Transcribed by Cynthia Mitchell
From the article "Disease and Death in the Nineteenth Century: A Genealogical
Perspective", by James Byars Carter, M.D. Exerpted from a complete article on
the subject from
The National Genealogical Society Quarterly, Vol. 76, (Dec 1988) pp 289?301.
MEDICAL TERMS AND DEFINITIONS
Most of the definitions of diagnoses in the glossary that follows are from
medical dictionaries or medical texts compiled at different points in the
nineteenth century. [see NOTES AND REFERENCES at end of article]. To determine
which medical terms should be defined, the author has surveyed various mortality
schedules, death certificates, and other medical sources of the nineteenth
century. While he has tried to submit the best?possible interpretation of these
terms, there are certainly other interpretations which may be valid.
Glossary
Abscess. A localized collection of pus buried in tissues, organs, or confined
spaces of the body, often accompanied by swelling and inflammation and
frequently caused by bacteria. The brain, lung, or kidney (for instance) could
be involved. See boil.
Addison's disease. A disease characterized by severe weakness, low blood
pressure, and a bronzed coloration of the skin, due to decreased secretion of
cortisol from the adrenal gland.
Dr. Thomas Addison (1793?1860), born near Newcastle, England, described the
disease in 1855.
Synonyms: Morbus addisonii, bronzed skin disease.
Ague. Malarial or intermittent fever characterized by paroxysms (stages of
chills, fever, and sweating at regularly recurring times) and followed by an
interval or intermission whose length determines the epithets: quotidian,
tertian, quartan, and quintan ague (defined in the text). Popularly, the disease
was known as "fever and ague," "chill fever," "the shakes," and by names
expressive of the locality in which it was prevalent?? such as, "swamp fever"
(in Louisiana), "Panama fever," and "Chagres fever."
Ague?cake. A form of enlargement of the spleen, resulting from the action of
malaria on the system.
Anasarca. Generalized massive dropsy. See dropsy.
Aphthae. See thrush.
Aphthous stomatitis. See canker.
Ascites. See dropsy.
Asthenia. See debility.
Bilious fever. A term loosely applied to certain enteric (intestinal) and
malarial fevers. See typhus.
Biliousness. A complex of symptoms comprising nausea, abdominal discomfort,
headache, and constipation?? formerly attributed to excessive secretion of bile
from the liver.
Boil. An abscess of skin or painful, circumscribed inflammation of the skin or a
hair follicle, having a dead, pus? forming inner core, usually caused by a
staphylococcal infection. Synonym: furuncle.
Brain fever. See meningitis, typhus.
Bronchial asthma. A paroxysmal, often allergic disorder of breathing,
characterized by spasm of the bronchial tubes of the lungs, wheezing, and
difficulty in breathing air outward?? often accompanied by coughing and a
feeling of tightness in the chest. In the nineteenth century the direct causes
were thought to be dust, vegetable irritants, chemical vapors, animal
emanations,
climatic influences, and bronchial inflammation?? all of which were reasonable
guesses. The indirect causes were thought to be transmissions by the nervous
system or by the blood from gout, syphilis, skin disease, renal disease, or
heredity. Only the latter cause was a reasonable assumption.
Camp fever. See typhus.
Cancer. A malignant and invasive growth or tumor (especially tissue that covers
a surface or lines a cavity), tending to recur after excision and to spread to
other sites. In the nineteenth century, physicians noted that cancerous tumors
tended to ulcerate, grew constantly, and progressed to a fatal end and that
there was scarcely a tissue they would not invade. Synonyms: malignant growth,
carcinoma.
Cancrum otis. A severe, destructive, eroding ulcer of the cheek and lip, rapidly
proceeding to sloughing. In the last century it was seen in delicate, ill?fed,
ill?tended children between the ages of two and five. The disease was the result
of poor hygiene acting upon a debilitated system. It commonly followed one of
the eruptive fevers and was often fatal. The destructive disease could, in a few
days, lead to gangrene of the lips, cheeks, tonsils, palate, tongue, and even
half the face; teeth would fall from their sockets, and a horribly fetid saliva
flowed from the parts. Synonyms: canker, water canker, noma, gangrenous
stomatitis, gangrenous ulceration of the mouth.
Canker. An ulcerous sore of the mouth and lips, not considered fatal today.
Synonym: aphthous stomatitis. See cancrum otis.
Carcinoma. See cancer.
Catarrh. Inflammation of a mucous membrane, especially of the air passages of
the head and throat, with a free discharge. It is characterized by cough,
thirst, lassitude, fever, watery eyes, and increased secretions of mucus from
the air passages. Bronchial catarrh was bronchitis; suffocative catarrh was
croup; urethral catarrh was gleet; vaginal catarrh was leukorrhea; epidemic
catarrh was the same as influenza. Synonyms: cold, coryza.
Childbirth. A cause given for many female deaths of the century. Almost all
babies were born in homes and usually were delivered by a family member or a
midwife; thus infection and lack of medical skill were often the actual causes
of death.
Cholera. An acute, infectious disease, endemic in India and China and now
occasionally epidemic elsewhere characterized by profuse diarrhea, vomiting, and
cramps. It is caused by a potent toxin discharged by the bacterium Vibrio
cholerae, which acts on the small intestine to cause secretion of large amounts
of fluid. The painless, watery diarrhea and the passing of ricewater stool are
characteristic. Great body salt depletion occurs. Cholera is spread by feces
contaminated water and food. Major epidemics struck the United States in the
years 1832, 1849, and 1866. In the 1830s the causes were generally thought to be
intemperance in the use of ardent spirits or drinking bad water; uncleanness,
poor living or crowded and ill ventilated dwellings; and too much fatigue. By
1850 cholera was thought to be caused by putrid animal poison and miasma or
pestilential vapor rising from swamps and marshes or that it entered the body
through the lungs or was transmitted through the medium of clothing. It was
still believed that it attacked the poor, the dissolute, the diseased, and the
fearful while the healthy, well-clad, well-fed, and fearless man escaped the
ravages of cholera.
Cholera infantum. A common, noncontagious diarrhea of young children, occurring
in summer or autumn. In the nineteenth century it was considered indigenous to
the United States; was prevalent during the hot weather in most of the towns of
the middle and southern states, as well as many western areas; and was
characterized by gastric pain, vomiting, purgation, fever, and prostration. It
was common among the poor and in handfed babies. Death frequently occurred in
three to five days. Synonyms: summer complaint, weaning brash, water gripes,
choleric fever of children, cholera morbus.
Chorea. Any of several diseases of the nervous system, characterized by jerky
movements that appear to be well coordinated but are performed involuntarily,
chiefly of the face and extremities. Synonym: Saint Vitus' dance.
Chronic. Persisting over a long period of time as opposed to acute or sudden.
This word was often the only one entered under "cause of death" in the mortality
schedules.
Colic. Paroxysmal pain in the abdomen or bowels. Infantile colic is benign
paroxysmal abdominal pain during the first three months of life. Colic rarely
caused death; but in the last century a study reported that in cases of death,
intussusception (the prolapse of one part of the intestine into the lumen of an
immediately adjoining part) occasionally occurred. Renal colic can occur from
disease in the kidney, gallstone colic from a stone in the bile duct.
Congestion. An excessive or abnormal accumulation of blood or other fluid in a
body part or blood vessel. In congestive fever (see text), the internal organs
become gorged with blood.
Consumption. A wasting away of the body; formerly applied especially to
pulmonary tuberculosis.
The disorder is now known to be an infectious disease caused by the bacterial
species Mycobacterium tuberculosis. Synonyms: marasmus (in the mid-nineteenth
century), phthisis.
Convulsions. Severe contortion of the body caused by violent, involuntary
muscular contractions of the extremities, trunk, and head. See epilepsy.
Coryza. See catarrh.
Croup. Any obstructive condition of the larynx (voice box) or trachea
(windpipe), characterized by a hoarse, barking cough and difficult breathing
occurring chiefly in infants and children. The obstruction could be caused by
allergy, a foreign body, infection, or new growth (tumor). In the early
nineteenth century it was called cynanche trachealis. The crouping noise was
similar to the sound emitted by a chicken affected with the pip, which in some
parts of Scotland was called roup; hence, probably, the term croup. Synonyms:
roup, hives, choak, stuffing, rising of the lights.
Debility. Abnormal bodily weakness or feebleness; decay of strength. This was a
term descriptive of a patient's condition and of no help in making a diagnosis.
Synonym: asthenia.
Diphtheria. An acute infectious disease caused by toxigenic strains of the
bacillus Coryne-bacterium diphtheriae, acquired by contact with an infected
person or a carrier of the disease.
It was usually confined to the upper respiratory tract (throat) and
characterized by the formation of a tough membrane (false membrane) attached
firmly to the underlying tissue that would bleed if forcibly removed. In the
nineteenth century the disease was occasionally confused with scarlet fever and
croup.
Dropsy. A contraction for hydropsy. Edema, the presence of abnormally large
amounts of fluid in intercellular tissue spaces or body cavities. Abdominal
dropsy is ascites; brain dropsy is hydrocephalus; and chest dropsy is
hydrothorax. Cardiac dropsy is a symptom of disease of the heart and arises from
obstruction to the current of blood through the heart, lungs, or liver. Anasarca
is general fluid accumulation throughout the body.
Dysentery. A term given to a number of disorders marked by inflammation of the
intestines (especially of the colon) and attended by pain in the abdomen, by
tenesmus (straining to defecate without the ability to do so), and by frequent
stools containing blood and mucus. The causative agent may be chemical
irritants, bacteria, protozoa, or parasitic worms. There are two specific
varieties: (1) amebic dysentery caused by the protozoan Entamoeba histolytica;
(2) bacillary dysentery caused by bacteria of the genus Shigella. Dysentery was
one of the most severe scourges of armies in the nineteenth century. The several
forms of dysentery and diarrhea accounted for more than one-fourth of all the
cases of disease reported during the first two years of the Civil War. Synonyms:
flux, bloody flux, contagious pyrexia (fever), frequent griping stools.
Eclampsia. A form of toxemia (toxins-or poisons-in the blood) accompanying
pregnancy, characterized by albuminuria (protein in the urine), by hypertension
(high blood pressure), and by convulsions. In the last century, the term was
used for any form of convulsion.
Edema. See dropsy.
Effluvia. Exhalations or emanations, applied especially to those of noxious
character. In the mid-nineteenth century, they were called "vapours" and
distinguished into the contagious effluvia, such as rubeolar (measles); marsh
effluvia, such as miasmata; and those arising from animals or vegetables, such
as odors.
Emphysema, pulmonary. A chronic, irreversible disease of the lungs,
characterized by abnormal enlargement of air spaces in the lungs and accompanied
by destruction of the tissue lining the walls of the air sacs. By 1900 the
condition was recognized as a chronic disease of the lungs associated with
marked dyspnea (shortness of breath), hacking cough, defective aeration
(oxygenation) of the blood, cyanosis (blue color of facial skin), and a full and
rounded or "barrel-shaped chest. This disease is now most commonly associated
with tobacco smoking.
Enteric fever. See typhoid fever.
Epilepsy. A disorder of the nervous system, characterized either by mild,
episodic loss of attention or sleepiness (petittnal) or by severe convulsions
with loss of consciousness (grand mal). Synonyms: falling sickness, fits.
Erysipelas. An acute, febrile, infectious disease, caused by a specific group ~4
streptococcus bacterium and characterized by a diffusely spreading, deep?red
inflammation of the skin or mucous membranes causing a rash with a well?defined
margin. Synonyms: Rose, Saint Anthony's Fire (from its burning heat or, perhaps,
because Saint Anthony was supposed to cure it miraculously).
Flux. See dysentery.
Furuncle. See boil.
Gangrene. Death and decay of tissue in a part of the body??usually a limb due to
injury, disease, or failure of blood supply. Synonym: mortification.
Gleet. See catarrh.
Gravel. A disease characterized by multiple small calculi (stones or concretions
of mineral salts) which are formed in the kidneys, passed along the ureters to
the bladder, and expelled with the urine. Synonym: kidney stone.
Hectic fever. A daily recurring fever with profound sweating, chills, and
flushed appearance??
often associated with pulmonary tuberculosis or septic poisoning.
Hives. A skin eruption of wheals (smooth, slightly elevated areas on the skin)
which is redder or paler than the surrounding skin. Often attended by severe
itching, it usually changes its size or shape or disappears within a few hours.
It is the dermal evidence of allergy. See the discussion under croup; also
called cynanche trachealis. In the mid?nineteenth century, hives was a commonly
given cause of death of children three years and under. Because true hives does
not kill, croup was probably the actual cause of death in those children.
Hospital fever. See typhus.
Hydrocephalus. See dropsy.
Hydrothorax. See dropsy.
Icterus. See jaundice.
Inanition. Exhaustion from lack of nourishment; starvation. A condition
characterized by marked weakness, extreme weight loss, and a decrease in
metabolism resulting from severe and prolonged (usually weeks to months)
insufficiency of food.
Infection. The affection or contamination of a person, organ, or wound with
invading, multiplying, disease producing germs such as bacteria, rickettsiae,
viruses, molds, yeasts, and protozoa. In the early part of the last century,
infections were thought to be the propagation of disease by effluvia (see above)
from patients crowded together. "Miasms" were believed to be substances which
could not be seen in any form??emanations not apparent to the senses. Such
miasms were understood to act by infection.
Inflammation. Redness, swelling, pain, tenderness, heat, and disturbed function
of an area of the body, especially as a reaction of tissue to injurious agents.
This mechanism serves as a localized and protective response to injury. The word
ending ?itis denotes inflammation on the part indicated by the word stem to
which it is attached??that is, appendicitis, pleuritis, etc. Microscopically, it
involves a complex series of events, including enlargement of the sizes of blood
vessels; discharge of fluids, including plasma proteins; and migration of
leukocytes (white blood cells) into the inflammatory focus. In the last century,
cause of death often was listed as inflammation of a body organ such as, brain
or lung but this was purely a descriptive term and is not helpful in identifying
the actual underlying disease.
Intussusception. The slipping of one part within another, as the prolapse of one
part of the intestine into the lumen of an immediately adjoining part. This
leads to obstruction and often must be relieved by surgery. Synonym:
introsusception.
Jail fever. See typhus.
Jaundice. Yellow discoloration of the skin, whites of the eyes, and mucous
membranes, due to an increase of bile pigments in the blood often symptomatic of
certain diseases, such as hepatitis, obstruction of the bile duct, or cancer of
the liver. Synonym: icterus.
Kidney stone. See gravel.
Kings evil. A popular name for scrofula. The name originated in the time of
Edward the Confessor, with the belief that the disease could be cured by the
touch of the king of England.
Lockjaw. Tetanus, a disease in which the jaws become firmly locked together.
Synonyms: trismus, tetanus.
Malignant fever. See typhus.
Marasmus. Malnutrition occurring in infants and young children, caused by an
insufficient intake of calories or protein and characterized by thinness, dry
skin, poor muscle development, and irritability. In the mid-nineteenth century,
specific causes were associated with specific ages: In infants under twelve
months old, the causes were believed to be unsuitable food, chronic vomiting,
chronic diarrhea, and inherited syphilis. Between one and three years, marasmus
was associated with rickets or cancer. After the age of three years, caseous (cheeselike)
enlargement of the mesenteric glands (located in the peritoneal fold attaching
the small intestine to the body wall) became a given cause of wasting.
(See tabes mesenterica.) After the sixth year, chronic pulmonary tuberculosis
appeared to be the major cause. Marasmus is now considered to be related to
kwashiorkor, a severe protein deficiency.
Meningitis. Inflammation of the meninges (the three membranes covering the brain
and spinal cord), especially of the pia mater and arachnoid??caused by a
bacterial or viral infection and characterized high fever, severe headache, and
stiff neck or back muscles. Synonym: brain fever.
Morbus. Latin word for disease. In the last century, when applied to a
particular disease, morbus was associated with some qualifying adjective or
noun, indicating the nature or seat of such disease. Examples: morbus cordis,
heart disease; morbus caducus, epilepsy or failing sickness.
Neuralgia. Sharp and paroxysmal pain along the course of a sensory nerve. There
are many
causes: anemia, diabetes, gout, malaria, syphilis. Many varieties of neuralgia
are distinguished according to the part affected??such as face, arm, leg.
Paristhmitis. See quinsy.
Petechial fever. See typhus.
Phthisis. See consumption.
Pleurisy. Inflammation of the pleura, the membranous sac lining the chest
cavity, with or without fluid collected in the pleural cavity. Symptoms are
chills, fever, dry cough, and pain in the affected side (a stitch).
Pneumonia. Inflammation of the lungs with congestion or consolidation???caused
by viruses, bacteria, or physical and chemical agents.
Pus. A yellow?white, more or less viscid substance found in abscesses and sores,
consisting of a liquid plasma in which white blood cells are formed and
suspended by the process of inflammation.
Putrid fever. See typhus.
Putrid sore throat. Ulceration of an acute form, attacking the tonsils and
rapidly running into sloughing of the fauces (the cavity at the back of the
mouth, leading to the pharynx).
Pyrexia. See dysentery.
Quinsy. A fever, or a febrile condition. An acute inflammation of the tonsils,
often lead- ing to an abscess; peritonsillar abscess. Synonyms: suppurative
tonsillitis, cynanche tonsillaris, paristhmitis, sore throat.
Scarlatina. Scarlet fever. A contagious febrile disease, caused by infection
with the bacteria group. A beta?hemolytic streptococci (which elaborate a toxin
with an affinity for red blood cells) and characterized by a scarlet eruption,
tonsillitis, and pharyngitis.
Scrofula. Primary tuberculosis of the lymphatic glands, especially those in the
neck. A disease of children and young adults, it represents a direct extension
of tuberculosis into the skin from underlying lymph nodes. It evolves into cold
abscesses, multiple skin ulcers, and draining sinus tracts. Synonym: king's
evil.
Septic. Infected, a condition of local or generalized invasion of the body by
disease-causing microorganisms (germs) or their toxins.
Ship fever. See typhus.
Spotted fever. See typhus.
Suffocation. The stoppage of respiration. In the nineteenth century, suffocation
was reported as being accidental or homicidal. The accidents could be by the
impaction of pieces of food or other obstacles in the pharynx or by the entry of
foreign bodies into the larynx (as a seed, coin, or food). Suffocation of
newborn children by smothering under bedclothes may have happened from
carelessness as well as from intent. However, the deaths also could have been
due to SIDS (sudden infant death syndrome), wherein the sudden and unexpected
death of an apparently healthy infant, while asleep, typically occurs between
the ages of three weeks and five months and is not explained by careful
postmortem studies. Synonyms of SIDS: crib death and cot death. It was felt that
victims of homicidal suffocation were chiefly infants or feeble and infirm
persons.
Summer complaint. See cholera infantum.
Suppuration. The production of pus.
Tabes mesenterica. Tuberculosis of the mesenteric glands in children, resulting
in digestive derangement and wasting of the body.
Teething. The entire process which results in the eruption of the teeth.
Nineteenth-century medical reports stated that infants were more prone to
disease at the time of teething.
Symptoms were restlessness, fretfulness, convulsions, diarrhea, and painful and
swollen gums.
The latter could be relieved by lancing over the protruding tooth. Often
teething was reported as a cause of death in infants. Perhaps they became
susceptible to infections, especially if lancing was performed without
antisepsis. Another explanation of teething as a cause of death is that infants
were often weaned at the time of teething; perhaps they then died from drinking
contaminated milk, leading to an infection, or from malnutrition if watered-down
milk was given.
Tetanus. An infectious, often?fatal disease caused by a specific bacterium,
Clostridium tetani, that enters the body through wounds; characterized by
respiratory paralysis and tonic spasms and rigidity of the voluntary muscles,
especially those of the neck and lower jaw.
Synonyms: trismus, lockjaw.
Thrush. A disease characterized by whitish spots and ulcers on the membranes of
the mouth, tongue, and fauces caused by a parasitic fungus, Candida albicans.
Thrush usually affects sick, weak infants and elderly individuals in poor
health. Now it is a common complication from excessive use of broad?spectrum
antibiotics or cortisone treatment. Synonyms: aphthae, sore mouth, aphthous
stomatitis.
Trismus nascentium or neonatorum. A form of tetanus seen only in infants, almost
invariably in the first five days of life, probably due to infection of the
umbilical stump.
Typhoid fever An infectious, often-fatal, febrile disease, usually occurring in
the summer months characterized by intestinal inflammation and ulceration caused
by the bacterium Salmonella typhi, which is usually introduced by food or drink.
Symptoms include prolonged hectic fever, malaise, transient characteristic skin
rash (rose spots), abdominal pain, enlarged spleen, slowness of heart rate,
delirium, and low white blood cell count. The name came from the disease's
similarity to typhus (see below). Synonym: enteric fever.
Typhus. An acute, infectious disease caused by several micro?organism
species of Rickettsia (transmitted by lice and fleas) and characterized by acute
prostration, high fever, depression, delirium, headache, and a peculiar eruption
of reddish spots on the body. The epidemic or classic form is louse borne; the
endemic or murine is flea borne. Synonyms: typhus fever, malignant fever (in the
1850s), jail fever, hospital fever, ship fever, putrid fever, brain fever,
bilious fever, spotted fever, petechial fever, camp fever.
Virus. An ultramicroscopic, metabolically inert infectious agent that
replicates only within the cells of living hosts, mainly bacteria, plants, and
animals. In the early 1800s virus meant poison, venom, or contagion.
Yellow fever. An acute, often?fatal, infectious febrile disease of warm
climates caused by a virus transmitted by mosquitoes, especially Aledes aegypti,
and characterized by liver damage and jaundice, fever, and protein in the urine.
In 1900 Walter Reed and others in Panama found that mosquitoes transmit the
disease. Clinicians in. the late nineteenth century recognized "specific yellow
fever" as being different from "malarious yellow fever." The latter supposedly
was a form of malaria with liver involvement but without urine involvement.
NOTES AND REFERENCES
William Cullen, First Lines of the Practice of Physic with Practical and
Explanatory Notes by John Rotheram (New York: Evert Duyckinck, 1801
); Robert Hooper, Lexicon?Medicum or Medical Dictionary (New York: J. & J.
Harper, 1826); Marshall Hail, The Principles of Diagnosis (New York:
D. Appleton & Co., 1835); Robley Dunglison, A Dictionary of Medical Science,
Containing a Concise Account of the Various Subjects and Terms
(Philadelphia: Lea and Blanchard, 1844); Richard D. Hoblyn, A Dictionary of
Terms Used in Medicine and the Collateral Sciences
(Philadelphia: Henry C. Lea, 1865); William Aitken, The Science and Practice of
Medicine, 2 vols. (Philadelphia: Lindsay & Blakiston,
1872); Richard Quain, ed., A Dictionary of Medicine (New York: D. Appleton and
Company, 1883); Austin Flint, A Treatise on the Principles
and Practice of Medicine (Philadelphia: Henry C. Lea's Son & Co., 1884); George
M. Gould, An Illustrated Dictionary of Medicine, Biology,
and Allied Sciences (Philadelphia: P. Blakiston's Son & Co., 1901); Glentworth
Reeve Butler, The Diagnostics of Internal Medicine (New York and London: D.
Appleton and Company, 1903); The Random House Dictionary
of the English Language, 2d ed., unabridged (New York: Random House, 1987);
Dorland's Illustrated Medical Dictionary (Philadelphia: W.B.
Saunders Co., 1988).