Milk sickness

Milk sickness

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Milk sickness, also known as tremetol vomiting, or in animals as trembles, is characterized by trembling, vomiting, and severe intestinal pain that affects individuals who ingest milk
Milk is a white liquid produced by the mammary glands of mammals. It is the primary source of nutrition for young mammals before they are able to digest other types of food. Early-lactation milk contains colostrum, which carries the mother's antibodies to the baby and can reduce the risk of many...

 or other dairy products, or meat from a cow that has fed on white snakeroot
White Snakeroot
White Snakeroot , also known as White Sanicle or Tall Boneset, is a poisonous perennial herb in the family Asteraceae, native to eastern North America...

, which contains the poison tremetol.

Although highly rare today, milk sickness claimed thousands of lives among European-American migrants to the Midwest in the early 19th century in the United States, especially in frontier areas along the Ohio River
Ohio River
The Ohio River is the largest tributary, by volume, of the Mississippi River. At the confluence, the Ohio is even bigger than the Mississippi and, thus, is hydrologically the main stream of the whole river system, including the Allegheny River further upstream...

 Valley and its tributaries, because they were unfamiliar with the plant and its properties. A notable victim was Abraham Lincoln's
Abraham Lincoln
Abraham Lincoln was the 16th President of the United States, serving from March 1861 until his assassination in April 1865. He successfully led his country through a great constitutional, military and moral crisis – the American Civil War – preserving the Union, while ending slavery, and...

 mother, Nancy Hanks Lincoln. Nursing calves and lambs may have 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, called Dr. Anna on the frontier, is credited today with identifying white snakeroot as the cause of the illness, but she was said to have been told about the plant's properties by a Shawnee
The Shawnee, Shaawanwaki, Shaawanooki and Shaawanowi lenaweeki, are an Algonquian-speaking people native to North America. Historically they inhabited the areas of Ohio, Virginia, West Virginia, Western Maryland, Kentucky, Indiana, and Pennsylvania...

 woman she befriended. That woman's name has been lost to history.


Milk sickness emerged as a suspected disease in the early 19th century, as European-American migrants moved into the Midwest, first into the areas bordering the Ohio River
Ohio River
The Ohio River is the largest tributary, by volume, of the Mississippi River. At the confluence, the Ohio is even bigger than the Mississippi and, thus, is hydrologically the main stream of the whole river system, including the Allegheny River further upstream...

 and its tributaries. They often grazed their cattle in frontier areas where white snakeroot grows. 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 like the infectious diseases of cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 and yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

. Cattle will not graze on the plant unless other forage is not available; but, when pastures are scarce or in times of drought, the cattle would graze in woods, the habitat of white snakeroot.

Milk sickness was first described in writing by a European American in 1809, when Dr. Thomas Barbee of Bourbon County, Kentucky
Bourbon County, Kentucky
Bourbon County is a county located in the U.S. state of Kentucky. It is the remnant of what was previously a much larger Bourbon County, established as part of Virginia in 1785, and comprising what are now thirty-four modern Kentucky counties...

 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. Sometimes half the people in a frontier settlement might die of milk sickness. Doctors used their contemporary treatment of bloodletting
Bloodletting is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health...

, but it had little success as it was unrelated to the cause of the illness.

Cases were identified in Ohio
Ohio is a Midwestern state in the United States. The 34th largest state by area in the U.S.,it is the 7th‑most populous with over 11.5 million residents, containing several major American cities and seven metropolitan areas with populations of 500,000 or more.The state's capital is Columbus...

, Kentucky
The Commonwealth of Kentucky is a state located in the East Central United States of America. As classified by the United States Census Bureau, Kentucky is a Southern state, more specifically in the East South Central region. Kentucky is one of four U.S. states constituted as a commonwealth...

, Tennessee
Tennessee is a U.S. state located in the Southeastern United States. It has a population of 6,346,105, making it the nation's 17th-largest state by population, and covers , making it the 36th-largest by total land area...

, Indiana
Indiana is a US state, admitted to the United States as the 19th on December 11, 1816. It is located in the Midwestern United States and Great Lakes Region. With 6,483,802 residents, the state is ranked 15th in population and 16th in population density. Indiana is ranked 38th in land area and is...

, and Illinois
Illinois is the fifth-most populous state of the United States of America, and is often noted for being a microcosm of the entire country. With Chicago in the northeast, small industrial cities and great agricultural productivity in central and northern Illinois, and natural resources like coal,...

. The illness was particularly ruinous in Henderson County, Kentucky
Henderson County, Kentucky
Henderson County is a county located in the U.S. state of Kentucky. It was formed in 1799. As the latest census data update of 2010, the population was counted 46,250. The county seat is the City of Henderson. The county was named for Colonel Richard Henderson who originally purchased of land...

, along the banks of the Green River
Green River (Kentucky)
The Green River is a tributary of the Ohio River that rises in Lincoln County in south-central Kentucky. Tributaries of the Green River include the Barren River, the Nolin River, the Pond River and the Rough River...

. Because of the losses from the illness, on January 29, 1830, the Kentucky General Assembly
Kentucky General Assembly
The Kentucky General Assembly, also called the Kentucky Legislature, is the state legislature of the U.S. state of Kentucky.The General Assembly meets annually in the state capitol building in Frankfort, Kentucky, convening on the first Tuesday after the first Monday in January...

 offered a USD$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.

United States 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, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...

 enabled the analysis of the plant's toxin.

But, anecdotal evidence and local Illinois legend today credit Dr. Anna Pierce Hobbs (1808–1869) of Hardin County, Illinois as the first European American to learn the cause of the illness in the 1830s. She was told about the plant's properties and its effect on humans by an elder Shawnee woman, who had deep knowledge of herbs and plants in the area. Familiarly called Dr. Anna in her community, Hobbs had come to the Illinois country with her parents, but returned to Philadelphia to study medicine: her studies included nursing, midwifery and dental extraction, 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 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 eaten by the cattle.

The legend says that while following the cattle in search of the cause, Dr. Hobbs happened upon an elderly Shawnee
The Shawnee, Shaawanwaki, Shaawanooki and Shaawanowi lenaweeki, are an Algonquian-speaking people native to North America. Historically they inhabited the areas of Ohio, Virginia, West Virginia, Western Maryland, Kentucky, Indiana, and Pennsylvania...

 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 saw its poisonous properties when the animal died, as she fed other plants to other calves that survived. She enlisted others in her community to dig up and eradicate the plant from their settlement. Although Dr. Hobbs had learned valuable information from the Shawnee woman and had done additional study to demonstrate proof of it, by her death in 1869, she had received no official credit for her writing about milk sickness. After her first husband died of pneumonia, Anna Hobbs married Eson Bixby (this is the surname she is now known by.)

Signs and symptoms

The illness is typically characterized by:
  • Loss of appetite
  • Abdominal pain
    Abdominal pain
    Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...

  • Violent vomiting
    Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

  • Constipation
    Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...

  • Severe thirst
  • Tremors
  • Acetone breath
  • Prostration
    Prostration is the placement of the body in a reverentially or submissively prone position. Major world religions employ prostration either as a means of embodying reverence for a noble person, persons or doctrine, or as an act of submissiveness to a supreme being or beings...

  • Delirium
    Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...

  • Coma
    In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...

  • Death
    Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....

Milk sickness today

Although the poison tremetol is not inactivated by pasteurization, 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 temetrol present in dangerous amounts. Although milk sickness is extremely rare, it can occur if someone drinks contaminated milk or products gathered from a single cow or from a smaller herd that has fed on the white snakeroot plant.

External links

Further reading

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