1840: A Case of Milk Sickness

Nature is wonderful stuff. I delight in watching the shifting strength of various woodland plants as they compete through the summer. I got to studying the mayapples of late spring, when the forest floor is covered with them. Each plant labors to create a single drooping fruit. Roots, shoots, fruits and all are mostly gone by July. 

Introducing White Snakeroot

There isn’t much that first blossoms around here in September, but two exceptions are the goldenrod and white snakeroot. Both of these have the run of the place right into October, lining the edge of woods and walking paths. Their tiny flowers serve the vital function of providing late season nourishment to bees, butterflies and moths. The only other reason to deliberately plant it might be that its bitter taste deters deer and rabbits.

This autumn, the white snakeroot seemed ubitquitous. As the Brooklyn Botanic Garden puts it, “You barely notice the plant until suddenly – poof! It’s everywhere you turn, abloom with fluffy white flowers.” It looks innocent enough, and resides in the same taxonomic family as the daisy. I decided to look into it, and stumbled into a weird Halloween-appropriate history. 

One more scourge for the pioneer

In the early 1800s, as settlers first poured into the Ohio River valley, a strange and deadly medical condition manifested itself each summer. The name given to it in horses and cattle was the “trembles.” In humans, a healthy person would weaken over the course of a week to ten days with vomiting, spasms, delirium, coma and death. It was unprecedented, scary and baffling.

In the absence of a more scientific approach, many blamed alkali water, evil spirits or “arsenous fumes.” Whatever it was, it accounted for up to half of all summer mortalities in a number of midwestern counties. Thousands, including the mother of nine year old Abraham Lincoln, succumbed to the disease during the first half of the 19th century. Physicians resorted to bloodletting in patients, without any resulting benefit. Word spread, panic grew, and the influx of pioneers slowed. The General Assembly of Kentucky even offered $600 in 1830 and then $3,000 in 1842, to anyone who could diagnose what was happening. Journals of the 1840s variously referred to “milk sickness,” the “trembles” and the “puking complaint.” 

An understanding of early animal husbandry would help here. At the time, most frontier families had a milk cow that grazed more/less freely in nearby fields and forests. Physicians noted a higher rate of death among calves, and thought there may have been some type of poison in the water. As populations grew, similarly mysterious epidemics like yellow fever and cholera often followed. As with those, it was easy to blame air or water. Or witches. 

A scientific approach on the frontier

As the only medical practitioner within a day’s ride of Rock Creek, Illinois, Anna began a scientific study of this affliction. The seasonality of cattle death became the first clue toward solving the puzzle. The second clue was that the loss of calves, lambs and human babies seemed to indicate tainted milk. The mysterious disease acquired the name milk sickness, based upon its frequency in nursing individuals.

Suspecting the linkage, she began following cattle (goats, by some accounts) through the woods, to see what they ate, and how it affected them. Happening upon a Shawnee medicine woman, Anna learned that the Native Americans knew white snakeroot, thriving in the dry late summer weather, made animals sick and poisoned their milk. It’s a nasty tasting plant, but in an overgrazed field, or during drought, herbivores get less picky about their diet. 

White snakeroot, Ageratina altissima, is small, perennial and easy to grow. It loves both sun and shade, is pH tolerant, thrives in both dry and wet conditions, and propagates both by wind blown seeds and underground rhizomes. Wildly successful, its habitat runs everywhere in North America east of the Rockies, from Florida to New Brunswick. As most other plants become heat stressed toward the end of summer, white snakeroot takes off, growing and blooming well into October. 

Anna began an experiment by feeding white snakeroot to animals, who then showed symptoms of milk sickness. She spread the word, urging her neighbors to “abstain from milk and butter…till after the killing frosts.” 

A gratifying but localized victory

Her campaign quickly generated results. County residents went into forests and fields, destroying the plant. Anna herself grew a garden of white snakeroot so others could easily identify it. Over the following three years, the plant was nearly eradicated in southeast Illinois. 

Unfortunately, word of this breakthrough didn’t spread more widely. Anna lacked the credentials to make more of an impact on other physicians, or with medical journals. Milk sickness remained endemic, poorly understood, and rarely mentioned in textbooks. 

It was the industrialization of dairy science, rather than an epidemiological approach that finally tamed milk sickness in America. By 1900, dairy cattle were fed better, in large groups on tended fields. The pooling of milk from many cattle diluted any that may have harbored the causative ingredient, tremetol.

The USDA catches on

Tremetol itself is not just toxic, but potent. In silage like baled hay, it retains up to 20% of its original toxicity even after five years.  Fat soluble, it concentrates in milk, serving to weaken the child, while actually improving the condition of the affected mother. 

The first published account of the toxicology of white snakeroot by the USDA appeared in 1927, fifty years after Anna’s death. She was not cited in the report. In fact, her story was forgotten until historians first recounted it in the 1960s.

Wealth, greed and the end of Anna

Cave-In-Rock on the Ohio River was first settled in 1816. It was always small, with a population that never exceeded 400. A good place to hide in and operate from, it became a haven for various unsavory characters. In the 19th century Cave-In-Rock played host to what has been called an “ancient colony of horse thieves, counterfeiters and robbers.” Crime has a long history – in fact, crime pretty much is the history – of Cave-In-Rock. 

More dispassionate friends cautioned Anna that Eson was only in it for the money, and might well kill Anna to get it. She apparently set about insuring herself from that by hiding a tidy sum from her first marriage, and from her medical practice. Rumor was that it lay buried in a small cavern near Cave-In-Rock.

Eson grew frustrated with his futile attempts to learn the location of Anna’s stash. He finally determined to abduct his wife, tie her up, and work the information from her. Then he could get rid of her for good and leave the area.

Eson’s foul deed

As the story goes, a rider came to her door late one stormy night, calling that someone needed her medical help. She immediately came out, mounted a horse, and rode into the woods with the other rider. A flash of lightning illuminated her companion, revealing him to be her own husband. Exposed, Eson halted the horses and made to tie her up. When Anna heard the jingle of chains from Eson’s saddlebag, she panicked and ran headlong into the dark woods. She tumbled from a bluff, breaking several bones, but managed to hide behind a tree. Elon searched in vain for her, then turned his horse and rode away. 

It took all night for Anna to reach a nearby farmhouse, but found that it contained friends, and was very near her own home. They tended to her wounds while the authorities quickly took Eson into custody. He escaped, was later captured in Missouri and escaped again, then was never heard from again. 

Anna died at Cave-In-Rock in 1869. She was buried beside the grave of her first husband, Isaac Hobbs. The cave where she allegedly hid her money is still known as Anna Bixby Cave, where people, as they do, report strange lights moving in and out of the trees there.

Epilogue

And so it goes that, despite her medical accomplishment, the part of the story of Anna Pierce Hobbs Bixby that gets the best milage is that of her treasure, buried near a small town called Cave-In-Rock in Hardin County, Illinois. Maybe there’s a little Eson Bixby in most of us. That would be human nature. 

There is a marker in Anna’s honor at Cave-in-Rock, as well as a shelter for abused women and children named for her in nearby Harrisburg, Illinois. 

The last locally reported case of milk sickness was in two St. Louis babies in 1963. Both were treated in a hospital and survived. 

When the white snakeroot leafs out in the spring, it can be identified by curvy trails on some leaves. A certain fly lays its eggs on the leaves, and the larvae (leaf miners) tunnel through the leaf, creating the patterns. So there’s a bit of irony in a plant that could kill a horse but wouldn’t hurt a fly. 

Resources

As mentioned, a history of crime in Cave-In-Rock pretty much tells the story of the place. It’s all in Wikipedia at https://en.wikipedia.org/wiki/Cave-In-Rock,_Illinois

Part of a Smithsonian Magazine series on Women Who Shaped History, Will McCarthy’s story of Anna Pierce Hobbs Bixby gave this researcher some well-deserved credit. https://www.smithsonianmag.com/innovation/how-1800s-midwife-solved-poisionous-mystery-180982343/

Closer to home, the Missouri Department of Conservation treats white milkweed as a poison. https://mdc.mo.gov/discover-nature/field-guide/white-snakeroot#

Reference to the Brooklyn Botanic Garden from Saara Nafici; https://www.bbg.org/article/weed_of_the_month_white_snakeroot

Wikipedia has a good layman’s overview of milk sickness at https://en.wikipedia.org/wiki/Milk_sickness

A lot of in-depth information on Anna Bixby and the paranormal history of Anna Bixby Cave is available, compiled by Neil Gale, Ph.D, at the Digital Research Library of Illinois History, at https://drloihjournal.blogspot.com/search?q=Anna

Internet ephemera site Gizmodo posted a story by Esther Inglis-Arkell in 2013, titled Anna Bixby, The Treasure-Hoarding Epidemiologist. It’s funny how these tales take on lives of their own, like the game “telephone.” There is reputed to be a diary somewhere, which would be at least first-hand, but the conjecture piles up with time, distorting whatever the real story was. 

Another semi-apocryphal but entertaining history is on Aminoapps, in a subset on witches, (poor Anna!) called The Legend Of Bixby Cave. https://aminoapps.com/c/pagans-witches/page/blog/the-legend-of-bixby-cave-legendsandlandmarks/06k3_o0rfkuQY2nXeWolnoDmEQxMQGxoGQe

Another essay covers the human side of providing for the mother trying to provide for young children in early 20th century St. Louis. Fannie Ayers and her mother and child summer camps. Story at lafayettesquarearchives.com/1918-babies-camps-in-lafayette-park/

Photos of Anna Bixby, courtesy of David Chittenden at https://www.findagrave.com; always a good resource for historical people and their ends.