What Killed Jane Austen?: And Other Medical Mysteries (17 page)

Among them, besides the likeness of Mendelssohn, John Keats, Isaac Newton and Dr Samuel Johnson, was the cast of William Burke’s head. Although he appears to have been somewhat out his league, he was probably better known to the public at large than any of the other artistic or intellectual giants in the collection.

(JL)

Having watched their oats, turnips and wheat … trampled, burned and raided by English armies, the peasants recognised the potato as a vegetable that could be cultivated and stored in secret … that could endure the malevolence of the English (Andrew Nikiforuk)

The potato first came from the mountains of Bolivia and Peru, and fed the crews of Spanish ships returning to the Old World.

It is not known how the Irish first came across potatoes. Perhaps from hulks of Spanish ships washed onto their coast after the defeat of the Armada in 1588. Or perhaps Sir Walter Raleigh planted potatoes from Virginia on his Irish estates.

In any case, Irish peasants took up the new plant far more eagerly than other Europeans. It was to prove both a blessing and a curse to the Irish. By the 1590s, the potato was a key part of their diet.

No other crop grown on only one acre could feed a man, his wife and six children. For breakfast, lunch and dinner they had potatoes and milk. A working man would eat up to 6 kilograms of potatoes each day! Pigs, chickens, dairy cattle and family could all eat from the one cauldron.

Peasants banked and spent potatoes almost like money. They had many names for the potato: pratie, prata, fata, taters and Murphy. They even called themselves ‘praties with a bone’. There were several warnings of the Great Famine. One came as early as 1740, when a bad frost killed most of the Irish crops. Starvation, typhus and dysentery (‘fevers and fluxes’) killed about 300,000.

But the ultimate tragedy came in 1845 after 17 shaky harvests, with various pests and diseases already affecting Ireland’s potatoes.

According to J.S. Schapiro, ‘The failure of the potato crop … resulted in a great famine that brought the climax of suffering to a people already half starved.’

The potato blight travelled from the United States and came to Ireland via England. Eventually it hit all the potato-growing countries of Northern Europe.

The fungus had originally been a benign companion of the wild potato in the Andes. But the relationship went sour after the potato crossed the Atlantic. Several factors increased the ravages of the fungus and made this famine especially devastating.

July 1845 was unusually cold and rainy. Moreover, potatoes in Ireland were planted close together, as most farms were so small. So the spores could easily spread over what started as Ireland’s largest-ever potato crop.

The first sign of blight was the stench. Affected plants blackened and withered in the ground; even those tubers which looked sound rotted once they were stored. As Nikiforuk says, ‘the fungus … sucked the life out of both the potato and its cultivator’.

Ironically, the potato itself had encouraged the population explosion which worsened the devastation of the blight.

It has been estimated that between 1760 and 1840 the population grew from 1.5 million to 9 million; a sixfold increase in just 80 years! Disraeli called Ireland the most densely populated country in Europe. The overpopulation was worst in the west. It was Oliver Cromwell who, two centuries before, had forced many Irish into the barren western province of Connaught.

The infestation killed over half the crop of 1845, wiped out that of the following year, and returned again in 1847 and 1848. Some historians believe the Famine continued until 1851.

Famine was also widespread elsewhere in Northern Europe, but because of their dependence on the potato, it hit the Irish hardest.

Among the deadly diseases were typhus (‘black fever’) and relapsing (yellow) fever, both transmitted by the common louse which flourished.

Whole families dragged themselves to cemeteries, dug their own graves and quietly lay down. Doctors and clergy did what they could; some of them died as well.

Some Englishmen said the famine reports were exaggerated. Subsidised imports of corn came late, and were then poorly distributed; many Irishwomen didn’t know how to cook corn.

By 1847 (the third year of the Famine), the English Treasurer Charles Trevelyan organised soup kitchens for 3 million people.

According to Máire and Conor Cruise O’Brien:

Historians, both English and Irish, generally see the outbreak of famine as inevitable, but think that disaster on the scale which actually occurred could have been avoided by more determined governmental action … Some individual Englishmen, and groups of Englishmen and Irishmen—notably the Society of Friends [Quakers]—did all that they could…but help on the great scale which alone would have sufficed to avert it was not forthcoming.

In desperation, many Irish emigrated. Yet, as Cecil Woodham-Smith says, ‘they did not leave fever behind; fever went with them, and the path to a new life became a path of horror.’

It took emigrants about two months of further starvation and disease to cross the Atlantic to America in ‘coffin ships’. These had too little food and water, were overcrowded and ‘dangerously antique in construction’’, according to Woodham-Smith. Many captains buried half their passengers at sea.

In America, the survivors rented damp, dark one-room cellars for families of a dozen plus a pig or two. Other, even poorer Irish, sank into the ghettos of Liverpool, Manchester or Glasgow.

Yet others of course started afresh in Australia.

When the Famine struck, the population of Ireland was perhaps 9 million. By 1851, famine and fever claimed between half a million and 2 million. Another 1–2 million emigrated, or died in the attempt. Since those terrible times, the Irish have controlled their population, which is now only about half of that before the Famine.

Ireland commemorated the 150th anniversary of the Famine with the theme: ‘Look back in sorrow, not in anger.’

(GB)

It is 70 years since the death of Mary Mallon. ‘Mary who?’ you may well ask. Mary Mallon, who for years strode through New York society like a grim reaper, dispensing typhoid bacteria with deadly and feckless abandon.

The word ‘typhoid’ is from the Greek
typhos
, meaning smoke or cloud, and refers to the floating confusion which occurs in the later stages of the malady. It is one of the so-called enteric fevers which cause gastroenteritis. The causative bacillus enters the body through contaminated food or water, and, once entrenched, there is an incubation period of seven to 14 days followed by malaise, loss of appetite and headache. At that stage it could be anything, but then a step like rise in temperature takes place to a hectic 104 degrees Fahrenheit (40 degrees Centigrade).

In the second week rose-coloured spots appear and later delirium. You then either recover very slowly or you die, and in inadequately treated cases, about nine per cent do just that.

Antibiotics are used now and are very effective. But in former days, about three per cent of sufferers who recovered remained long-term carriers, blissfully unaware they were shedding the bacteria from its hiding place in their gall bladder while at the same time suffering no ill effects themselves. If a carrier was a food handler and maintained poor hygiene, then he or she was a disaster waiting to happen. Such was Mary Mallon.

The typhoid bacillus has never been fussy where it gathered its prey, and has had some pretty up-market victims in its time. Prince Albert, consort of Queen Victoria, died of it, and their son, later to be Edward the VII, almost did. An earlier English king, Henry I, the ‘Lion of England’, succumbed, it was said, to the effects of a ‘surfeit of lampreys’, which was probably a euphemism for typhoid.

It caused almost 33 per cent of the deaths in the American Civil War, a conflict, incidentally, where another third died of other diseases, and only the remaining third of the deaths were in heroic circumstances. It was the cause of a major public health problem in the 1890s in Western Australia during the early rumbustious days of the discovery of gold in the Coolgardie and Kalgoorlie area. Poor sanitation was the culprit in this instance.

Which brings us to the New York of 1900. In September that year a young man died of typhoid in the house in which Mary Mallon was staying. Nothing unusual about that; at the time such things were regarded as all part of life’s immutable laws.

The next year she worked in a lawyer’s house in Maine, and within a fortnight seven of the eight members of the household were down with the disease. Mary worked unstintingly in the sick-bay situation. So much so that she was given a $50 bonus. She and that outbreak were only connected years later. If she had but realised it then, of course, the tie up might have proved to have been a regular source of income for her—infect a family and then look after them.

Fairly frequently she moved from house to house in her job as a cook. For as Saki prophetically wrote at the time in another situation: ‘The cook was a good cook, as cooks go. And as good cooks go, she went.’

She took a job in a Long Island house in 1909, whereupon six out of ten in the establishment promptly fell ill. Mind you, there were 3,467 cases in New York that year with 639 deaths, so at the time the disease was not regarded as the public-health scandal that it would be now. It was just the worm in the Big Apple, so to speak.

But on this occasion the medical fraternity did not sit around sucking their teeth or pursing their lips as they bemoaned the course of events whilst waiting to hit off on the second tee. No. A Dr George Soper went and smelt the drains and poked in the privy and pondered long and suspiciously over the local delicacy of giant clams. Disappointingly, none had been eaten.

‘Well, has any other exotica been eaten, for goodness’ sake?’ wondered the exasperated doctor. The cook’s tangy ice cream that had been everybody’s favourite was a lame afterthought. ‘Not the present cook, you understand, but the one who left three weeks ago just after the illness. Wait a minute, wait a minute. That’s right, just after the typhoid started.’

Dr Soper took six harrowing months to track down Mary through a series of grief-stricken houses. In the end he knew she was a 40-year-old single woman and a migrant from Northern Ireland. Eventually, he ran her to ground in the kitchen of a top-drawer home in Park Avenue, New York.

One can picture the good doctor leaning slightly forward, placing the tips of his fingers together, and affecting his best bedside manner and wheedling tone, as he wondered aloud if she could see any possible connection between herself and the trail of people with hectic temperatures, rose-coloured spots and greenish diarrhoea who had remained behind as she had moved on, and who displayed all the characteristics of, er, um, typhoid.

Her answer was short, to the point and impressive: she attacked him with a meat cleaver.

He bolted, and so did she in the opposite direction—he to the police, she to the outside toilet.

In a new-found coyness for New York’s finest, the sergeant shouted through the toilet door that he believed Miss Mallon could help with their enquires. Her answer was uncompromising, succinct and hurtful to any person’s sensitivities about his or her parentage. So, with an inspector sitting on her chest, she was removed kicking and screaming and sent to the Riverside Hospital for communicable diseases.

There Dr Soper had her stools cultured, and it came as no surprise to anyone that they were teeming with typhoid bacilli. Again it fell to the lot of the luckless GP to explain to Mary that she was the carrier of a condition dangerous to other people, and that the germs were lodging in the stones in her gall bladder. Furthermore (and he must have braced himself as he told her this) the treatment was simple—have the gall bladder removed.

It is not necessary to draw pictures for you regarding her response. Suffice it to say that the interview room had prudently been stripped of potential missiles.

So she was kept incarcerated in the hospital for three years; brooding, malevolent, a study in suppressed anger. She worked in the laundry, retaining all the while those typhoid tombstones in her gall bladder, while at the same time honing to perfection a heart rending derring-do story for which her countryfolk are supposed to be famous. The upshot was that Mary Mallon was released after promising with all the vehemence she could muster, which was considerable, that she would stick to the copper rather than the casserole and report to the Health Department every three months.

She promptly disappeared, seemingly from the face of the earth. In fact she did what probably any upright, downright and forthright person would have done. She changed her name to Mrs Brown, and her job, surprise, surprise, back to cook.

For five more years Mary plied her deadly culinary art round New York city, while unsuspecting trenchermen wolfed her typhoid-ridden gobbets. In 1915 there was a serious outbreak in the Sloane Hospital for Women, where she was working. In a moment of ingenuous banter another cook called her Typhoid Mary, whereupon to everyone’s surprise she fled. The police were notified and she was caught on Long Island. Rather disappointingly, she went like a lamb.

She was returned to the Riverside Hospital and given a life sentence of custodial care. By now the stuffing had been knocked out of her, even though the potent gall stones remained, and she went over to the enemy, so to speak, by becoming a worker in the hospital laboratory. The management even built her a small cottage in the grounds and she gave tea parties there. To accept an invitation no doubt meant playing rock-bun roulette, and perhaps was held as a kind of threat to the more obstructive patients.

Mary had a stroke in 1932 and died in 1938, not, as you may suppose, of the long-term complications of typhoid, but of bronchopneumonia. You will be relieved to know that she secreted the typhoid bacillus to the end.

When Mary Mallon died her score card was marked and the certainties came to ten outbreaks of typhoid fever which involved fifty-three cases and caused three deaths. Besides that she was almost certainly responsible for the 1904 outbreak at Ithaca in upstate New York when there were 1,400 cases. On top of these there were very many likely but unattributable episodes stretching back some thirty years.