First Annual Report of the Board of Health of the City of San Diego for the Year Ending December 31st, 1888
|Table No. 1 [commentary by the author]
Typhoid fever is a bacterial infection now known to be caused by Salmonella typhi. Persons with typhoid have a high fever, weakness, stomach pains, headache, loss of appetite and some have a rash of flat, rose-colored spots.
Malarial Fever could have been caused by malaria or other diseases causing fever.
Cerebrospinal Fever probably refers to meningococcal meningitis, a serious bacterial infection of the fluid that surrounds the brain and spinal cord.
Phthysis pulmonalis meant tuberculosis of the lungs, a chronic, wasting illness that often led to death from “consumption.”
Pneumonia is an infection of the lungs, usually caused by a microorganism. It is still a common cause of death, especially in the elderly.
Heart disease might refer to heart failure caused by damaged heart valves from rheumatic fever. Coronary artery disease was not widely recognized at the time. Dr. Gochenauer himself was reported to have died suddenly from “heart failure, superinduced by acute indigestion,” suggesting that he died from a heart attack.
Enteritis is an inflammation of the small intestine resulting in diarrhea, frequently caused by viruses or bacteria.
Bright’s Disease, now known as glomerulonephritis, a kidney disease of unknown cause manifested by albumin in the urine. Symptoms include fatigue, puffiness of the eyes and face, and high blood pressure. Richard Bright was a physician at Guy's Hospital in London in the early 1800s. Bright's disease is believed to be an allergic reponse to infection elsewhere in the body.
Purpura hemorrhagica describes bruising of the skin, without a history of trauma, caused by disorders interfering with normal blood clotting. There were probably a number of different causes. The diagnosis was often seen on death certificates, and this table identifies a young boy who died from such a disease. Purpura can be associated with internal bleeding, because of thrombocytopenia (low blood platelets).
|Table No. 2 [commentary by the author]
Cholera infantum, or “summer diarrhea of children,” produced severe, watery, diarrhea in infants who had been weaned from their mother's milk. The diarrhea caused dehydration and was often fatal. It might have been an infectious disease caused by a virus (such diseases continue to kill young children in developing countries today) or from the bacterial contamination of cows’milk. We now know that tuberculosis, brucellosis, listeriosis, and other infections can be caused by bacteria present in unpasteurized milk. Cholera infantum did not appear to cause illness in adults, clearly distinguishing it from epidemic Asiatic cholera.
Diarrhea was considered a “zymotic” disease, one caused by atmospheric changes and the difference in temperature between day and night.
Cerebrospinal Fever was probably meningococcal meningitis, a serious bacterial infection of the fluid that surrounds the brain and spinal cord.
Typhoid fever (see Table 1)
Typho-malarial fever could have been caused by typhoid, septicemia, or possibly malaria.
Septicaemia is a term still used to describe widespread dissemination of bacterial infection through the bloodstream
Erythema means redness and was probably used to describe a skin infection caused by staphylococcus or streptococcus bacteria.
Pertussis is a highly contagious bacterial disease of the respiratory tract, still known as “whooping cough.”
Phthysis Pulmonalis was tuberculosis of the lung, described in the previous table.
Tabes Mesenterica was the name for tuberculosis involving the abdominal lymph nodes of children, probably caused by drinking milk from cows infected with tuberculosis.
Convulsions might have resulted from sever epilepsy, brain injury or bleeding, poisoning, cerebral malaria, encephalitis, or any infectious disease causing a high fever.
Bright’s Disease was a kidney disease now known as glomerulonephritis. (see Table 1)
Nephritis is a name for any inflammation of the kidneys, which has a number of causes, often secondary to antibodies. This term might have referred to Bright’s Disease or pyelonephritis, a bacterial infection of the kidney.
Dropsy is an old term describing swelling in the legs (edema) or abdomen (ascites) usually caused by heart failure, cirrhosis of the liver or kidney failure.
Diabetes is a disease long-recognized by the presence of sugar in the urine. Insulin, the hormone used for the treatment of diabetes, was not discovered until the 1920s.
Heart and Organic Diseases could have had a wide variety of causes.
Inflammation of the Liver might have been used to describe cirrhosis, infectious hepatitis or jaundice caused by obstruction of the bile duct due to gallstones or cancer.
Other Diseases of the Brain and Nervous System probably included strokes, with sudden onset of paralysis or difficulty with speech or swallowing.
Purepera hemorrhagica, (an apparent misspelling) might have meant Purpura hemorrhagica, mentioned in Table 1, or puerperal hemorrhage, heavy bleeding of the mother from the uterus during or following childbirth.
Premature Birth caused three deaths. Table No. 7 notes that there were 17 stillbirths, all attended by a physician. Gochenauer points out that this number of stillbirths is probably too low, since not all cases were reported.
Crushed by Cars probably refers to injuries by streetcars or trains.
Accidental poisoning was responsible for two deaths, one from Mrs. Winslow’s Soothing Syrup. Widely promoted as relief for teething babies, the syrup contained morphine in doses high enough to kill a child. Until the Pure Food and Drug Act of 1906, there was no public restriction on the sale of such powerful and dangerous drugs.