By Claire Schen

At the corner of Zimmerman and Boston State Roads in North Boston, NY, stands a new historic marker memorializing an outbreak of typhoid fever in 1843. This bright marker replaced a dark-colored, densely-worded one that had been like wallpaper during my childhood in the Southtowns: ever-present, but not closely studied. This changed in the spring of 2022 with the collaborative research project of a group of undergraduates at the University at Buffalo, State University of New York. The students’ digital story-telling project took us far beyond the brief story told on the historic markers.

In September 1843, a young traveler from Warwick, MA, fell ill and disembarked from the stagecoach at Fuller’s Tavern in North Boston. The traveler—identified by UB Librarian Kimberly Plassche as Ephraim Tuel Merrifield—died that October at the age of 21.  His illness and death, and the subsequent illnesses of 28 of the 43 inhabitants in North Boston, perplexed local physicians in both allopathic (biomedical) and Thomsonian (botanical) medicine. The 10 people who died were all younger than 23 years old. 

Dr. Austin Flint, a founder of the Buffalo Medical College, now the Jacobs School of Medicine and Biomedical Sciences, investigated the outbreak in the rural town at the behest of Erie County superintendents of the poor. The fact that some families experienced no illness and did not need to—or were forbidden to—use the well at Fuller’s Tavern created a control group for Flint, and led him to pinpoint the well as the source of contamination and disease. His investigation was a form of contact tracing, noting the distance of “attacked” families from the water source, as well as surnames and ages.

Typhoid Fever—the cause of Merrifield’s death—was unknown in Western New York in the 1840s. No one had identified its causes or how it spread. In the 21st century, researchers know that typhoid is caused by salmonella typhi, and contracted either through close contact, person-to-person, or through food or water contaminated with the bacteria, through oral-fecal contamination. But in the 19th century, theories connecting water-borne contamination and disease were slow to gain acceptance over longstanding perceptions that bad air, miasma or bodily humors were the cause of illness. 

The evidence from Flint’s study of typhoid in Western New York, along with similar analyses done around the world of water-born fevers and illnesses, would eventually cement new medical theories. In the mid-1850s, for example, British physician John Snow famously mapped a cholera outbreak in London that centered on a Broad Street pump and contamination, and referred to Flint’s study of the typhoid outbreak in Boston for supporting evidence of a similar case. Snow’s interpretation was not embraced before his death, however, and Flint would likewise battle against other theories regarding causes and treatments. 

Flint wrote in Clinical Reports of Continued Fever (1852) that the Western New York townspeople remained convinced for more than a decade that a neighbor had poisoned the well after being forbidden to use it, thereby sickening many in the community. The townspeople explained away contrary evidence, saying the well-water had been mysteriously switched and thus the sample tested for toxins in Buffalo was clear of poison. Instead, they called on local Thomsonian practitioners, like Dr. Swain, who would have used plants to treat typhoid symptoms like fever and diarrhea or constipation.  Swain may have been the practitioner Flint hastily dismissed from treating anyone in Boston. Likewise, Ira Fuller, the North Boston tavern owner, was a local representative of a botanical medicine network spreading this popular approach to health through the Northeast around the 1840s. Flint refused to work with these sorts of “irregular” physicians, as he and other detractors called them. The Spragues, a family near the tavern with their own well, additionally had ties to spiritualism through the 19th century. Besides campaigning for evidence-based medicine over “irregular” practices, Flint rebutted spiritualism, notably by investigating the Fox sisters’ “knockings” and seances. Dr. Keith Mages, curator of the Robert L. Brown History of Medicine Collection at the University at Buffalo, suggested that the typhoid case may have stiffened Flint’s resistance to botanical or homeopathic medicine and sensitized him to spiritualism and “excesses of credulity.” He did not label this ignorance.

The students from my spring 2022 history class, “Plagues and Pandemics,” at the University at Buffalo embarked on an investigation behind the bare facts listed on the historical marker.  Their efforts resulted in a collaborative digital history research project on this medical episode, titled “Typhoid in North Boston, NY, 1843: Small Town, Big Story.” 

My colleague at UB, Professor Yan Liu, and I developed the Plagues and Pandemics course, yet we each teach it individually. Our goal is to study past epidemics around the world and to set our own pandemic experience into historical and public health perspective. My goals for the spring 2022 students centered on hands-on research, done collaboratively, and then shared widely using the digital platform StoryMaps. 

UB librarians, Ms. Kimberly Plassche and Dr. Mages, helped to bring together an “archive” of local history and Flint-related materials, as well as maps and medical implements from the UB collections. Ms. Plassche got us working with StoryMaps, since mapping and contact tracing were at the heart of Flint’s investigation. Behind the historic markers’ summaries, emphasizing the disease and its toll, the students found a rich story of a town making sense of a deadly disease in their own ways. As many historians do, the students revisited a familiar story and dug more deeply.

The original historical marker’s reference to a “stranger” conveyed suspicion of the young traveler. Yet Flint remarked that because townspeople blamed the neighbor for poisoning the well, they visited the sick man almost daily. Flint observed that “social intercourse” was the main activity for those on speaking terms, and one can imagine local inhabitants asking for information from old family homesteads in Vermont, Massachusetts or eastern New York. Historic maps plot movement—of people, their ideas and diseases. The maps marked wagon routes, “Indian trails,” canals and, eventually, railroads. One Sprague descendant claimed not only spiritualist mediums in the family, but abolitionists active on the Underground Railroad, another important “route” in the United States.

The students researched many sources, but the most substantial were Flint’s own accounts, the works of an elite professional focused on identifying disease and transmission. He used surnames of the heads of households, but no first names, making for an imprecise means of identification. Flint—or the townspeople themselves when he interviewed them—also rounded ages to five- or ten-year intervals, resulting in another imprecise identifier. No diaries or letters existed to answer 21st century questions about fears or grief over a disease so deadly to the young, nor did letters surface to tell us what anyone talked to the traveler about while he lay dying in an unfamiliar town. We could only guess his motivations for traveling west, and for college students who were of a similar age, his plans may have been especially intriguing.

Other sources demonstrated the challenges of uncovering and writing about the lives of ordinary people and the poor. A group of students used census records through a genealogical site and learned that when handwritten documents are read by machines the transcripts may be wrong; 21st century computers do not read old handwriting reliably. Students then turned to digital copies of the handwritten census pages. The census reports reveal how wealth, gender and race frequently limit the historical record. The 1840 census, for example, listed only the first name of the head of household, so often male, and used a slash to show the presence of an unnamed wife or child(ren). By 1850, the census included the names of women and children, places of origin, occupations, property values, race and whether children had recently attended school. Building networks through census research was painstaking, but it revealed information about the “ordinary” townspeople.

The typhoid project also reinforced how slowly paradigms in medicine change, and how strongly social and cultural factors shape responses to epidemics, whether in the 1840s or the 2020s. Using archival documents, gravestones, historic maps, local history, crowd-sourced genealogy and other historic markers, the students were able to tell the history of the people in this small Western New York community. They lived on the edge of what was once a contested frontier, in a time of change and radicalism during a fast-moving, deadly outbreak of typhoid. Familiar historical markers dotting our rural and urban byways and roads invite us to learn more about the stories and significance of the people and historical moments commemorated on them.

Interested in viewing the students’ project? 

Dr. Claire Schen is Associate Professor of History and specialist in Early Modern British history at the University at Buffalo, SUNY. She has published on the history of London, old age, the Reformation, poor relief, and piracy and captivity. As this collaborative project shows, she guides students to use new tools to understand the past and to communicate research findings.