Elizabeth R. McNair's Passing - A Victorian Medical Dilemma

A Painful Cause

In The Sudden Death of Mrs M. M. McNair, I shared that cause of Elizabeth's death was implied as "She had never fully recovered from the effects of a fall last winter in Minneapolis."

In researching records, I discovered the official Registration of Deaths which stated Elizabeth's death had been caused by a perforation of her stomach which had lingered from an "old ulcer."

This is unfortunately quite a lingering and painful death for Elizabeth to suffer.

About Ulcers in the Victorian Era

"A particular challenge is an explanation for the emergence of perforated peptic ulcers in young women during the period 1850–1900 and a sharp decline during the period 1900–1920. In the article in the Lancet, this was attributed to 'something in the environment or in the mode of life.' The majority of these women were under the age of 25 with chronic gastric ulcers. In addition, it was noted that perforation was rare in pregnancy. In a contemporary study in the Colombian Andes, girls had a lower frequency of acquisition of H. pylori than boys, perhaps because girls had less exposure to contaminated water. If this applied in the second half of the 19th century, girls and young women might have been the first group to have delayed acquisition of the infection." ~ Ian C. Roberts-Tomson

How Elizabeth's ulcer would have been treated in 1910

"Very few take into account the subsequent condition of the patient with regard to relapses of the symptoms. This discrepancy indicates that collections of cases of this sort are of relatively little value in comparing the efficacy of various modes of treatment. There are several reasons for this. The diagnosis of gastric ulcer presents great difficulties, and in a large number of cases is impossible. The disease is very variable, both with regard to the condition of the ulcer, its position, extent, and external adhesions, the associated gastric disturbances of motility and secretion, and the condition of the gastric mucous membrane with regard to the presence or absence of gastritis. Acute and chronic ulcer are usually not distinctly separated by the observer. The constitution of the patient must also be taken into account. As in health there are individual idiosyncrasies of diet, so in disease a diet suitable for one patient may be unsuitable for another."

Sources

cited from Remarks ON SOME POINTS IN THE TREATMENT OF GASTRIC ULCER
cited from Rise and fall of peptic ulceration: A disease of civilization? ... published August 27th, 1910