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The Cough that Carried Them Off
[This article first appeared in the now obsolete Practical Family History in 2010]
One of the most
sinister sounds of the past must have been that of a small child with whooping
cough. The disease began like the common cold with a runny nose, sneezing,
decreased appetite, increased phlegm, broken sleep and fever. From this, a
repeated hacking cough developed. Parents must have dreaded the onset of the
inspiratory whooping (a high-pitched intake of breath) which could end in a fit
of vomiting. Such are the wonders of the internet that you can now listen to
the sound of a child with whooping cough at
http://www.whoopingcough.net/sound%20of%20whooping%20cough%20with%20some%20whoop.htm
Pertussis should be considered as a really important
contributor to the histories of those many families who contracted it. In the
first place, along with measles,
scarlet fever, and diphtheria, it was one of the four great killers of children of the
nineteenth century. Death certificates of ancestors who died from whooping
cough may refer to the disease by its scientific names - ‘pertussis’ or ‘tussis
convulsiva’ (‘tussis’ meaning ‘cough’). In letters, diaries and other records,
it may have been mentioned more colloquially as ‘chin cough’ or ‘the cough of a
hundred days.’ Since the cough weakens
the body’s immune system and makes it susceptible to other diseases, there may
be other causes of death recorded alongside whooping cough on death
certificates: pneumonia or bronchitis, for example. Because of the intense
coughing it induced, whooping cough could also bring on burst blood vessels,
nosebleeds, skin bruises, hernias and even brain damage.
Secondly, it’s worth remembering that many of our ancestors
suffered but did not die from whooping cough. In their cases, having this
particular disease (with its unsociable symptoms and cures that were more
guesswork than science) often shaped both their childhood and their subsequent
life experiences. Many children suffering from the distinctive cough, for
instance, were sent away to spend time in the fresh air at seaside resorts and
spa towns away from other children. Others visited one of the many specific
sites around the country renowned for their supposed ability to get rid of the
disease. These included the National Trust’s first property Dinas Oleu
(acquired in 1895) in the cliffs above Barmouth, and Dupath Well near
Callington in Cornwall - an ancient bathing spot in which the waters were
purported to cure whooping cough and skin diseases. For some children, then,
having whooping cough was their first (and perhaps their only) period away from
home.
For some adults, a persistent cough throughout life was a
lasting testimony to the fact that they had survived whooping cough as
children. Charles Lutwidge Dodgson (aka Lewis Carroll) (1832-1898) caught
whooping cough in the spring of 1848. He recovered but was so debilitated that
he contracted mumps later the same year. The cough returned at various times
during his life and the mumps left him partially deaf. The prolific children’s
writer Enid Blyton contracted whooping cough in the first months of her life
(in 1897) but was nursed through it by her father – something to which her
biographers have attributed her very close relationship with him in later life.
There were some more surprising results of the disease that
may shed light on the future careers of your ancestors. Those who suffered as
children later recalled the weeks and months spent isolated from others and the
painful psychological legacy of these. For some, their time spent with whooping
cough was a crucial period in their development
- a period in which, forced upon their own resources, they read or
painted, developing artistic habits and powers of concentration that were to
determine how they went on to lead their adult lives.
Death of Lillie Symes
Lillie Symes (my
great aunt) died from whooping cough at the age of thirteen months in January
1894. In many ways, Lillie was a typical victim of the disease in that she was
under eighteen months old, female and from a poor industrial community. At the
time of her death, she was living in crowded conditions with her parents, four
sisters (all under eight years old) and a lodger, in Ancoats, one of the
poorest areas of Manchester. And Lillie’s death – as in the case of many
victims – was the result of complications rather than from whooping cough
alone; her death certificate also records bronchopeneumonia as a cause of
death.
Medical websites
such as www.whoopingcough.net
have given me enough
information to enable me to be able to imagine the growing sounds of panic in
that little house in Ancoats as Lillie’s illness developed over weeks and
perhaps months. The ordinary cough would have developed into intense bouts of
coughing – paroxysms of one or two minutes duration in which the little child
would have gone red, her body tense, her eyes bulging. She may have had up to a
hundred bouts of coughing a day each one ending in a desperate attempt to take
in a breath and with it (probably, though not necessarily) the infamous,
dreadful ‘backdraw’ or whoop. Vomiting of mucus and food may well have
followed.
Whooping cough is
extremely contagious, particularly among children. It’s now known that the
infection is spread through contaminated droplets in the air produced during
coughing. Luckily, none of Lillie’s sisters, including her twin, Annie, fell
prey to the disease. More fortunately still, perhaps, Lillie’s mother (my
great-grandmother) who was three months pregnant with my grandfather at the
time, also managed to escape infection.
Lillie was one of
many victims of whooping cough. Before immunisation, epidemics of the disease
came every three or four years in Britain. Some sources suggest that eight in
ten children in the period had whooping cough before they were five. In
Scotland alone in the year before Lillie’s death, 131 children died from
whooping cough in the month of April and 145 in May. These accounted for
between 5 % and 6 % of all mortality rates at the time. School log books from
the nineteenth century often record school closures because of the disease or
the exclusion of large numbers of children with the infection.
No Specific Cure
Despite the fact that it was widely acknowledged that there
was ‘no specific cure for whooping cough and that no drug could check the onset
nor stop the progress of the disease’ Quain’s Dictionary of Medicine, 1902,
there were a large number of embrocations, liniments and inhalants available on
the market at the time of Lillie’s death. These included Bevington’s drops
(ingredients unknown) and Dr Bow’s Liniment thought to contain ammoniated
camphor liniment, belladonna liniment, soap liniment, strong ammonia and
tincture of opium.
As well as the range of costly – and mostly useless -
pharmaceuticals on offer, a whole host of alternative ‘cures’ for whooping
cough were also suggested. In Cornwall, infusions made from holly were
recommended. In Staffordshire an ancient legend suggested that you should take
the sick child outside and let it look at the new moon, lift up its clothes and
rub your right had up and down its stomach whilst reciting a prayer. Passing a
child three times under and over a donkey was the most bizarre in a long list
of non-scientific cures recommended to the desperate.
Since they were
poor and Methodists, it’s unlikely that the Symes family either procured
expensive medicines for Lillie or tried any of the more fanciful of these
suggested cures. Rather they probably followed popular medical guidance of the
time: advice passed down from one generation to another by word of mouth or in
common household advice books. Lillie would have been nursed in a sitting
position, efforts would have been made to clear the mucus from her nose and
throat, and her intake or food and drink would have been fussed over. Homemade
medication might have involved a ‘liniment made of one teaspoonful of oil of
cloves, two teaspoonfuls of oil of amber, and two tablespoonfuls of camphorated
oil well shaken up together in a bottle, [and] rubbed into the pit of the
stomach and into the spine every night.’ Teas, garlic and honey were also
recommended as methods of cutting the phlegm.
For those with access and means, whooping cough was serious
enough to warrant hospital admission. It was also contagious enough to warrant
some institutions such as King’s College Hospital having a separate entrance
for whooping cough cases from 1913. The new online Historic Hospitals Admission
Project (http://www.hharp.org) makes it possible for family historians to
search for individual children who may have been admitted to one of a number of
London Children’s Hospitals (and other institutions) with various diseases
between 1852 and 1914. Many of those
admitted to Great Ormond Street Hospital with whooping cough were also
suffering from complications (‘sequela’), including croup and bronchitis. Two year old Emma Day, for example, was admitted
with whooping cough on April 24th 1852, she was treated for 12 days
and left the hospital cured. Joseph Hamlet was not so lucky. Aged 2 years and 2
months, he was admitted to hospital on May 3rd 1853 and died the
following day. The database includes his handwritten case notes.
A Vaccine At Last
Unfortunately for
her, my great aunt Lillie’s death preceded the discovery of the whooping cough
bacterium (‘Bordatella pertussis’) by twelve years. But it was a good
while before an effective vaccine was developed. Indeed, well into the twentieth century even
those in the highest classes of society could succumb to the cough. In
May 1923, Elizabeth Bowes Lyon (Duchess of York, wife of the future King George
VI and later the Queen Mother) caught whooping cough on her honeymoon at Glamis
Castle and described it as ‘not a very romantic disease.’
A vaccine finally
became available and was tested by scientists from the Whooping Cough
Immunisation Committee of the Medical Research Council between 1948 and 1954.
Prior to its introduction by the NHS in 1957, whooping cough was affecting
approximately 100,000 people a year in England and Wales. Afterwards, the rate
of reported cases dropped to 2,000 a year. Fears about the safety of the
whooping cough vaccine in the 1970s caused a drop in its uptake and a
corresponding rise in the number of cases. From the mid 1980s, however, the
general efficacy of the vaccine has been recognised. Antibiotics are now also
prescribed if the disease does occur.
Thankfully, cases
of whooping cough are now very few and far between and deaths are rare indeed.
The atrocious whooping noise that so often signalled disaster in the households
of our ancestors is now very much a sound of the past.
Useful Books
Day, Paul, Whooping Cough: A Journey Towards Truth,
Lulu.com, 2008
Jerger, Jeanette J. A Medical Miscellany for
Genealogists, Heritage, 2009
Porter, Roy. The Cambridge Illustrated History of
Medicine, CUP, 2001
Useful Websites
www.whoopingcough.net
General site of information and advice on whooping cough
http://www.olib.rpsgb.org.uk/pdfs/mussheetwhoopcough.pdf Museum of the Royal Pharmaceutical Society showing the different cures that have been suggested for whooping cough through the ages.
www.rmhh.co.uk/medical.html
Website of archaic medical terms including a timeline of major epidemics
in the UK throughout history.
http://www.antiquusmorbus.com/Index.htm Archaic medical terms (including German and French terms).
http://www.cyndislist.com/medical.htm#Diseases Collection of websites and medical terms
useful to genealogists.
http://www.online-medical-dictionary.org/
A free online medical dictionary.
http://hharp.org/ Historic Hospital Admission Records
Project. On-line database of admissions to various hospitals mainly in London
between 1852 and 1914.
Keywords: European ancestors, family history, genealogy, England, health, whooping cough, death certificates
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