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Milk sickness, also known as tremetol vomiting or, in animals, as trembles, is a kind of poisoning, characterized by trembling, vomiting, and severe intestinal pain, that affects individuals who ingest
milk Milk is a white liquid food produced by the mammary glands of mammals. It is the primary source of nutrition for young mammals (including breastfed human infants) before they are able to digest solid food. Immune factors and immune-modulat ...
, other dairy products, or meat from a cow that has fed on white snakeroot plant, which contains the poison
tremetol Tremetone is a chemical compound found in tremetol, a toxin mixture from snakeroot (''Ageratina altissima'') that causes milk sickness in humans and trembles in livestock. Tremetone is the main constituent of at least 11 chemically related substan ...
. Although very rare today, milk sickness claimed thousands of lives among migrants to the
Midwestern United States The Midwestern United States, also referred to as the Midwest or the American Midwest, is one of four census regions of the United States Census Bureau (also known as "Region 2"). It occupies the northern central part of the United States. I ...
in the early 19th century, especially in frontier areas along the
Ohio River The Ohio River is a long river in the United States. It is located at the boundary of the Midwestern and Southern United States, flowing southwesterly from western Pennsylvania to its mouth on the Mississippi River at the southern tip of ...
Valley and its tributaries where white snakeroot was prevalent. New settlers were unfamiliar with the plant and its properties. A notable victim was
Nancy Hanks Lincoln Nancy Hanks Lincoln (February 5, 1784 – October 5, 1818) was the mother of U.S. President Abraham Lincoln. Her marriage to Thomas Lincoln also produced a daughter, Sarah, and a son, Thomas Jr. When Nancy and Thomas had been married for ...
, the mother of
Abraham Lincoln Abraham Lincoln ( ; February 12, 1809 – April 15, 1865) was an American lawyer, politician, and statesman who served as the 16th president of the United States from 1861 until his assassination in 1865. Lincoln led the nation throu ...
, who died in 1818. Nursing calves and lambs may have also died from their mothers' milk contaminated with snakeroot, although the adult cows and sheep showed no signs of poisoning. Cattle, horses, and sheep are the animals most often poisoned.
Anna Pierce Hobbs Bixby Anna Pierce Hobbs Bixby, sometimes spelled Bigsby, born Anna Pierce ( – c. 1870), was a midwife, frontier doctor, dentist, herbologist, and scientist in southern Illinois. Bixby discovered that white snakeroot (''Ageratina altissima'') conta ...
is credited today by the American medical community with having identified white snakeroot as the cause of the illness. Told about the plant's properties by an elderly
Shawnee The Shawnee are an Algonquian-speaking indigenous people of the Northeastern Woodlands. In the 17th century they lived in Pennsylvania, and in the 18th century they were in Pennsylvania, Ohio, Indiana and Illinois, with some bands in Kentucky a ...
woman she befriended, Bixby did testing to observe and document evidence. She wrote up her findings to share the discovery in the medical world. The Shawnee woman's name has been lost to history.


Signs and symptoms

An early sign in several animals including cattle, sheep, and guinea pigs is listlessness, which is commonly followed by significant loss of weight and pronounced trembling in the legs and muzzle. These signs often appear several hours after ingestion of white snakeroot. Signs of abdominal pain, polydipsia, and vomiting may be noted. As the effects of the poison progress, signs of constipation, appetite loss, weakness, and difficulty standing and/or walking are usually observed. Complete loss of muscle coordination, stupor, and/or coma precede death. Death usually occurs within two to ten days of symptom onset. Signs unique to cattle and sheep include peculiar odors found in the breath and urine, breathing difficulties, and over-salivation. Symptoms unique to horses include depression, bloody urine, and choking. In addition to increased heart rate and jugular pulse, swelling around the thoracic inlet is also observed. Horses may also stand with their hind legs wide apart. Symptoms unique to guinea pigs include crouching with half-closed eyes and roughening of the hair. Treatment for milk sickness is typically symptom amelioration, as well as administration of laxatives, sodium lactate, glucose, or hypotonic
Ringer's solution Ringer's solution is a solution of several salts dissolved in water for the purpose of creating an isotonic solution relative to the body fluids of an animal. Ringer's solution typically contains sodium chloride, potassium chloride, calcium chlo ...
.


Present day

Human milk sickness is uncommon today in the United States. Current practices of animal husbandry generally control the pastures and feed of cattle, and the pooling of milk from many producers lowers the risk of tremetol being present in dangerous amounts. The poison tremetol is not inactivated by pasteurization.Kim Maratea, "Final Diagnosis: White Snakeroot Intoxication in a Calf"
''Winter 2003 Newsletter,'' Purdue University, accessed January 9, 2012
Although extremely rare, milk sickness can occur if a person drinks contaminated milk or eats dairy products gathered from a single cow or from a smaller herd that has fed on the white snakeroot plant. There is no cure, but treatment is available.


History

Milk sickness was suspected as a disease in the early 19th century as migrants moved into the Midwest; they first settled in areas bordering the
Ohio River The Ohio River is a long river in the United States. It is located at the boundary of the Midwestern and Southern United States, flowing southwesterly from western Pennsylvania to its mouth on the Mississippi River at the southern tip of ...
and its tributaries, which were their main transportation routes. They often grazed their cattle in frontier areas where white snakeroot grows; it is a member of the daisy family. They were unfamiliar with the plant and its properties, as it is not found on the East Coast. The high rate of fatalities from milk sickness made people fear it as they did the
infectious diseases An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
of
cholera Cholera is an infection of the small intestine by some strains of the bacterium '' Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting an ...
and
yellow fever Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. ...
, whose causes were not understood at the time. Cattle do not graze on the plant unless other forage is not available. When pastures were scarce or in times of drought, the cattle would graze in woods, the habitat of white snakeroot. Early settlers often let their livestock roam freely in the woods. Milk sickness was first described in writing in 1809, when Dr. Thomas Barbee of
Bourbon County, Kentucky Bourbon County is a county located in the U.S. state of Kentucky. As of the 2020 census, the population was 20,252. Its county seat is Paris. Bourbon County is part of the Lexington–Fayette, KY Metropolitan Statistical Area. It is one of Ken ...
, detailed its symptoms. Variously described as "the trembles", "the slows" or the illness "under which man turns sick and his domestic animals tremble", it was a frequent cause of illness and death. The fatality rate was so high that sometimes half the people in a frontier settlement might die of milk sickness. Doctors used their contemporary treatment of
bloodletting Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily f ...
, but it had little success as it was unrelated to the cause of the illness. Cases were identified in
Ohio Ohio () is a U.S. state, state in the Midwestern United States, Midwestern region of the United States. Of the List of states and territories of the United States, fifty U.S. states, it is the List of U.S. states and territories by area, 34th-l ...
,
Kentucky Kentucky ( , ), officially the Commonwealth of Kentucky, is a state in the Southeastern region of the United States and one of the states of the Upper South. It borders Illinois, Indiana, and Ohio to the north; West Virginia and Virginia ...
,
Tennessee Tennessee ( , ), officially the State of Tennessee, is a landlocked U.S. state, state in the Southeastern United States, Southeastern region of the United States. Tennessee is the List of U.S. states and territories by area, 36th-largest by ...
,
Indiana Indiana () is a U.S. state in the Midwestern United States. It is the 38th-largest by area and the 17th-most populous of the 50 States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th ...
, and
Illinois Illinois ( ) is a state in the Midwestern United States. Its largest metropolitan areas include the Chicago metropolitan area, and the Metro East section, of Greater St. Louis. Other smaller metropolitan areas include, Peoria and Rock ...
. The illness was particularly ruinous in
Henderson County, Kentucky Henderson County is a county in the U.S. state of Kentucky. The county is located in western Kentucky on the Ohio River across from Evansville, Indiana. As of the 2020 census, the population was 44,793. Its county seat is Henderson. The coun ...
, along the banks of the Green River. Because of the losses from the illness, on January 29, 1830, the
Kentucky General Assembly The Kentucky General Assembly, also called the Kentucky Legislature, is the state legislature of the U.S. state of Kentucky. It comprises the Kentucky Senate and the Kentucky House of Representatives. The General Assembly meets annually in ...
offered a $600 reward to anyone discovering its cause. Many scientists in the area tried to determine the cause of the illness, but without success. Farmers found that only clearing the riverbanks and grazing cattle on tended fields ended the occurrence of milk sickness.Walter J. Daly, "'The Slows', The Torment of Milk Sickness on the Midwest Frontier"
''Indiana Magazine of History'', Vol. 102, No. 1, March 2006 American medical science did not officially identify the cause of milk sickness as the tremetol of the white snakeroot plant until 1928, when advances in
biochemistry Biochemistry or biological chemistry is the study of chemical processes within and relating to living organisms. A sub-discipline of both chemistry and biology, biochemistry may be divided into three fields: structural biology, enzymology and ...
enabled the analysis of the plant's
toxin A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849 ...
. Dr. Anna Pierce Hobbs (1808–1869) of
Hardin County, Illinois Hardin County is a county located in the U.S. state of Illinois. According to the 2020 census, it has a population of 3,649, making it the least populous county in Illinois. Its county seat is Elizabethtown. Hardin County is located in the p ...
, is credited in the 21st century as the first person to learn the specific cause of the illness back in the 1830s. She first learned of the plant's properties and its effect on humans from an elder Shawnee woman, who had deep knowledge of herbs and plants in the area.John W. Allen, ''It Happened in Southern Illinois''
Carbondale: Southern Illinois University Press, 1968 (reprint, paperback, 2010 – Googlebook version), pp. 5–6, accessed July 1, 2011
Hobbs had migrated as a girl to the Illinois country with her parents. She returned to
Philadelphia, Pennsylvania Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Since ...
, to study medicine: her studies included nursing, midwifery and
dental extraction A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or informally, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reaso ...
, the sum of what women at the time could study in medicine. After her return to southern Illinois, she started practicing and also worked as a teacher. She was familiarly called Dr. Anna. She soon married Isaac Hobbs, son of a neighboring farmer. When milk sickness broke out, Anna Hobbs studied the characteristics of the illness and noted the results in her diary. She determined that it occurred seasonally, beginning in summer and continuing until the first frost. She noted that it was more prominent in cattle than in other animals, and thought it might be due to a plant which the cattle were eating. The legend says that while following the cattle in search of the cause, Dr. Hobbs happened upon an elderly
Shawnee The Shawnee are an Algonquian-speaking indigenous people of the Northeastern Woodlands. In the 17th century they lived in Pennsylvania, and in the 18th century they were in Pennsylvania, Ohio, Indiana and Illinois, with some bands in Kentucky a ...
woman, whom she befriended. During their conversations, the Shawnee told her that the white snakeroot plant caused milk sickness in humans. Hobbs tested this by feeding the plant to a calf and observed its poisonous properties when the animal died; she had fed other plants to other calves that survived. With that evidence, she gathered members of her community to dig up and eradicate the plant from their settlement. Although Dr. Hobbs learned valuable information from the Shawnee woman and did additional study to demonstrate proof of it, by her death in 1869, she had received no official credit from the medical community for her writing about milk sickness.W. D. Snively, ''Minnesota Medicine,'' V. 50, April 1967, pp. 469–476 After her first husband died of pneumonia, Anna Hobbs married Eson Bixby; she subsequently came to be known by his surname.


Notable victims

*
Nancy Hanks Lincoln Nancy Hanks Lincoln (February 5, 1784 – October 5, 1818) was the mother of U.S. President Abraham Lincoln. Her marriage to Thomas Lincoln also produced a daughter, Sarah, and a son, Thomas Jr. When Nancy and Thomas had been married for ...
, who died in 1818, was the mother of
Abraham Lincoln Abraham Lincoln ( ; February 12, 1809 – April 15, 1865) was an American lawyer, politician, and statesman who served as the 16th president of the United States from 1861 until his assassination in 1865. Lincoln led the nation throu ...
.


References


Further reading

* , at Illinois Periodicals Online * Lowell A. Dearinger, "Dr. Anna and the Milksick", ''Outdoor Illinois'' (March 1967) * *


External links


''Starling's History of Henderson County''
Henderson County, Kentucky History Website {{DEFAULTSORT:Milk Sickness Toxic effect of noxious substances eaten as food