A cycle of high fever and shivering chills, often occurring seasonally was understood by people in nineteenth century America as ague (pronounced "aaag"). Ague occurred regularly in the autumn, particularly after a wet summer, and was often a chronic condition for people who had recently settled in the frontier lands. As with many illnesses, it was believed that ague arose from toxic miasmas. Dark humor of the day offered the following anecdote surrounding the regularity of the illness and its bodily impacts:

How would you like to live in a place where a manÕs salutation to his neighbor of "good morning, sir" is immediately followed by the query, "is this your day for shaking, sir?," and "no, bless the Lord! I donÕt shake till to-morrow," or the day after, as the case may be, it being periodical in its attacks, amusing some every day at a certain hour, others on every second or third day. (1)

A patient with ague would be treated at home with a variety of possible treatments, sometimes as simply as a hot fire during periods of chills and a wet sheet during times of fever. The only reliable relief against ague was the introduction of quinine pills in the 1820s which helped relieve the symptoms, although it caused queasiness and one's ears to ring. Other approaches included purgatives such as calomel, rhubarb or castor oil which sought to expel the illness from the system by interrupting its rhythms. If a doctor was called, they might prescribe more treatments in addition to bleeding the patient. Several patients died of acute cases of ague, while many lived with ague as a chronic condition. Whole areas might be characterized by thin, gaunt people where unhealthy miasmas were located.

Note

1. Valencius, Conevery Bolton. The Health of the Country: How American Settlers Understood Themselves and Their Land. New York: Basic Books, 2002. p. 80.