If you have read our previous post on the Dundee Health Report of 1896 into zymotic diseases, you’ll already know that disease was prevalent in our city – just like in any other – with all sorts of nasties just waiting to bump you off without so much as a warning. The Health Report also talks about general mortality and causes of death not covered by the heading of ‘disease’. It also gives us a lot of good information as regards the overall status of the town, from which we can draw our own conclusions.
Respiratory diseases and complications accounted for 663 of the 3103 deaths in 1896, amounting to just over 20% of the overall death rate for that year. Bronchitis was the biggest killer, claiming 338 lives. Inflammation of the airways causes sufferers to have problems with breathing as swelling narrows the air passages. Excess mucus build-up can also complicate the breathing process, and without treatment, lungs become unable to clear themselves, making them more prone to chronic infection. Viral bronchitis also carries the risk of fever, which brings its own set of problems. Death is usually due to the extra pressure put on the heart to produce more oxygen, although it has been noted that severe respiratory problems can result in death.
Pneumonia was the next largest killer of Dundonians, knocking off 285 of us in 1896. Another respiratory infection, pneumonia is considered more serious than bronchitis (at least, nowadays). Poor health or advanced age can make pneumonia even more of a killer. Whereas bronchitis affects the air passages, pneumonia affects the tissue of the lungs themselves. Symptoms include fever and/or chills, laboured/rapid breathing, pain upon breathing and excessive coughing. Normally death from pneumonia is because of sepsis, which is the body’s toxic response to infections (sometimes known as blood poisoning). Even today, early detection of sepsis is vital, as, worldwide, over 30% of people who develop sepsis, die.
Pleurisy took 14 of us that same year, and usually pops up when you’re already being deluged by some kind of other nasty infection, whether they be bacterial, viral, or otherwise (usually infections of the lungs, air passages or ailments such as arthritis). Poor health and bad lifestyles don’t help the matter much, so if the initial disease didn’t kill you, you could be assured that pleurisy would. With extreme shortness of breath and intense, stabbing pains when breathing, sufferers have been known to pass out from pain or even run out of breath completely. Add in our old favourite, fever, rapid weight loss and collapsed lungs, and you’ve got all the classic symptoms of pleurisy. Thankfully only 14 of our 3103 dead had to suffer that excruciating fate that year.
Laryngitis accounted for 8 lives, with croup claiming 9. Croup and laryngitis are very similar in that they are inflammations of the larynx and vocal chords. Whilst not a huge killer, paralysis of the vocal chords can restrict breathing and swallowing, with no indication of when the paralysis occurs. Diseases marked as ‘other’, but not elaborated on, made up for another 9 deaths.
370 deaths were attributed to ‘phthisis’, which is explained as a ‘chronic wasting away’ or tuberculosis – then known as ‘consumption’. Another disease commonly associated with the lungs, tuberculosis can actually occur in any organ of the body. Other names this infection goes by include, ‘the white death’, and ‘the robber of youth’, with sufferers seen to waste away in rapid fashion. From the lungs, where it causes the usual myriad of health issues such as night sweats, chest pains and rapid weight loss, it then moves throughout the body, wreaking havoc as it goes. Pustules can form and burst on the skin. The spine can become infected, causing them to collapse and cause paralysis. Infection can quickly spread through the kidneys, bowels and bladder. For men, the prostate can be affected, and in women, ovaries are at severe risk. Arthritic pains in joints can accompany meningitis, heart failure and eventual wasting away (consumption). With no real way to treat it at the time, patients were often kept isolated in a hospital or sanatorium.
The report goes on to state that 261 people died in 1896 from ‘diseases of the heart’, but does not elaborate. Considering that many of the above diseases put undue stress on the heart as a matter of course, we must assume that subsequent examinations of otherwise healthy bodies brought medical officials to this conclusion. Further reading shows a list of sudden and accidental deaths, which we will paraphrase here, as it is fairly succinct:
“The sudden and accidental deaths during the year numbered 188, as follows:- Convulsions, 42; Overlaying, 28; Suffocation, 13; Apoplexy, 25; Severe burns, 14; Fracture of Skull, 19; Other Fractures (Accident), 13; Dislocation of Neck, 1; Acute Poisoning by Alcohol, 4; Poisoning by Opium, 2; Drowning, 11; Hanging, 1; Choking, 1; Cut throat, 3; Gunshot Wound of Heart, 1; Gunshot Wound of Abdomen, 1; Syncope, 3; Spasm of Glottis, 2; Angina Pectoris, 1; Sun-stroke, 1; Ulceration of Stomach, 1; Ruptured Blood-vessel (fall), 1 – total, 188.”
A lot of these you will have heard of, but some you may not have. Overlaying is the accidental death of a child by smothering, usually when a larger person rolls onto them during sleep. Mechanical asphyxia occurs as the child is unable to breathe due to the force pressed against it. Whilst overlaying was mainly said to be accidental, any family whom it happened to faced stigma – more so if they already had a large family, as overlaying was also seen as a way of getting rid of extra mouths to feed!
Apoplexy relates to a stroke and the paralysis that so often accompanies it. Syncope actually means fainting or swooning, so, as a primary cause of death, it’s not particularly descriptive, as it merely indicates that someone ‘dropped down dead’. It is likely that ‘syncope’ refers to a sudden, unknown death. Spasm of the Glottis can result in immediate death and usually occurred in young children. The muscles which control the vocal chords contract suddenly, preventing air from entering the lungs. In severe cases, the muscles do not relax, asphyxiating the sufferer. It’s not all doom and gloom in the report – some people managed to live a fairly long (albeit hardly wonderful) life:
“Eighty-seven died at ages of 80 and upwards, 32 males and 55 females. Of these 76 were between 80 and 90, and eleven between 90 and 100 years, three of the latter being females who died at the age of 96.”
It just goes to show you, that, even with all these diseases and afflictions running rife in not-so-olden Dundee, some hardy critters managed to hang on until the bitter end. Women did better on the life-expectancy scale compared to men in the late 1800’s – something they still continue to do now. Thankfully, we now have proper sanitation, preventative medicines and vaccines in our country to combat the worst effects of some of the most horrific diseases mankind has ever seen…but it’s not that way for everyone in the world. It may seem alien to us now, as we’ve moved on more than a century from this, but for other places in the world, it’s still very much a harsh and fatal reality.
‘City of Dundee Report of the Medical Officer of Health for the year ending 31st December 1896.’ (Dundee City Archives) pp 1 – 15.
‘The White Death: A History of Tuberculosis’, T. Dormandy. Hambledon Press, 1999, pp 34-36, 125-137, 392.
‘The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2’, John Harvey Kellogg, Pacific Press 1881, Nabu Press, 2010 pp 7-12, 218-220, 425-431.
‘Vaccines’ (Sixth Edition), S. Plotkin, W. Orenstein & P. Offit, Elsevier Health Sciences, 2012, pp 747.