When history does not cooperate

Don’t you just hate when you’re doing research and what you find out leads not to answers, but more questions?  Such was my experience over the past two weekends as I dug deeper into the cholera epidemics in Buffalo.

After sitting in the damp and chilly bleachers watching my son’s football team get stomped on by a team they were supposed to beat, I ran over to the Buffalo History Museum, still clad in multiple fleece lined layers, to take a look at some municipal reports for the Erie County Poorhouse.  I was interested to see if there would be any discussion of the cholera epidemics (of 1832 and 1849) and their impact on the poorhouse.  As I have mentioned before, the Erie County Board of Supervisors Reports for this period are hand written and only available on reverse negative microfilm.  With only an hour left before the Museum’s library closed, I knew my best strategy was to quickly review the documents, identify the pages pertaining to the cholera epidemics or the poorhouse and come back at a later date for a more thorough examination.

I rushed into the Museum’s research library and went straight to the shelf that held my rolls of microfilm.  I nodded a brief greeting to the staff so that I could make the most of what little time I had left before the doors were closed for the evening.  After quickly feeding the microfilm into the machine, I realized I had loaded it upside down.  When the film was finally loaded correctly, I wasted a good bit of time fumbling with the machine trying to remember which levers controlled the quality and size of the image. 

I did not find any mention of the cholera epidemic in the Board of Supervisors report of 1832, the year of the first major pandemic.  I found that very odd because the disease had such a disastrous impact on many large cities.  The hand written reports were extremely difficult to read and there is always the possibility that I missed something important.  Also, it may be that there was no time to record any details of the epidemic, as it struck so quickly and with such ferocity.  I will examine the reports again and also take another look at the reports for 1833 in the event that the Board needed time to process the events of the previous year before they could evaluate the impact of the cholera epidemic on the city.

I scrolled carefully on to the year 1849, stopping every time I saw the shapes that I came to know spelled the words poorhouse, poor, or cholera.  Finally in a meeting dated October 8, 1849 there was some discussion of this disease.  Members of the Board of Supervisors moved to give the recently (and temporarily) established Board of Health the authority to employ nurses and procure what supplies were necessary to deal with the epidemic.  They further moved to make the Board of Health permanent and give them discretion to set quarantines where they were needed to contain the disease.  I thought that was particularly interesting because physicians were arguing at the time that cholera was not contagious and quarantines were not necessary.  Also, because of Buffalo’s strategic location on the Erie Canal, quarantines would have brought commerce to a screeching halt.  However, the impact of quarantines on economic well being of the city was not mentioned in the proceedings.

Beyond that report, there was no mention of the disease itself, how many individuals had died, or if the epidemic was abating at all.  The rest of the account focused on which municipal entity was financially responsible for the cost incurred by the Board of Health.  Some argued that the Act of 1832, which established a temporary Board of Health to deal with the cholera epidemic of that year, maintained that all expenses relating to cholera and other “malignant diseases” be paid for by the county.  Others insisted that the city of Buffalo should take on the burden of said costs. 

There was also a discussion concerning the Board of Health established in the town of Evans to contain the spread of small pox.  It was argued that Boards of Health should only be established to contain “malignant diseases”.  Small pox was considered a “contagious disease” and, it was argued, if they allowed a Board of Health to be established to contain contagious diseases, what would stop another town from establishing a Board of Health to contain other diseases such as whooping cough!  I found it very interesting that members of the Board of Supervisors were more concerned with malignant diseases (malignancy is the tendency of any medical condition to get progressively worse) than contagious diseases (those passed from one organism to another via direct or indirect contact).  I am becoming very interested in the public perception of illness during this period before the germ theory of disease was understood and accepted.

The next logical place to investigate the impact of cholera on the Erie County Poorhouse was the actual records from the institution.  There are no surviving inmate or hospital records for the year 1849, so I looked through the inmate records for 1832 in the hopes of finding some mention of the disease.  Again, my investigation yielded very little information.  Twenty eight inmates died at the ECPH that year compared to 14 in 1831 and 17 in 1833.  The number of deaths in 1832 still seems low for an epidemic year.  Cause of death was not usually listed in these records, although cholera was sometimes written in the margin as a cause of death in later years.  However, 11 of the 28 deaths (39%) occurred between May and September (warmer months when the epidemic would have been at its peak).  These mortality statistics suggest that the ECPH was not being used as a pesthouse (a place to house infected patients) during the cholera epidemic of 1832.  It also appears that the institution's remote location with respect to the rest of the city (and likely the use of a well on the property) may have offered some protection from the spread of the disease.  Clearly more research is needed.

So my investigation into the primary sources has left me with more questions than answers (what else is new?).  Where were the people infected with cholera in the city of Buffalo treated?  Why did the disease not hit the ECPH harder?  What role did the Board of Health have in managing the epidemic during either pandemic year (1832, or 1849)?  What did they learn from the epidemic in 1832 that helped in the containment of the disease in 1849?  I’ll keep digging.  Stay tuned…

Early nineteenth century treatments for cholera

Although I am well acquainted with early nineteenth century medicine in the United States, I am seldom able to stifle a shudder when I read about the various treatments typical of the period.  Such was my experience over the past few days when I was reading about the cholera pandemics of the mid nineteenth century.  I am particularly interested in the impact of cholera on the Erie County Poorhouse in Buffalo, New York, as the pandemic of 1849 will figure significantly into my third book of the Orphans and Inmates series.

When reading medical accounts of cholera from the mid nineteenth century it is important to remember that most of the advances we now take for granted, like the germ theory of disease, came much later in the century.  By the 1848-49 pandemic, cholera was widely thought not to be an infectious disease.  The logic being that those who treated the sick seldom became ill.  In support of this was the claim of a physician to have slept on the very cot of a man who had died of the disease just the night before.  “To these facts I may add another, namely, of a gentleman with the disease dying upon my own cot, and my having not only slept, on the following night, in the same room, but upon the cot and bedding as well…”  

There was a general belief that environmental miasma, or poisonous air resulting from poor sanitation and overcrowding was to blame (for cholera and many other infectious diseases).  Such atmospheric toxins acted to depress the nervous and vital energies of the body and, as a result, produce other symptoms of the disease (such as vomiting and diarrhea).   Although London physician Dr. John Snow suggested as early as 1849 that contaminated water was the cause of cholera, it would be years later, during the 1854 pandemic, that he obtained proof by linking afflicted individuals to a specific well in London.   

          

While treatments during the 1849 pandemic varied, most practitioners held that the best results were obtained if therapy began in the primary stage of the disease.   The intent was to relieve “nervous prostration and congestion”.  Treatment was aimed at freeing the body of whatever might be in excess.  Initially substances were given to encourage perspiration such as Dover’s powder (a substance made up mainly of ipecac and opium), calomel, camphor, and opium.  After several hours of sweating, a patient was given cathartics (purgatives) such as rhubarb, magnesia and castor oil. Emetics, substances used to induce vomiting, were also employed.  Some physicians thought that cholera was caused by the accumulation of acids or other substances in the blood.  “Congestion” of the blood could be relieved either by bloodletting, cupping (the process of applying cups to the skin to form suction in the attempt to bring blood or heat to the skin’s surface) or by injecting substances like saline into the veins.  The problem with treatment in the primary stage of the disease according to physicians was that few individuals acknowledged symptoms like lethargy and loss of appetite and seldom sought treatment until the more severe symptoms like vomiting and diarrhea, characteristic of the later stages, set in.  It was generally agreed that treatment in the later phases was futile and mortality was high. 

According to C.B. Coventry, MD, a professor at both The Medical Institution of Geneva College and the Medical Department of the University of Buffalo in 1849, cholera came back to the United States aboard the packet ship called New York.  The ship left France in November of 1848 with over 300 steerage passengers, mostly from Germany, bound for New York.  At the time there was no cholera reported in Paris, or Havre, where the ship departed.  However, on November 25th, a single passenger became ill with a “severe bowel complaint”.  The disease spread and when the ship arrived in New York those who had not died were transferred to a quarantine hospital.  Although there were other passengers on that ship, only the Germans were afflicted with the disease.  Ninety one people were stricken by cholera in New York City as of January 1, 1849.  Of those, 47 died.  The disease would make its way via the Erie Canal to Buffalo, where over 900 people would lose their lives.  

Sadly, there are no surviving inmate records or hospital records from the Erie County Poorhouse for this period.  It is my hope that some mention of how the 1849 cholera epidemic in Buffalo impacted the poorhouse will be mentioned in the Keeper's Report, contained within the Erie County Board of Supervisors Report.  A trip to the Buffalo History Museum's research library is on the books for the upcoming weekend.  Wish me luck!!

The fate of the unclaimed dead

Because the burial procedures at the Erie County Poorhouse have figured prominently in both my research and my novels, I thought it might be interesting to share what I have learned.  The mortality ledgers from the Erie County Hospital (the hospital associated with the Erie County Poorhouse) were perhaps the most important primary sources of data.  These musty old leather bound volumes recorded the details of every person who died at the hospital.  While this medical facility served in one form or another throughout most of the second half of the nineteenth century, I have only examined the records between 1880-1913 (if there are others, I do not know where they are located). 

It is important to be clear that the majority of those who sought medical care at the ECH were not residents of the poorhouse, although inmates were treated there when they became sick or injured.  Most of the folks who came to this hospital lived in the city of Buffalo but could not afford alternative health care.  The records also indicated that the Erie County Hospital may not only have served the poor.  An examination of the occupations listed for patients revealed many skilled professions.  There were jewelers, musicians, confectioners, and book keepers mixed in with the many general laborers that were seen there.  There was even an evangelist.

Regardless of their occupation, these people came to the hospital because they were in need of medical attention.  Unfortunately, many of the patients who were treated at the hospital also died there.  The records were often very detailed regarding the interment of those who took their last breath at the ECH.  Because the county wanted to contain the ever growing costs associated with the poorhouse, great efforts were taken to locate the family members or friends of the deceased so that they could make proper arrangements for burial (thus saving the county of the expense).  Nearly half of the people who died at the hospital were claimed by family or friends.  

Most of the individuals (over 40%) who were not claimed were buried in the poorhouse cemetery. A numbered wooden stake marked their burial location in the event someone might come along and claim them afterall.  In the interest of thrift, the stakes that marked the places of individual burial in the poorhouse cemetery were pulled up each year to be used again, leaving the person interred below all but forgotten  The corresponding grave number in the ledgers indicated the individual's name, age, cause of death, date of death, nativity, occupation and, in later years, the time of death.  I recall collecting data from these records late one night and feeling the crushing sadness as several patients all died within hours (sometimes even minutes) of each other in a single evening.  

There was a small group of individuals in the later decades of the nineteenth century and into the early twentieth century who were unclaimed by family or friends and were transferred to area medical schools for dissection.  In 1854 New York passed the Bone Bill and it became legal to transfer the unclaimed dead from poorhouses, prisons and morgues for medical education.  Between 1897 and 1913 over 450 unclaimed individuals listed in the mortality ledgers were transferred for use in medical schools.  Who were these people in life?  Was their socioeconomic status a factor in why they were chosen for transfer?  What about their deaths made them likely candidates for dissection?  Was the cause of death important, or was it the time of year the death occurred? The mortality records along with other documentary sources will be critical in helping to find answers to these questions. Stay tuned!

Looking from the other side

Around the beginning of August I was feeling the pressure of my full time day job and so many deadlines approaching in the weeks thereafter.  As I am not the only aspiring author out there trying to fit my writing into that small space left over after the obligations of day job, family and other real world responsibilities are met, I find I am wondering how the rest of you do it.  So, let me share with you the reality of the last few months and maybe we can compare notes.

Here I am at the end of September with two successful speaking engagements behind me, my second book in the hands of my copy editor, my abstract submitted on time to the American Association of Physical Anthropology, and only a scholarly article to finish (with a whole month to do so).  An impressive series of accomplishments, to be sure, but rest assured that this short burst of literary and scholarly productivity was achieved at the expense of just about everything else.  I’ve aged a few years, gained perhaps as many pounds (I refuse to get on the scale) and my liver has asked me to take a break from that dram or two (or three) of whiskey enjoyed at the end of each long day.  The house is a mess, the garden is full of weeds and both my phone and computer have long since reached their capacity to store messages.

On the positive side, my husband and my son are alive and well and have managed to care for themselves adequately while I have been otherwise occupied (my son even learned to do his own laundry).  Thanks to the Higgins men I had clean clothes and takeout food to sustain me as I worked into the wee hours of the night.

At work, my very dedicated staff exceeded my expectations in their efforts to ensure that all of the pooches entrusted into our care each day were safe and happy.  Had it not been for their diligence, I would not have been able to retreat into my tiny office for a few hours during the day to finish a chapter or tweak a Power Point presentation.  The only barrier to productivity during that bonus window of time was the gassy old hound who lounged daily just outside my office door.

So, at the end (almost) of a several long weeks of intense productivity, I have survived with my family and my business intact.  Don’t be too impressed.  Assuming I didn’t die of exhaustion, I doubt very much that my loving family and loyal staff would be so supportive were this schedule to continue.  A long term strategy is needed if I am to persist with this very precarious juggling act.  How do you get the most out of each of the 24 hours and still keep your life, your love and your sanity intact?  

On the subject of book covers...

It's the middle of September and the mood has changed.  It's not just because most of my scholarly obligations have been met and the Bills are, as yet, undefeated.  Many of the dogs that were off enjoying their cottages in Canada during the summer months have returned, so it feels much like the start of school in Dogdom.  All of this excitement is swirling around like leaves on a windy fall day, not yet ready to settle.  I guess the question is where will it land?

If I could direct all of this positive energy, I would point it toward the St. Jude project.  So far we have sold 30 copies of Orphans and Inmates to benefit the hospital.  That may seem like a lot, but royalties are paltry in the self publishing universe and it only amounts to about $100.  I need some help getting the word out. Suggestions are welcome!!!

I am at the point where I need to start thinking about a cover design for Grave Reconciliations, the second book in the Orphans and Inmates series.  As you might guess from the working title, the fate of those buried in the poorhouse cemetery is an important part of the tale.  The trick is to have an eye catching cover that speaks for the story and will also attract people who have not read the first book.  My husband did the concept sketch for the O & I cover, which I was very pleased with and everyone seemed to like.  From there, the graphic designer (Dane, from Ebook Launch) did a great job of translating our vision into the perfect cover.

So, I am hoping that the same magical formula will work again.  Below is one of my husband's concept sketches for Grave Reconciliations.  It is meant to represent the cemetery at the Erie County Poorhouse, which I know from my research was located far away from the building.  The graves were marked by numbered wooden stakes.  Each number was linked to an individual, whose identity (name, age, sex, occupation, place of birth and cause of death) was recorded in a ledger.  At the end of each year, the wooden stakes were pulled up and reused, leaving the individual lying beneath all but forgotten.

Without revealing too much of the plot, Grave Reconciliations introduces a paranormal element and moves between the past and the present as the spirit of an almshouse inmate reveals clues that expose widespread corruption, not the least of which was body snatching and the illegal sale of the unclaimed dead from the poorhouse to an area medical school for dissection.  Would this cover (or, rather, a color version of it) and the description mentioned above attract your interest?  If not, why?  Is the image of the cemetery too creepy? Not creepy enough? Should I include a ghost? Please let me know what you think!

Balancing the past and the present: Healthcare and humidity

Fall is here, sort of, and the dogs are settling into the change in routine and the change in weather.  This is a time of transition for us as the college help goes back to school and we scramble around the schedule to accommodate their classes and internships.  Who knew the hottest days of the summer would be in September?  We added extreme heat and humidity (comparatively) to a largely understaffed week at work and the start of school for the teenage son (and his first out of town varsity football game).  With the usual combination of awesome husband, after work cocktails and dumb luck, I managed to survive it all, plus a gardening injury that sent me to Urgent Care for some super glue and a tetanus shot!

So here we are a week away from the abstract deadline for our national meeting (The American Association of Physical Anthropology) and the plan is to spend the day looking at the physician reports from the Erie County Poorhouse.  They are contained within the Proceedings of the Erie County Board of Supervisors from 1880-1910 (Available at the Buffalo and Erie County Public Library).  The working hypothesis is that the Erie County Hospital (part of the Erie County Poorhouse complex) provided adequate care for the city’s poor.  Quantitatively, we have the Hospital Department Report (sometimes called the Physician’s Report).  These reports documented the number of people treated, what they were treated for, if they were cured and if they died (among other variables, such as nativity, or country of origin).  We will use these data to calculate crude death rates and disease specific death rates for the Erie County Hospital to compare with the census data for the general population. (Below: Proceedings of the Erie County Board of Supervisors, 1895, from the Buffalo and Erie County Public Library)

There are also qualitative data such as resolutions or written reports from the Medical Superintendent that documented changes in procedure, such as the report below.  This report documented the hospital’s move to the former lunatic asylum (now Hayes Hall on the University at Buffalo’s Main Street Campus) by Dr. Francis Metcalf in 1894.  This report discussed the reclassification of many cases from chronic to treatable, as well as improvements/changes to the facility and the staff.  These types of reports are critical to understanding what else was going on in terms of policy and procedural changes that might have impacted the quality of care available at the hospital. (Below: Proceedings of the Erie County Board of Supervisors, 1894, from the Buffalo and Erie County Public Library)

Why are we interested in the quality of care at the Erie County Hospital, you ask?  Well, we have determined that most of the individuals excavated from the Erie County Poorhouse Cemetery were likely not inmates of the poorhouse, but rather residents from the city of Buffalo who couldn't afford alternative health care.  We have been able to compare the diseases, injuries, and other conditions identified in the skeletons with those recorded in the hospital’s mortality index.  However, these data only allow some understanding of the people who died.  The Physician Reports also document those individuals who were treated and survived their ailments, therefore providing us with a more complete picture of the health issues experienced by the city’s poor and the health care available to them.

Having only been through 20 of the 30 reports, I had better stop blogging and finish collecting data! (Go Bills!)

A chance to give back

A great deal has happened since last we spoke!  I am pleased to report that I am able to check one thing off of my creative/scholarly "To Do" list.  We gave our presentation at the Museum of disABILITY History last Friday.  The idea of studying early urban poverty through the lens of disability is of great interest to me and I always enjoy comparing ideas with my new friends at the Museum.  There was a great crowd of interested and knowledgeable folks and they made the evening very enjoyable with their insights and thoughtful questions.  Many Buffalonians are very interested in our city's great history and some of them have been helpful in both my scholarly and creative pursuits.  I met one of the most brilliant and talented scholars of early Buffalo a few years ago.  She was interested in my work and contacted me about it.  We became fast friends and she has made significant contributions to just about every project I have worked on since then.

I finally got a chance over the weekend to visit the Research Library at the Buffalo History Museum.  I have been wanting to get back there ever since I found out that they now have the Proceedings of the Erie County Board of Supervisors for the period that the Erie County Poorhouse was at its original location in Black Rock.  There is not much known about the early history of the poorhouse.  Until now, we have only had the inmate records to study.  These Board of Supervisors Reports contain resolutions that were passed regarding the management of the poorhouse, budget issues and references to the reports filed by the Keeper of the Poor.  The only problem is that they are next to impossible to read!

Report of the Proceedings of the Erie County Board of Supervisors, 1830, from the Buffalo History Museum

The original documents are hand written, as opposed to the typed version in later years, and they only exist on microfilm, reverse negative microfilm, no less!  It is hard enough reading nineteenth century hand writing, let alone nineteenth century handwriting on reverse negative microfilm!  I was only able to get through the first three years before my head was spinning.  Needless to say, I need a new plan!  I learned that the level of detailed record keeping that we have been so impressed with during the later period of the poorhouse's history evidently evolved over time.  The resolutions passed in these early proceedings often refer to the need for more detailed reports and improvements in tracking items that were purchased for or produced at the asylum.  As yet, no actual report from the Keeper of the Poor, so I will be interested to note when they started to include the full Keeper's Report in the County Proceedings.  This will be a slow process and I will, of course keep you informed as I go!

Now on to a more personal topic.  In 2004 we lost our 11 year old son after a nearly year long battle with a rare form of pediatric cancer.  There are no words to describe that experience.  Over the ten years since he died, we have been stunned to realize that pediatric cancer gets very little public attention and even less money.  For years my husband and I have been searching for a way to make a meaningful contribution. September marks Pediatric Cancer Awareness Month.  Starting on September 1 and going through December 31, 2014 we will donate 100% of our profits from the sale of Orphans and Inmates to St. Jude Children's Research Hospital.  We have chosen St. Jude's because not only do they do pediatric cancer research, they also help the families who are in a battle for their children's lives.  It is our hope to raise some awareness and some money for a very important cause.

Orphans and Inmates is available on line at:

http://www.amazon.com/-/e/B00JZML4NG

http://www.barnesandnoble.com/w/orphans-and-inmates-rosanne-higgins/1119387444?ean=2940045859172

Locally the book is available at:

Floral Explorations

1448 Hertel Ave, Buffalo, NY 14216
(716) 838-4916

The Antique Lamp Company and Gift Emporium

1213 Hertel Ave, Buffalo, NY 14216

Dog Ears Bookstore and Café

688 Abbott Rd, Buffalo, NY 14220
(716) 823-2665

Talking Leaves

3158 Main St
Buffalo, NY
(716) 837-8554

Talking Leaves

951 Elmwood Ave
Buffalo, NY
(716) 884-9524

  

Old Editions Book Shop and Café

74 E Huron St, Buffalo, NY 14203
(716) 842-1734

The Buffalo History Museum

1 Museum Ct, Buffalo, NY 14216
(716) 873-9644

The Museum of disABILITY  History

3826 Main St
Buffalo, NY
(716) 629-3626