In her letter to her son, Henry, Eliza has learned of the Scarlet Fever epidemic in Natchez in 1848, and writes that the disease is spread “by the touch and clothing not by the air.” While it is true the disease is spread by touch, scientists have since learned that it is also spread by inhalation.
In the early Victorian period disease transmission was largely understood as a matter of inherited susceptibility (today's 'genetic' component) and individual intemperance ('lifestyle'), abetted by climate and location, which were deemed productive of noxious exhalations (a version of environmental causation). Water and air-borne infection was not generally accepted.
Much of what Eliza recommends in her letter can be attributed to the 1848 edition of Buchan’s Domestic Medicine, which showed the symptoms of smallpox, scarlet fever and measles and:
“[L]isted among the general causes of illness 'diseased parents', night air, sedentary habits, anger, wet feet and abrupt changes of temperature. The causes of fever included injury, bad air, violent emotion, irregular bowels and extremes of heat and cold. Cholera, shortly to be epidemic in many British cities, was said to be caused by rancid or putrid food, by 'cold fruits' such as cucumbers and melons, and by passionate fear or rage.
Treatments relied heavily on a 'change of air' (to the coast, for example), together with emetic and laxative purgation and bleeding by cup or leech (a traditional remedy only abandoned in mid-century) to clear 'impurities' from the body. A limited range of medication was employed, and the power of prayer was regularly invoked.”
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