Leading Causes of Death for Americans in 1900

While railroad travel was relatively safe in the first half of the 19th century, increases in speed, industrial growth, and expansion contributed to significant railroad accident deaths. One such accident was in 1896, when two trains collided in Atlantic City, New Jersey, killing 50 people.

Peritonitis is an umbrella term for inflammation in the lining of the abdomen. The disease can emerge from a variety of sources including complications following a ruptured appendix, bacterial entry during surgery, and bowel abscesses. Today, peritonitis is often treated with intravenous antibiotics and emergency surgery, but at the turn of the 20th century, treatment options were limited and risky, leading to increased mortality rates.

A hallmark of whooping cough is the cacophonous “whoop” sound infected patients make while gasping for air after coughing. The disease, medically known as pertussis, is caused by the bacterium Bordetella pertussis. Infected infants are particularly at risk, and prior to the development of a pertussis vaccine in the 1940s, the disease was a leading cause of childhood death in America.

Dropsy, known today as edema, is the swelling caused by fluid retention and imbalance. Dropsy stemmed from one of four main causes: heart, liver, or kidney failure or malnutrition. Doctors often diagnosed patients with dropsy after seeing a distended abdomen. Historically, the disease was treated using archaic methods like bleeding, leeching, and lancing, in attempts to drain the excess fluid mechanically.

Inanition refers to symptoms resulting from starvation and malnutrition. Inanition was prevalent across populations during the turn of the 20th century, often co-occurring with other diseases like tuberculosis. Deaths from inanition increased from 1890 to 1900, and starvation still contributes to many deaths in developing nations globally.

“Diseases of the brain” were wide-ranging, including aphasia and hydrocephalus. While brain diseases were common, some specific diagnoses were rare prior to the maturation of the neurological field. Following the Civil War, the clinical practice of neurology began in America, with universities forming neurological institutions in the early 1900s. The field is now highly specialized, and brain diseases Alzheimer’s and other forms of dementia, increasingly prevalent among seniors, are the subject of much research.

“Diseases of the liver” included conditions and symptoms like jaundice, inflammation and abscesses. These diseases are caused by a variety of agents; some stem from the bacterium Leptospira hemorragica, some result from blood toxin build-ups, and others from unknown causes. The liver is the body’s filtration and detoxification system, so agents that alter liver function can be dangerous and deadly for the body.

While the more serious complications of croup are currently tempered by the Tdap vaccine given to young Americans, severe cases once lead to many deaths of children under five. Croup often resulted from a diphtheria infection, causing inflammation of the larynx and blockage of the airways. A marker of croup is a seal-like barking cough.

Measles is a highly transmissible viral disease that can lead to death, particularly in young children. Prior to the development of a measles vaccine in the 1960s, measles was very common, with hundreds of thousands of cases across the world. Following vaccination efforts, measles was nearly eradicated within the U.S., though cases amongst unvaccinated populations still occur.

“Diseases of the stomach” and gastritis are overarching terms for conditions that cause inflammation of the stomach lining. This inflammation may lead to ulcers and stomach cancer. From 1890 to 1900, deaths from diseases of the stomach increased. Today, mild gastritis is relatively common, and may be treated with antacids. Severe, long-term gastritis is more serious, and can lead to complications.

In 1890 and 1900, premature birth was a high risk for infants. Hospital infrastructure did not allow for the technology like ventilators and warming beds, later used to address the problem. While incubators for newborns were invented in 1890, they were not utilized until years later. As the decades progressed, significant progress was made in saving the lives of premature babies.

While malaria is not currently endemic to the United States, the disease was prevalent in the country in the late 19th century. During the Civil War, malarial fevers killed thousands of Union Army recruits. Malarial infection, which is caused by a parasite transmitted by mosquitoes, disrupts the immune system, causes malnutrition, and can lead to cognitive impairment.

Around the turn of the 20th century, convulsions referred to involuntary muscle spasms that often stemmed from fevers or a lack of oxygen. During this time in U.S. history, convulsion deaths were most prevalent among young children, with 70% of deaths occurring under the age of one, and 90% under the age of five.

Diphtheria is an extremely contagious bacterial disease that is particularly risky for children. Complications from respiratory diphtheria can result in nerve damage, paralysis, airway blockage, and kidney failure. Modern cases of diphtheria have dropped in the United States due to immunization efforts, though cases still exist globally.

Though the severe 1918 “Spanish Flu” pandemic had not yet occurred, influenza was still a prominent cause of death at the turn of the 20th century. Influenza is a viral illness that prompts symptoms like fever, chills, body aches and sometimes lung issues. Without fever-relieving medication, patients with influenza were at greater risk of death.

Debility and atrophy refer to the deterioration of muscle, as well as weakness, that occurs with old age. At the turn of the 20th century, these terms were applied to a wide range of conditions that were all associated with old age, some thought to lead to death. While these terms were listed as causes of death at that time, contemporary records would likely list more specific conditions, like osteoporosis.

Bronchi are tubes within the lung that help transport air. Bronchitis refers to inflammation of the bronchi, a condition that often occurs following a lung infection. Bronchitis typically presents with flu symptoms and a deep cough that can persist for weeks.

Paralysis was used to describe loss of sensation and voluntary function of one or more parts of the body. While the term “paralysis” may cover several conditions, records are unclear about which specific diseases the 1890 and 1900 censuses refer to. General paralysis of the insane was associated with syphilis-induced loss of bodily control.

Many infants died from cholera infantum, a disease whose cause was questioned by doctors at the turn of the 20th century. Some surmised it was the result of exposure to excessive summer heat, while others pointed to overfeeding. Afflicted infants experienced vomiting and diarrhea, a dangerous combination for a young child.

The meninges is a membrane that wraps around the brain, and when inflamed, creates a condition referred to as meningitis. Meningitis can be caused by bacteria, viruses, amoebas, parasites, and non-infectious agents. A vaccine was developed to prevent bacterial meningitis, which helped to lower cases, but some forms of the disease are still dangerous today.

Apoplexy, known today as stroke, is specifically bleeding into or loss of blood flow to the brain. At the turn of the 20th century, doctors first associated apoplexy with burst blood vessels in the brain, coinciding with a sudden loss of consciousness or movement. Stroke remains one of the leading causes of death in the United States today.

There is varied information on what was historically classified as an “old age” cause of death. Now, modern-day coroners and doctors are trained to specify a cause of death, such as cardiac arrest or pneumonia, rather than using that term. During the 1890 and 1900 censuses, the greatest proportion of old age deaths were in the age group 80-84 years old, for both genders.

While cancer is currently the second leading cause of death in the United States, the disease was also prominent at the turn of the 20th century. In the 1890 and 1900 censuses, the greatest proportion of men’s cancer was stomach cancer. For women, uterine cancer was the most prevalent. Today, the most common type of cancer is breast cancer, followed by prostate and lung cancer.

Poor sanitation contributed to typhoid fever, a disease caused by the bacterium Salmonella typhi. Symptoms include fever, headache, diarrhea, and a rash. In the early 20th century, “Typhoid Mary” famously spread the disease across New York, despite being mostly asymptomatic. While typhoid fever still exists, patients in the United States have typically traveled to a foreign country where sanitation infrastructure is lacking. Today, there are vaccines available that help prevent the disease.

Kidney function in the body is extremely important, as the organ helps regulate excretion. Bright’s disease, now known as nephritis, is an inflammation of the kidneys, stemming from a variety of causes, like autoimmune disease or infection. Without modern medicine, including processes like dialysis, those who were afflicted by kidney disease at the turn of the 20th century were at far greater risk of death than they are today.

The medical field and scientific communities continued to make strides at the turn of the 20th century, but specialized disease diagnoses were lacking compared to contemporary methods. This may account for how high unknown-cause-related deaths ranked in 1890 and 1900.

Diarrheal diseases were rampant in the 19th and 20th century, stemming from poor sanitation, crowded living conditions, and lack of water filtration infrastructure. Treatment methods were limited, and young children were particularly at risk. Diarrheal disease is still one of the leading causes of child death globally.

Between 1890 and 1900, heart disease had the biggest increase in deaths, and continued to increase throughout the decades, peaking in the 1960s. While deaths due to heart disease have decreased since then, it is still the leading cause of death in the United States, followed by cancer and COVID-19. Heart disease includes pericarditis, congestive heart failure, and coronary artery disease,

Pneumonia can come in a bacterial or viral form, but in either case is the accumulation of fluid in lung air sacs, along with a suite of flu-like symptoms. Pneumonia was one of the leading causes of death for centuries, and prior to the 1900’s, the disease was challenging to treat. In the 1930’s and 40’s, a series of game-changing antibacterial treatment methods, such as penicillin, provided relief for many sufferers.

Referred to as “phthisis” in ancient Greece, and later known as “consumption”, tuberculosis was a common disease during the late 19th and early 20th century, afflicting large portions of the population. The disease is caused by the bacteria Mycobacterium tuberculosis, which infects the lungs, but can also attack many other parts of the body, including the kidney, spine and brain. Tuberculosis remains an issue in some parts of the world, particularly amongst those who are immuno-compromised.