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Shadows in the Valley

Shadows in the Valley: A Cultural History of Illness, Death, and Loss in New England, 18401916

Copyright Date: 2010
Pages: 264
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  • Book Info
    Shadows in the Valley
    Book Description:

    How does the experience of sickness, death, and loss change over time? We know that the incidence and virulence of particular diseases have varied from one period to another, as has their medical treatment. But what was it like for the individuals who suffered and died from those illnesses, for the health practitioners and institutions that attended to them, and for the families who buried and mourned them? In Shadows in the Valley, Alan Swedlund addresses these questions by closely examining the history of mortality in several small communities in western Massachusetts from the midnineteenth to the early twentieth century—from just before the acceptance of the germ theory of disease through the early days of public health reform in the United States. This was a time when most Americans lived in rural areas or small towns rather than large cities. It was also a time when a wide range of healing practices was available to the American public, and when the modern form of Western medicine was striving for dominance and authority. As Swedlund shows, this juncture of competing practices and ideologies provides a rich opportunity for exploring the rise of modern medicine and its impact on the everyday lives of ordinary Americans. To indicate how individuals in different stages of their lives were exposed to varying assaults on their health, the book is structured in a way that superimposes what the author calls “lifecourse time” onto chronological time. Thus the early chapters look at issues of infancy and childhood in the 1840s and 1850s and the last chapters at the problems of old age after 1900. The reader becomes familiar with specific individuals and families as they cope with the recurrent loss of children, struggle to understand the causes of new contagions, and seek to find meaning in untimely death. By using a broad time frame and a narrow geographical lens, Swedlund is able to engage with both the particularities and generalities of evolving medical knowledge and changing practice, and to highlight the differences in personal as well as collective responses to illness and loss.

    eISBN: 978-1-61376-049-9
    Subjects: Sociology, Anthropology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Illustrations
    (pp. ix-x)
    (pp. xi-xvi)
    (pp. 1-8)

    This book is about the circumstances that occur when illness leads to death, and death to loss and mourning. Anthropologists sometimes remark that birth and death are the only true universals for humankind. But though death is universal, the way it is experienced is not. This book also is about death in a specific place and time: Massachusetts from the mid-nineteenth to the early twentieth century. It is about those who attended the dying, from a parent or spouse to the doctor, undertaker, and officiating civil authority. Most of all, it is about how death informed life for the people...

    (pp. 9-22)

    In the early spring of 1842 a country doctor sits at his writing desk. As he writes, he ponders a recent epidemic of dysentery in his town, unaware that another is soon to follow. The doctor’s name is Stephen West Williams, and he lives in the small agricultural town of Deerfield, County of Franklin, Commonwealth of Massachusetts. A third-generation medical man, he began his career in the Deerfield practice of his father, William Stoddard Williams, whose own father, Thomas Williams, served as a surgeon in the French and Indian War.

    A visitor to Deerfield in the spring of 1842 would...

    (pp. 23-45)

    When Timothy Dwight traveled throughout New England in 1796–97, soon after assuming the presidency of Yale University, he saw a landscape dotted with small farming communities and mill sites that reflected prosperity and abundance. New Englanders had been cultivating the land for about 175 years, ever since Plymouth Plantation was settled in 1620. Dwight wrote of Deerfield’s center village and the adjacent Deerfield River:

    Few scenes are more delightful than this river and its borders. The intervals, which accompany the whole of its northern and considerable part of its Eastern course, are unusually elegant, and productive. The town itself...

    (pp. 46-64)

    Upon returning to Deerfield after delivering his address to the Massachusetts Medical Society in May, Stephen West Williams hoped that the ailment known as the “summer complaint”—cholera infantum—would spare his town come August. The previous year, 1841, as he had told his colleagues in Boston, Deerfield had lost thirteen infants and toddlers (out of thirty-one deaths), most of them during an epidemic of that disease. At the time, cholera infantum was a vaguely defined set of ailments, chiefly dysentery and fever. We now include it in the pneumonia-diarrhea complex, a name that characterizes, symptomatically, a group of common...

    (pp. 65-83)

    Among the childhood diseases that tormented families, communities, and public health officials in nineteenth-century New England, the so-called childhood fevers—scarlet fever, measles, and diphtheria—worked by far the greatest devastation. They took their heaviest toll on young children who had survived the precarious first two years of infancy and toddlerhood. For “statists” such as Lemuel Shattuck and William Farr, these diseases, along with cholera infantum, fell into the zymotic order of nosological nomenclature.¹ They were listed in the miasmatic class, suggesting that they originated in bad air. We now understand that they are caused by viruses or bacteria transmitted...

    (pp. 84-103)

    “Consumption, that great destroyer of human health and human life, takes the first rank as an agent of death; and as such, we deem it proper to analyze more particularly the circumstances under which it operates. Any facts regarding a disease that destroys one-seventh to one-fourth of all that die, cannot but be interesting.” So wrote Lemuel Shattuck, who had earlier lost his own father to consumption, in hisReport of the Sanitary Commission of Massachusettsin 1850.¹ Throughout the nineteenth century consumption—a large proportion of which was pulmonary tuberculosis—was a major killer in the United States and...

    (pp. 104-124)

    A simple entry by the Reverend Edgar Buckingham, a Deerfield Congregational minister, in the First Church’s book of baptisms, marriages, and funerals for 1870 reads: “April 19, Mary E. wife of John H. Stebbins. Age, 34, causepremat: Confin’t.[premature confinement].”¹ Mary E. Stebbins had died from complications in childbirth, apparently with a premature infant, her fourth child. In the town’s vital records, her death was listed as having been caused by fever—most likely what is now called puerperal fever. She was one among many.

    The members of the Franklin District Medical Society had almost nothing to say about...

  12. 7 SURVIVING THE ODDS: The “Privilege” of Old Age
    (pp. 125-146)

    At the close of the nineteenth century, Dr. Samuel Abbott, secretary to the Massachusetts State Board of Health, took a keen interest in the long series of vital statistics available to him through the Registry of Vital Records and Statistics. In a report published in 1897, he noted that whereas in 1855 approximately 6.2 percent of the people alive in Massachusetts were age sixty or older, by 1895 the figure had risen to 8.2 percent. Five years later, in 1900, only 3.6 percent of the state’s population was over the age of sixty, the result of high immigration rates of...

  13. 8 MANAGING DISEASE IN THE LONG NINETEENTH CENTURY: Numeracy and Nosology, Nature and Nurture, 1840–1916
    (pp. 147-166)

    On the strength of a compendium of data remarkable for its time, theReport of the Sanitary Commission, Lemuel Shattuck and the commission concluded in 1850 that “causes exist in Massachusetts, as in England, to produce premature and preventable deaths, and hence unnecessary and preventable sickness; and that these causes are active in all the agricultural towns, but press most heavily upon cities and populous villages.” In their report the commission named suspected causes and conditions they believed required immediate attention. Further, they recommended that the state create a board of health, initiate uniform vital registration, implement the system for...

  14. 9 BODIES OF EVIDENCE: Death, Loss, and The Search for Meaning
    (pp. 167-190)

    On a beautiful, sunny Memorial Day shortly before I finished the book, I walked into Deerfield’s Laurel Hill Cemetery to revisit the resting places of Frankie and George Sheldon, Hattie Willard, and the other people I had come to know during my research. I wanted to take a final look at the gravestones and epitaphs of those whose names fill these pages, and I had brought my camera to rephotograph the grave markers. Flags adorned the markers of veterans of many past wars. During my visit maybe a half-dozen other visitors came. Most of them quickly planted a geranium or...

  15. APPENDIXES: Data Collection and Evaluation
    (pp. 191-200)
  16. NOTES
    (pp. 201-234)
  17. INDEX
    (pp. 235-246)
  18. Back Matter
    (pp. 247-248)