In The Patriarch, John and Ambrosia Casper suffer the heartbreak that came to so many young parents in the 1800s. Their first born child, Johnny died suddenly. The illness, “The Summer Complaint,” always came on during the hot summer months.

As John relates it in The Patriarch: “He spit up everything at first. Then, his diapers smelled like rotted wood, just putrid. Then came diarrhea and a high fever we couldn’t bring down.” Their doctor said “I could tell when I walked into this room. The boy has the Summer Complaint”…“Cholera Infantum.”

From about 1800 to about 1870 in America, the leading causes of child and infant mortality from disease were tuberculosis, diarrhea of infancy, bacillary dysentery, typhoid fever, and contagious diseases including scarlet fever, diphtheria and lobar pneumonia. The Summer Complaint was considered one of the diarrhea diseases associated with hot summer months. It was often nicknamed “disease of the season.” Not all young children who got the illness died, but many did.

Researchers have studied the causes of the Summer Complaint for decades. Excellent summary articles are included in the “For Further Reading” section below.

The likeliest cause(s) of Johnny Casper’s contracting Summer Complaint was unpasteurized cow’s milk and/or unfiltered water, rendered contaminated under the excessive heat of the summer months. Treatment options for Summer Complaint for infants and children of rural farmers were very few. Most were tended at home by whatever medical personnel may have lived in the general area, if any. For some of the most contagious diseases such as typhoid fever and tuberculosis, small, specialized homes were established (see photo below).

In scientific studies conducted in the early 1900s, researchers found that women who continued to breastfeed rarely had infants who contracted The Summer Complaint. In contrast, infants whose mothers shifted to bottle or spoon feeding of cow’s milk were far more likely to contract the disease during the summer months.

For further reading:

Anderson, M., Rees, D. I., & Wang, T. (2019, March). The Phenomenon of Summer Diarrhea and Its Waning, 1910-1930. I. Z. A. Institute of Labor Economics Discussion Paper Series. Retrieved at http://ftp.iza.org/dp12232.pdf .

Shulman, S. The History of Pediatric Infectious Diseases. Pediatr Res 55, 163–176 (2004). https://doi.org/10.1203/01.PDR.0000101756.93542.09

Typical small home for children ill with typhoid in the 1800s.