Monday, October 5, 2015

Elections and the Old West

Last month, the caving walls of our economy (well, stock market) provided a starting point for exploring how those current facts may have existed, or not, during the time period of my current novel (1883 - 1887). The facts and the musings gave me the blog and, in the month that followed, gave me two opportunities to use this (newfound) knowledge of the circumstances prevailing at the time. Western Fictioneers are dealing with universal truths. Men who have a hard time getting a job sometimes do things they would not do if they had a job.

Since my current novel’s action is partially determined by Washington’s legislative reach out into the West, it struck me that the 2016 elections coming up provided another relevant opportunity to understand the times in which my characters lived.

Again, I invite you to take a not too scholarly, but not fictional, glimpse.

Where to start? Action in 1883 started with the nomination, election, and assassination of James A. Garfield. Less than four months into his term, he was shot at 9:30 a.m. on July 2, 1881, at the Baltimore and Potomac Railroad Station in Washington, D.C. The second president to be assassinated, he was succeeded by his vice-president, Chester A. Arthur.

List of Presidents
Year Name No.
1892 Grover Cleveland (D) 24
1888 Benjamin Harrison (R)* 23
1884 Grover Cleveland (D) 22
1881-85 Chester A. Arthur (R) 21
1880 James Garfield (R) 20
1876 Rutherford B. Hayes (R) 19
*Cleveland won popular vote 5.53M v. 5.44M,
lost electoral college 168 v. 233.

Chester Alan Arthur was an attorney, machine politician, and v.p. nominee by virtue of his ticket balancing New York residence. Generally viewed as a hack of little luster or few values, he was one of the remarkable few who entered office with a lower reputation than he left it. Lincoln biographer, Alexander McClure, reputedly wrote, "No man ever entered the Presidency so profoundly and widely distrusted, and no one ever retired ... more generally respected, alike by political friend and foe." 

Suffering from poor health, Arthur made but a limited effort to secure the Republican Party's nomination in 1884.  That proved a serious drawback for the Republicans.

Arthur’s health paved the way for Maine Senator James G. Blaine to win the nomination over the – my personal editorial comment – scurrilous Senator George F. Edmunds of Vermont. By then, of course, Edmunds had won his fame and infamy for the 1882 Edmunds Act – that plays a central role in the action of my novel that starts in 1883.

President Grover Cleveland
The Mugwumps

Taken together, and by giving the nation the Mugwumps, Blaine delivered to the Democrats something they had not had since 1856 - the election of a Democrat as President of the United States. Although we may decry today’s dirty politics, this campaign reached the heights of exceptional political acrimony and personal invective. Nevertheless, New York Governor, Grover Cleveland broke the longest losing streak for any major party in American political history: six consecutive presidential elections.

As a matter of interest, that lovely name, title, and epithet, The Mugwumps, belonged to the Republican political activists who bolted from the party and supported Cleveland. They switched parties because they rejected the financial corruption associated with Republican candidate, Blaine (and remember, he was nominated over an even worse candidate, Edmunds.)

With real political acuity, the Mugwumps chose a close election to bolt and made the difference in New York state and swung the election to Cleveland. (The word still finds use when describing persons who are "sanctimonious" or "holier-than-thou," in holding themselves aloof from party politics.)  (One further footnote, Theodore Roosevelt did not bolt, preferring to clear the way for his own political aspirations and hold himself pure until he bolted for his much bigger dissident party, The Bull Moose Party, in 1912.)  (Oops, perhaps accuracy requires noting it was actually called the Progressive Party.

The Mugwumps considered Blaine to be an untrustworthy and fraudulent candidate. Their idealism and reform sensibilities led them to oppose the political corruption in the politics of the Gilded Age.

Notwithstanding his breakthrough, Grover Cleveland was not to have it easy. And yet, in his trials, he achieved another first: the first president to split his first and second term with the incumbency of another man of another party.

Benjamin Harrison (R), a former Senator from Indiana, won the presidency despite the Democratic
candidate's greater share of the popular vote. (A situation repeated in the 2000 election.). For the 26th quadrenni
President Benjamin Harrison
al presidential election, the economy was prosperous and the nation was at peace, and Cleveland may have lost because he strenuously denounced high tariffs as unfair to consumers. His opposition to Civil War pensions and inflated currency made few friends among veterans and farmers.

The general election in 1888 elected the members of the 51st United States Congress. North Dakota, South Dakota, Montana, Washington, Idaho, and Wyoming were admitted during the 51st Congress. This election was the first time that one party had won a majority in both chambers of Congress since the 1874 elections.   Note that after the election of 1888, only Utah, New Mexico, Arizona, and Oklahoma remained as territories, not yet Western states.  
Electoral College 1888

The presidential election of 1888 also produced seven additional parties and nominations for president, namely, Prohibition Party, Union Labor Party, United Labor Party, Greenback Party (perhaps the most famous and with this election, it ceased to exist), the American Party, the Equal Rights Party (with a male nominee), and the Industrial Reform Party.

Relevance to my 1883 - 1887?

My Fugitive Sheriff deals with the Edmunds Act, the Edmunds-Tucker Act, just about every carpet bagging U.S. Marshal who rides the West in search of bounty created by Congress in Washington.  Presidents campaigned and Congresses were elected and the people settling the West barely had a voice (as can clearly be seen from the electoral college map.)  Still, their destiny was determined all of these electoral forces.  Some of it I already show in my stories and more I hope to discover.

E-mail Edward Massey with comments, author of 2014 Gold Quill winner, Every Soul Is Free and Amazon ABNA 2009 Quarter-finalist, Telluride Promise.

Tuesday, September 29, 2015

#NewRelease -- SIX-GUNS -- Boxed Set of Six Western Novels -- #99cents

Six classic Western novels. The good old shoot-'em-up westerns are still around, and this collection has six by the masters of the genre.

William M. "Bill" Tilghman had one of the most illustrious careers of any Old West lawman, but he faced perhaps his greatest and most dangerous challenge when he rode alone into the wild Oklahoma Territory settlement of Burnt Creek on the trail of a gang of rustlers and outlaws with some unexpected allies . . . THE LAWMAN, by New York Times bestselling author James Reasoner, is the first novel in the West of the Big River series.

In Frank Roderus’ HOME TO TEXAS, Charlie McMurty brought a herd north, got a great price, and had enough left over once he repaid his neighbors to buy a ranch so he could ask for the hand of his sweetheart. Unfortunately, on the way back to Texas he was robbed and left for dead. To make matters worse one of his attackers was his friend he'd hired to help him with the herd. All he had left was a big debt back home and a big hole in his chest. His new quest became the need to be able to return his neighbor's money. First he had to heal and learn some fancy shooting.

Violence stole young Ben Brand's family from him, but blessed with uncanny speed and skill with a gun and befriended by an old mountain man, Ben sets out on a bloody quest for vengeance. As he tracks his enemies over the years and the miles, Ben battles men and the elements—and risks his own soul—to become the avenging nemesis known as Iron Heart! Long out of print and originally published under the pseudonym Walt Denver, IRON HEART is a classic Western from Jory Sherman.

Veteran author Clay More spins a fast-paced Western adventure in STAMPEDE AT RATTLESNAKE PASS. With her father murdered and her brother crippled by bushwhackers, half her herd stolen and her crew massacred by vicious rustlers, beautiful blond Elly Horrocks is going to have her hands full keeping the family ranch going. Luckily for Elly, drifting cowpoke Jake Scudder has a nose for trouble. It'll take all of Scudder's skill with guns and fists to save himself and keep Elly from being wiped out. Diamondbacks aren't the deadliest varmints in Rattlesnake Pass anymore!

Some men deserved to die like rabid animals. In FAST HAND the Thornberrys and their worthless cousin counted among those the world would be better off without. Judge Sebastian Hand sentences the Thornberry gang to the gallows for rape and murder. But when they escape, the judge trades in his gavel for a gun, and suddenly he's judge, jury, and executioner all in one. Karl Lassiter is the pen name of a prolific author who also writes under the pen name Jackson Lowry.

James J. Griffin's famous character Texas Ranger Jim Blawcyzk isn’t really working for the Rangers this time. In fact, he winds up on the wrong side of the law with the Rangers after him, because he takes off his badge and goes after the gang that attacked and possibly murdered his wife and son. As a result, RANGER’S REVENGE is a little grittier than Griffin’s earlier books, but it has the same fine action scenes, interesting settings, and welcome touches of humor.

Sunday, September 27, 2015


It’s harvest time again and many of us are shuffling things around in the pantry to make room for a batch of newly filled Mason jars. Because I traveled heavily this summer, I’ve only made bread and butter pickles so far. Of course, most who preserve vegetables by canning don't stop there. They peel, blanch, and strain tomatoes, corn, okra, beans and beets. Then there are the fruit preserves and jellies! One of the nicest neighbor gifts I receive every year is a tall jar of pear chutney. Perfect alongside pork tenderloin.

Is there anything prettier than a rainbow row of canned fruits and veggies? It’s one of my favorite exhibits at county fairs.

But what if you live in a climate that is not conducive to growing lush vegetable gardens? What if the only green(ish) thing around is covered with spines and thorns and appears more vicious than delicious? How can one can one? 

Verrrry carefully.

First, get yourself some heavy gloves and a super-seriously-sharp knife. (You might want to consult Marc Cameron regarding the latter.) I would probably keep needle-nose pliers in the back pocket too. Some of those splines are next to invisible but, boy, can you feel them.

I’m thrilled to share with you the news that RIGHT NOW is prime harvest season for luscious prickly pear fruit and….AND…yummy in the tummy mesquite pods! Are you excited now? I thought so!

CLICK HERE to learn more about mesquite!
On a trail ride near the Cochise Stronghold in Arizona last July, my guide informed me that, during tough times, local tribes historically relied on the mesquite bush for survival. The beans could be eaten alone or flour could be made by grinding both the pods and beans.

I would add that mesquite branches are considered to be tasty trail snacks, according to my horse Cisco. He snatched a mouthful of mesquite every chance he got. I never knew horses would eat something so thorny!

Let’s talk about cactus. I know…a prickly subject. The bulbous fruit of the prickly pear (called tuna) can be sliced and eaten raw or turned into jellies. I understand the petals of the flowers can be used in salads. The inside flesh of the cactus pad is also edible. I’ve had cactus pad jelly and it isn’t half bad. Another preparation calls for cooking the de-spined pads and serving them as a dish called nopales.  CLICK HERE for a link to a few recipes if you'd like to test some in your own kitchen.

Prickly Pear Fruit, perfectly ripened
We’ve all heard of the notion of surviving in the desert by eating cactus. Not surprisingly, great care should be exercised if you find yourself in this scenario. According to survival expert Peter Bigfoot, you must be aware of spine colors, time of year and, most important, which species are especially suspicious. (Sorry, I have frequent alliterative attacks.)

Peter has some great tips for feasting on raw hedgehog cactus here.

So there you go. Running short on dinner ideas? Surprise your family with some Mesquite Bean Chili. Mesquite Pod Pancakes. Or Prickly Pear Pad Thai. 

Might pair well with a certain distilled beverage made from blue agave plants...

All the best,


Vonn McKee
“Writing the Range”
2015 Western Fictioneers Peacemaker Finalist (Short Fiction)
2015 Western Writers of America Spur Finalist (Short Fiction)


Friday, September 25, 2015


I do love fashion - not necessarily wearing it, since I'm a jeans and tee shirt type for every day. But I do love seeing all the fancy gowns (not the excess craziness of Lady Gaga, of course) worn at all the major award ceremonies, and I have several bookshelves devoted to fashions from the past. I love delving into the shifts in fashion throughout history.

But Sarah McNeal put an idea in my head with her comment a few months ago when I wrote about The Hourglass Figure. Here's what she said: "One thing I find fascinating about clothing from the Victorian age and the flappers is the extreme attention to detail--embroidery, crochet, lace, tassels, smocking, and so on. Their clothing were works of art." Bingo! So let's explore some "works of art." Especially lace - I love all the patterns, the gorgeous edgings and every tiny swirl below.

The Renaissance brought on the era of lace (hand-tatted, of course, by seamstresses and pieceworkers). Queen Elizabeth I wore it with style. Due to its expense, the nobility kept it fairly exclusive. But during  the 1700's, more details came into fashion. Think table-wide panniers, silk and satin fabrics, embroidery, embroidery, embroidery, powdered wigs for the ladies or elaborate updos, huge hats (even shaped like a ship, with rigging!) plus ribbons galore, heeled shoes, etc., for both men and women. And embroidery - did I mention all that embroidery? Look at that needlework! Even men wore lace and embroidered coats if they wanted to look presentable.

Knee breeches were the norm for men, with hose to show off the lower legs - erm, limbs. Long hair worn in curls, or tied back, or a powdered white wig covered the scalp shorn close of hair - pretty easy if the gent had a gene for balding hair. The jabot of lace fell over the long coat, and more lace showed below the sleeves. Buckled shoes of leather finished the look. And then came Brummel.

The Regency era (generally 1795 to 1837, during the mad King George III's reign, when his son George IV was Prince Regent, plus a few years after his death) changed fashion. For men - Beau Brummel ushered in the tailored look, tossing out the knee breeches (horrors!) for trousers - although the tall knee-high or higher boots definitely showed the curve of the le - limb! Cutaway coats with brass buttons, impeccable linen shirts and the cravat became the norm. Gloves of kid leather were a must, and top hats of beaver fur (oh yes, the Hudson Bay company would make huge amounts of money on that trade) replaced the tricorn hat of felt. Handkerchiefs may have lost the lace edging to match the more masculine look.

Women's garments turned slender - think Jane Austen's heroines in their Empire waists, narrow skirts (doorways were no longer a problem after losing the panniers, although they seemed handy at the time as an elbow rest), with day gowns of less sumptuous fabrics. Tiny prints or pale plain colors replaced the embroidery, although trims still held sway. Especially on bonnets for ladies.

And then came the Victorian era.

There she is, the Queen of England with her beloved Prince Albert (of the can). Fashion went into overdrive both in England, France, and America. A lot of it depended on the economy - see the chart to the left. Women's skirts widened to the point of those ridiculous hoops up until (and during, if you could make due with green velvet draperies a la Scarlett O'Hara) the Civil War. Excess fabric gradually moved toward the backside with bustles; fashions ended up slenderized again at the end of the century. But frou-frous went crazy - gowns of lace, silk, satin, wool, moire, etc. More lace trim flowed, along with tassels, ribbons, fringe, seed pearls, beads, sequins, you name it.

Real flowers decorated skirts, bosoms, and hats, to hand-sewn silk or satin ribbon flowers that lasted far longer. Seamstresses hired women to fashion these delicate blossoms separately or in bunches, and proved to be true works of art. Look at all that detail! You won't find such luscious stuff on gowns at the Oscars now. What a shame, really.

What about in the old west? Women certainly loved the femininity of lace or even a flounce or two on a skirt. If they couldn't afford to buy it, they sewed, knitted, or tatted their trims by hand. And men who visited the houses of ill repute expected the "doves" to wear their fanciest corsets, petticoats, and garters. Edwardian fashions of the early 1900s continued to embellish women's clothing with lace, floral ribbons, and more.

Throughout the 1900s, the Renaissance Fairs and steampunk fads, and the early 21st century with the resurgence of lace parasols, hats, fascinators, and the like... women and men just love to dress up.

The video above show the shifts in fashion from 1700 until 1900 - fascinating, so enjoy!

Mystery author Meg Mims earned a Spur Award from WWA and also a Laramie award for her western historical mystery series, Double Crossing (still 99c!) and Double or Nothing. Meg is also one-half of the writing team of D.E. Ireland for a mystery series featuring Eliza Doolittle & Henry Higgins for Minotaur books. Book 2 just came out, MOVE YOUR BLOOMING CORPSE. Book 1, WOULDN'T IT BE DEADLY, was nominated for a 2015 Agatha Award. Meg lives in Southeastern Michigan with her husband and a sweet Malti-poo. She loves reading and writing novels, novellas and short stories, both contemporary and historical.

Thursday, September 24, 2015



the blog about medicine and surgery in the 19th century

Keith Souter  aka Clay More

The 19th century saw monumental changes in medicine and surgery as the Germ Theory of disease and the discovery of the disease-making potential of micro-organisms gave doctors an understanding of how infections were caught. The development of aseptic surgery gave people a fighting chance of surviving operations and the infections that developed afterwards. Yet it would be public health measures based on hygiene, sanitation and fresh water supplies that would reduce mortality rates in towns and cities.

Epidemics were a problem for cities as the century advanced. With industrialisation, people moved to the cities to gain employment. Overcrowding in unsanitary conditions created the right conditions for infectious diseases to develop and pass rapidly through the population.

In London in 1854 there were 14,000 cases of cholera with 618 deaths. In the USA there were three cholera epidemics in the 19th century.

Yellow fever was a huge problem in the northeast states between 1793 to 1805. Then in the first half of the 19th century it hit the southern states, to reach a peak in the 1850s.

Infections and disease during the Civil War
The war had a devastating effect on the country, but there were more deaths from disease than from battle. This may seem surprising, until you consider that the assembling of armies with men living in close contact, with limited hygienic precautions, poor sanitary standards and sometimes inadequate nutrition and water.

Wounded Union soldiers being tended near the Marye house in Fredericksburg, Va, after the Battle of Spotsylvania

According to Medicine of the Civil War by Paul E Steiner, published  by the National Library of Medicine, there were almost 3 million enlistments to the Union Army and between 1.3 - 1.4 million to the Confederacy.

The deaths from various causes were highly significant:


In battle                                    110,070
Disease                                     224,586
Accidents, suicide, etc               24,872

Total                                         359,528


In battle                                      94,000
Disease, etc                              164,000

Total                                         258,000

The total deaths in battle amounted to 204,070, compared to 388,586 deaths from disease. Effectively, diseases caused almost twice as many deaths as did  actual battle.

Figures for admissions to hospital for the Confederacy are not available, but for the Union:

Typho-malarial fever
Acute diarrhoea
Chronic dysentery

These sickness figures show that some conditions had an alarmingly high mortality rate. The mortality rate for typhoid was over 35 per cent of cases. Typhus was less common, but had a mortality rate of 34 per cent. Typho-malarial fever, a common diagnosis, which showed the lack of understanding about the conditions of typhoid and of malaria (which are separate conditions) and the non-specificity of diagnosis, had a mortality rate of 8 per cent. Other conditions like acute diarrhoea caused huge numbers of cases, throwing a terrific drain on resources and taking so many men off the field of battle, without having a high mortality rate. Add to that the huge number of men who had to be treated for the venereal infections and the men who would have been very ill from scurvy, caused by lack of vitamin C and you can see how disease was just as much a dangerous enemy as the foe on the opposing side.

The figure are not complete, of course. There would be the added cases of tetanus and gas gangrene, both potential complications of being wounded and lying on a muddy battlefield where the wounds would be likely to get infected from organisms in the soil.

The Union, which lost control of the battlefields in the early stages battles took the greatest number of casualties with infected wounds, but gradually both sides developed ambulance services and field and general hospitals so the wounded fared better in the later stages of the war.

Surgeon General William A Hammond (1828-1900) was in charge of the Union medical services at the start of the war, but fell from grace and was court-marshalled on trumped up charges against him.

The Confederacy's medical services were overseen by Dr Samuel Preston Moore (1813-1889). He was able to build up the southern medical corps with comparatively little interference.

Dr Samuel Preston Moore - surgeon general of the southern medical corps

The 1854 London Cholera Outbreak and the Broad Street Pump
A very severe outbreak of cholera broke out in the Soho area of London in 1854. At the time the medical opinion was that cholera was caused by bad air and that one could acquire a miasm from this, that caused the disease. The idea that it was due to an infecting organism had not occurred to anyone.

Dr John Snow (1813-1858) did not accept this idea and wrote an essay On the Mode of Communication in Cholera in 1849, in which he postulated that cholera entered the body through the mouth, not through inhaling bad air.

Part of the cholera death map of Soho in London, pinpointing the Broad Street Pump (centre of picture)

During the outbreak of cholera in 1854 he performed the first ever epidemiological survey. He charted all the cases of cholera and all the deaths, to produce a cholera death map. He was able to deduce that the commonality was that all deaths had occurred in an area supplied by a water pump in Broad Street. The water from it had been contaminated by a cracked sewage pipe. He had the handle of the pump removed so that it could not be used and the number of cases started to drop straight away.

Dr John Snow was also a pioneer in the development of anaesthetics and gave chloroform to Queen Victoria during one of her labours. Because it was so successful for the queen anaesthetics was given a much-needed boost in popularity.

Transmission of infection
Once the Germ Theory became accepted, doctors began the hunt for micro-organisms in all of the infectious diseases. Gradually, it became clear that there were various modes of transmission of these infections.

Airborne transmission
The organisms are transmitted in droplets from coughs and sneezes. These droplets are inhaled by  someone else, who develops the illness.

Diseases spread in this manner:

  1. The Exanthemata (the diseases characterised by a distinctive rash) - measles, rubella (German measles), chickenpox, smallpox, scarlet fever.
  2. Mouth and throat infections - diphtheria, tonsillitis, mumps, herpes stomatitis.
  3. Respiratory tract infections - pertussis (whooping cough), influenza and other respiratory virus infections, pulmonary tuberculosis.
  4. General - meningococcal and staphylococcal infections.
Infection present in the bowel excreta of a case or a carrier (someone who has the infection, but who has no symptoms) is ingested by a previously uninfected person. This transmission may be immediate and direct, via infected fingers and hands, eating utensils, clothing, toilets, or indirectly via infected food or water. 

Diseases spread in this way include - typhoid and paratyphoid, salmonellosis, dysentery, cholera, gastroenteritis, poliomyelitis, viral hepatitis.

Direct contact

This is from person to person by skin contact. These are mainly cutaneous (skin) conditions like impetigo, scabies and cowpox. But other serious conditions like anthrax can also be transmitted by direct contact.

Venereal route
These are infections by sexual contact. This includes syphilis, gonorrhoea, lymphogranuloma venereum, herpes genitalis and HIV.

Insect or animal route
Infections transmitted by animal and insect bites include malaria, trypanosomiasis, typhus and rabies.

Other infections like Weil's disease (leptosprosis icterohaemorrhagica) is excreted in infected rat's urine and contaminates stagnant water. This could later penetrate the skin of a bather. It causes jaundice and blood in the urine.

Tetanus can be contracted from the faeces of herbivorous animals which has contaminated the soil.

Other diseases can be transmitted by animals' milk. The bovine form of tuberculosis, for example can be transmitted by drinking infected milk.

Common infectious diseases of the 19th century
The following diseases were all common. The years that the infecting organisms were first identified have been included, where known.

This is an infection of the small intestine caused by Vibrio cholera, a type of bacterium, which was discovered by the Italian anatomist Filippo Pacini in 1854. He did not realise that it caused cholera. This was concluded by Emile Koch in 1884.

It is transmitted by drinking or eating infected food or water. The incubation period is 4 -12 hours, so it is a fast-spreading disease.

It causes profuse diarrhoea and vomiting, abdominal colic and leg cramps. Fluid loss from the diarrhoea, classically described as 'rice-water stools', can produce a state of shock within 24 hours. Kidney failure can be a complication in those who recover. Death can occur within 24 hours to a few days without hydration.

The treatment depends on adequate fluid replacement. Nowadays this is with intravenous fluids. Some antibiotics are effective, but hydration is the essential.

Prevention depends on strict hygiene, the provision of pure water and safe sanitation.

This used to be a common childhood disease, but is now uncommon, thanks to vaccination in childhood. It is still a danger however to those children who are un-immunised. It is caused by Corynebacterium diphtheria, discovered by Edwin Klebs and Freidrich Loffler in 1884. It is sometimes known as the Klebs-Loffler bacillus.

Diphtheria causes the formation of a grey membrane of exudate in the throat, which may completely obstruct the airway. It is characterised by high fever, increasing drowsiness and difficulty breathing.

When people were treated they were to be kept lying down and not sat up, because the bacterium can spread to the heart to cause damage to the heart. This would produce a myocarditis, or inflammation of the heart.  This makes abnormal heart rhythms develop at a point between 10 and 21 days. These could be fatal.  Recovery would not be considered complete until after that danger time.

Later complications at the third week up to the seventh week could affect the nervous system to paralyse muscles. This could affect speech or eye movements or the swallowing mechanism. Recovery would  eventually be complete.

The membrane and respiratory problems could cause suffocation and it could be necessary to perform the operation of tracheotomy, an operation to make a hole in the airway and insert a metal tube to by-pass the obstruction until the membrane resolved.

An antitoxin was developed by Emil von Behring in 1890. This would be given by injection. Nowadays all children are immunised against the disease as babies.

The mortality rate for diphtheria was 5-10 per cent. In 1881 and 1887, nearly 5,000 people died from diphtheria in the city of New York.

The tracheotomy operation
This is an operation to make a hole in the trachea. The word is sometimes used interchangeably with tracheostomy, although to be correct tracheostomy refers to the hole that is made, while tracheotomy is the operation to make the hole.

There were various methods of doing the operation, sometimes referred to as a high or a low tracheotomy. The easiest way would be to do an operation that is still used today in emergency rooms, involving making an opening in the cricothyroid membrane, a soft tissue just below the Adam's apple in the throat.

To do the high or low operations the following instruments would be required: scalpel, forceps, the more slender the better, 2 pairs of fine toothed forceps, a sharp hook. A tracheotomy tube with a retaining cuff, tongue forceps and gag.

The patient's head would be steadied on a sandbag, arranged so that the throat could be steadied. It is important to maintain the midline, so that the surgeon knows precisely the anatomy that he is going to work through.

To perform an emergency operation in the Old West, an incision would be made precisely in the median line of the neck, about one inch in length. The cricothyroid membrane would be identified and an incision made in it. Then the tracheotomy tube would be inserted. A fine feather would have been used to clear the tube.

Tracheotomy - the cricothyroid membrane is indicated by ll - an incision was made and the tube inserted

Upon making the tracheotomy there would be a noisy rush of air entering and escaping though the wound. The child would cough, expelling mucus and the grey membrane. It would be life-saving.

In my novel The Doctor, based on events in the life of Dr George Goodfellow, published by Western Fictioneers Library I have the good Tombstone doctor perform an emergency tracheotomy upon a patient lying on pool table.

This widely feed disease could affect people of all ages.  It had a very poor prognosis in young children.

It is caused by either the Variola major or the Variola minor virus. The Variola word means spotted or pimpled. Variola major caused a much more serious disease. It is now considered an eradicated disease by the World Health Organisation, thanks to the success of the smallpox vaccination programme.

After an incubation period of 11-12 days the rash of smallpox would develop. It had several clinical patterns, but effectively, they all produced a rash with multiple small blisters covering the body. They would burst and form scarring crusts.

There was no effective treatment, merely supportive care, adequate nutrition and hydration.

The mortality rate in the 19th century was high. Depending upon care facilities, the previous health of the population affected and a good measure of luck, it could kill 20 to 60 per cent of cases.

It would leave scarring and it caused a third of the blindness of the day.

This was a disease that as we saw earlier caused significant mortality. It is caused by rickettsia bacteria transmitted by lice, leas, ticks and mites. It is the name given to a number of related illnesses. The insects are carried from person to person or are brought from other animals.

Epidemic typhus was called camp fever, jail fever or war fever.  Overcrowding in unsanitary conditions encouraged its spread.

The incubation period was about ten days, after which the person develops headaches, loss of appetite, malaise, raging fever, chills and nausea. Four to six days after the start a rash develops over the whole body.

The fever would continue until about the 12th day, then recovery would take place on about day 14.

Left untreated the circulation becomes sluggish and thromboses may occur, leading to areas of gangrene on the digits, genitals, nose and ears.  Pneumonia or kidney failure, or both, could develop.  The course may be progressively downhill, ending in death.

It is effectively treated with chloramphenicol and tetracycline antibiotics nowadays, but in poor sanitary conditions, overcrowding, as occurs in disaster areas around the world,  and without medical facilities the death toll can still be high.

A vaccine was developed during World War ll.

Yellow Fever
This viral disease is spread by the bite of infected mosquitoes. Humans and other primates can be affected. The usual mosquito involved is called Aedes aegypti. The virus is an RNA Flavivirus.

The incubation is 3 to 5 days, when symptoms begin. These include headache, severe muscle pains, high fever, nausea and vomiting. The condition usually resolves after 3 or 4 days, but 15 per cent go on to develop more severe symptoms, including jaundice, whence it gets its name, and bleeding from the  nose, eyesore stomach. Half of those suffering the severest form will die.

It had various names - yellow plague, bronze john or yellow jack.

Yellow fever caused many deaths in ares of the world prone to it during the 19th century. These were mainly South America and Africa, where it is still a problem.  The USA also was hit by numerous major outbreaks.

Dr Wilbur Sawyer developed the first effective yellow fever vaccine in 1931. A safer vaccine was produced in 1937 by Dr Max Theiler. In 1951 Dr Theiler won the Nobel Prize for Medicine for the yellow fever vaccine.  For some unaccountable reason Dr Wilbur Sawyer was not also given the prize.

The vaccine makes the disease entirely preventible and it is given 10 days before entering a yellow fever area. Protection will last for 10 years.

This infectious disease mainly affects children, but is now preventible through vaccination. It attacks the central nervous system, often resulting in a child waking to be partially or totally paralysed. Bed rest was the only treatment, until people discovered the need for physiotherapy. When then respiratory muscles were affected people were left unable to breathe without assistance, so the 'iron lung' was developed in 1928. This was a large cylinder in which the person lay. Controlled negative pressure inflated and deflated the chest to assist breathing. Earlier wooden versions had been developed worked by hand cranked bellows.

The vaccine against polio was developed by Jonas Salk in 1952.

We briefly referred to malaria in the post on Fevers and Pest Houses. Hippocrates described in beautifully, differentiating the different types of fever associated with it. He thought that it was caused by bad air, which thought persisted until the 19th century in the name 'mal' 'aria', literally meaning 'bad air.'

Malaria is still the most common and serious of all the tropical infectious diseases. It is still endemic in large areas of the Pacific, Southern Asia, Central and Southern America and Africa. If it is not treated promptly it is frequently fatal.

The author had experience of treating malaria while working in an infectious disease hospital in Southern India back in the 1970s, while still a medical student.

Malaria is caused by protozoal parasites of the Plasmodium group. They are spread by a single bite of an infected Anopheles mosquito. There are many different Plasmodium parasites, but only five of these cause the disease in humans.

Three of these, Plasmodium vivax, Plasmodium ovale and Plasmodium malaria cause a relatively benign illness with tertian (alternate day) fevers, or occasionally quartan (every third day) fever. Plasmodium falciparum causes a more serious  type of malaria, which used to be called 'malignant malaria' or 'blackwater fever.' In this the kidneys are affected and broken down blood appears in the urine to make it appear extremely dark, like black water. This is called haemoglobinuria.

The different types of fever, which Hippocrates described, relate to the life cycle of the malarial parasites in the blood. The condition causes the variable fevers mentioned above, chills, headaches, abdominal pains, muscles pains, vomiting and diarrhoea and general prostration. The spleen can become extremely enlarged, as outlined in the post on Fevers and Pest Houses.

In the 19th century before the malarial parasite was discovered it was found difficult to differentiate it from typhoid fever, hence it was often called typho-malarial fever. From experience, I can attest to the difficulty of distinguishing them on purely clinical grounds. Fortunately, we now have blood tests, which will distinguish them, as the parasites will be found in the blood.

Sir Ronald Ross (1857-1932) was a British doctor working in India. In 1895 he discovered the Plasmodium parasite in the stomach of the Anopheles mosquito. He conducted research over two years and managed to cultivate mosquitoes from eggs,  effectively elucidating the life cycle of the mosquito. He then had a volunteer patient who already had malaria and managed to get them to bite him. When they did they sucked up blood into their stomachs. He examined them over the following days and was able to see how the parasites developed in their stomach. He had found that the mosquito was an important link in the chain.

Notebook belonging to Ronald Ross, describing the parasites from the mosquito stomachs he had seen down the microscope

He realised their significance and wrote a poem to his wife about them:

This day relenting God
Hath placed within my hand
A wondrous thing; and God
Be praised. At His command,
Seeking His secret deeds
With tears and toiling breath,
I find thy cunning seeds,
O million-murdering Death.
I know this little thing
A myriad men will save.
O Death, where is thy sting?

Thy victory, O Grave?

He knew that he was on the verge of a discovery that could save countless lives. By attacking the life cycle of the mosquito which develops in stagnant water, the sort of surroundings that Hippocrates had thought produced 'mal' 'aria,' it was possible to reduce the number of cases.

Sir Ronald Ross, the discoverer of the malarial parasite

In 1902 he was awarded the Nobel Prize for medicine.

Quinine was used to treat malaria since the 17th century. The bark of the cinchona tree (quina quina) was called Jesuit's bark, Cardinal's bark or Sacred bark. It was discovered by a Jesuit priest in South America in 1630, although their are legends about it being used by the local native population before then. 

The introduction of quinine to Europe involves the Spanish Countess of Chinon, who contracted malaria in Peru.  She was given a draught concocted from the bark of a tree and recovered.  When she returned to Spain she introduced quinine to Europe in 1638. It was known as the Countess's powder. In 1742 the botanist Carl Linnaeus called the tree Cinchona in her honour. 

Supplies of quinine were critical during the Civil War. The Union Naval blockade cut off supplies to the Confederacy, who were forced to find alternatives. Dr John Chisolm, the inventor of the Chisolm inhaler was tasked with doing this, which he set about quite ingeniously, as described in the post on him. 

The great writer and preacher John Bunyon wrote:

Yet the captain of all these men of death that came against him to take him away, was the consumption, for it was that that brought him down to the grave.

Consumption was a great catch-all diagnosis. It would have included all sorts of degenerative disease, including many cancers and respiratory conditions that could not be specifically diagnosed in days gone by. Nowadays we know it as tuberculosis.

Tuberculosis is highly contagious infectious illness cause by a bacterium called Mycobacterium tuberculosis. It exists as two main strains,  the human  and the bovine. The main source of infection of the human strain is from the respiratory tract of a person with the disease. Transmission takes place by droplet spread, in other words coughs and sneezes.

The  bovine form is contracted from ingesting infected milk or dairy products.

Even today, according to the World Health Organisation, WHO, tuberculosis is  second only to HIV as the greatest killer worldwide due to a single infectious agent.

Common symptoms of active TB are cough with productive sputum, sometimes with blood, general malaise, chest pains, weakness, weight loss, fever and night sweats.

Antibiotics are the treatment nowadays for active cases. A vaccine called BCG, which stands for the 'Bacillus of Calmette and Guerin,' is available, but is not much used in the USA.  It is often  given to young children in  Europe and in countries where it is a problem.

In the 19th century people often sought better climates to cope with their illness, hence many people suffering from it would head to the American southwest. Later, people who were very ill would be admitted to a  tuberculosis sanatorium.

Doc Holliday famously had tuberculosis and moved west, to Dodge City and Tombstone where the climate and the lifestyle suited him. One of the doctors he consulted in Tombstone was Dr George Goodfellow, the surgeon to the gunfighters. He had nothing to offer him, since the causative organism was not discovered by Robert Koch until 1892. Doc Holliday died in Colorado in the Hotel Glenwood. Many stories say that he died in a tuberculosis sanatorium, but the Glenwood Springs Sanatorium was not built until 1896, 9 years after his death.

Another person who had apparently travelled west because of her consumption, was the singer and actress Dora Hand. She went to Dodge City in 1878 and became extremely popular. Sadly, she was shot to death when a cowboy named Spike Kenedy fired into the cabin she was sleeping in,  because he believed that the mayor, 'Dog' Kelley was sleeping there. A posse was formed, the members including Wyatt Earp, Bat Masterson and Charlie Bassett. They caught him, wounding him in the process, but he was later acquitted, because there was deemed to be insufficient evidence.  His father, Mifflin Kenedy had come to the young cowboy's rescue, as he had done before.

Dora Hand was interred in Boot Hill.

Variolation to vaccination
The discovery of vaccination has been one of the greatest advances in the history of medicine. The ancient Greeks had observed that people who contracted and survived smallpox did not get a second attack. It seemed that once you had the disease you had protection.

The Chinese presumably noted the same thing and tried to do something to produce a milder form of the illness. They discovered a process called variolation in the 10th century AD. It was in effect a primitive form of vaccination against smallpox. It involved exposing healthy non-infected people to the scabs of people who had smallpox. These were either put under the skin or  inhaled up the nose. Variolation certainly seemed to protect against smallpox by inducing a milder illness. Even so, it   was not completely safe. It could still kill, although not as often as smallpox did.

The Chinese practiced this for centuries, but it was not until merchants from Turkey brought it back centuries later that it spread to Europe. This was very welcome, since the disease at that time killed one in five people during epidemics.

In 1717 Lady Mary Wortley Montague (1689-1763), the wife of the British Ambassador to Turkey heard about variolation in Constantinople. So impressed was she, and so convinced of its efficacy that back in Britain she and the princess of Wales persuaded the authorities to permit a hazardous and unethical experiment. A group of convicted prisoners and orphaned children were given variolation, by having scabies scabs inserted under their skin. A few months later they were deliberately exposed to smallpox. None of them contracted the disease and the procedure was deemed to be safe. Several members of the royal family were inoculated, the result being that variolation became fashionable.

Variolation was introduced to America by African slaves. Cotton Mather, a Boston theologian and Puritan minister learned about variolation from his slave, whom he had christened Onesimus. Mather discovered that other slaves had also been variolated and he found some literature that referred to the method employed in Turkey. When an epidemic  of smallpox hit Boston he was able to  encourage variolation, with good effect.

In 1796 Dr Edward Jenner (1749-1823) an English physician and scientist discovered vaccination.

He had been inoculated by variolation as a child. Unfortunately for him, he suffered complications from the process for the rest of his life, but wondered if there could be a more effective way of giving protection against the condition.

Dr Edward Jenner resting against a tree, by John Raphael Smith

Dr Jenner noticed that cow maids often contracted cowpox, a much milder condition than smallpox, but did not contract smallpox. He researched this and found that by inoculating pus from the lesions of cowpox onto a healthy person it gave them protection against smallpox.From this he established the principle of vaccination, which has since saved millions of lives.

In the 1880s, with the development of the Germ Theory a greater understanding of how micro-organisms caused disease was developed. This helped enlightened researchers to look for ways of curbing the ravages of these infectious illnesses. In 1884 Louis Pasteur discovered the rabies vaccine and put it into practice in humans in 1885.

In 1890 Emil von Behring added to the success story of vaccination when he discovered the diphtheria  vaccine and the tetanus vaccine. Then the Japanese physician Shibasaburo Kitasato dissevered the antitoxins of both diphtheria and tetanus, when he demonstrated that animals could be protected by injections of these antitoxins.

In the 20th century vaccination programmes were developed around the world against many of the dangerous infectious diseases, and in 1955 polio vaccination dramatically reduced the suffering from poliomyelitis.  Now this disease is very rare.

In 1980, one of the greatest success in medicine was achieved when theWorld Health Organisation declared that smallpox had been eradicated.

Some of Clay More's latest releases:

Redemption Trail published by Western Trail Blazer
- a novelette- novella

Sam Gibson used to be a lawman, until the day he made a terrible mistake that could never be taken back. Since then, he has alternated between wishing there were a way he could redeem himself and believing he deserved punishment. 

He’s about to get both… 


And his collection of short stories about Doc Marcus Quigley is published by High Noon Press

Available at

And his latest western  novel Dry Gulch Revenge was published by Hale on 29th August.