Nosology is the systematic classification of disease. Over the course of the nineteenth century, our understanding and clarification of diseases improved dramatically, and with it occurred a substantial increase in global human life expediency. Even so, early medical diagnostics could be rudimentary and Athenians officially died from various causes--some of which weren’t even fatal. Teething, fatigue, senility, rheumatism, and worms do not normally kill people; while listed as official causes of death, these were symptoms, not causes of death.

In order to make our death certificate data more meaningful to researchers, we have grouped our data into categories: eighteen distinctive causes of death. Our nosology is described below:

Understanding CODs

Abortion --> Death stemming from a terminated pregnancy. “An abortion induced at home by the woman herself was the most invisible to observe at the time and remains so to the historian now,” claims historian Leslie J. Reagan. Death certificates and mortuary records, however, reveal abortion cases by documenting maternal mortality rates. The death certificate of Emmie Sue Edwards, for example, lists the official cause of death as "septsis following abortion." Her private actions became a public record after her death on April 16, 1923. A nineteenth-century woman seeking to terminate a pregnancy oftentimes ingested herbs, poisons, or other medicines to induce early labor, expel the fetus, and restore menstruation. While less common, other women inserted instruments, often mundane household tools or objects, into their uteruses to achieve the same result. In addition to terminating a pregnancy, such abortions could kill women.

Accident --> Occurring without intent and unrelated to personal health, this category includes transportation accidents, house fires, unintentional falls, accidental drownings, and other workplace injuries. For example, four-year-old Tomas Cleveland was playing with fire in July 1924; “third degrees burns of body” killed him. Automobile and train accidents killed, too. A concussion, sustained in a car accident on January 5, 1927, ended the life of George Middlebrooks. Many deaths recorded within this category were workplace accidents. Thirty-six-old Austin H. Vaughn worked for Georgia Power Company; he died “while engaged in his occupation as lineman was electrocuted accidental.” Ambus Mckeever, an African-American laborer in his forties, was injured “due to dirt caving in on him.” Life was hard for working men, and they were dying prematurely as a result. Most of the white and Black men within this category died young, too young.

Apoplexy --> A term commonly used in the nineteenth century, apoplexy is a form of sudden death caused by internal bleeding. Today, it would be referred to as a heart attack or stroke. While very different medical conditions, the distinction between a heart attack and a stoke were blurry at best in the nineteenth century; in both cases the victim sudden became incapacitated and died. Adhering to this historical categorization system, we have included all forms of sudden death -- stoke, heart attack, brain hemorrhage, and sudden paralysis -- with this category.

Cancer --> Then as now, cancer kills in large numbers. In Athens, residents died from "carcinoma of bowel," "carcenoma of breast," "cancer of stomach," "cancer of larynx," "cancer of liver," "carcinoma of rectum," "cancer of uterus," "carcinoma of throat," and "acute limphatic leukimia." In 1924, cancer of the uterus claimed the life of Sussie Wagen when she was just thirty-seven years old. Treatment options during the late nineteenth and early-twenty centuries were primitive, and many patients failed to survive their diagnoses.

Cardiovascular Disease --> This broad category includes all heart ailments and heart conditions, excluding sudden heart attack. Included are conditions such as “myocarditis,” “angina pectoris,” “valvulor heart disease,” and “cardiac dropsy.” Sixty-five-year-old Ida Mayfield, for example, died from “organic heart trouble” on July 24, 1925. Lizzie Smith, meanwhile, died from "heart dropsy" on July 27, 1923.

Diabetes --> This disease effects how the body processes blood sugar, or glucose. In 1877, Doctor William Morgan defined it “as the secretion of an inordinate quantity of sweet-tasting, violent-smelling urine; accompanied with great thirst, dryness of skin, extreme debility, and general emaciation.” In 1922, both nineteenth-year-old Elizabeth Amy Coile and fifty-seven-year-old Martin G. Greenway died from diabetes.

Illness or Infection --> This broad category includes myriad virial and bacterial infections, including “influenza,” “meningitis,” “pneumonia,” "Septicemia," "typhoid fever,” and “whooping cough.” The 1919 flu season claimed the lives of Milas Irving, William Lloyd Smith, and Josie Moss. At just two years old, diphtheria killed Corene Odoms. Today, vaccines prevent some of these deaths, but influenza and pneumonia still kill thousands of Americans each year.

Kidney Disease --> Cases of “nephritis” and “Bright's disease” comprise the bulk of this category. Richard Glenn, an eighty-five-year-old, African-American laborer, died from “acute nephritis” on August 4, 1923; he is buried in Spaulding Cemetery. Glenn, like many within this category, were older adults at the time of their deaths. In addition, we have included “uremia”—blood in the urine; this symptom is often indicative of kidney disease.

Natural Cause --> Deaths not caused by disease, illness, or other external means; individuals within this category died of old age or an undiagnosed aliment. According to her death certificate, Susan Derricott died from “Old Age;” she was 100 years old. Others within this category died from “natural causes;” we do not know the particulars of their demise, and, therefore, they are included here.

Neonatal --> “Premature birth” and “stillborn” are leading causes of death in Athens, Georgia. Infants within this category died during or soon after birth from “congenital malformation,” “inanition,” or “starvation.” The son of Rilly Pittard, for example, was born premature at seven months; he died just four days after birth. Odessa C. Singilton also lived just four days; she died from an “infection [contracted] through [the] umbilical cord.” Cases of unintentional milk poisoning and starvation are also included within this category since these mothers did not intentionally harm their infants.

Neurological Disorders --> Disorders and conditions relating to brain or mental health. “Convulsions,” “dementia,” “congestion of brain,” and “encephalitis” are frequently occurring causes of death within this category. Likewise, “insanity” is included here. Myrtle Lee Adair, for example, died from “Acute Insanity” on January 9, 1921; we do not know precisely what condition plagued the twenty-nine-year-old woman. While occasional attributed to “insanity” or “derangement,” suicide cases are not included here; those sad ends are listed in the “Unnatural Death” category.

Pregnancy --> Childbirth was deadly in the nineteenth and early twentieth centuries. Any number of things could and did go wrong—postpartum shock, puerperal septicemia, hemorrhaging, toxemia, and eclampsia. And women frequently died from such complications. Twenty-one-year-old Elizebeth Tripp died from “Puerperal Septicemia following the expulsion of [a] dead fetus.” A “pospartum hemorrhage” ended the life of Etta Boswell on February 29, 1923. After an hour in labor, thirty-three-year-old Lorane Weatherly slipped into a coma and died.

Respiratory Disease --> Aliments of the lungs, including “asthma,” “bronchitis,” and “empyema.” A “lung abscess” killed fifteen-year-old Florrie Mae Hubbard in December 1927. That same year, Ossie Mattox, an African-American domestic worker in her late forties, died from “bronchal asthma.” While effecting the respiratory system, lung cancer is not included here; we have categorized it as “cancer.”

STD (Sexually Transmitted Disease) --> STDs were not a commonly reported cause of death in Athens, Georgia. Nonetheless, syphilis does occasional appear on local death certificates. Mr. D. P. Patrick, a railroad worker, contracted syphilis and died at just forty-three years old. Sallie Mae Jones was a far sadder case study; the infant, infected at birth with syphilis, died a mere ten hours later.

Stomach Aliment --> This category includes a broad array of stomach ailments, including “gastritis,” “perforated gastric wall,” and “peritonitis.” Some officially listed causes of death (such as “acute indigestion”) are more likely symptoms of another deadlier disease, but without additional details these cases were included within this category.

Tuberculosis --> Tuberculosis, or consumption as it was often called in the nineteenth-century, is a deliberating bacterial infection effecting the lungs. Those infected experienced coughing, chest pains, difficult breathing, and a loss of appetite. Associated with pale-skin and wasting away, the aliment had certain-genteel, sentimentalized characteristics; it was the aliment of the wealthy and well-associated. It killed writers, it killed poets, it killed philosophers; John Keats, Jane Austin, Emily Brontë, and Henry David Thoreau all succumbed to it. But, in fact, it was a painful way to leave this world, as Athenians Ferdie Cook, Martha Eberhart, or Ada Gray would have attested, had they survived. But tuberculosis killed them.

Unnatural Death --> Death by external or internal, often violent, means. Beatris Jackson died from a “pistol shot in breast administered with homicidal intent.” Kelly Stephens Herring drank himself to death with whiskey. A murder victim, Columbus Foley was “cut to death.” Mary Bimett, meanwhile, was “killed by axe” in 1922. Feeling like he had no choices left, Jack Mortimer ingested “cyanide potassium [with] suicide intent.” Hugh Abercrombie died from a self-inflected gun-shot wound to the head. And Walter Teasly was “stabbed in heart.” Indeed, these were ‘bad ends’ resulting from suicidal acts, homicide, and substance abuse.

Other --> Some causes of death defy classification. Most of these are illnesses or medical conditions not commonly occurring enough to warrant their own category. Dysentery is one such example. An bacterial infection caused by contradicted water or food, the patient suffered (and died) from bloody stools. This category also includes men and women who died from rabies, small pox, sun stroke, pellagra, uremia, hernias, and other uncommon aliments. Likewise, those adults who supposedly died from “cold,” “rheumatism,” “malnutrition,” or “inanition” are included here; these are most likely symptoms of a more serious condition, rather than the sole cause of death. In other cases, we simply cannot be sure what precisely killed the victim. An unknown African-American woman was “Found in marsh. Found dead in satchel in small branch.” We can speculate, but we cannot know how she died.

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