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The state of being wasted or diminished; waste; diminution; loss. A gradual decay or diminution of the body; especially, the disease called phthisis pulmonalis (pulmonary consumption), a disease seated in the lungs, attended with a hectic fever, cough, &c. — Webster, 1882

“He has consumption, and came out here to take the prairie-climate cure.” – By the Shores of Silver Lake, Chapter 15, “The Last Man Out”

At the time of the Little House books, tuberculosis was known as Phthisis Pulmonalis or pulmonary consumption; it was usually called by its common name: consumption. The disease was said to deposit tubercles in the lungs, which somehow caused a wasting away of the affected individual. Thought to be hereditary, Phthisis was also thought to be exacerbated by living in confined spaces with an impure atmosphere, unhealthy or too prolonged occupations, innutritious food, and anxiety. — E.H. Ruddock, M.D., The Stepping Stone to Homeopathy and Health (London: The Homeopathic Publishing Company, 1880), 136-137.

According to early medical texts, tuberculosis symptoms were often obscure and appeared at any age, but most frequently from the 18th to the 22nd year of age. The chief symptoms were: impaired digestion – loss of appetite, red or furred tongue, thirst, nausea, vomiting, and in rare cases, gastralgia; more or less a cough, chiefly in the morning and continuing for months prior to any other symptoms; irregular pains in the chest; shortness of breath upon slight exertion, with blood discharged when coughing; debility, languor, and palpitation; persistently accelerated pulse; heightened temperature; night sweats; and progressive emaciation. The gums often had a red line next to the teeth, and fingernails would curve downward at the ends. During the course of the disease, the body would waste away, but the mind could remain clear.

Today, we know that tuberculosis is a contagious bacterial disease caused by the Mycobacterium tuberculosis bacterium. The disease causes small round bumps, or tubercles, to form in living tissue. Tuberculosis is primarily a lung disease (Mycobacterium tuberculosis requires oxygen to live), although in advanced stages, other parts of the body may be affected. Tuberculosis bacteria was first isolated in 1882 by Robert Koch, a German doctor. He received the Nobel Prize in 1905 for his work. Click HERE to read an 1884 text about tuberculosis and its treatment at the time of the Little House books.

The Topography of Consumption.

A review of the census returns of 1890 reveals some interesting and startling facts. The total number of deaths reported from consumption was 102,199, a proportion of 121.49 per 1,000 of all deaths. The five years’ records of the large cities gives Boston the largest percentage of mortality, 164.88 per 1.000 deaths. Chicago’s proportion was 83.11 per 1,000.

So far as the states and territories are concerned New York returns the greatest number of deaths by consumption, 14,854; Indian Territory, the least, 22. If some of the states having the largest mortality were grouped consecutively, they would stand as follows: New York, Pennsylvania, Ohio, Massachusetts, Illinois, Tennessee, Missouri, Kentucky, Indiana, New Jersey, Virginia, California, Michigan, Maryland, North Carolina, Alabama, Georgia, South Carolina, Texas, and Wisconsin.

With the exception of California, the to-called climatic states present a good showing, Colorado standing thirty-fifth in the list, Florida thirty-seventh, Minnesota twenty-fourth, North Dakota forty-first, and South Dakota thirty-eighth. Of the New England States Maine, New Hampshire and Vermont are comparatively free from consumption according to the mortality statistics.

The question arises why is New York the storm center from which the current of consumption flows toward the Middle States? It cannot be due to climatic causes entirely, because the contiguous states have almost identical climatic conditions. On the other hand it is a well known fact that the more dense the population and the higher the degree of civilization, the more prevalent the scourge becomes. This fact is strikingly brought out by following the line of the progress of the disease in its course throughout the United States. If one traces the line through the states that have been mentioned he will see that the disease is concentrated at the centers of civilization. The social conditions that produce anxiety, mental strain, overcrowding, bad sanitation, debauchery, the struggle for existence, render the human kind less able to resist the onslaught of the consumptive germs. The states that are freest from consumption are those where the people live more out of doors, where the struggle for existence is less violent, and there is less need of improved sanitarium.

The influence of heredity is another factor to be considered. The families that reside in the pest-ridden states are in the majority of cases the direct descendents of a tuberculosis ancestry. Often the successive families occupy for generations the same dwellings that have harbored consumptives and being susceptible to the disease they succumb to its influence.

A fact of interest to the little is that the states that have the greatest amount of humidity do not seem to be over-ridden with consumption, as Washington Territory and Michigan. The unfortunate states, however, are those of a low or medium altitude.

There are many other considerations in the study of the distribution of phthisis pulmonalis that emphasize the necessity of educating the public to the fact that the best way to stamp out the disease is to institute such hygienic and social measures as will improve the physical well being of man and thus enable it to better resist the invader.

Centuries before the discovery of the bacterial causation of the disease, Italy enforced sanitary laws that lessened the frightful mortality by consumption to a low degree.

— George Wilkinson, M.D., Wilkinson’s Clinic: A Monthly Journal Devoted to Medicine and the Interests of the Medical Profession of the West, (Omaha, Nebraska: George Wilkinson, Editor and Publisher), Volume VIII, November 1895, 266-267.

The Prairie-Climate Cure.
In By the Shores of Silver Lake, Charles Ingalls helps persuade a consumptive homesteader (Horace Woodworth) to leave his claim before the winter of 1879-1880 rather than remain alone in his shanty all winter while “taking the prairie cure.” The prairie cure was said to be “the one cure the doctors recommended as pretty near a surefire thing” and people came “from all over the world to take it.” (Chapter 15, “The Last Man Out”)

Based on statistics (see above), it was known that consumption was most prevalent in areas with a high population, foul moist air, and unsanitary living conditions. Tuberculosis spread because the bacterium which caused it was distributed via contaminated sputum, and could be spread by coughing, spitting, vomiting, talking, or kissing.

Removal of infected persons from the cities to the unsettled prairies – or, in fact, any climate that was different from the one in which an infected person was living – was highly advertised. Since there was no real cure for consumption at the time, “sending the patient away” was often the last resort taken when patent medicines (usually containing nothing more than opium and alcohol) proved unsuccessful. Climate treatment was said to cure consumption “by removing the consumptive from the evil influences of unfavorable meteorological conditions and of an injurious soil, and by transferring him to a climate where fresh air, sunshine, and an out-door life may be freely enjoyed, and where, in consequence, the processes of respiration, digestion, and sanguification proceed with sufficient energy to combat successfully the hereditary tendency or individual proclivity to pulmonary disease.” Locations included marine areas (typically a sea voyage), dry inland areas, and the mountains. The dry inland promoted open-air life, plain diet, and simple manners. It was the piney atmosphere of mountain areas that was thought to bring relief. — James Alexander Lindsay, M.D. in The Sanitarian, A Monthly Magazine Devoted to the Preservation of Health, Mental and Physical Culture, January 1888, 26-32.

Of course improvements in diet, air quality, and living conditions would most likely make a person “feel better;” it was not a cure. It was believed that invigorating air would cause the invalid to want to eat more and better foodstuffs, which should include meat, milk, and fresh vegetables, items definitely not available to Horace Woodworth on his prairie homestead! Sanitoriums were therefore established in desirable areas, and consumptives were often charged a premium for fresh air, sunshine, and fresh food. One item in quantity on the prairies – sunshine – was deadly to tuberculosis bacterium, and transmission rarely occurs our-of-doors in the daylight. In the 1800s, seven out of every ten people became infected with tuberculosis, but only one in seven died from the disease. Reverend Woodworth lived for twenty years following his five-year residency in Dakota Territory, from 1879 to 1884.

A full recovery is possible today when several drugs are administered on a regular basis for an extended period of time, all drugs being those to which the organisms are susceptible. While a vaccine against tuberculosis exists, it has often proved unsuccessful, and a tuberculin skin test (to show the presence of tuberculosis in an individual) currently is used in the United States to identify and monitor the disease.


consumption (SSL 15; TLW 9; PG)
     prairie cure / prairie-climate cure (SSL 15; TLW 9)