A HISTORY OF THE TERRIBLE EPIDEMIC, VULGARLY CALLED THE THROAT DISTEMPER, AS IT OCCURRED IN HIS MAJESTY'S NEW ENGLAND COLONIES BETWEEN 1735 AND 1740* ERNEST CAULFIELD INTRODUCTION Both Young and Old, 0 come behold the Works which God hath wrought, The fearful Desolation, which he on this Land hath brought. -Awakening Calls to Early Piety. Almost as far back as written records go we find evidence that mankind has been afflicted by frequent recurrences of horrible epi- demics. Periodically occurring without any apparent cause, each one has taken its toll of life and then departed as strangely as it came. They have halted social progress, determined the results of wars, and sometimes even threatened the existence of civilization itself. Nearly every age has witnessed some distressing disease in epidemic form. Leprosy and influenza were prevalent at the time of the Crusades and the Black Death of the Middle Ages is said to have destroyed one-fourth the population of the earth. The plague closed the theatres and retarded the full development of Elizabethan culture, and numerous other outbreaks followed down to the end of Stuart times. Smallpox and dysentery epidemics fre- quently occurred throughout the eighteenth century. Not so long ago, influenza spread rapidly around the world. We now fear the return of infantile paralysis. And so it goes. It has long been known that there was an epidemic of some disease in Kingston, New Hampshire, in 1735, but it is not so well known that this was merely a small part of a greater epidemic which involved most of the inhabited regions of New England and caused great loss of life wherever it appeared. To that generation of Americans it was a new disease and to them its behaviour was as strange as it was mortal. In some of the towns nearly half of all *Presented at the Beaumont Medical Club, December 9, 1938. 220 YALE JOURNAL OF BIOLOGY AND MEDICINE the children died and at times it was feared that the disease would actually destroy the colonies. It drove the people to their churches to meditate and pray, and special fast days were proclaimed in Massachusetts and in Connecticut. "How terrible hath GOD been in his Doings," they cried, "Numerous Families have been emptied. A great Number of the Children are cut off from without, and the young Men from the Streets . . . We may reasonably conclude that GOD is giving of us Warning to prepare for all Events." The excitement that prevails at the time of epidemics is usually in proportion to the severity of the disease. As an example, we have only to remember the infantile paralysis epidemic in New England in 1931. At first it was regarded as an unavoidable nui- sance, but in a very short time the reports became more alarming. In spite of all precautions it continued to spread nearer and nearer to home and soon we were very much concerned. Then appeared the screeching headlines, pictures of dying children in mechanical respirators, long lists of horrible and dangerous symptoms, and fran- tic appeals for donors ofblood. In a few months all was quiet again and when the statistics were compiled it was found that among every two hundred thousand people about ten deaths had occurred. Let us now compare this with the "throat distemper" of eighteenth cen- tury New England. That epidemic continued for at least five years and among an equal number of people about five thousand deaths occurred. Except in a very few towns, however, one finds no evi- dence of any great confusion, and certainly there was not the loss of self-control that people usually exhibit during great epidemics of this kind. Perhaps this apparent outward calm did not truly reflect the inward feelings of the people, but there is good reason to believe that it did, for with implicit faith in God they did not ques- tion the meaning or justice of their misfortunes. That they were submissive and composed may be one reason why most historians have overlooked this terrible disaster, although it was a major epi- demic in the annals of this country and caused more deaths than any pre-Revolutionary war. But it seems that the emotions were only temporarily suppressed, for immediately following these five years ofsickness and death, indeed, so close in time that a causal connection might be suspected, there occurred a period of intense excitement,- that great psychological and religious upheaval better known as "The Great Awakening." Outside of Boston and its environs, New England in 1735 con- sisted of numerous small isolated towns, each with from two hun- itTHROAT 221 THE DISTEMPER" OF 1735-1740 dred to five thousand inhabitants. Products of the garden, field, and forest were brought to the larger towns, especially those along the coast, but except for an occasional fair, where produce, sheep, and cattle were bartered and except for help in the protection against Indian raids, each of the smaller frontier towns was self-supporting and independent of its neighbor. Although in the very early days most of the homes were grouped around the church and the central common, by 1735, particularly where the Indians were no longer feared, many of the homes were far from the center of the town and often widely separated from each other. Each family had its own supply of water, milk, and other foods and could live in com- fortable seclusion even through the long cold winters when snow- bound for many weeks. Therefore, it seems somewhat strange that an epidemic of a contagious disease could gain much headway because the means were at hand for an almost complete isolation had the most elementary precautions been enforced. But there was more to life than mere existence on a farm, and there were many complicating factors that might explain the spread of a disease. To appreciate one complicating factor, one must consider the prevailing theories of contagion, best illustrated by the treatment of smallpox which was very common at that time. When a case occurred in Boston, for example, the patient was sent to either Spectade or Rainsford Island where the province maintained pest- houses for the isolation and treatment of contagious cases. At one time, a house in the sparsely settled west end of the town was con- verted into a hospital and, while patients were there for treatment, a guard was thrown around the house and a red flag was hoisted to warn visitors ofthe danger. Ships coming from infected ports were stopped in the harbor, thoroughly inspected, and the crew and pas- sengers were frequently detained until all danger of infection had subsided. Most of the provinces had stringent laws to prevent the spread ofsmallpox and other contagious diseases. In Rhode Island, the penalty for violation of the sanitary code was death "without benefit of clergy." It was also known that a person was generally immune following an attack of smallpox and was therefore less liable to spread the disease. Nurses and attendants had to prove that they had been previously infected and a pock-marked slave had an increased value at the market. The intense controversy that fol- lowed the introduction of inoculation in 1721 was not only about the immunizing value of inoculation, but also about the danger of an inoculated case to other people. No one doubted that smallpox 222 YALE JOURNAL OF BIOLOGY AND MEDICINE could be contracted by direct exposure to another case. Contagion, however, was not so readily apparent when there were epidemics of those diseases that we now know are spread by healthy carriers and when all the facts could not be readily explained the whole contagion theory was hastily abandoned. This accounts for the fact that the "throat distemper" was treated as a very strange disease and as one that did not spread by contact. The rapid progress of the epidemic can be partly attributed to this error in judgment, but the error itself was the result of other circumstances. The interpretation of medical facts concerned the physician most of all and in this period all manner of men called themselves physi- cians. First, there was the quack. He existed in eighteenth cen- tury New England just as he has existed in all other times and places. Perched upon a platform he extolled the virtues of his secret drug, while a two-piece band squeaked forth some simple tunes and a well-trained dog leaped through a paper hoop. But he cleverly managed to perform his cures in towns where there were no epidemics, so he can be neither praised nor blamed for anything that happened. Opposed to the quack was the physician who made an honest effort to improve both himself and his profession. With the welfare of his patients at heart he studied his cases, listened with respect to the opinions and advice of others, and then fearlessly expressed his own conclusions. During this epidemic there was one such man in particular who stood above the others,-William Douglass, a Boston physician, wrote a detailed account of his experi- ences and in doing so made a valuable contribution to the existing medical literature of the world. The great majority of physicians, however, were of the country doctor type,-kindly, honest, diligent, respected. As there were no medical schools in this country, most of them acquired their skill in blistering, bleeding, and prescribing from preceptors, whose knowledge consisted chiefly of an intricate arrangement of the folk-lore of the times. The professional repu- tation of the doctor was measured by his ability to memorize a lot of ineffectual remedies or to control the dosage of a violent puke or purge, but he was sincere in his efforts and even if he stumbled while he went groping for the truth, he must be gready admired for his undaunted courage in the face of many difficult tasks. When con- fronted with this epidemic of an apparently new disease he carried on against overwhelming odds, but partly because of inadequate training and partly because of misinterpretation of the facts, it was the country doctor who first decided that the disease was not con- THE ccTHROAT DISTEMPER) OF 1735-1740 223 tagious and who was, therefore, responsible in a large measure for the spread of the disease. The best educated man in the New England town was the min- ister, who, spending many hours with the sick and dying, soon acquired the medical knowledge of the day and often applied it quite successfully. In towns where there were no physicians, the ministers tended bodies as well as souls, and during the "throat distemper" epidemic we find such men as Parson Smith of Fal- mouth, Hugh Adams of Durham, John Tucke ofthe Isles of Shoals, Nathaniel Williams of Boston, and Thomas Toucey of Newtown (Conn.) playing the double role. In fact, it was Jonathan Dickin- son, a minister-physician, who wrote one of the best nmedical treatises on the "throat distemper." But even when the minister did not practice medicine, he was the acknowledged leader in the interpre- tation of extraordinary events, and when the people sought the explanation of anything unusual he seldom hesitated to expound upon the first causes of all things. To be sure, Cotton Mather was dead and a bit of liberalism had somewhat softened the fire-and- brimstone theories of an earlier day, but the people still gave a religious interpretation to every event of their daily lives and still considered each adversity as a just punishment for sin. During the many days of fast and prayer they humbly reflected upon the "espe- cial Sins wc" God is angry wth ye Land & with us for." One can find very little evidence of bitterness or complaint. As a natural result of a century of Puritanism there was no conflict between their theology and their science. When this epidemic began, science and theology agreed. Science failed, and when it could not adequately explain all the facts, the people turned to theology for assistance in their distress. But it was this readiness to adopt a theological explanation for the epidemic which was chiefly responsible for the hasty abandonment of a scientific one. The ministers and physicians were factors in the spread of this disease in another way. They were in physical contact with the sick and carried the infection on their clothes and hands to their own families, at least, and probably all around the town. Doubtless some of them were healthy carriers. One of the very noticeable characteristics of the "throat distemper" epidemic is the frequent occurrence of many deaths in the families of the ministers and physicians. Because this epidemic spread chiefly among the children, some aspects of their lives need to be considered. Since the middle of the 224 YALE JOURNAL OF BIOLOGY AND MEDICINE seventeenth century, the law had decreed that towns with more than fifty householders must provide for childhood education and by 1735, public schools were firmly established throughout New England. Schoolhouses were one-room buildings and during the winter months the children huddled about the open fire. Those whose parents contributed a share of wood were given the choice seats, but if the spread of an epidemic was in direct proportion to exposure, then the pupils who sat off in chilly corners by themselves were in somewhat less danger of contracting the disease. On Sun- days, trailing their elders along the road or mounted with them upon a horse, the children went to church. They accompanied their parents to the church door, but a strict ritual demanded that within, the children must sit together at the rear or in the gallery. A tithing man watched over them and attempted to prevent their rest- lessness and disorders during the two- or three-hour sermons. The unruly youngsters ran noisily up and down the stairs and in and out of church; occasionally they "sported and played, and by indecent Gestures and Wry Faces, caused laughter and misbehaviour in the Beholders, and thereby greatly disturbed the Congregation." After church there was again the temptation to play. The boys threw stones at the meeting-house windows and "profaned the Sabbath" in manyother ways. The evidence indicates that the children, at least, did not wear long faces, but frequently played together, particularly on Sundays, when they undoubtedly contracted many of their con- tagious diseases. Funeral ceremonies of colonial New England have been fre- quently described. We need not be concerned about the order of procession, the gifts of mourning rings and gloves, or the tolling of the bells, but reading between the lines we find some means by which a disease could spread. The funeral of a child was an occa- sion when all the playmates and younger relatives of the deceased were brought together. Children acted as bearers in the long march to the grave; they came into close contact with the corpse and no attempt was made to separate the healthy mourners from the other infected children of the afflicted family. Thus a child's life on a solitary farm was not so isolated as one might at first suppose. The conditions were almost perfect for a contagious disease to spread, and when the "throat distemper" epi- demic appeared in one of these old New England towns, its begin- ning was as explosive as it was malignant. ¢~~~~~~~~3~~"~~T~Gs|o ^^~~~~~~~~~~~~~~~~IfsoKtouS I 1 LI WICKCK lrM9 K ekc tRWEDEL * t 7bRP@IE I )Ghtsvg,T . 0Jt* OAll T WoeKuI(o Ws,ueae ~@Tf Wq&p.i.u.[ 'E3b6iR4. Ox'P I, v vTU,,1w1r 226 YALE JOURNAL OF BIOLOGY AND MEDICINE I KINGSTON) NEW HAMPSHIRE It makes me weep in sorrows deep, to hear the dying moans, Which Death has made, in these our Days, among our little Ones. -A Lamentation. Fifteen miles north of the Merrimac River and about the same distance from the coast is a little fresh water lake which has been known for a longtime as "The Great Pond." Nearby lies the town of Kingston, famous in that part of New Hampshire as the ancestral home of Daniel Webster and the adopted home of Josiah Bartlett, physician, Governor of New Hampshire, and, according to tradition, the first to sign the Dedaration of Independence. Even without any very unusual scenery Kingston, nevertheless, has the charm of a peaceful, sleepy, quaint New England town with its few old colonial homesteads set back from a road that encircles "Kingston Plaine," the shaded village green.' Across the road, eastward from the green, is the old burying ground with its scattered groups of brown moss-covered stones. Some are overturned,- others partly crumbled or buried in the earth, but their distinctive shapes, grimly smiling cherubs, and ornamental borders mark them as relics of early colonial days. Although most of them are difficult to read, an occasional inscription identifies these stones as marking the graves of children who died during an epidemic when Kingston was a thriv- ingtown on the western frontier of New England civilization. About the middle of the seventeenth century when the English began to extend their frontiers inland, they found the Indians inhab- iting the country surrounding "The Great Pond," for it was good hunting ground and the land was more fertile than was the sandy soil nearer to the coast. The early settlers met with prolonged and stubborn resistance from the natives, but by 1694 the country had become sufficiently populated to warrant a charter for a township which was to be called "Kingstowne" in honor of William of Orange, then King of England. After many rigorous winters and frequent raids by hostile tribes, the town began to thrive and by ' George H. Moses: The Road-Encircled Plain: A Sketch of Kingston. Granite Monthly, 1894, xvii, 351. "tTHROAT 227 THE DISTEMPER" OF 1735-1740 the time of George the Second about four or five hundred people had selected this region for their homes. Among the eighty-one families of Kingston in 1725, the names of Bean, Clifford, Ladd, Prescot, Samborn, and Webster are found most frequently; some of them, direct descendants of the earliest settlers, had lived there for many years. The boundaries of the town were not well defined and included the greater part of the present Sandown, Danville, and East Kingston. By this time, the people had learned to face their hardships with resolute determi- nation and had overcome many of the difficulties of earlier frontier life. They had no particular trade, but like other New Hampshire people raised their own livestock, barley, corn, and wheat; cut their own timber and brought it on ox-carts to the mill. The average family possessed a horse, four cows, and four or five hogs. Salting down the pork in preparation for the long cold winter was as impor- tant as gathering the harvest in the fall, and so, to Bostonians, these people soon became known as "great pork eaters" which, after all, was not a very distinctive characteristic, for it was common to the inhabitants of most of the other inland New England towns. At that time, Kingston was almost self-sufficient and an occasional "pedalar" or visiting relative was the only contact with the outside world. There were no wars or famines, the scene of Indian raids had shifted to the west and north, and, except for a perennial argu- ment with their southern neighbors about the Massachusetts boun- dary-line, the people were as content and happy as the Puritan conscience would allow. To this small group of sturdy, upright, farming people, the Rev. Ward Clark was called to be the minister when the church was organized in 1725.2 Since his graduation from Harvard College (M.A., 1723), he had taught a grammar school in Exeter, his native town, a few miles to the north, but he was still only twenty-two when he undertook his new assignment and proudly entered in his book the names of his parishioners, headed by the Esquires, Cap- tains, Ensigns, and Lieutenants. A leader in fostering community pride, he himself planted most of the elms that later shaded the village green. This kindly young man, able to interpret liberally a rigid Calvinistic doctrine, was devoted to his work and his efforts were soon rewarded with the admiration and respect of an apprecia- 2Rev. J. H. Mellish: Historical Address on the 150th Anniversary of the Kingston Congr. Church. 1876, 12. 228 YALE JOURNAL OF BIOLOGY AND MEDICINE tive congregation. Pleased with £80 a year, a home, and the pros- pects of a permanent settlement, he married Mary Frost of Kittery in 1727. During the first ten years of his ministry a new and larger meeting-house was built, for a hundred and thirty new members had joined the church and the population of the town had almost doubled, many of the new settlers coming from neighboring towns in northeastern Massachusetts. During the same period there were about eighty marriages and four hundred baptisms; Clark's salary was increased many times and he was granted liberal tracts of land. There had been a small epidemic of some childhood disease during the autumn and winter of 1730-31, but now the usual good health again prevailed and the minister and people of Kingston, with many of their earnest hopes fulfilled, looked forward to a tranquil and satisfying future. Spring seems always late in coming to New England, but it was later than usual when it reached New Hampshire in 1735. It was said that the weather was uncomfortably wet and cold and that easterly winds prevailed. As the tradition goes,' in April of that year, one of the hogs that belonged to a Mr. Clough was "taken sick with a complaint in its throat and died. Mr. Clough skinned the hog and opened it. Soon after, he was taken with a complaint in his throat, and died suddenly." But this is probably mere tradi- tion, because there is no record of the death of Mr. Clough in 1735. However, on May 20, 1735, Parker Morgan, the son of John Morgan, died after a few days' sickness. About a week later, in a house four miles away, Nathaniel, John, and Elizabeth, the three children of Jeremiah Webster, died within three days. There was something unusual about the deaths of these four children, each with the same short illness. Some blamed the unseasonable weather; others knew it was a warning from an angry God; all agreed that it was very strange. The events of June are effectively told in the stark realism of the parish records:' June ye 5 Deborah Child of Josiah Batchelor Died 7 Dorothy Daughter of Jacob Gilman Died 17 Samuel Lock Lost a Daughter 18 Ebenezer Sleeper Lost a son. Both died with a Quinsey 19 Samuel Emons Eldest Daughter Died 21 Died David son of Joseph Greely J. Farmer and J. B. Moore: Collections, Topographical, Historical and Bio- graphical relating principally to New Hampshire. 1822, i, 143. 4Kingston Church Records: New Hampshire Geneal. Record, ii, 43; iii, 37.