819, late 1830s, 1846-1849, spillover in North America from emigrants. Epidemics in Europe early 19th century.
Not to be confused with Typhoid Fever (another common 19th-century killer), typhus is caused by the Rickettsia typhi or Rickettsia prowazekii bacteria. Spread by lice and fleas, typhus was a constant companion wherever overcrowding and poor hygiene existed. In the 19th century this could mean anywhere, but especially passenger ships, cities and military camps. A military ancestor who died on a battlefield could have well been killed by typhus instead of by the enemy. According to the U.S. National Institutes of Health (NIH), untreated epidemic typhus (as opposed to endemic typhus) can kill 10% to 60% of infected patients.
Hardest hit were the Irish. Typhus was one of the main causes of death during the 19th-century Irish Famine, wrote Dr. Patrick Rowan in the Irish Medical Times in 2009. Six epidemics swept the Isle in the 1800s, sustained by potato crop failure, primitive living conditions and poor hygiene.
When Irish emigrants set sail for North America, the lice and fleas came with them. Several memorials across North America mark where immigrants were contained while authorities tried to deal with typhus and prevent it from spreading into the general population. Antibiotics, as well as improved living conditions and hygiene, combined to minimize typhus in North America. Endemic (or murine) Typhus still exists in the southern and southeastern US.., but is "rarely deadly" according to the NIH.
What may appear on death certificate: Cholera, Indian Cholera, Asiatic cholera, epidemic cholera
When it was prevalent: Global pandemics in 1817-1823, 1832, 1848-50, 1854-57, 1865-67, and 1873-74
"Thursday, 2 August 1832…The first victim of the disease was Eliza MacGregor, a sister of Peter MacGregor. Mrs. MacGregor, mother of Peter and Eliza, prostrated herself on the damp earth of her daughter's grave and died the next morning. . . . The following day, her son-in-law Richard Pullen, a coach-maker, died. Dr. John Patrick Donnelly died on 30 July. The wife of his colleague Dr. Elam Stinson died on 20 July, and their infant son five days later."
Such is the description of cholera's impact on the then-village of London, Ontario, recounted in London 200: An Illustrated History. Originating in India and sweeping across the planet, the Vibrio cholera bacteria and the diarrheal illness it caused was "the classic epidemic disease of the 19th century" writes Charles E. Rosenberg in his book The Cholera Years: The United States in 1832, 1849, and 1866. "It flourished in the great cities, New York, Cincinnati, Chicago; it crossed the continent with the forty-niners; its victims included Iowa dirt farmers and New York longshoremen, Wisconsin lead miners and Negro field hands."
Cholera is easily spread by water, bodily fluids, or food contaminated with cholera-infected fecal matter. The primitive to non-existent water and sanitation systems at the time allowed the disease to claim victims quickly. According to the NIH, the 1832 pandemic came from India via Russia and Western Europe, entering North America through ports in Quebec, Montreal and New York.
Science, led by English physician Dr. John Snow, was able to identify the water-borne transmission of cholera and argue for improved water and sewage treatment systems in communities. Rosenberg writes that in the end, cholera's greatest North American victim was cholera itself as "the cholera epidemics of the 19th century provided much of the impetus needed to overcome centuries of governmental inertia and indifference in regard to problems of public health."
Unfortunately, cholera is still present in much of the world, especially the Indian subcontinent and sub-Saharan Africa, although it is easily treated with rehydration. The CDC recommends, however, that 21st-century travelers visiting poorer parts of the planet learn about the disease that was only too familiar to their 19th-century ancestors.