Diphtheria Epidemic

By Anne Dealy, Director of Education and Public Information

"Diphtheria prevails to no little extent in Geneva, although there have been but few fatal cases." This brief notice in the October 4, 1878 Geneva Gazette marks the first mention of what would come to be one of the worst epidemics in the community's history. By April 1879 at least 75 people, mostly children, lost their lives. Over 400 of the village's residents fell ill with the disease between September and March 1879. Whole families became sick, and a few parents lost all of their children to the disease. Some people had relatively mild cases, but others had the particularly frightening "membraneous" type, in which a thick gray substance formed over the throat causing the victim to gasp and choke when breathing.

Window in St. Peter’s Episcopal Church tower dedicated to the ten members of the Sunday School class who died in the diphtheria epidemic.

Most Americans today have no experience with this disease, which has been largely eliminated in the west due to vaccination. Symptoms include a sore throat, fever, chills and swollen glands. The illness itself is not deadly, but the diphtheria bacteria can produce a deadly toxin that causes heart damage, nerve damage, paralysis, and lung infection. It is one of many ailments that is particularly devastating to children, but can kill anyone, even those who have had it before.

Aside from dealing with the fear that normally accompanies a disease epidemic, Genevans in 1878 also had no understanding of the cause of diphtheria, nor any real defense against it. The scientific revolution in medicine was just beginning in Europe, and medicine was not yet synonymous with science. Particularly in the United States, there were almost no standards for medical education, nor were there standards for diagnosing disease. Any sore throat could be labeled diphtheria, particularly by an inexperienced doctor. Doctors were free to follow any treatments they believed worked, and they relied on personal observation and experience, rather than evidence, to diagnose and treat illness. As a result, theories of disease causation and treatment varied from the reasonable to the ridiculous.

Some believed open drains, dirt roads and streets strewn with manure caused the 1878 diphtheria epidemic. Castle Street, c. 1870s.

One popular theory circulating in the late 19th-century posited that sewage and filth caused disease. "Filth" could refer to human and animal excrement, trash, swampy land, or rotting plant or vegetable matter. Recognition that water supplies were connected to the spread of diseases like typhoid and cholera led people to conclude that many other ailments resulted from water and air contaminants. One headline in the Geneva Gazette during the epidemic read "Malarial Disease and Its Remedy." The article went on to decry that "Geneva is deplorably defective in sewerage. Without it many people have been accustomed to drain into several little open streams which have their outlets into the lake and canal." The newspapers were full of letters and editorials on the danger of open drains and piles of dead leaves, and the need for a sanitary sewer and safe water system. A sewer system might have prevented waterborne diseases, but would have done nothing to stop the spread of diphtheria, which is transmitted by airborne secretions or contaminated items, like utensils or clothing.

The boards leading from South Main Street’s sidewalks allowed pedestrians to step over the filth in the gutters.

There was some recognition that the disease could be passed from one person to another, but there was no quarantine in effect. By late October, the village Board of Health made several regulations to try to control the spread of the disease, declaring that "The body of every person who has died of diphtheria or scarlet fever, shall be immediately enclosed in an air-tight coffin..." and "No person shall enter any house where there is a case of diphtheria or scarlet fever, unless invited for the purpose of assistance...and no visit shall be made after death..." It did not help that many victims had mild infections, and people assumed the mild form was not as communicable as the "malignant" form. In all likelihood, this difference in severity was not due to the infection itself, but whether or not the diphtheria bacteria had produced its deadly toxin.

Druggist E. Maynard in a mid-November article advocated "the unceasing use of disinfectants in the sick-room and in every room adjoining, and every vessel, slop-jar, etc., etc. that shall contain any secretion of the sick." He went on to recommend burying all clothing or bed clothes that came in contact with discharges from the patient's mouth and washing clothes in carbolic acid. These precautions probably did help prevent transmission of the disease. On the other hand, the next article advocated gargling with kerosene oil as a cure. Many people recognized their helplessness in the face of this disease, "confess[ing] that when [diphtheria] advances to a certain stage, poisoning the blood in the arteries and veins, a cure is impossible."

List of Deaths, Geneva Gazette, November 29, 1878

Among the dead were dry goods merchant George Seelye and his only two children. His wife survived. Civil War veteran Dr. Calvin H. Carpenter, while treating patients with the disease, watched it take his own 11-year old son before he himself fell ill. The doctor's brother then died of it. Three other village doctors also saw their children die. African-American Charles Gates lost his 6-year old daughter Lena May. Machinist Mathew Easterbrook died at 54 years old. Several Hobart students fell ill and the college closed for two weeks. One went home to Syracuse to die there. A sales agent for the Geneva Courier who had just moved from Bellona fled back there with his children, only to watch them both die.

Matthew Easterbrook.

Then in December new cases slowed. From 10-15 deaths a week, losses fell to two or three, then one or two a month. People had no explanation and turned to religion for consolation. Said one mother, "I was distracted when my Bessie went but now I am calm. Bessie and Gracie are together, and safe, safe from every danger."

The village began to examine the cost and methods of creating a sanitary water and sewer system, but the cost was high and many did not think it worthwhile. Over the next decade village voters rejected plans to fund a sewer system multiple times. The community continued to use Castle Creek as an open drain and deposited sewage in Seneca Lake. It would be more than twenty years until the city created a sewer system--about the same time the diphtheria bacteria was identified and an anti-toxin and vaccine were developed, finally preventing the countless deaths caused by the disease.

For more information - 

How Horses Helped Cure Diphtheria 

Neither shall there by any more pain

By Alice Askins, Site Manager at Rose Hill

New York February 24, 1851  

My Dear Margaret

. . . Caroline is now doing very well & has one of the prettiest little girls I ever saw. . . [she] had a better time than usual[,] she took the Ether & did not know when the child was born.”  

Mary Saidler Swan to her daughter-in-law, Margaret Swan

The quest to eliminate pain goes back at least to 3,000 years BCE.  Early cultures used various preparations, including alcohol, opium, and cannabis to relieve pain.  The first documented use of general anesthesia during surgery was performed by the Japanese doctor Hanaoka Seishu.  Trained in both Chinese herbal medicine and Western surgical techniques, Dr. Hanaoka worked for years to develop a compound of plant extracts that would numb pain and cause temporary unconsciousness.  His first recorded operation using his formula took place in October 1804, when he performed a partial mastectomy for breast cancer on a woman named Kan Aiya.  Because the government of Japan kept the country isolated from the rest of the world, Dr. Hanaoka’s achievements were not known in the larger world during his lifetime.   By the time the isolation ended in 1854, different techniques for general anesthesia had already been independently developed in America and Europe.

Dr. Hanaoka Seishu

By the late 1830s, Western doctors and scientists had experimented with such compounds as nitrous oxide, ether, and chloroform.  The interest at that time was in the altered consciousness the compounds caused.  Traveling lecturers would hold public gatherings called “ether frolics,” where members of the audience inhaled ether or nitrous oxide to demonstrate their mind-altering qualities and entertain the onlookers.  Several men who participated in these events later used these substances as medical anesthesia.

Dr. Crawford Long practiced in Jefferson, Georgia.  As a student the University of Pennsylvania, he attended ether frolics.  Long noted that some participants experienced bumps and bruises, but afterward had no memory of the injuries.  In March 1842, he gave ether to James Venable, in order to remove a tumor from the man's neck.  In December 1845, Long first used ether as an anesthetic during childbirth.  The patient’s name seems not to have been recorded.  Because Dr. Long wanted to test ether in many patients over time, before publishing his findings, he did not at first receive credit for his pioneering work.  There was, in fact, considerable controversy about who first used ether for anesthesia, but now Dr. Long’s work is being recognized.

Dr. Crawford Long

We do know the names of two women who became well-known for using anesthesia in childbirth.  Frances “Fanny” Appleton Longfellow, wife of the poet Henry Wadsworth Longfellow, bore six children.  When her third child was born on April 7, 1847, Dr. Nathan Cooley Keep administered ether to her.  She later wrote,

I did it for the good of women everywhere as no woman should have to suffer that much pain. I am very sorry you all thought me so rash and naughty in trying the ether. Henry's faith gave me courage and I had heard such a thing had succeeded in abroad where the surgeons extend this great blessing more boldly and universally than our timid doctors.... This is certainly the greatest blessing of this age.

Fanny Longfellow with her sons

Emma Darwin, the wife of naturalist Charles Darwin, also tried anesthesia.  Darwin gave chloroform to his wife for the last two of her eight births. The first time she used chloroform was also in 1847, and for the next (and final) birth she is said to have screamed, “Get me the chloroform.”

Historians debate whether conservative clergymen objected to obstetric anesthesia on Biblical grounds.  In Scotland,  Sir James Young Simpson, who advocated chloroform and painless delivery, faced objections from certain Calvinists, who cited Genesis 3:16:   "Unto the woman he said, 'I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children.'”  Opponents interpreted this passage to mean that God wanted women to suffer in childbirth.  It seems, though, that religious opposition to anesthesia was from a vocal minority.  There were also many doctors who were understandably cautious about anesthesia, because it could present dangers to mother and child.

There was a third woman who used anesthesia for childbirth, and she was famous before the issue arose.   Queen Victoria’s eighth child was born in 1853, with his mother under an accurate and controlled dose of chloroform.  She reported, "Dr. Snow gave that blessed chloroform and the effect was soothing, quieting and delightful beyond measure.”  Her example broke down barriers against the practice.  In fact, though, as Dr.  Simpson said,

Medical men may oppose for a time the superinduction of anaesthesia in parturition, but they will oppose it in vain; for certainly our patients themselves will force use of it upon the profession. The whole question is, even now, one merely of time.

Queen Victoria, Prince Albert and their children, 1857

Caroline Post Swan (Margaret Swan’s sister-in-law) tried “the ether” in 1851, before even Queen Victoria.  We might consider her a pioneer as well.