Ague in Ann Arbor
When malaria was a menace
by Laura Bien
Don't go to Michigan, land of ills;
The name means ague, fever, and chills.
-Popular nineteenth-century saying
In September 1824 a twenty-year-old Irish immigrant, Walter Oakman, bought 123 acres of land near Ypsilanti. Thirteen days later he died of malaria. His was the first death recorded in Washtenaw County.
In 1829, according to the Portrait and Biographical Album of Washtenaw County, Michigan, schoolboy Daniel Hiscock helped his family clear land for a farm northwest of Ann Arbor. According to the Album, Hiscock "assisted his father in clearing the farm, grubbing stumps for other people, and drove a team comprising four yoke of cattle, at the same time shaking like a leaf with the ague."
In 1831 Pennsylvania immigrant John Ansley collapsed on the side of the road to Ann Arbor. "We had not accomplished more than half our journey," his wife, Philena, later wrote, "when my husband was taken with the fever and ague, and was obliged to lie down by the roadside and wait the approach of some person with a team, or until he should be able to proceed on foot."
The disease the settlers called "the ague" ("aig-yew"; from the Latin febris acuta, "sharp fever") is one of the oldest known human plagues, described by Herodotus. It's now known as malaria--and it still afflicts up to half a billion people worldwide. Though now largely confined to the tropics, in the infant United States malaria was common as far north as New England. Endemic in then-swampy Michigan, it was a leading sickness in nineteenth-century Washtenaw County.
Anson Van Buren, who settled in Calhoun County in 1836, described the disease as a chill that "crept over your system in streaks, faster and faster, and then colder and colder in succeeding undulations that coursed down your back." The chills caused shaking so violent that "the dishes rattled on the shelves against the log wall." Afterward came fever, sweat, and relief. Then the cycle repeated, sometimes for months.
Farmers scheduled their lives around the sickness,
saving strenuous tasks like plowing for "well" days. On "ague" days, even professionals found it hard to work, as a justice of the peace learned when he was struck by the fever when he was scheduled to officiate at a wedding. "In the morning he attempted to fortify himself by taking a large dose of quinine and at noon repeated the precaution by taking a larger dose, and by the time the wedding party arrived, the justice was delirious," noted the 1880 Michigan Historical Collections. The official was "taken to the well and drenched with cold water, and for a short time, consciousness returned, and seizing that moment the parties were married."
Made from the bark of the Peruvian cinchona tree, quinine subdued malaria's worst symptoms. But for most of the nineteenth century it remained scarce and expensive, so people tried all kinds of alternatives. One Michigan doctor wrote that he found "a tea or decoction made from the poplar and iron wood bark to answer a very good purpose." The same physician also made a "cure" with tarry extract of butternut bark--though he admitted that patients who tried it often told him "that they much preferred the disease to the remedy."
Ann Arbor druggist A. W. Chase's famous 1863 compendium Information for Everybody offers no fewer than a dozen do-it-yourself ague cures, one brewed from mandrake root and another supplied by a clairvoyant. Many commercial cures concocted by nostrum-mongers contained quinine in more or less random amounts, adulterated with substances ranging from wintergreen to molasses. Rhodes' Fever and Ague Cure vowed to protect "any resident or traveler . . . from any ague or Bilious disease whatever, or any injury from constantly inhaling Malaria or Miasma." Chemist O. L. Churchill reported that the Rhodes "cure" contained no quinine but only charcoal, glucose, alcohol, iron, and muriatic acid-a corrosive today used to "pickle" steel and make mustard gas. Even worse was the Anti-Chill Pill, whose recipe contained arsenic. No wonder some sufferers opted instead for a curative slug of whiskey, one man regarding it as "necessary as a means of keeping off the pond ague."
From 1868 to 1882, forty-eight county residents died of malaria. Because the cold-tolerant strain that was likely prevalent here has a fatality rate of around 1 percent, thousands may have been infected. In 1887 the Ann Arbor Business Men's Association published a guide to Ann Arbor that declared, "The whole place is entirely free of malaria." But in fact, more than sixty years after Walter Oakman's death, many still suffered from the disease. That year, nearly every edition of the weekly Ann Arbor Courier carried an ad for Tutt's Pills--"In malarial districts their virtues are widely recognized, as they possess peculiar properties in freeing the system from that poison." A competing product, Ayer's Ague Cure, was advertised in the issue of August 3, 1887. Even ten years later--on June 4, 1897--the Ann Arbor Argus contained a large ad, headlined "Shakes," for Scott's Emulsion of Cod-Liver Oil with Hypophosphites, to combat "a genuine malarial chill."
By then, though, the worst was over. By 1890 large-scale cinchona cultivation was under way in Indonesia, making quinine much cheaper. And in 1897 British officer Ronald Ross made the discovery--for which he won a 1902 Nobel Prize--of the malarial role of the anopheles mosquito. Malaria, it turned out, was caused by the microparasite Plasmodium cycling between humans and mosquitoes. Though a vaccine remains elusive to this day, Ross's discovery showed how malaria could be controlled by draining mos-quito breeding sites and applying pesticides. With many of Michigan's wetlands already drained for agriculture, the infectious cycle was soon broken in Michigan.
Then, in 1925, the U-M brought it back. Austrian psychiatrist Julius Wagner-Jauregg had found that high malarial fevers seemed to alleviate the symptoms of advanced syphilis. The discovery earned him a 1927 Nobel Prize, the second of four Nobels eventually awarded for malaria work. Following the New York State Psychiatric InŽstitute and the Mayo Clinic, the U-M began a program of "malarial fever therapy," in which patients were injected with malaria-contaminated blood. It remained the state-of-the-art therapy for advanced syphilis until penicillin supplanted it after World War II.
In 1947 the newly organized Communicable Disease Center (forerunner of today's Centers for Disease Control and Prevention) launched a nationwide campaign to eradicate ma-laria. Through application of the pesticide DDT to millions of rural homes, malaria was eliminated as a significant public health problem in the United States within two years.
Similar eradication efforts in tropical countries failed, however, and were eventually abandoned. The CDC estimates that malaria still kills a million people a year, most of them young children in sub-Saharan Africa. Only in the past few years has the infection again become a global public health focus.
Last year, United Nations secretary general Ban Ki-moon called for making insecticide-treated bed nets and other malaria-control measures available throughout Africa by the end of 2010. It's an ambitious goal, but if it succeeds, the "ague" may eventually be a historical footnote not just in Michigan, but worldwide.
[Originally published in March, 2009.]