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What disease might this be in 1902? (self.AskHistorians)
submitted 16h ago by SnarkOff
I am transcribing my great-grandmother's biography (written in 1984) and am trying to add additional details when appropriate. I'm wondering if anyone has any hypothesis on what this disease might be:


"Always frail and delicate, exhausted by childrearing, Mamma sank into physical and mental helplessness after the birth of her ninth child in 1902. She remained an invalid until her death in 1943."

She was a white woman (probably late 30s/early 40s in 1902) in Roanoke Virginia.
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amandabang 150 points 13h ago
Ultimately, it's really difficult to try to retroactively diagnose historical figures. 1902 might not seem like that long ago, but medicine has changed dramatically in the past 100 years, as has our understanding of how to diagnose and treat different conditions.

This is especially true for women, whose symptoms were often dismissed or characterized by vague and non-scientific/medical terms like hysteria, feeble-mindedness or, like in this case, "frail" and "delicate."

These in and of themselves are obviously not diagnoses nor are they really symptoms. These kinds of terms were also used interchangeably and inconsistently to describe both common physical ailments (like anemia or malnutrition) and mental illnesses, (ranging from depression to autism spectrum disorders). These terms could also be used to describe the symptoms of things like PMDD, PTSD, post-partum depression, and generalized anxiety, though some of those terms simply didn't exist in the early 20th century.

Notably, a lot of medical terminology during this period in the US was ascribed to the person rather than the illness (thanks, eugenics movement). This muskies the waters even further.

Additionally, there is no way to rule out the very real possibility that she suffered from multiple physical and/or mental illnesses or disabilities. For example, perhaps she lived in housing that exposed her to black mold or lead, which can cause a range of chronic symptoms. Tack on 9 (!) pregnancies at a time when pre- and postnatal care was poorly understood, and that could have exacerbated the symptoms of a preexisting condition or introduced new physical or mental issues. She may have also just been really tired. We greatly underestimate the effects of chronic fatigue, exposure to cold, a lack of sanitation, and just what life was like living in the early 1900s.

Ultimately, there isn't enough information for us to even guess at what she may have had, both because of how little information there is in the account and because historians aren't medical professionals. That being said, we do know that lead exposure, anemia, malnutrition, and tuberculosis were not uncommon, though it's hard to day how common those were due to lack of record keeping as well as a lack of standardization in medicine and diagnostics. The certifications for medical professionals themselves were kind of all over the place. Licensing boards first emerged in the US after the Civil War, but their development at state and local levels was inconsistent. And even when licensing was more rigorous and standardized, it was still limited by the medical knowledge at the time, which was (by today's standards) not great.
SnarkOff [OP] 21 points 11h ago
Excellent response!
seriousallthetime 7 points 11h ago
This is a fantastic response and quite accurate. I honestly can't think of anything to add to it that wouldn't just be speculation. Well done.
amandabang 5 points 10h ago
Thank you!
rocketsocks 36 points 9h ago
/u/amandabang's answer is really the correct answer here, there's no way to know for sure or even with reasonable certainty, what this could have been, due to the vagueness of all medical terminology and many other issues in the medical field from back then.

However, I would like to offer up one possibility, which is at least historically educational: pellagra. America in the early 1900s experienced a pellagra epidemic that affected millions of people, killed at least 100k, changed our whole landscape of federal nutrition programs and food production and was rapidly forgotten about because of how embarrassing it was and how much of an indictment it was of the economic and government systems in the US.

Pellagra is a niacin (vitamin B-3) deficiency, which is fairly abundant in many common foods like whole grains, legumes (like peanuts), nuts, seeds, meat, poultry, fish, etc. Most people who eat a balanced diet have a very low risk of developing pellagra. But if you eat a narrow diet of foods that have been processed in a way that removes the niacin (like corn that hasn't undergone nixtamalization) then you can, and that was exactly what happened in many poor areas especially in the Southern US in the late 19th through early 20th centuries.

The symptoms of pellagra include exhaustion and weakness, mental confusion (developing into dementia), dermatitis and rashes, lack of coordination, sensitivity to bright lights or strong odors, among others.

In the late 19th century in the Southern US a lot of farms and plantations were dedicated to cotton production. There were lots of reasons for that but one reason was dependency. If you only grow cotton on a sharecropped farm then the sharecroppers are dependent on the money and potentially access to food from the property owners. Cheap processed cornmeal ended up being one of the major staples for poorer folks in the South, and that ended up resulting in a significant number of cases of pellagra.

It wasn't until the 1920s that the cause of pellagra was fully established and an understanding of how to prevent it began to become known. Even then there was a great amount of placing the blame for pellagra on the victim's themselves and their "poor diet", instead of calling out the socio-economic systems which drove people into diets where their best option to stay fed was one that still left them with incomplete nutrition. It took food fortification becoming commonplace through the '40s and '50s before the pellagra epidemic came to a close in the US.

So, who knows, could it have been pellagra? Maybe, the time frames line up, the symptoms seem to line up as well, and pellagra afflicted millions of Americans in that period. But the details are too vague to know for sure.
SnarkOff [OP] 6 points 8h ago
This is exactly the type of answer I was hoping to get with this post! Thank you.
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