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The "Slows"
The Torment of Milk Sickness on the Midwest Frontier
WALTER J. DALY
| In the early nineteenth century, as white settlers flooded onto the midwestern frontier, a new and highly fatal disease appeared among them. The sickness was unknown along the eastern coast and elsewhere in the world. Settlers were forced to guess at its cause and attempt to treat it without benefit of prior experience or modern clinical research. An understanding of the disease's pathology and the discovery of a successful treatment had to wait until the advent of twentieth-century biochemistry. By that time, milk sickness had almost disappeared, and today it is nearly forgotten. |
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The "interior valley of North America," as Daniel Drake described it, was settled by people who moved across the mountains to an arduous and precarious life. Pioneers labored to eke out an existence, and they came into frequent contact with violence, malnutrition, and disease. |
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Chief among the diseases of the area and time were malaria, dysentery, cholera, typhoid fever, streptococcal infections, smallpox, and pneumonia. These were common in the East, and pioneers possessed a level of popular understanding about the symptoms and the available treatments for each disease. Unfortunately, in the early 1800s, the popular understanding of medicine was often more medieval than modern: treatments advocated by the Greek physician Galen were still alive in Drake's "interior valley." Bleeding, purging, and an ancient pharmacopoeia were the rule. Both physicians and folk doctors aimed at balancing the body's humors and knew neither the origins of their treatments nor the bases for their presumed efficacy. Diagnosis was based upon slender findings, and diseases were classified, not by etiology or pathology, but by prominent symptoms, such as fevers, fluxes, and the locations of pain. Too often efficacy was judged by improvement in individual patients rather than by the collected results of systematic trials, and the placebo effect was not recognized. Most of the sick never saw a physician. |
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In such a medical climate appeared the mysterious disease which came to be called milk sickness. Ordinary settlers and their doctors found it unpredictable, untreatable, and highly fatal. Milk sickness killed many, frightened more, and caused local economic crises. Villages and farms were abandoned; livestock died; entire families were killed. Migration to areas thought to be safer became common. And then the disease almost disappeared without any special preventive actions, at least without any targeted at its eradication. Its disappearance would prove to be a consequence of the progress of midwestern civilization and advances in agriculture. |
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THE FIRST REPORTS OF MILK SICKNESS | |
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In 1810, Daniel Drake wrote an extensive essay on Cincinnati and its environment. In an appendix, he included an 1809 report by a Dr. Barbee of Virginia, who had visited southwestern Ohio. Barbee described a potentially new disease, with a clinical constellation of weakness, muscular pain, vomiting, severe constipation, disagreeable breath, lassitude, coma, and death. He observed a similar disorder in cows, horses, sheep, and dogs. Pioneer farmers called the sickness "the trembles," because their animals became feeble and trembled when they exerted themselves. The condition generally occurred in oak forests and valleys. Drake reproduced Barbee's entire report "so that physicians may determine how far it deserves the appellation of a new disease." Drake and Barbee were the first to describe milk sickness, although neither knew of its association with milk. The disease was first called "sick stomach," or the "puking illness," and later, the "slows."1 |
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