Monthly Archives: April 2017

Was my Ancestor Insane or Did They Have Encephalitis?

5 blog post imageWas my ancestor insane or did they have encephalitis?

I have been researching into the death of my great great grandmother that died in 1911 at the Taunton State Hospital in Massachusetts.  Her cause of death was listed as “general paralysis.”  After researching into the hospital and the classification of her death in the previous post it is easy to first conclude that she was “insane” or had a mental instability.  The Taunton State Hospital was originally named the State Lunatic Hospital at Taunton before the name was made more PC and her cause of death falls into the category linked with the “insane” classification.

But wait, this ancestor of mine was not committed to Taunton until she was about 43 years old.  In the course of her life she was married, left England to come to American, and had at least seven children.  This doesn’t sound like a woman that did not have all of her wits about her.  Look at the cause of death classifications in Part 2 of this post; I found that they both list different forms of encephalitis along with general paralysis in the neurological category.

I have come to the conclusion that my ancestor most likely contracted a virus that caused encephalitis which led to her general paralysis and eventual death.  At the time, 1911, encephalitis was not well understood or for that matter easily tested for. So you may be wondering what exactly is encephalitis?  Encephalitis is inflammation of the brain that is caused by a viral, bacterial, or fungal infection.  The symptoms associated with viral encephalitis include but are not limited to:

  • Fever
  • Headache
  • Stiff neck
  • Confusion
  • Muscle weakness
  • Paralysis
  • Eventual Coma

Symptoms may occur within 2 days of infection or as late as 2 weeks after infection.  How does one contract a virus that causes encephalitis?  There are many different types of vectors which are living organisms, such as mosquitos, that transfer diseases from human to human or from animal to human.  I believe my ancestor could have contracted Eastern Equine Encephalitis (EEE) from a mosquito.  I find this scenario to be probable due to the current occurrence of EEE in the state of Massachusetts as compared to the rest of the United States.

Per the Centers for Disease Control and Prevention’s Technical Fact Sheet:  Eastern Equine Encephalitis, EEE is commonly found around the Atlantic and Gulf Coast states.  The states with the most frequent occurrence in 2016 were:  Massachusetts, New Jersey, Georgia, and Florida.

Below is a map of Eastern Equine Encephalitis Virus neuro-invasive disease average annual incidence by county, 2004-2013 from the CDC.  I find it pretty interesting that there is a high incidence of EEE just south of the Boston area of Massachusetts.  My great great grandmother lived most of her life in Fall River, Massachusetts before being placed in the Taunton Hospital.


The take away from all of this is to “investigate” every piece of evidence you find.  Don’t take everything at face value when researching your ancestors.  Look deeper for the hidden stories.  Does this prove that my great great grandmother died from EEE?  No, not really, but it does shed doubt on her original classification of death.

Please leave me your comments below and as usual keep a look out for my upcoming post.

How to Understand the Cause of Death Listed on a Death Certificate Part 2

Understand Cause of Death Part 2

How to Understand the Cause of Death Listed on a Death Certificate Part 2

In Part 1 of this 2 part series I explained how to understand the cause of death also referred to as the International Classification of Diseases (ICD) code listed on your ancestor’s death certificate.

The International Classification of Diseases (ICD) grew from the Bertillon classification system, there have now been 10 revisions since its original instatement.  So how did the ICD come into existence?  The city of Paris’ Chief Statistician, Jacques Bertillon propelled the need for uniform disease classifications in 1853.  By 1891, the International Statistical Institute (ISI) convened in Vienna and accepted Bertillon’s statistical list created to categorize the cause of death.  Jacques Bertillon later chaired the 1893 ISI Chicago meeting where he presented three lists.  One list cited 44 conditions (that caused death), the second list had 99 conditions, and the other list had 161 conditions.  Each condition had its own subdivision broken down and designated by an alphabetical letter.

You can take a look at the three lists or nomenclatures in the book Bertillon Classification of Causes of Death, on page 13.  He list well known diseases such as small pox, measles, and scurvy to the more obscure such as glanders and farcy, scrofula, Bright’s disease, Pott’s disease, white swellings, and metritis.  Pages 18 to 33 give definitions to many of the diseases listed in “nomenclature three.”

I was able to even place one of my ancestor’s death certificates in better context after looking up the cause of death in Bertillon’s book published in 1899.  Below is a screen shot of my ancestor’s death certificate from 15th July 1911.  Her place of death is listed as the Taunton State Hospital in Taunton, Massachusetts.  The cause of death is General Paralysis.  I found this death certificate to be curious so I started researching the Taunton State Hospital for this time period.

Annie Albin Death Cert

I found that the hospital was originally called the State Lunatic Hospital at Taunton and it was established in 1854.  The older parts of the building were demolished in 2009.  I also came across some hauntingly beautiful photos that can be found over at Abandoned America taken by Matthew Christopher.

I wanted to know more about this ancestor’s life and if she truly was someone that should have been placed in a lunatic asylum, so I looked her cause of death up in the 1899 Bertillon book and the Manual of the International List of Causes of Death Second Revision, Paris, 1909.  Remember from the previous post the second revision covers years 1910 to 1920.

The Bertillon Classification of Causes Of Death page 22

  • General Paralysis is listed as number 45 in the third nomenclature column. “ #45.     General Paralysis includes: general paralysis of the insane; paralytic insanity; paralytic dementia; paralytic cachexia; paralytic marasmus; diffuse-meningo encephalitis; diffuse periencephalitis.”

Manual of the International List of Causes of Death Second Revision, Paris, 1909, page 76:

  1. “General Paralysis of the insane: Alcoholic paralysis, Bayles’s disease, Chronic alcoholic paralysis, Dementia paralytica, Diffuse meningoencephalitis periencephalitis, General alcoholic paralysis, General paralysis (insane), Imbecile paralysis, Paralysis of insane, Paralytic cachexia, Paresis, Paretic dementia, Progressive dementia”

Both classifications do give more insight into this time period.  It is curious that encephalitis is listed with both of the general paralysis of the insane.  I believe it is more probable that my ancestor had contracted encephalitis and was not truly “insane” as the classification could lead one to believe.

Please keep on the lookout for my next post where I will discuss encephalitis and how the term “General Paralysis” could have been easily misinterpreted for “insane.”  Also please leave me your comments below.

How to Understand the Cause of Death Listed on a Death Certificate Part 1

How to understand Cause of Death Listed on Death Cert

“Death really is just a number, the International Classification of Diseases number.”

Sometimes when we find a Death Certificate we just find more questions.  Maybe the handwriting is not legible or the informant was a hospital worker. Yeah, like you’re gonna get any hard facts from the hospital worker that so thoughtfully asked about who your ancestor’s parents were.  If you are lucky, sometimes (depending on the year) you can get a hold of a death certificate that has the cause of death and a numerical code written all catawampus in the cause of death field.  The code or number is referred to as the International Classification of Diseases.  We are currently on the 10th revision so you may see people refer to it now as the ICD 10 code.

Looking this number up can give you more insight into the cause of death of your relative when you are performing genealogy research.  I’ve included an example below for more detail.  So what is the International Classification of Diseases and how did it come into existence?

The ICD codes were designed to create international uniformity for healthcare workers when they have to collect, process, classify, and present mortality statistics.  But we must go a little deeper down the rabbit hole and ask, “Why are death certificates so important?” “Or more so why must we keep track of disease classifications and death registrations?” Simply put, we must keep track of reoccurring epidemics.  Recall any of the historical cholera, plague, yellow fever, malaria, and small pox epidemics? Yeah, lets try and prevent those from happening again J

Death registration in the United States was mirrored after the English Registration Act of 1837.  Massachusetts was the first state to enact the registration law in 1842.  More states started to follow suit and by 1855 the American Medical Association pushed for more states to create offices specifically for the registration of vital events.  By the time 1900 had rolled around there were about 10 states that had complied with the U.S. Death Registration Area so they were able to start compiling the yearly mortality statistic reports.  By 1933 all states were on board with registration.

The ICD has been revised ten times, below is a list of revisions in relation to the years they apply to.  So if you have a death certificate from 1958 you’ll want to look into the ICD7.

Revision   Years
1st 1900-09
2d 1910-20
3d 1921-29
4th 1930-38
5th 1939-48
6th 1949-57
7th 1958-67
8th 1968-78
9th 1979-98
10th 1999-present

But what about before the 1900s in the United States, how can one understand that messy handwriting or the very archaic disease classification? Stay tuned for part 2 of this post.  Below is the example I promised.

I’ll use one from my family tree as an example.  My relative died 2 April 1955 on Highway 91 North Salt Lake, Utah in a motor vehicle collision.  The death was ruled an accident and the death certificate was filled out in depth so I really had no reason to look up the ICD code (see that letter and four digit number written in pencil below) yep E8161 is the ICD code used in this case.

Death Cert example

An easy way to look this code up is to go to HIPPASpace for ICD9 and ICD10 searches. The link will take you to the ICD9 version which occurred way after my relative’s death but it is still a useful quick link.

Type the code: E8161 in the “any search query” box and click Search.

The results that were returned back to me were:

ICD 9 example

So see here that the ICD9 code states that this accident occurred without a collision which I KNOW a collision with a truck did occur, so if I wanted more information I would look up the ICD6 for the correct year.

The website is another great resource for looking up the outdated codes.  Just follow the link and select ICD6, 4 digit code (because this is what correlates with my ancestor’s death certificate).  Search by using short cut keys “Crt and F” for control find.  Type in the code that is on the death certificate “E816” and search.

You should see this list:

ICD6 list

Please keep an eye out for part 2 of this series and as always leave me a comment below.