Understanding Causes of Death in Vital Records
They didn't know what medicine knows now
One aspect of genealogical research and putting together stories about family history is understanding the “extras” in vital records. The name, date, place - those are the core tidbits of information. But the extras, like how someone died, they help tell the story.
The problem with causes of death, though, is that medicine and science have changed over time and what we understand about disease today isn’t what our ancestors knew.*
Take, for example, lung fever. This isn’t an actual condition. It was an umbrella term for a number of conditions we differentiate today but that they didn’t understand the etiology of or have a term for prior to the mid-20th century. Lung fever is often simply considered to be code for pneumonia, but it comprised any lower respiratory infection that was accompanied by a fever. It could have been COPD (fever can occur during a flare-up), bacterial pneumonia (secondary to influenza or a primary infection with Strep), inhaled fungal spores, or a viral pneumonia. Another term used for this, especially if there was rib pain, was pleurisy.
Although germ theory - the idea that a pathogen infects a person, causing disease - dates back to the 1700s, we didn’t have a way to actually test for these disease-causing agents until Robert Koch and Louis Pasteur developed their bacterial culture methods in the mid-1800s. And it would still be a couple decades before viruses were identified.
So any vital record noting what we know today as an infection as the cause of death should be considered in the context of its time.
What other hidden meanings can be found in the causes of death?
Dysentery? Umbrella term for diarrheal disease. It is still an umbrella term for bacterial or parasitic infection of the bowels. Another term that meant the same thing was pyrexy.
Consumption? Malnutrition and wasting disease, later attributed to tuberculosis (caused by Mycobacterium tuberculosis). Pulmonary tuberculosis is just one form of the infection and was singled out as its own disease in 1820. Another term for the wasting disease was phthisis.
Whooping cough? Respiratory infection with a distinctive cough, known today as pertussis - though still better known by its whoop - because it is caused by the bacterium Bordatella pertussis.
Croup? Swollen or blocked throat - could have been a respiratory infection, could have been allergies. Today the name refers to an upper respiratory infection caused by parainfluenza virus that causes a “seal-like bark” in children.
Diphtheria? Could have been diphtheria (caused by the toxin of the bacterium Corynebacterium diphtheriae), but it could have been scarlet fever (caused by untreated Strep group B, advanced stage of strep throat) or croup - the terms used depended on the doctor and symptoms but are distinguished today mostly by the causative agent.
Typhoid fever? Typhoid was dysentery with a rash. We know today that it’s caused by the bacterium Salmonella typhi and is sometimes called enteric fever.
Chorea? It was code for a neuromuscular disorder - jerky movements, loss of coordination, convulsions were all symptoms considered under this umbrella. It could have also captured some mild forms of tetanus or epilepsy though those were known as their own entities early on in the written documentation of vital records.
Rheumatism? Traditionally this term means pained joints, but in conjunction with death it’s a malaise or all over muscle aches and pains. It was likely a viral infection or sepsis. Rheumatic disease (rheumatology) is now known to be an autoimmune reaction, such as rheumatoid arthritis, which is not life-threatening. This is not to be confused with rheumatic fever (i.e. advanced scarlet fever), which can cause rheumatic heart disease - it occurs when strep throat goes untreated.
Dropsy? Swelling due to the build up of fluid in the tissues. It’s known today as edema or ascites depending on the where, why, and what type of fluid. Common causes are heart failure and kidney disease.
Inflammatory disease? Inflammation was and is a clear symptom of infection - swelling, redness, heat, and pain. Though today we wouldn’t treat it with bloodletting like they did in the 1700s. They also considered it as a disease on its own because they didn’t know it was caused by something. So if this is listed as a cause of death, it could have been just about anything - infected injury, skin cancer, allergic reaction, or spider bite, among others.
Have you run across any interesting causes of death and wondered what it means?
*Although this is a genealogy publication, I have a background in pathology and used to teach graduate students about infectious disease. My dissertation was on the genetics underlying hypertension. Death, disease, and a changing understanding of anatomy are kind of my thing and I find it absolutely fascinating when my two worlds collide.
This is great. I saw a bible from 1881 that said the 8 year old died from meningitis. I was surprised they could diagnose that in the 19th century.
Thank you for this excellent explanation. Many of the diseases of the past are now considered the symptoms of a disease. For instance dropsy is, as you say, is nowadays called oedema; fluid in the tissues from a number of causes. Or Aphasia which is the difficulty in speaking or understanding, we know is a result of a stroke. We are so fortunate to live in a world with modern medicine.