History and Geography

Milk sickness has vanished from the list of major concerns of modern Americans. Although endemic in the Midwest and upper South, it had never been seen elsewhere in the United States, in Europe, or in any other continent. The settlers along the Atlantic seaboard knew nothing of it, and if the Indians or their cattle suffered from the disease, they did not inform the early settlers. Not until the pioneers began to push westward beyond the Alleghenies did the disease attract attention.

The first sporadic cases to be recognized occurred in North Carolina in the years preceding the Revolution. It was generally known that on the western side of the Allegheny Mountains from Georgia to the Great Lakes a disorder called trembles prevailed among cattle, and that wherever it appeared, the settlers were likely to get a disease, which from its most prominent symptom received at first the name "sick stomach" and from a theory concerning its cause that of "milk sickness."

In 1811, the Medical Repository of New York contained an anonymous report entitled "Disease in Ohio, Ascribed to Some Deleterious Quality in the Milk of Cows." This appears to be the earliest surviving reference to a disease that was to become a frequent cause of death and a major source of misery and mystification in the rural South and Midwest through a large part of the nineteenth century.

William Snively and Louanna Furbee (1956) described a discovery made in 1834 by Anna Pierce Hobbs, a pioneer doctor, in southeastern Illinois. Having learned from a Shawnee medicine woman that white snakeroot caused trembles and milk sickness, she had a calf fed several bunches of the root. The calf developed typical trembles, enforcing her conviction that she had found the cause of milk sickness. John Rowe, a farmer of Fayette County, Ohio, wrote in 1838 that he had discovered through similar experimentation that trembles was caused by ingestion of white snakeroot.

During the second half of the nineteenth century, milk sickness occurred sporadically, which made sequential observations difficult to make, and the reason for its cause was lost in the widely held medical belief in miasmas and exhalations from the ground. Moreover, because milk sickness was limited to the Midwest, upper South, and Southwest, influential eastern physicians tended to ignore it or even discount the possibility that it really existed as a disease sui generis.

Nonetheless, the solution was eventually found when attention was turned back to the poisonous plant theory advanced during the first half of the century. Although many plants were suspected, such as poison ivy, water hemlock, Virginia creeper, coral-berry, spurge, mushrooms, and march marigold, scrutiny finally centered once again on white snakeroot. Yet it was not until 1928 that the white snakeroot was established with certainty as the cause of milk sickness - over a century after the anonymous 1811 article appeared.

The question that Snively has asked remains: "How could a disease, perhaps the leading cause of death and disability in the Midwest and Upper South for over two centuries, go unrecognized by the medical profession at large until 1928?"

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