CHAPTER XVIII (b).
By S. L. Jepson, M. D. 

EPIDEMICS


The first epidemic of which we get any definite information was that 
of a disease called the "cold plague," which scourged the western 
settlements in 1820-21. The cases were marked by a sudden chill and 
great pulmonary congestion. Deaths were numerous.  At that period  
swamps and ponds were numerous in and near Wheeling, and were a 
source of malarial fevers, diarrhoea and dysentery.

During 1832-33 the first epidemic of Asiatic cholera visited Wheeling 
and neighborhood.  The town was in extremely bad sanitary condition, 
and the advice of physicians being unheeded by the authorities, a 
great many cases occurred, with a mortality estimated at 50 to 60 per 
cent. The disease prevailed from May until late in July.  In the 
spring of 1834 there occurred an outbreak of puerperal fever, which 
was extensive and very fatal.  In connection with this, many cases of 
erysipelas(1) were also seen.  Profuse bleeding, calomel and tarter 
emetic were the remedies most frequently used,  and we may well pause 
to inquire whether more harm than good was not done by this 
treatment.

In the winter of 1836 and 1837 occurred a very malignant epidemic of 
scarlet fever.  Death often occurred in the forming stage of the 
disease.  An individual would often be attacked in the evening with 
nausea and great prostration, and become comatose and die before 
morning, without any external development of the disease.  The 
following winter (1836-7) scarlatina again prevailed with ever 
increased malignancy.  Whole families were often stricken down with 
it, even in the country, on the hill-tops where the best sanitary 
conditions seemed to exist.  In 1843, the "Tyler Grippe," or 
influenza, made its appearance.  It was said to have come from Europe.  
The cases were ushered in by pain in the back and limbs, great 
muscular lassitude, chilliness, running from eyes and nose, 
hoarseness, cough and fever.  They generally lasted only a few days, 
but often the system seemed to be rendered very susceptible to 
disease.  During the following autumn many cases of typhoid fever 
appeared, and the type of disease seemed about this time to change 
from the sthenic(2) to the asthenic(3) or typhoid.  Blood-letting, 
purging, and other depressing measures were hence largely abandoned, 
and a more supporting treatment introduced, which has continued to 
the present time.  Scarlet fever again prevailed very extensively, 
and in a very fatal form in 1848 and 1849. If the patient survived 
the first stage, the eruption was profuse, the throat and adjacent 
parts greatly swollen and very painful, rendering deglutition almost 
impossible.  This was often followed by sloughing off of portions of 
the tonsils and soft palate, usually terminating in death.

In 1847-9 there prevailed about Wheeling, as well as in many parts of 
the country, a disease called black tongue, erysipelas, etc.  
Puerperal fever of a malignant type prevailed at the same time, 
producing many deaths.  No causes could be assigned for these 
outbreaks.  A second epidemic of cholera set in May 19, 1849, and 
continued until September.  The cases were not nearly as numerous as 
in the epidemic of 1832, but many cases occurred during the two or 
three summers following, perhaps to 1854. Many deaths from this 
disease occurred among the men working on the B.& O. railroad, then 
in course of construction.  "The narrows," about five miles below 
Wheeling on the river, seemed to be a choice locality for the 
disease, and about here many railroad laborers died.  In the fall of 
1857 diptheria made its appearance in Wheeling as an epidemic. The 
older physicians claimed to have seen the same disease in sporadic 
form under the name of putrid sore throat.  Now, however, the cases 
were numerous and severe; sometimes affecting whole families, and 
being attended with frightful mortality.  Since this endemic, 
diptheria has frequently visited the city, and sometimes the 
surrounding country.  In the autumn of 1879 it prevailed to such an 
extent in the eastern part of the city, that a number of prominent 
physicians petitioned the city council for the enforcement of rigid 
sanitary measures against its further spread.  In 1863 a few cases of 
cerebro-spinal meningitis, or spotted fever, occurred in the city.  
Some of the patients died very suddenly, after but a few hours' 
illness; others were sick for several days before a fatal result 
occurred, while a number recovered, but very slowly.  Cases of this 
disease were seen also during 1864-5.  During these years there were 
also very many cases of typhoid fever, pneumonia and erysipelas.

In the summer of 1873 cholera made its appearance in the city.  Dr. 
Jepson, at that time city health officer, believed that the disease 
was imported from Cincinnati, Ohio.  During the summer thirty-five 
cases were officially reported to the health officer by the attending 
physicians.  If these, twenty-two proved fatal, a mortality of sixty-
three per cent.  It is probable that a few unreported cases occurred, 
with favorable results, thus reducing the mortality.  The reported 
cases were carefully looked after by the health officer, and all 
possible sanitary precautions were taken to limit the disease.  

During the early part of 1873, puerperal fever cases were more 
numerous than at any time since 1849, and they were attended with 
great fatality.  The disease generally set in within forty-eight 
hours of delivery, the initial symptoms being either a distinct chill 
or chilly sensation.  These were followed by fever, varying from 102 
to 105 degrees.  The pulse was quick and never strong, abdomen always 
distended, tenderness in pelvic region, and a tendency to delirium 
which was sometimes well marked.  The tongue early became dry, 
sordes(4) appearing on the teeth, and the pulse early gave way, this 
typical condition speedily terminating in death.  For several years 
there continued in the city a tendency toward puerperal diseases.

In the fall of 1873 typhoid fever prevailed in Wheeling to an extent 
never before known.  It was estimated that four or five hundred cases 
occurred during the last four months of the year in Wheeling alone.  
As a rule the cases were of a mild type and very many of them were 
among children.  In the winter of 1874-5 scarlet fever cases were 
very numerous, especially in the southern end of the city.  It was 
estimated that in the Eighth ward, with a population of about 4,000, 
not less than 250 cases occurred from October to April, inclusive.  
More of the cases were severe, many being of the anginose variety, 
and the others were complicated with diptheria.  In the malignant 
cases the eruption was of a dark, purplish hue, and it was slow to 
recede, remaining long after its usual period.  An indescribable, 
peculiarly fetid odor was said to exist, by which, alone, cases were 
sometimes diagnosed before the patient was seen.  Inflammation of the 
cervical glands, as a sequel was quite common, and in an unusual 
number of cases this was followed by suppuration and sloughing of 
tissue.

About the beginning of 1890 influenza, under the name of the Russian 
grippe, made its appearance in this section of the country on its 
westward journey from Russia, where it seems to have had its origin.  
It prevailed to an unheard of extent, scarcely a family escaping.  
The symptoms varied in different cases, sometimes the nervous system, 
sometimes pulmonary, and again the gastro-intestinal tract being 
chiefly affected.  Hence some patients suffered violent pains in the 
head and other parts of the body, others were attacked with vomiting 
and purging, and still others with more or less grave pulmonary 
symptoms.  Nearly all experienced the ordinary catarrh of nose and 
bronchial tubes.  All cases were attended with prostration, and while 
as a rule the acute symptoms continued but a few days, not 
unfrequently pneumonia, bronchitis, or a continued fever of longer 
duration developed, while the prostration, especially with the aged 
and feeble, was great and protracted.  The mortality in Wheeling 
during the first months of 1890, was unprecedented.  Pneumonia, 
dysentary, measles and typhoid fever all prevailed.  During February, 
March and April, the number of typhoid cases was very large, but the 
type was not severe.  The deaths during the first four months were, 
from pneumonia, 57; typhoid fever 64.  Total from all causes, in 
January, 77; February, 96; March, 104; April, 86.  For the four 
months, total equal 363, which is over 31 per 1,000 of population.

*For the facts here given concerning the earlier epidemics we are 
indebted largely to published papers of Drs. Hildreth & Frissell.


(Some Definitions...) 

(1) erysipelas - Acute febrile disease with localized inflammation 
and redness of skin and subcutaneous tissue accompanied by systemic 
disturbance. Caused by Streptococcus pyogenes.
(2) sthenic - Normal or unusual strength.
(3) asthenic - Weak.  
(4) sordes - Foul brown crusts or accumulations on the teeth and 
about the lips from foul stomach or secretions of the mouth in low 
forms of fever.