On February 27, 1842, Jerusha Howe died from tuberculosis. It was a disease she had lived with for years, with bouts of remission. Tuberculosis, also known as consumption, phthisis, the “White Plague,” and the “wasting disease,” is a chronic, infectious disease.

Tuberculosis symptoms include fever, chills, cough, fatigue, loss of appetite, and weight loss. Though dreaded as a disease, it was also romanticized in the 19th century. Tuberculosis symptoms enhanced features that were seen as attractive in women in the 19th century: pale skin, thinness, “sparkling eyes,” rosy cheeks, and red lips.

Tuberculosis was the most frequently cited cause of death in adults in the United States in the late-18th century. When Jacques Pierre Brissot de Warville wrote about his travels in 1788 - 1789, he said that “of all the diseases in the United States consumption undoubtedly wreaks the greatest ravage.” He wrote extensively on the problem in Philadelphia, yet tuberculosis was as common in small towns as in cities.

In 1850, approximately 85% of the United States population lived in rural areas. Like Sudbury, rural areas were known as relatively healthy places to live and life expectancy was higher than in crowded cities like Boston. Prior to 1882 when Robert Koch discovered the bacteria causing tuberculosis, M. tuberculosis, it was thought that it was contracted by “miasmas,” or bad air. New England practices in the 17th and 18th centuries may have aided the transmission of tuberculosis in rural settings. Ventilation in homes decreased dramatically in winter, and American doctors were opposed to open windows and fresh air, even in warmer months.

In 1842 Sudbury’s town doctor, Dr. Thomas Stearns, reports in his journal on January 31st:

“There has been much sickness this winter and no less than eight deaths have occurred, the greatest mortality for one month ever known in the town.”

By February 17th Jerusha’s death added to that tally, and by April 4, 1842, Jerusha’s mother too would die, bringing the death toll to fourteen, a significant number for a town with a population of 1,422.

Victims can live with tuberculosis for years. There could be periods of remission which left a life of uncertainty for the afflicted, though many married and had children. Could Jerusha’s illness have been the reason she chose not to marry? Or, was she busy with the family business at the Inn?

Two weeks before her death, Sarah Chaplin wrote to Jerusha:

“I am sorry to hear dear Jerusha,” she began, “that you are so unwell – and hope that as you have many times been ill, and again, made comfortable, that you will when the spring opens find yourself improving…”

Along with the letter, Sarah sent Jerusha guava jelly to help with her cough.

There was not much in terms of medical advice for those with tuberculosis. The middle and upper class could afford time to rest and heal. In the early 19th century, a woman like Jerusha would have been advised to stay home in order to regain health. Men on the other hand, were advised to travel in search of a cure. Sanatoriums offered fresh air and healthful food. It is not known whether Jerusha traveled to a sanatorium for her illness, or if she received treatment from a doctor.

One may think that tuberculosis has been eradicated in the 21st century, however, it is estimated that about one-third of the world’s population carries the tuberculosis bacteria. More than 90% of those infected have latent tuberculosis that will never develop into the active form of the disease. They experience no symptoms and cannot spread it to others.