Distribution and Incidence

Milk sickness was unknown in Europe or in any other region of the world except North America. It appeared in North Carolina as early as the American Revolution near a mountain ridge named Milk Sick. Its highest incidence was in dry years when cows wandered from their brown pastures into the woods in search of forage. As more forests were cleared so that cattle had more adequate pasture, and as fences were built, the incidence of milk sickness decreased rapidly.

The disease wrought havoc in the Midwest, especially in Illinois, Indiana, and Ohio, and in the upper southern states of Kentucky, North Carolina, Tennessee, and Virginia. Milk sickness was, in some years and some localities, the most important obstacle to settlement by the pioneers. Beginning about 1815, a flood of pioneers moved west. As they penetrated the forest wilderness of the Midwest they all too frequently came upon evidence of epidemics of the disease as several villages were abandoned. Physicians in Kentucky and Tennessee described milk sickness as being so widespread that the Kentucky legislature appointed a committee in 1827 to investigate its cause. A few years later, the state medical society of Indiana also attempted a similar investigation. Interestingly, in that state it has been noted that "Evansville, Indiana, owes its prominent position . . . today, in part at least, [to] the fact that its early competitor, Darlington, was abandoned" because of milk sickness (Snively 1967).

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