Malvern Family History Society

What is dropsy?

A recent meeting was so interesting and informative I felt I would like to relay some of this to those of our members who were unable to attend. The speaker, Dr David Webster, is a retired GP from Upton-on-Severn, who was born in Kenya and lived and worked both in Kenya and Uganda before settling in England. His accounts of his work there were fascinating and would have been a superb topic on its own but Dr Webster had been asked to talk to us about the many and varied medical queries we have all come across in our research.

Before the question/answer session began, Dr Webster explained the complex requirements now in place for a doctor registering a death (changing now in the light of the Shipman case) but this will need to be the subject of a separate article at a later date. So - on with the questions:

Is one’s DNA unique and can it indicate propensity to inherited diseases and can tests reveal unexpected parentage?
Each person’s DNA is unique but would be more like those of our relatives than anyone else. Even identical twins would have minor differences. DNA can be and is used for medical purposes such as embryo screening for certain inherited conditions such as breast cancer, cystic fibrosis, muscular dystrophy, autism, haemophilia etc. Alzheimer's disease, which can also be hereditary, has recently been added to the research list. Finally, DNA has been used in parental disputes.

How accurate is ‘present at the death ···' for the person registering a death and would this have to be someone who could write?
Those registering the death are called The Informant and the Law has laid down who those informants can be, ie a person present at the death or during the last illness or be aware of the circumstances of death, etc. The Informant must give the following information: date and place of death - full name and maiden name if a married lady - occupation - address - pensions and allowances - date of birth of surviving spouse if there is one.

What is dropsy?
This is an archaic word which basically means an accumulation of fluid in the body and is a symptom not a diagnosis. There can be many causes for such accumulation such as cardiac asthma, fluid in the lungs, heart failure, swollen ankles or legs, kidney failure and malnutrition.

What, on an 1841 death certificate, would the word ‘debility’ as a cause of death be describing?
Again, this is a symptom rather than a diagnosis which would be hiding an ignorance of the real cause such as undiagnosed TB, cancer, anaemia, starvation. Today we would use the term ‘old age’.

Was there any treatment for cancer of the thigh in 1890 and how would the condition manifest itself?
Cancer can manifest itself in many ways, ie bone, muscle, cartilage, skin, etc. These days we would have to be more specific but in the late 19th century it would have made little difference. At that time the only treatment for cancer in limbs would be amputation but this would probably lead to secondary cancers which would be inoperable and therefore fatal.

What were the common causes of infant mortality throughout the 19th century? Was there a different between town and country?
There were strong links between poverty and mortality generally; the causes being poverty, pollution, poor drainage/sewage causing deaths from cholera, TB, typhus, diphtheria, scarlet fever, gastro-enteritis in addition to malnutrition. In 1851 infant mortality in industrial areas was 170/1000 but in rural areas 100-120/1000. Figures for Fairford, Gloucestershire for deaths between 1810 and 1860 show that 23% were infants and in Manchester in 1842 the gentry had a life expectation of 38 years whereas in the working classes, this was only 17 years. In rural areas at that time, the figures were 52 years for gentry and 38 for agricultural labourers. By contrast, the average infant mortality rate today is 5/1000.

In Victorian and pre-Victorian times, children appeared to be born every 18 months to 2 years. To what extent does breast feeding work as a form of contraception?
Breastfeeding was and is a recognised method of birth control as the hormone produced discourages ovulation. To some this would have been the only method of contraception but would only be effective if total.

What is apoplexy?
This is now called a ‘stroke’. Haemorrhage or clotting is the literal meaning, usually in the brain.

Family history publications often refer to setting up a medical pedigree. Which conditions would be most useful to chart and do they skip generations? If a great-grandmother died of diabetes, does that make the current generation more susceptible to it?
It is always useful to have a medical pedigree and yes, diabetes can be hereditary but that would depend on the type (Type 1 or 2). Other problems such as heart disease, blood pressure, breast cancer, ovarian cancer can run in families. For example, if there is a history of heart disease, keep a close check on blood pressure and cholesterol.
What does ‘morbus cordis’ mean written above cardiac failure as the cause of death?
This literally means a ‘sick heart’ and could be from a number of causes.

Was there any treatment for TB in the 1870s?
The main treatment would have been fresh air, good diet, in a sanatorium if you were lucky. In the case of TB of the lung, the infected lung was often ‘collapsed’ to allow it to rest and heal. TB is contagious where people live in close proximity and it can affect any organ of the body.

Do you know of any treatments for common ailments that are no longer used, any that worked, and any that were thought to work but did not?
Treatments today are ‘evidence based’. We no longer use tonics, antiseptics, poultices, placebos, nor, with a good diet, do we need vitamins supplements. Some old methods are however coming back, such as the use of leeches and maggots.

What can you tell us about the 1918/19 'flu epidemic and is it true that more people died because of this than during the First World War? What about UK death figures?
This was in fact a pandemic which probably spread from the USA to Europe. 2.5% of the world's population died, with 25% in total having been infected. Worldwide casualties were 50/70 million with 5% of the population of India dying. 228,000 died in the UK. In comparison 9 million died worldwide in WWI, 750,000 being British casualties.

A death certificate of 1890 lists the cause of death as ‘general paralysis of the insane and another of 1912 shows the cause as ‘general paralysis since admission’. Both deaths occurred in a city lunatic asylum. What would this have been describing?
General paralysis of the insane is syphilis (GPI as it is known) and was common in asylums.

What is erysipelas?
This is a streptococcal infection which spreads rapidly and is similar to septicaemia.