The late Dr. H. Rawling Pratt-Thomas, MUSC's eminent pathologist, is said to have taught over 5,000 medical students.
Born Rawling Pratt in Yorkshire, England, in 1913, his father died shortly after WWI. His mother ended up marrying an American who adopted the boy, thus explaining the hyphenated name. He grew up in Sumter, attended Davidson College, later MUSC, and completed his training at Cincinnati General Hospital before returning to Charleston and a distinguished 49-year career with the university.
He died in 2008 at age 94. Besides family, lecturing was the great love of his life. I was pleasantly surprised to learn that one of his lectures was recorded for posterity at St. Philip's Church during an adult forum held May 2, 1993.
The lecture was titled "Diseases That Claimed our Ancestors," and addressed a brief window of time during the early 1800s when one John Smith, the church clerk, kept meticulous records. Dr. Pratt-Thomas pored through these and other registries and delivered a scintillating and informative talk, which reminds certain listeners of the magic he once worked in the academic classroom.
I should know because I'm one of them. What follows is a brief synopsis. Who would have thought that death could be so interesting?
The first recording made by Smith in 1825 describes an individual who died of "the fever." Fever was one of four general categories used by the clerk to describe cause of death, the others being consumption (tuberculosis), dysentery and the common childhood illnesses of the day (diphtheria, "whooping cough," abscesses and so forth.)
It's important to remember that the communicable nature of disease was not in the least understood during the early part of the 19th century, and that the mechanisms of disease concerning malaria and yellow fever, for example - two of the more common sources of "fever" in the Charleston area - were not elucidated until 1898 and 1900.
About the best they could come up with was environmental association. In his classic 1824 work, "The Modern Practice of Physic," Robert Thomas observed that "marsh myasmata" and the "effluvia" arising from stagnant water or marshy ground were among the most common ingredients for the development of pestilence. Other scientists blamed solar and lunar eclipses and even moon phases.
The issue of smallpox was always lurking in the background, although the St. Philip's registries don't indicate a ravaging impact on its congregants. In fact, only two deaths were recorded in the registries as attributable to smallpox - both in 1806. (Board of Health statistics cite 85 deaths from smallpox in 1816-1817. None apparently were congregants of St. Philip's.)
Diphtheria was the most feared and deadly of the childhood plagues, made worse by the painful struggling and prolonged suffocation of its small victims. Parents who had to witness this never really recovered. (My paternal grandmother lost a four-year-old daughter to diphtheria and could never discuss it for the duration of her life without breaking down.) According to Dr. Pratt-Thomas' lecture, Charleston's Jewish population considered diphtheria the most horrible of its list of 939 varieties of death.
Well, there weren't nearly so many diagnostic choices at St. Philip's, although the doctor did uncover the following statistics from the records of the clerk: Cancer was recorded five times (with breast listed as primary in one instance), nine listings for intemperance or drunkenness, three for insanity, one lockjaw (tetanus), four rheumatologic listings, seven through childbirth, seven from "worms," and one suicide.
Realizing that pathos, misfortune and high adventure might be gleaned from these brief recordings, it should be noted that three died during the Sept. 27-28 hurricane of 1822, and that one congregant was murdered.
Some died from a particularly unusual malady: Decay or decline of nature, a vague diagnosis given to young and old alike, possibly representing chronic illness or failure to thrive. Other diagnoses defy analysis: Stoppage in the chest and gout in the stomach are examples. The term pneumonia isn't used at all.
Cardiovascular disease, one of the biggest killers as understood in the modern era, isn't mentioned and probably wasn't even imagined back then, although the term "dropsy" was employed and may be the best indirect reference to myocardial infarction or heart failure.
I urge former students of Dr. Pratt-Thomas (or anyone else) to listen to this recording. His rich, sonorous tone and authoritative lecture style are sure to bring back nice memories. And, once again, you'll learn something.
Edward M. Gilbreth is a Charleston physician. Reach him at edwardgilbreth@
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