I just got diagnosed with strep but thanks to modern antibiotics, I will be back and ready to go in a couple of days.
It got me wondering, what did people do prior to antibiotics? Either die or get better? But then I realized that is what happens with every human with every illness. So, what would happen to a reasonably healthy person with strep in 1850? Be very sick for a month and get better? Or what else?
A woman I know was diagnosed with Strep Throat a few weeks ago at an Urgent Care. She took the script they gave her to a pharmacy, but couldn’t afford the $80 antibiotic. She was very sick with a fever and severe sore throat. She gargled with salt water, drank tea with honey, took acetaminophen, and recovered.
I recall an article about dentistry from before antibiotics. Kid had an oozing ulcer on his jaw. Doctors couldn’t do anything about it, and he was forbidden to attend school for over a year because it could be an infectious disease. Then a dentist saw it, realized it was an infected root - pull the tooth and the infection healed fairly soon.
Usually, the body’s natural immune system deals with these. If it can’t it stays a chronic infection, possibly weakening the body and immune system making the person more likely to suffer from other disease.
There’s a reason so many people died before antibiotics and especially vaccines made us so much safer. One statistic I read said that about half of children died before the age of 5.
I’m going to guess that “sore throat” was probably a generic illness until microscopes came along and doctors bothered to look for distinct causes. There were probably assorted folk remedies for assorted illnesses - “Sore throat? Gargle with vinegar. Or chamomile tea might help… or willow bark tea.”
The names of diseases change over time (sometimes), but that doesn’t mean that people in the past couldn’t diagnose them. They wouldn’t have called it “strep” throat or “tuberculosis” because those names were based on what the bacteria look like, which no one would know until microscopes, but both diseases are reasonably diagnosable by symptoms.
The doctor said that I have white nodules on the back of my throat, and we could test to see if it is strep, but he would save me the lab fee because whatever it is, it is bacterial, and we’re doing a course of antibiotics. Plus the Covid test was negative.
Pharyngitis (sore throat) was a commonly known entity in the nineteenth century. It wasn’t until late in the century, after Streptococcus pyogenes was identified, that the sequence of events leading from strept throat to rheumatic fever to heart damage was described. As late as the 1920s, rheumatic fever was a leading cause of death from childhood through age 30.
Nineteenth century docs lumped a lot of conditions under the heading “rheumatism”, meaning fever, joint pain and debility.
Interestingly, the huge decline in rheumatic fever and its sequelae in this country is thought to be only partly due to effective antibiotic treatment. It seems that group A strep are less likely now to cause rheumatic heart disease, though it remains a serious problem in some parts of the world.
Heck, I can recognize the feel of strep throat, as distinct from other forms of “sore throat”. For a while there in my teens, I seemed to get it every year, in late spring or early summer. Went to college, got a sore throat, told the clinic “It feels like strep throat”, they checked it out and said “Yup, here’s a prescription for penicillin”.
I expect that that would be enough to see bacteria, but not necessarily enough to differentiate between them by sight. Probably also some progress in culturing bacteria required, and I know other things used to identify bacteria like Gram staining came later in the 19th c.
The germ theory of disease did not gain widespread acceptance in the Western medical community until well after 1850 with the work of Pasteur, Koch, and Lister. Your strep throat would likely have been attributed to miasma (if attributed to an outside cause at all). You just needed some bloodletting - let’s find some leeches…
“I forced the heavy silver spoon back of her teeth and down her throat till she gagged. And there it was - both tonsils covered with membrane. She had fought valiantly to keep me from knowing her secret. She had been hiding that sore throat for three days at least and Iying to her parents in order to escape just such an outcome as this.
Now truly she was furious. She had been on the defensive before but now she attacked. Tried to get off her father’s lap and fly at me while tears of defeat blinded her eyes.”