The "milk-sick" came to the Lincoln family

[Liz Rosenthal]

(09-19-2013 06:02 PM)Troy Cowan 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?

In 1817, Elizabeth and Thomas Sparrow along with their wards, Dennis Hanks and Sophie Hanks, moved in with the Lincoln family at Pidgin Creek. Thomas and Nancy had just finished their cabin and move out of their lean-to. Also called a half-faced camp. The Sparrows were given the lean-to to live in while they built their cabin. Shortly after the Sparrows arrived, Nancy bought six milk cows to provide milk for the two families.

In the fall of 1818, a neighbor told Nancy and Elizabeth about the sickness that was in the area. She called it the milk-sick and told them about people dying from drinking milk. To be safe Nancy and Elizabeth stopped the children from drinking milk. Thomas didn't have a problem with the milk, he preferred whiskey. Thomas, Elizabeth, and Nancy had been drinking the milk for almost two years and believed it safe. They continued to drink the milk.

Thomas and Elizabeth became sick. Maybe they had the milk-sick and maybe they didn't. Nancy decided to drink the milk to see if it were safe. It wasn't. She and the Sparrows died of the milk-sick.

Six cows for six people? Sounds like an awful lot of cows. As far as I know, when Abe Lincoln and wife Mary lived with sons Robert, Willie and Tad in the Springfield of the 1850s, they only had one cow, and they were a family of five, not to mention much better off financially than were the Lincolns of Pigeon Creek, Indiana.

[Gene C]

Liz, I was thinking along the same line. Not sure their farm had a lot of pasture land for that many milk cows.

[Eva Elisabeth]

That was my question, too. Troy, what is your source?

[RJNorton]

This doesn't have to do with the number of cows but just a reminder that Dr. Ed Steers has a different theory on what Nancy Hanks Lincoln really died of. His post on this is here.

[Troy Cowan]

White snakeroot (Ageratina altissima) is a moisture loving, shade tolerant plant. When rain is plentiful, grass grows well on sunny pastures and cattle are well feed and they don't come in contact with white snakeroot. 1816 marked the beginning of a decade long dry period. Cattle would forage down by the stream under the shade of a tree where the snakeroot would be found.

Snakeroot is plentiful in Kentucky and in southern Indiana and southern Illinois. Cattle eating it may come down with the tremors. If they ate too much, they would probably die. Too much would be 1% of their total body weight.

People drinking the milk from cows that ate too much snakeroot would show signs of muscle weakness, loss of coordination, and tremors. Onset could occur two days after drinking the milk or up to two weeks. Recover was slow, taking two to twelve days. Many didn't recover. Thousands died of the milk sick.

Years later, Abraham wrote, “She coughed at times and often would have to lie down for a little while. We did not know she was ill. She was worn, yellow, and sad."

[Eva Elisabeth]

Roger, thanks for posting the link to Mr. Steers post. I didn't read it before and also didn't pay much attention on that Nancy was ill for 7 days, but now I find this topic very interesting and did some research. This I found in a veterinarian magazine:

"In humans, the disease begins with a day or two of weakness and debility, followed by loss of appetite, abdominal pain and severe, repeated vomiting. Constipation and unquenchable thirst develop, which are accompanied by repeated drinking and then loss of ingested water by vomiting. Muscular tremors commonly are observed. As the disease progresses, the characteristic odor of acetone appears on the breath. In terminal cases, delirium and coma precede death (Kingsbury, 1964). Mortality ranges between 10 and 25% of diagnosed cases. Fatty degeneration of the liver is the most prominent lesion. When death is prevented, recovery is slow and uncertain, with relapses following moderate exertion. Many subjects who recover are incapacitated for several years or are permanently barred from hard physical labor."

I agree on Mr. Steers' statement: "Nancy 'died on the 7th day after she took sick.' That does not sound like death by neurotoxin."

Nancy "died on the 7th day after she took sick." means she suffered for seven days after the onset. I found no information on the period within which death occurs after the onset of the first symptoms, but like Mr. Steers, I would assume that, IF it turns out to be fatal for the affected person and there's no turning point, it would take less than 7 days, like in many cases of lethal mushroom poisonings. E.g. in case of poisoning due to amanitin, the stage of gastrointestinal upset is followed by severe liver damage and failure of other organs (heart, kidneys etc) which lead to death within 1-3 days.
A German pharmaceutical book focussing on medical plants I have says that the toxic effect of tremetol needs enzymatic activation. This is probably the reason for the period of latency. (This book also states that the disease in English speaking counties is also known as "alkali disease", "puking fever" or "trembles", I wasn't aware of that.)

Personally I, by now, too, doubt Nancy Hanks died from tremetol poisoning and also second Mr. Steer's brilliant argument that this would have affected everyone who drank the milk, whereas the onset and course of bacterial infections much more depend on the individual constitution and immune system.

Mr. Steers, I would be interested in what other scientific literature you have on this topic. The available German literature I've skimmed yet doesn't deal a lot with this since it's less relevant.

[L Verge]

Eva,

Be careful what you ask for when asking Dr. Edward Steers, Jr. for other scientific literature. Ed is a dear friend and an excellent historian, but his doctorate degree is in the sciences. His career was with the National Institutes of Health here in the U.S., where he retired as director of one of its branches. I believe that his field of exact study was in micro-biology. He is certainly more than well-qualified enough to speak to the subject of milk-sickness and to cast doubts that it took the life of Lincoln's mother.

[Eva Elisabeth]

Laurie, I asked for more information on the topic not because I doubt Mr. Steers is right - it's just the opposite, I hope I worded that well in my post - but because I'm truly interested in it. Although it was some years ago and this has not been part of my daily life since, I graduated in biology and my 100+ pages degree dissertation dealt with the topic of herbal drugs and their influence on writers and literature (since my second degree focused on English and North American literature and I wanted to write it "two-in-one" ). I admit, biochemistry and molecular biology were my weaker subjects. So Mr. Steers surely is the expert from whom I would like to learn more details if possible. I just write this because my impression is my post was possibly misunderstood and to say I didn't make up my opinion totally out of thin air.

[L Verge]

Oh, I knew what you meant, Eva; I was just trying to convince certain other people that we have a person well-qualified to speak on neurotoxins in our midst.

Now that I know your fields of expertise, I will suggest to others that we have at least two, well-qualified people in that field. Of course, sometimes expertise and facts are not well-taken by some individuals.

And may I say that you never cease to amaze me, my friend!?!!

[Ed Steers]

(09-23-2013 07:31 AM)Eva Elisabeth Wrote:  Roger, thanks for posting the link to Mr. Steers post. I didn't read it before and also didn't pay much attention on that Nancy was ill for 7 days, but now I find this topic very interesting and did some research. This I found in a veterinarian magazine:

"In humans, the disease begins with a day or two of weakness and debility, followed by loss of appetite, abdominal pain and severe, repeated vomiting. Constipation and unquenchable thirst develop, which are accompanied by repeated drinking and then loss of ingested water by vomiting. Muscular tremors commonly are observed. As the disease progresses, the characteristic odor of acetone appears on the breath. In terminal cases, delirium and coma precede death (Kingsbury, 1964). Mortality ranges between 10 and 25% of diagnosed cases. Fatty degeneration of the liver is the most prominent lesion. When death is prevented, recovery is slow and uncertain, with relapses following moderate exertion. Many subjects who recover are incapacitated for several years or are permanently barred from hard physical labor."

I agree on Mr. Steers' statement: "Nancy 'died on the 7th day after she took sick.' That does not sound like death by neurotoxin."

Nancy "died on the 7th day after she took sick." means she suffered for seven days after the onset. I found no information on the period within which death occurs after the onset of the first symptoms, but like Mr. Steers, I would assume that, IF it turns out to be fatal for the affected person and there's no turning point, it would take less than 7 days, like in many cases of lethal mushroom poisonings. E.g. in case of poisoning due to amanitin, the stage of gastrointestinal upset is followed by severe liver damage and failure of other organs (heart, kidneys etc) which lead to death within 1-3 days.
A German pharmaceutical book focussing on medical plants I have says that the toxic effect of tremetol needs enzymatic activation. This is probably the reason for the period of latency. (This book also states that the disease in English speaking counties is also known as "alkali disease", "puking fever" or "trembles", I wasn't aware of that.)

Personally I, by now, too, doubt Nancy Hanks died from tremetol poisoning and also second Mr. Steer's brilliant argument that this would have affected everyone who drank the milk, whereas the onset and course of bacterial infections much more depend on the individual constitution and immune system.

Mr. Steers, I would be interested in what other scientific literature you have on this topic. The available German literature I've skimmed yet doesn't deal a lot with this since it's less relevant.

Dear Eva Elisabeth, I enjoyed your post and especially your conclusion that Nancy Hanks may/probably did not die of trematol poisoning. I became suspicious while working at the National Institutes of Health in Bethesda, Maryand where I had available to me some of the world's leading chemists, toxicoligists, and clinicians. My own undergraduate training was in comparative pathogenisis (bacterial infections) so I had some understanding od disease not only current, but thoughout history. In studying trematol as a neurologic toxin (both its structure and mode of action) I became skeptical that it was the causitive agent in Nancy's death. This toxin is potent and absolute. It does not effect some and no others. I concluded that the children in both the Lincoln cabin and Sparrow cabin surely drank the same milk that Nancy drank, and most likely in larger quantities, and yet thet were uneffected. While Nancy and the Sparrows died and the children did not, the symptoms were much more like those commonly found with the meat contaminating bacillus known as Brucellosis. Brucillosis was more common a killer than tremetol being more widely spread and more widely consumed. There is no specific research on the subject. Just anecdotal accounts and scientific papers on the two agents - trematol and Brucellosis. One has to read them and using circumstantial eveidence come to their own conclusion. I will say that David Donald, in the first edition of his book "Lincoln" does write that Nancy died from Brucellosis. As no one had ever suggested that before, and because I had come to that conclusion privately, I asked Professor Donald why he came to that conclusion. He said he read it somewhere in a journal article which he could not remember. He said he was obviously wrong and Nancy died of "milk sick." Why? Because everybody else said so. So there you are. You have symptoms, descriptions, secondary sources, and scientific knowledge. Draw your own conclusions. Ed Steers

[Eva Elisabeth]

Thanks, Mr. Steers!
Laurie, I'm sorry, I really felt (and feel) uncomfortable with my last post, I wouldn't have told this if I hadn't felt misunderstood. And if I had known Mr. Steers' reputation before I anyway wouldn't have dared to add my humble opinion on this topic. As for the amazement - I think I've (unintentionally) played almost all my cards now... Now I hope I don't misunderstand your last question mark.

May I add that affected sucking cattle obviously eleminates a great deal of the toxine via the milk. Thus a) the suckling animal is often less severely affected and the latency period is longer than for humans, and b) the milk is extremely poisonous since it contains the tremetol in a high concentration (compared to the plant).
BTW, horses already die within 1- 3 days after eating the sufficient amount of the plant. I think it's because they can't vomit nor are they ruminants to anyhow get rid of the toxine, and they have a small stomach relative to their body size, so that the food is passed on quickly. And the severe stage usually begins once the stomach is passed.

Finally - it doesn't harm to know what the plant that probably did not kill Nancy Hanks (Ageratina altissima, formerly Eupatorium rugosum) looks like:
   
   
   

[L Verge]

Eva,

You have absolutely nothing to feel uncomfortable about. Your were presenting facts in an effort to combat bad history, and we all admire you for that. I meant every word in saying that your knowledge on a wide variety of topics never ceases to amaze me. I doubt that you have played all your cards because we only see the face of those cards. I suspect that you have a lot of knowledge and information stored behind those faces. As our younger generation would say, "You go, girl..."

[BettyO]

Quote:BTW, horses already die within 1- 3 days after eating the sufficient amount of the plant. I think it's because they can't vomit....

You are correct Eva. Horses cannot regurgitate. They also have a one-way windpipe and if they do try to regurgitate, they suffocate and die.

You, milady, are amazing!

[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.

[RJNorton]

(09-26-2013 07:19 AM)Eva Elisabeth Wrote:  Does anyone have (access to) these or can recall any other primary sources?

Eva, I was able to locate some of those references.

Reminiscences of Henry Brooner can be found on this page

The Hobson letter is here

The Jordan article is here

The other Jordan article is here