The Reality of Dying of Consumption in the Old West

If you could hop into a DeLorean time machine and go back to an Old West saloon, one thing you’d notice — along with the open-carry side arms, overpowering stench of body odor, and dirtiness of the bar glasses — would be all the dry, hacking coughing.

Sure, the Old West was a dusty place, but that wasn’t the only reason. In most cases, it was because of consumption, a condition you’ll come across as you skim through news articles, journals, and literature from that era. But what was consumption, and what was it like to die of this disease in the Old West?

Let’s learn the gross, gritty details of consumption in the Wild West.

Consumption? What’s Consumption?

So, what is consumption and why don’t people get it today? I’ll answer the second question first: they do.

Consumption is still around, and it is still a major problem in some parts of the world. Like an FBI informant in the Witness Protection Program, consumption changed its name and moved away. It’s new name? Tuberculosis.

Consumption, or tuberculosis, is a bacterial lung disease. In the latter half of the 1800s, consumption accounted for about 14% of all deaths. Today, thanks to modern medicine, tuberculosis is very rare in the U.S., but cases are on the rise in developing nations. With prompt diagnosis, tuberculosis is treatable, but symptoms can last for months, and even years.

And it was a totally different story a century and a half ago.

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Consumption: a Serial Killer

Did you know that, despite what Hollywood westerns try to tell us, the leading cause of death in the Old West era wasn’t middle-of-the-dusty-street gunfights, attacks by rampaging mama bears, scalping by Native Americans (come on, those stories were mostly exaggerated), or dramatic rattlesnake bites?

And, no, it wasn’t quicksand, either.

Consumption was the number one killer in the 1800s and early 1900s. The good news: your chances of drowning while steering your covered wagon across a raging river or being hanged at the gallows were relatively low.

The bad news? As much as 90% of the population of city-dwellers in North America in the 1800s were infected with consumption. Of those individuals who ended up with active consumption, the death rate from the disease was about 80%.

Related read: Why Did People Move West in the 1800s?

How Do I Get Consumption? Not That I Want It…

In the 1800s, most people, including doctors, didn’t understand how diseases are spread. Today, thanks to recent events, we are all experts in that department.

Records show us that consumption often infected entire families who were living together in tiny houses before tiny houses were a hipster thing. Since the symptoms of consumption can take a long time to appear, folks back then didn’t seem to put two and two together.

What they didn’t know is that tuberculosis is caused by a bacterium by the name of Mycobacterium tuberculosis. It can be spread through the air when an infected person coughs, sneezes, talks, or sings karaoke — anything that sends spittle droplets floating in the air.

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All the Nasty and Graphic Symptoms

Although they vary from person to person, consumption’s number one symptom is a persistent, dry, nagging cough. Not the nice “productive” coughs that doctors like to hear about. Productive = gunky and phlegm-y. As the disease progressed, the person coughed up blood, which is also unproductive — and gross.

Drastic weight loss was also associated with consumption, and not the good weight loss that happens when you do a keto diet. Consumption patients experienced sudden fever spikes, loss of appetite, and extreme fatigue. Finally, victims had night sweats — the kind that left their sheets more than just damp, but drenched, like a menopausal woman.

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Consumption Killed Doc Holliday

Doc Holliday wasn’t killed at the shootout at the O.K. Corral in 1881, or in a duel with Johnny Ringo. He was wounded at this famous Old West event, along with Morgan Earp and Virgil Earp, but he recovered from his injuries.

What really killed Doc Holliday was consumption. In 1873, a year or so after he began experiencing unexplained weight loss and a persistent cough, the dentist-turned-gambler was diagnosed with consumption, just like his mother had years before him.

His doctor suggested he “take the cure.” Holliday followed his advice, but he also self-medicated with alcohol and opium. Lots of alcohol and opium. He was a doctor, after all.  

As the story goes, Doc Holliday, who spent a lot of time in Old West gambling halls packed with quick-tempered drunks, grew so weak that he pretty much sucked at fist fights. He got tired of getting his ass kicked, so he honed his sharp-shooting skills and let his pistols do the fighting for him.

Related read: I’m Your Huckleberry: The Real Meaning of Doc Holliday’s Iconic Line

Consumption Patients Moved West — On Doctors’ Orders

When Doc Holliday headed west, he was just following his doctor’s orders. Holliday, like many others, were prescribed “the cure” or “the prairie cure” to treat consumption.

Medical science 150 years ago had lots of whacky ideas. Remember leeches? And predicting someone’s criminal tendencies by feeling the lumps on their skulls? Yea, science!

Doctors believed that the humid climates, foul smells of raw sewage, and the filthy living conditions of east coast cities caused consumption, so they suggested patients move to the dry, wide open regions of the West.

Holliday and other consumption patients were told to rest in the sun and breathe in the fresh, clean, country air. In fact, fancy resorts called sanatoriums were built by enterprising folks hoping to profit from desperate, dying consumption patients.

These sanatoriums charged people a lot of money for the opportunity to sit in the sun and breathe in the fresh, clean country air. Great racket. Doc Holliday died at Hotel Glenwood in Glenwood Springs, Colorado, hoping the nearby hot springs would help his ailments, but to no avail.

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Did “The Cure” Work?

We know the cure didn’t work for Doc Holliday, but did it work for others?

Not really.

Consumption, at that time, was incurable. It wasn’t until the 1940s before an effective medication to kill the bacteria was created. But living in the West made consumption patients feel better.

The fresh air was much healthier than the polluted stench they were breathing in the cities. The western towns were less crowded so air-borne virus and stuff wasn’t as thick in the air.

Plus, people worked outside on farms instead of indoors in stifling factories. They had access to fresher food. And then there was the sunshine. While it didn’t cure consumption patients, the UV rays of the sun killed the bacteria that caused tuberculosis.

So, when a person with consumption coughed or spit outside, the sunlight shriveled the bacteria in their vile spittle. No more transmitting the disease.

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An Undignified Death

Doc Holliday died in 1887 at the age of 36. He lived with the unpleasant and progressive symptoms of consumption for more than 14 years and died an undignified death.

At the end of his life, he was bedridden, too weak to care for himself. Big Nose Kate (also known as Mary Katherine Horony Cummings, or Kate Elder), a former lover, tended to him. His body was riddled with constant coughing, making it impossible for him to take in a full breath of air.

He was completely dependent on opium and drank whiskey to dull his chronic chest pain. According to legends, he was dismayed at the copious amounts of blood he hacked up.

Like a true Old West gambler, Doc Holliday insisted on keeping his holster at his side and argued with Kate when she removed his boots, who later recalled his last words: “Well, I’m going just as I told them — the bugs would get me before the worms.”

Related read: The Real Story of Doc Holliday and Big Nose Kate

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