The Black Killer
An excerpt from Saddlebag Surgeon by Robert Tyre
Manitoba Pageant, September 1959, Volume 5, Number 1
Doctors, especially rural practitioners, blessed the year 1898 for the weapon it brought them to combat the scourge of black diphtheria antitoxin. Before the discovery of the antitoxin the dread disease killed without hindrance and in its presence the doctor was like a firefighter called to quench a blaze with a cup of water.
The bacillus of the disease did its dirty work in the air passages and throat. Nearly everyone who was stricken died, and it was brutal death. Murrough O'Brien, like other doctors, dreaded to encounter "the black killer".
"Nothing was more frightful than to come into a home and find the cruel symptoms of diphtheria the high temperature, the gasping for breath, the inflamed tonsils and the blue skin, there wasn't much I could do for the patient. Sometimes I cut a hole in the trachea to let them breathe. After that they were in the hands of God.
"When the antitoxin first came into use in 1898, the health department in Winnipeg was not too sure how many units of the stuff represented a curative dose. One French-Canadian doctor in a Manitoba municipality was also not aware that the antitoxin was to be administered intramuscularly. This fellow let some of his patients drink the antitoxin. He was considerably vexed when his mortality rate for diphtheria registered no decline.
"Deciding it was better to give too much than too little, I always gave my diphtheria patients liberal doses of the antitoxin.
"I was called to a farm home one day and arrived to find two members of the family dead. A third died ten minutes after my arrival, and fourth went fifteen minutes later. One girl, about twelve, was in a pretty bad way and over a period of twelve hours I gave her eighty thousand units of the antitoxin. She recovered. I wrote the health department to request more antitoxin and they gave me blazes for using up my first supply too fast. It was finally determined that a curative dose was thirty thousand units."
One day when the spring thaw was in full flood and the countryside better suited for travel by boat than horse, a distraught rider, soaked by the splashing of his horse's hooves, pounded up to the doctor's door to cry the news of an emergency. "My girl sick in neck! Come quick, doctor!"
Murrough dressed himself in oilskin and rubber boots and saddled Dandy. It was a long trip. For fifty-six tedious miles the horses sloshed through the sticky mud of country lanes or waded through the fetlock deep water of flooded grain fields.
"I reached that farmhouse to find the man's daughter in the last choking stages of diphtheria. There was nothing for it but to do a hurried tracheotomy. But first I gave her a huge dose of antitoxin. Then I opened the flesh of the throat and cut a hole into the wind pipe to let air reach her labouring lungs. And then I discovered that I had forgotten to include a trachea tube in my equipment. And that was one heck of a note. I sent the farmer back to my office to get one. Told him where to find it and what it looked like. In the meantime I had to devise something to keep that emergency air passage open. Finally I hit upon an idea when I saw a bunch of hairpins lying on a dresser in the girl's bedroom. Bent two of them into the shape of a pair of fish-hooks and joined them with a string. Then I circled the patient's neck with this contraption and used the hooks to keep the flesh of the wound open.
"Next problem was to keep the opening free of mucous until the farmer returned with the trachea tube. The answer was supplied by the cackling of geese in the farmyard. Anyone going by that farm during the next ten minutes would have seen a hot perspiring doctor in cussing pursuit of an elusive goose. I finally trapped one in the barn and plucked a dozen of its feathers. Used the quills to dig out the mucous and they worked fine.
"The girl made a good recovery but I was informed that her father blew up and burst with indignation when he got my bill for twenty dollars. He said, according to my informant, that I had one heck of a nerve to ask for money after putting him and his horse to the trouble of going all the way back to my office to fetch something I hadn't sense enough to take with me."
While the antitoxin achieved some remarkable results among patients in various stages of diphtheria, the doctor tried to make town and municipal authorities understand that prevention was better than cure, and that inoculation was the only sensible way to stamp out the disease.
"But I couldn't get it through their thick heads. Every time I asked for authority to enforce inoculation of the residents of the town and municipality, they fussed and fidgeted and said it would be better to wait for a while.
"Well, they waited too long. One of the worst outbreaks of diphtheria occurred early in the summer of 1898 and the casket-maker had to hire two helpers to keep pace with the demand. Among the victims were children of the reeve and four of his councillors. Authority was given me then to begin a campaign of immunization.
"I didn't have much trouble convincing most of the people that the prick of a needle was a much pleasanter sensation than the strangling grip of diphtheria. However there were a few who flatly refused to take the inoculation. One fellow met me at the door with a rifle in his hands. I did not argue the point. Another time I was chased out of a yard by a woman wielding an axe.
"We took strong measures to. make these rebels capitulate. Their homes were put under quarantine and special constables were appointed to see that they did not leave their yards. The resistance lasted only a day or two and then they meekly agreed to take the needle."
Page revised: 30 June 2009