Dr. William Oatway proclaimed that Addie’s fast-acting diphtheria was the most virulent form of the disease he’d ever witnessed.

In fact, he said “[the diphtheria] had advanced with unusual rapidity…it was the most stubborn, and rapidly developing case he has ever met with, and the result seems to justify the belief that no human power or skill could have furnished relief…” (And yet he forgot to report it to the State Board of Health a few months later, when he told them there were no cases of diphtheria in 1901 in Lakes Mills.)

A mere 16 hours after the first symptoms appeared, Addie was dead, killed when the membrane in her throat (a trademark feature of diphtheria) broke off or closed up (depending on which version of the two obits you read). She died from asphyxiation.

Sounds awful, for sure. The good news is, according to an online report I found from the CDC, that’s not how diphtheria works. In other words, Oatway’s story is pretty far-fetched.

PHARYNGEAL AND TONSILLAR DIPHTHERIA

The most common sites of infection are the pharynx and the tonsils. Infection at these sites is usually associated with substantial systemic absorption of toxin. The onset of pharyngitis is insidious.

Early symptoms include malaise, sore throat, anorexia, and lowgrade fever. Within 2-3 days, a bluish-white membrane forms and extends, varying in size from covering a small patch on the tonsils to covering most of the soft palate. Often by the time the person seeks medical attention, the membrane is greyish-green in color, or black if there has been bleeding. There is a minimal amount of mucosal erythema surrounding the membrane. The membrane is adherent to the tissue, and forcible attempts to remove it cause bleeding. Extensive membrane formation may result in respiratory obstruction.

Did you see that? 

Within 2-3 days, a bluish-white membrane forms and extends, varying in size from covering a small patch on the tonsils to covering most of the soft palate.

Typically in children, diphtheria killed them 5-6 days after onset, due to this membrane formation. How could Addie die in 15 hours? In fact, according to Oatway, the membrane formed and then broke off. None of this makes sense.

And how could Addie die from this “membrane” in 15 hours, when it takes several days to form?

Part of the problem with diphtheric membrane was it was part of the tissue and could not be removed without causing excessive bleeding. How could all this happen in 15 hours?

It probably did not.

Addie

Addie as a child, at about age 8-10 (1880-1882).

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Addie at about 22 years old, in 1894.

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Addie in her fancy coat and matching muff.

To learn more about Addie, click here.