The "milk-sick" came to the Lincoln family

[Eva Elisabeth]

In the meantime I read and tried to find out more on the topic (tremetol poisoning+"milk sickness" in Indiana in 1818) and yesterday I discussed it for almost an hour with my neighbor, who is an internist. In the end we both concluded that several points indicate that Nancy Hanks (and the Sparrows and Mrs. Brooner) did most likely not die from tremetol poisoning but from a bacterial or viral infection or epizootic disease that also affects humans.

Unfortunatelly I can't find any original statement describing Nancy's symptoms. The only statement indeed is that "On October 5, 1818, a week after her symptoms first appeared, she died." (Dennis Hanks to Herndon, Chicago, 13 June 1865, Wilson and Davis, eds., Herndon’s Informants, 40)

Most descriptions go like this in M. Burlingame's "A.L.-A life": "If she died the way most victims did...she probably..." Some authors don't credit the "probable symptoms" so that it's not sure if those symptoms were indeed described in that area and time or if they just looked them up somewhere else.

Mr. Burlingame's sources regarding the disease are the following:
- Reminiscences of Henry Brooner in Hobson, Footprints of Lincoln , 79-80, and in J. T. Hobson to Ida M. Tarbell, Washington, Indiana, 3 December 1895, Tarbell Papers, Smith College.
- Philip D. Jordan, “The Death of Nancy Hanks,” Indiana Magazine of History 40 (1944): 103-10, and “Milk Sickness in Kentucky and the Western Country,” Filson Club History Quarterly Theodore Lemon to Ward Hill Lamon, n.p., n.d., in Lamon, Lincoln , 27n

Does anyone have (access to) these or can recall any other primary sources?

The following is from William H. Herndon/Jesse W. Weik: "Abraham Lincoln, Vol.1: The True Story Of A Great Life", chapt.II (D. Turnham, MS. letter):
A physician, who has in his practice met a number of cases, describes the symptoms to be "a whitish coat on the tongue, burning sensation of the stomach, severe vomiting, obstinate constipation of the bowels, coolness of the extremities, great restlessness and jactitation, pulse rather small, somewhat more frequent than natural, and slightly chorded. In the course of the disease the coat on the tongue becomes brownish and dark, the countenance dejected, and the prostration of the patient is great. A fatal termination may take place in sixty hours, or life may be prolonged for a period of fourteen days. These are the symptoms of the disease in an acute form."

This is what Mr. Burlingame writes:
"In 1818,..., an epidemic of “milk sickness” swept through southwest Indiana....The malady killed both cattle and the humans who drank their infected milk. In the summer, it struck down Mrs. Peter Brooner, a neighbor of the Lincolns, and then the Sparrows. Nancy Lincoln nursed all three of them.... Shortly after their deaths, she too came down with the disease. If she died the way most victims did...her body was convulsed with nausea, her eyes rolled, and her tongue grew large and turned red. After a few days, as death approached, she probably lay on her bed of pain, her legs spread apart, her breath growing short, her skin becoming cool and clammy, and her pulse beating irregularly.Before her final coma, she urged Abe and Sarah to be good to one another and to their father... On October 5, 1818, a week after her symptoms first appeared, she died."

First of all, the wordings "epidemic of 'milk sickness'" and "infected milk" are not appropriate to describe poisoning due to consumption of a toxic plant. As it has already been said there is no "maybe", this is not a matter of infection.

My neighbor seconded what I assumed about the seven days of (untreated) suffering, it would have been a very long time for poisoning due to a neurotoxine.

Many symptoms are not specific, they can indicate many different diseases (e.g. vomiting or abdominal pain). Some are more specific, and certain combinations, too.

Most symptoms mentioned by M. Burlingame and Herndon's physician are not very specific.They can occur with tremetol poisoning as well as with many other diseases.

But the following, VERY specific* symptoms of tremetol poisoning are nowhere mentioned:
- muscular tremors
- thirst (anadipsia)
- the breath smells like fruit or nail polish remover (This is due to acetone, a byproduct in the elimination process.)

*The metabolic effects and thus the symptoms and of tremetol poisoning are very similar to ketoacidosis, a poisoning that can occur with diabetes I (which was, of course, not the "epidemic" cause in Indiana)

Strange, isn't it? I'm sure, these symptoms, especially the thirst and the odor of the breath, would have been described somewhere if tremetol poisoning killed so many people. Dennis Hanks would probably have mentioned it or Herndon's physician who met so many cases.

Furthermore remarkable:
- only adults (Mrs. Brooner, Nancy Hanks and the Sparrows) died (were affected??)
- it's not mentioned that the Sparrows'/Lincolns' cow(s) indeed were affected or died.
- Mrs Brooner died in summer, the Sparrows afterwards and Nancy on October 5. Is it likely that different cows ate white snakeroot at different times so that the cases occured step by step? Regarding that if the amount they ate had been sufficient to kill humans they would have been seriously affected and probably have died, too?

We have discussed several other diseases that could match the symptoms. There were always pros and cons, so that I won't discuss them here, but, as I said in the beginning, there's much more indication for death from a bacterial or viral infection or epizootic disease than from tremetol poisoning.