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It’s difficult for us to imagine dying from a toothache or sore throat. But in our ancestors’ day, even such innocent-sounding symptoms could signal serious illness or death lurking around the corner. Our forebears didn’t line up every fall for flu shots or get the kids booster shots before school started. No one went to the doctor for a checkup, and antibiotics hadn’t been invented.
Epidemics swept through our ancestors’ communities with dreadful regularity, carried by airborne germs, contaminated water, bug bites and human contact. The 20th century witnessed the Great Flu Pandemic of 1918 and the 1950s polio outbreak; earlier generations repeatedly saw the grim toll of smallpox, yellow fever and cholera. An illness could wipe out all the children in a household. Genetic conditions, such as hemophilia and Huntington’s disease, were poorly understood. Accidents were a daily risk, with no 911 to call for help. A simple slipup on the farm could result in a lost limb or a slow, painful death from lockjaw.
Genealogists inevitably will encounter an unfamiliar malady, unexplained death or mysterious disappearance. Setting those deaths and disappearances in context with historical and genealogical records could answer the question “What happened to them?”
Health matters
Your ancestors’ medical records, of course, can help you fill in blanks on your family tree. They’ll also lead you to social history information about epidemics, local hospitals and common treatments that’ll give you an in-depth look at your relatives’ world (turn the page for research tips).
But even more vital, information about health problems in your family can help you take better care of yourself and your living relatives. Genealogist Paula Hinkel of Los Angeles never knew her Dad was classified as 4-F (not acceptable for service) in the WWII draft registration because of his heart. “We knew he spent the war years on the West Coast teaching dancing, driving taxicabs and serving as a bellman,” she says. But her family motto, she adds, was “It just never came up.”
Hinkel’s granddaughter forced the issue with a homework assignment to gather health histories from relatives. “It turned out to be a big deal for us,” says Hinkel, who helped out with information from her genealogy research. “Our female line carries an enzyme that messes with our coagulation, and we have four generations of stroke, phlebitis and pulmonary embolii. It got a good mother-daughter-granddaughter conversation going.”
Even if there’s no cure for an illness, family history knowledge can inform treatments and help you understand the disease. Genealogist Julie Judd Clark of Oreana, Ill., consulted courthouses, funeral parlors and family friends to trace her husband’s relatives with Marfan Syndrome. Sadly, the disease, which affects connective tissue, killed Clark’s 56-year-old husband and 36-year-old son just a year apart.
As you learn about family members’ illnesses and causes of death, record the details in your genealogy software and/or the Surgeon General’s My Family Health Portrait online tool—it resembles a family tree, but with spaces for medical information. Bring it to your next doctor’s visit to help him or her determine if you’re at risk for certain diseases, order appropriate tests and advise you about lifestyle changes.
Records examination
The Health Insurance Portability and Accountability Act (HIPAA) limits access to modern medical records, of course, which would enlighten you about illnesses of living or recently deceased ancestors. But you might be able to find prescriptions, doctors’ instructions or bills among family papers. Family photos can contain clues, too (see our Pictures of Health article). Your next step is to look for information about relatives’ health problems and causes of death using these resources:
- Family members: Gently ask relatives which illnesses run in the family and what Great-grandma died of. My mother recalls that one of her sisters developed diphtheria; their mother would hold a mirror under her nose to make sure she was still breathing.
Some tales will be clearly told, but family secrets such as alcoholism may be hidden in statements like “Uncle Joe sure lived in the fast lane.” Tactfully dig a little deeper by asking, “What makes you say that?”
- Diaries and letters: Health was a bigger deal to our ancestors than to us, and their diaries and letters are filled with litanies of the writers’ or family members’ symptoms and illnesses. The published writings of your ancestors’ contemporaries offer insights into medical conditions prevalent at that time: In A Midwife’s Tale: The Diary of Martha Ballard, Based on Her Diary, 1785-1812 transcribed by Laurel Ulrich (Vintage), you can follow Ballard’s daily interactions with patients. You’ve probably already examined any family papers you have, but be sure to ask relatives if they have any old letters and diaries.
Search for historical letters, diaries and other papers at repositories where your ancestors lived using an online search engine such as Google, the WorldCat library catalog search or the ArchivesUSA database (available at large public libraries and academic facilities). Search for your ancestors’ names and topics such as the places they lived, schools they attended, organizations they belonged to and wars or battles they fought in.
- Death records: Most states began keeping records of deaths in the early 20th century, though some states, counties and towns started earlier. You’ll need an approximate date of death to request a death certificate; if you don’t know this information, ask relatives, look for an obituary or cemetery record, or search online death indexes for the state where the person died (run a Google search of the state name and “death index”). You also can search the Social Security Death Index, especially for folks who died after 1962—search several sites’ versions of the index on Steve Morse’s One-Step site.
Historical death certificates could be on file at city and town halls, or county or state health departments. You can request records in person or by mail. You often need to fill out a form and pay a fee, so call or check the office’s Web site for instructions. Check to see if the state archives and/or the Family History Library (FHL) has the records on microfilm, too. Although death records are often closed for 50 years after the death (or another time frame, depending on privacy regulations), you might get access if you can prove a relationship to the deceased.
Death records will tell you where your ancestor died and what the doctor believed was the cause of death. Sometimes they provide the name of the hospital (if he died in one), burial place and funeral home. Bear in mind that a relative usually supplies information about the deceased, so you’ll want to verify the information in other records.
If the cause of death was suspicious, a coroner may have investigated. Contact the county coroner’s office to request a search (old files may have been transferred to a local historical society or the state archives). The FHL has some microfilmed coroner’s records.
- Obituaries: Obituaries of the 18th and 19th centuries record the passing of men, women and children, but rarely mention the causes of their demise (unless it was connected with a news story, such as an accident). Often, only in the 20th century do you see a cause of death in print. Even if you don’t get a cause of death, though, you’ll have an approximate date and, possibly, the name of a cemetery or funeral home, so you can look for other records.
You can search newspapers online using Google News Archive; the subscription sites GenealogyBank, Ancestry.com and Footnote; or ProQuest Obituaries, which is offered free through many libraries. You may find microfilmed newspapers in local libraries or the state archives where they were published (if you don’t live nearby, see if your library can borrow the film through interlibrary loan). Extend your search for several days to a week after a recorded death date—it often takes a few days for an obituary to appear in print.
- Funeral records: Search the Web, check phone books, or ask at the local public library or historical society to find out if the funeral home mentioned on a death record is still in business. Contact the home to request a copy of an old record. Keep in mind that not all funeral homes retain old records, and these private businesses aren’t obligated to share their records with the public. Most funeral home records give you the certifying physician’s name and residence, as well as the cause of death and, of course, details about the funeral.
- Census records: You might not think of the census as a source of health information, but US enumerations do contain some clues. In the 1900 census, for example, look in the columns listing the number of children a woman gave birth to and the number still living. Study several pages, and you’ll get a staggering picture of the reality of infant mortality our ancestors lived with.
Microfilmed census records are at National Archives and Records Administration (NARA) facilities, the FHL and some public libraries. Ancestry.com has images of all available US census records, as do Ancestry Library Edition and HeritageQuest Online (free through many libraries). FamilySearch has census images and/or indexes for many years on its Record Search Pilot.
In the 1850, 1860, 1870 and 1880 censuses, a special mortality schedule recorded information about individuals who’d died in the 12 months preceding the census date. Among other details, you’ll learn the month and cause of death. You’ll find these records along with regular population census records.
In 1880, census takers filled out special schedules of “defective, dependent and delinquent” classes—people who were physically or mentally disabled and/or institutionalized. If your ancestor’s 1880 population census listing has a mark in columns 15 through 20, look for more details about his condition on one of these special “DDD” schedules. Schedules for each state are at various libraries and archives, with a handful on microfilm at NARA and the FHL. Download our state-by-state list of DDD schedule locations.
- Hospital records: At the Rhode Island Historical Society <www.rihs.org>, a brief record from a Revolutionary War military hospital in Providence lists the names of the sick, each person’s illness and the nurse who cared for him. Most of the hospitalized soldiers suffered from smallpox.
Compare that scarcity of information with what you might find in a contemporary hospital chart: patient’s name, age, birthplace, hospitalization dates, illness, and discharge notes or a death record.
Older hospital records are usually admittance and patient population ledgers, rather than charts. Records, if they survived, might be restricted (you may be able to request a search—in which case you’ll get copies of records with all names blocked off except your ancestor’s). They can be hard to find, though. Ask the hospital itself where old records are, if it’s still in existence. If not, old records could be at historical society or library. Records from a religious hospital might be in a church archive. If the hospital was state-run, look for records at the state archives. For instance, Alice Eichholz, editor of Red Book: American State County and Town Sources (Ancestry) told me that she “found family health histories for a mother, her unmarried daughter and her married son, who were all hospitalized in mental institutions, at the Oregon State Archives.”
You’re in luck if FamilySearch has your ancestor’s record among its microfilmed 19th-century hospital records. Run a search of the online catalog on the subject hospital, then click a category that might cover the place where your ancestor lived.
- Insurance records: The next time you fill out insurance paperwork, think about the type of information you’re supplying—it’s a great source of health history details. In 1865, insurers began collecting medical data; in 1889, Mutual Life Insurance Co. first included a medical questionnaire as part of its application. In Hidden Sources: Family History in Unlikely Places (Ancestry), Laura Szucs Pfeiffer says that some insurance companies keep files for years and then discard them, but others microfilm the applications or retain the originals permanently.
Start by looking through family papers for insurance documents including policies, payments or certificates. Once you have the company’s name, contact the headquarters (if the company is still in business) to see if it has an archive of historical records and ask about access policies—the records may be restricted. The company might’ve been acquired or merged with another, so do some online research to track name changes.
If the company is no longer around, records might’ve been donated to an archive. Start your search on the Web using the name of the original company. Likely recipients are a library or historical society in the state where the company was located.
Fraternal organizations such as the Catholic Order of Foresters and immigrant aid societies such as the Czech-Slavonic Benevolent Society (Ceskoslvanska Podporujici Spolecnost) often provided life insurance benefits. If family papers hint your ancestor was a member, search online for the society’s name to find out where old records might be.
- Military records: Loads of medical details await you in military records. Soldiers’ service records might mention injuries received and absences due to hospitalization. Papers at NARA, writes Pfeiffer, might include “medical records for the periods 1821 to 1884 and 1894 to 1912, containing information relating to regular army personnel admitted to hospitals for treatment; abstracts of medical records for Civil War soldiers treated at medical facilities; and records of the Bureau of Medicine and Surgery pertaining to sick or wounded naval personnel; and hospital records for residents of some of the National Homes for Volunteer Soldiers.” For more details on what records are available for those who served in World War I and earlier wars, see NARA’s website.
Pension records detail medical problems for which soldiers or their survivors claimed compensation. My ancestor’s Civil War pension file included a diagram of how a musket ball had disabled his hand. Another file revealed why the soldier served only three months—dysentery. NARA is the guardian of original service and pension records, most of which aren’t microfilmed. You can order copies for a fee, though it might be cheaper to hire a local researcher to make copies.
Confederate service records are on Footnote. HeritageQuest Online and Footnote have Revolutionary War pensions (HeritageQuest Online has the first 10 pages from every file; Footnote has all pages). Footnote is adding approved Civil War Union widows’ pensions. Formerly Confederate state archives would have pensions for Southern soldiers.
Genealogical outbreak
If you’re not a medical professional (and maybe even if you are one), it’s possible you won’t be familiar with medical terminology on the documents you locate. Try running a Google search or type the term into The Free Dictionary. Antiquus Morbus has a long list of definitions for medical terms and causes of death often found in genealogical records. You also can try A to Zax: A Comprehensive Dictionary for Genealogists & Historians (Hearthside Press) by Barbara Jean Evans.
Whether you’re compiling health history for medical reasons or genealogical interest or both, you can add a little context to what you’ve learned by researching your ancestors’ illnesses and common remedies. Local histories can tell you when epidemics came through (see our timeline of major US epidemics), what commonly caused deaths in the area, and how sick and injured people received treatment. Use the resources in our online toolkit and see The Cambridge Illustrated History of Medicine by Roy Porter (Cambridge University Press). For a more ironic sense of medical history—one that’ll make you glad you were born today and not in your ancestors’ era—read The Alarming History of Medicine: Amusing Anecdotes from Hippocrates to Heart Transplants by Richard Gordon (St. Martin’s Griffin).
Applying your genealogy research skills to gathering health history information gives you a hard look into your ancestors’ lives—even the less pleasant aspects. It also could save your life and make you the longest-living member of your family.
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