The "milk-sick" came to the Lincoln family

[Rob Wick]

It looks like Burlingame got his citation wrong, because I have all of Tarbell's papers from Smith and the only letter from Hobson is dated 1899 and doesn't talk about the milk sickness at all. Roger linked to the correct letter in Tarbell's papers at Allegheny College.

Best
Rob

[Eva Elisabeth]

Thanks a lot for the links! That is absolutely fascinating material indeed!!!

[Eva Elisabeth]

(09-26-2013 06:51 PM)Eva Elisabeth Wrote:  Thanks a lot for the links! That is absolutely fascinating material indeed!!!

I admit, when skimming these sources my very first thought was that of the sorcerer's apprentice:"Lord and master, hear me crying! - Sir, my need is sore.
Spirits that I've cited
My commands ignore."
At first glance they seemed to prove the "milk-sickness cause". On closer examination they don't. But they helpfully enlarge the background information to make up an opinion.

I tried to find a prove, i. e. an eyewitness' account that recorded that the two most specific symptoms (fruity breath + thirst) actually occured with the disease that hit Little Pigeon Creek in 1818. All sources turned out just to be assumptions that the disease in this community at the respective time was milk-sickness or traced back to Herndon. Also I didn't find the two significant symptoms reported by an eyewitness. In the end, Herndon seems to be the "closest" source to a first-hand account. "His" physician (see post #29) described many symptoms in detail, but didn't mention these significant two.

But in general these two symptoms were well-known and had been described. In 1810 and again in 1815, Daniel Drake, a physician and medical lecturer from Kentucky, published the first definite accounts of "the trembles." He described the symptoms as follows:

"A typical milksick patient would manifest, first, lassitude, dizziness, and loss of appetite, soon followed by nausea and persistent vomiting. Then came pain in the region of the stomach and an intense thirst. The tongue was swollen, coated white, and the lips were dry. Peristalsis was completely absent and obstinate constipation was present. A subnormal temperature, a weak pulse, and slow respiration of the Cheyne-Stokes character indicated approaching death which usually was preceded by prostration and finally concluded in coma. A characteristic diagnostic aid was a pronounced odor on the breath and in the urine." (Philip D. Jordan:"Milksickness in Kentucky and the Western Country", The Filson Club History Quarterly, Vol. 19)

The white snakeroot as the causative agent was first suspected in 1838: "On October 1, 1838, John Rowe, a farmer of Fayette County, had announced publicly that the white snakeroot was the plant which gave cattle the trembles and humans the milksickness." In 1917, a pathologist of the Bureau of Animal Industry had isolated the active poison in the white snakeroot and given it the name of "tremetol." (ibid.)

Jordan's article also contained an illustrative example that after consumption of sufficient amount of tremetol severe, often fatal poisoning is inevitable:
"In November, 1838, a family of six persons, traveling westward, put up at a house a few miles east of Terre Haute, Indiana. At breakfast they drank milk and immediately departed on their journey. By the time they reached Illinois, five or six hours later, they were all taken ill and died, every one of them, in from two to six days."

By now I found no indication that Abraham, Sarah or Thomas Lincoln, Dennis or Sophia Hanks, Peter Brooner or any of the Brooners' sons, Henry and Allen, were even slightly affected by the disease. Particularly strange appears that in none of the three families any of the children was affected although milk was usually first of all given to the children.

To summarize:

The initial question was: "Why did others in the Lincoln (I add: and the Brooner) family not get the milk-sickness?"
These are the possible answers (of which I can think):
- Only Nancy Hanks, Thomas and Betsy Sparrow, and Mrs. Brooner drank milk, all the other members of the families didn't drink (any?) milk.
- Nancy Hanks, the Sparrows, and Mrs. Brooner drank milk from different cows than the others.
- The disease from which Nancy, the Sparrows, and Mrs. Broomer died wasn't the "milk-sickness".

In order to find an (your own!) answer, these are the background facts and thoughts to take into consideration:
- By now there exists obviously no indication that Abraham, Sarah or Thomas Lincoln, Dennis or Sophia Hanks, Peter Brooner or any of the Brooners' sons, Henry and Allen, were even slightly affected by the disease.
- If Nancy Hanks, the Sparrows, and Mrs. Brooner died of tremetol poisoning from drinking contaminated milk, anyone else drinking the same milk would have been seriously ill and probably have died, too.
- Children, due to less body weight, would even have been affected more severely (when drinking a similar amount).
- If an eyewitness' description of Nancy's or Mrs. Brooner's symptoms exists, I haven't found it yet. I'm sure scholars would frequently have quoted it. All descriptions I know are just assumptions (like the "Burlingame example" I gave in post #29). Here's another example from Jordan's "The death of Nancy Hanks" (Indiana Magazine of History 40 ): "If she followed the pathological pattern"..."Had her pulse been taken it probably would have been irregular"..."Not long after that she must have slipped into complete coma" and so on.
- The "closest" account describing the symptoms of the disease in the area at the respective time seems to be the one of Herndon's physician. The specific fruity odor of the breath, muscular trembles or thirst are not mentioned. The other symptoms are less specific and can occur with other diseases as well. Milk-sickness was most likely not the only occurring disease. It is also possible that milk sickness was the first diagnosis that came into people's mind when similar symptoms occured because it was such a serious and widespread threat in those times (but surely not the only occurring disease).
- All statements I checked saying Little Pigeon Creek was affected by milk-sickness in 1818 turned out just to state assumptions or can be traced back to Herndon.

So far, I haven't yet found any definite evidence, neither for nor against tremetol poisoning (milk-sickness) as the cause of Nancy Hank's death. Mr. Steers said David Donald concluded she died of "milk-sickness" because everybody else said so. And he well worded: "You have symptoms, descriptions, secondary sources, and scientific knowledge. Draw your own conclusions." Allow me to add:...why Abraham Lincoln - thanks God - did not suffer and die from milk-sickness in Indiana in 1818.

(PS: Tad Lincoln would have loved to be the sorcerer's apprentice:
http://germanstories.vcu.edu/goethe/zauber_dual.html )

[RJNorton]

Eva, thank you for sharing your research. It is truly amazing. Kudos on all your work. The name of Dr. Drake caught my eye. I wonder if this is the same Dr. Drake that Abraham Lincoln allegedly wrote in late 1840 or early 1841 when he was feeling down. Apparently Lincoln did not have enough confidence in the local doctors as Drake was located in Cincinnati. The topic was probably depression, but neither Lincoln's letter or Drake's reply are known to exist. Speed reported that Drake did not want to treat Lincoln before having a personal interview with him. There is no proof this ever happened.

[Eva Elisabeth]

Roger, thanks. Still I'm not sure if I have the right to publish such ideas, I'm not a scholar and maybe I overlooked something or made a logical mistake I'm not aware of. I hope I didn't.
This Dr. Drake indeed held lectures for students in Cincinnati.

[L Verge]

Just a side comment: I was struck by some of the symptoms of milk sickness being the same as Type I diabetes -- fruity breath, tremors, extreme thirst, slipping into a coma... I realize that an entire village could not suffer from diabetes at the same time. However, it would appear that the disease that took them (and Nancy?) might affect the pancreas also?

[Eva Elisabeth]

When with diabetes I, due to lack of insulin, the metabolism gets out of control, the liver produces a high level of "ketone bodies" (and acetone as a byproduct). These ketone bodies decrease the ph of the blood plasma, a condition called "ketoacidosis". And this condition causes all the symptoms. You could also say in a diabetic crisis the body "poisons" itself.

Tremetol poisons the (healthy) body from "outside", but also causes ketoacidosis and thus the same characteristic symptoms.

The cause of the diabetis (and thus a diabetic crisis) is lack of insulin due to a failure of the pancreas to produce sufficient insulin. (Another cause is that the cells do not respond to the insulin that is produced.) But not vice versa - diabetes or a diabetic crisis (and thus ketoacidosis) don't cause the failure of the pancreas.

Thus tremetol poisoning wouldn't affect the pancreas (although probably in the final stage all organs fail).

[LincolnMan]

(08-10-2012 08:00 AM)Ed Steers Wrote:  

(08-09-2012 01:52 PM)LincolnMan Wrote:  Truly a horrible time for the Lincoln family. I've often wondered why others in the family didn't get the sickness? If it was contracted from drinking the milk, then why Nancy-but not Thomas, Abraham, and Sarah? You say they didn't drink the milk? But even that seems odd. Why did Nancy drink the milk in the household but not the others? Do others ponder these things?

Dear Bill,

An interesting point. The causitive agent found in milk is a chemical compound known as "tremetol." It is a neurotoxin that almost certainly is fatal. Your are "spot on" with your question. Certainly Sarah and Abe would be drinking milk (far more than Nancy), and could not avoid the neurotoxin. I have come to the conclusion that Nancy Hank's symptoms as well as those of the Sparrows fit quite nicely with "Brucellosis" a disease caused by a bacterium common in cattle/cows and transmitted through the meat and milk. The disease occurrs over a period of two to three weeks and is accompanied by fever, malaise, and chronic headache. This is not the pattern of tremetol poisoning. David Donald in his excellent biography, "Lincoln" on page 26 writes that Nancy died from "brucellosis." When I questioned Donald he said he was wrong, and corrected the error in the Touchstone paperback edition of his book. I told him he should have stuck to his original statement. As a biochemist/molecular biologist I have made something of a study of this case, and consulted several top chemists and toxicologists at the NIH where I worked. They agree that tremetol is most surely not the cause of Nancy's death. Brucellosis is the more likely cause. This would explain why Thomas and the two children did not contract the disease. It does not strike everyone in a household. Most infectiousdiseases do not - thank goodness. Some have greater immunity/resistance than others, especially if introduced to the bacterium in small doses early on where antibodes can be built up over time. To the best of my knowledge, Bill is the first besides myself to raise the question of Nancy's death by "milk sickness." Ed Steers

Ed:
I just started listening to Carl Sandburg's Prairie Years on audiobook. I took note that the author mentioned that some of the cows died, as well. If that is true, does your thinking on the cause of death for Nancy Lincoln and others still hold true? Can the animals that are carriers also die of it?

[Ed Steers]

(08-25-2014 01:01 PM)LincolnMan Wrote:  

(08-10-2012 08:00 AM)Ed Steers Wrote:  

(08-09-2012 01:52 PM)LincolnMan Wrote:  Truly a horrible time for the Lincoln family. I've often wondered why others in the family didn't get the sickness? If it was contracted from drinking the milk, then why Nancy-but not Thomas, Abraham, and Sarah? You say they didn't drink the milk? But even that seems odd. Why did Nancy drink the milk in the household but not the others? Do others ponder these things?

Dear Bill,

An interesting point. The causitive agent found in milk is a chemical compound known as "tremetol." It is a neurotoxin that almost certainly is fatal. Your are "spot on" with your question. Certainly Sarah and Abe would be drinking milk (far more than Nancy), and could not avoid the neurotoxin. I have come to the conclusion that Nancy Hank's symptoms as well as those of the Sparrows fit quite nicely with "Brucellosis" a disease caused by a bacterium common in cattle/cows and transmitted through the meat and milk. The disease occurrs over a period of two to three weeks and is accompanied by fever, malaise, and chronic headache. This is not the pattern of tremetol poisoning. David Donald in his excellent biography, "Lincoln" on page 26 writes that Nancy died from "brucellosis." When I questioned Donald he said he was wrong, and corrected the error in the Touchstone paperback edition of his book. I told him he should have stuck to his original statement. As a biochemist/molecular biologist I have made something of a study of this case, and consulted several top chemists and toxicologists at the NIH where I worked. They agree that tremetol is most surely not the cause of Nancy's death. Brucellosis is the more likely cause. This would explain why Thomas and the two children did not contract the disease. It does not strike everyone in a household. Most infectiousdiseases do not - thank goodness. Some have greater immunity/resistance than others, especially if introduced to the bacterium in small doses early on where antibodes can be built up over time. To the best of my knowledge, Bill is the first besides myself to raise the question of Nancy's death by "milk sickness." Ed Steers

Ed:
I just started listening to Carl Sandburg's Prairie Years on audiobook. I took note that the author mentioned that some of the cows died, as well. If that is true, does your thinking on the cause of death for Nancy Lincoln and others still hold true? Can the animals that are carriers also die of it?

Dear Bill,

First, let's be sure we know what the cows died from. The assumption they died from "milk sickness" is no more than a guess. Cows died from all sorts of disease - same as humans. Can a cow that carries an infectious disease like brucellosis contract the disease and die? Yes. Humans can carry infectious diseases and if the bacterium gets into the wrong place or the person contracts a second disease or becomes weakened they can succumb to the bacterium they are carrying. Once again, I do not believe a neurotoxin like tremetol can kill certain members of the family while bypassing others - especially children; and the children are the principal milk drinkers in the family. Brucellosis was/is relatively common among dairy herds in the 19th century -at least moreso than today. Ed

[maharba]

Reading old county and family histories past, I often have read interesting stories of blights, plagues, a miasma about various places. Folks taking sick and the smarter ones moving on quickly to greener pastures. I wonder if the alcohol or alkaloid 'trematol' is the only specific agent, and whether it might not be in other members of that family. Semi-lush herbs of shade and partial shade, and with misty fuzzy white or purplish tinged flower clusters. I notice in my yard where the various plants always come up, can recognize them at the earliest appearances, and it's a fun part of gardening to know the bugs and weeds on your property, and then to
recognize them elsewhere. When volunteer plants and weeds do not appear where I expect, or to thrive, in a particular season, that interests me and I try and understand. Same when a dry year or a soft easy year allows lengthened seasons for warm weather or cool weather weeds. White snakeroot to me poses no threat at all, in my circumstance. No cattle or horses to eat it. Never seen a dog or cat have the slightest interest in it. Kids have never even noticed it, until its late season flowers, which are more weedy than showy looking. No danger of them eating it. Some years, White Snakeroot is coming up in enough patches, that I will reach down and snatch up several handsfull and thin it out. I anticipate its pleasing white color into brushy areas of my fence area, and I'll allow patches to continue there, and to flower in late summer. In Perry county, Indiana where the folks of 1815 were making a go of it, and raising cattle and horses, it would be a different matter. The description of the sickness sounds more to me like Milk Sickness and not brucellosis. My experience with brucellosis too is seldom that it is deadly in humans. I have known farmers to get it and with odd, even comical symptoms. Sometimes it will bring on almost a drunken careless character change in a man. They even realize what is taking place, where they got the brucelosis, and soon
get it treated with antibiotics. In cattle, it usually causes abortion of fetuses, and a man handling that can contract brucelosis.

[Ed Steers]

The descriptions are scant to be sure. Because trematol tends to be all or nothing while Brucellosis varies in its effect I have always felt that Nancy Hanks did not die of trematol poisoning but more likely Brucellosis. While Brucellosis is treatable today due to antibiotics it was more deadly in the 1800s. Since it is likely the children drank the same milk as Nancy it seems likely her illness was infectious and not neurological, which the children would have experienced. I still think David Donald got it right in his Lincoln biography.