My grandfather, Henry Irving Baker, Jr. died in 1949 when my father was a young boy and before his sister was even born. For many years, members of the family gave various reports of his final illness. Several years ago, I decided that a careful family history study could actually help pinpoint the reasons for his death.
My first stop was his death certificate. H.I. Baker, Jr. died on September 10, 1949 at his home on 26 Holmes St, Poughkeepsie, NY. He was age 31 years, 10 months, and 28 days. Cause of death is listed as angioneurotic edema
of larynx (12 hours) due to infective sinusitis and pharyngitis (1 week). His physician was Raymond McFarlin.
A translation of the medico-lese is that H.I. Baker Jr. died when his throat swelled shut over the course of 12 hours as the result of a cold he'd had for a week. This is essentially what my father remembers the adults telling him, but he was so young that it is difficult to entirely know what of his memories to trust and whether adults told him the whole story.
I next contacted the Dutchess County Medical Examiner's Office
, but no autopsy was performed. According to current policy, an autopsy is only necessary for:
"any death resulting from homicidal violence, criminal negligence, suicide, fire, asphyxia, vehicular and other accidents, drug or chemical overdose, when a death is unexplained, when a death occurs in police custody or legal detention, and whenever an autopsy is deemed necessary in the interests of public health and safety. The need for an autopsy in the evaluation of a sudden, unexpected death apparently due to natural disease is decided on an individual basis."
That last sentence appears to cover this case and it seems that an autopsy was not conducted.
My next step was to consult the obituary. From Poughkeepsie New Yorker, September 10, 1949:
Henry I. Baker Jr., Dies Unexpectedly at His Home
Henry I. Baker Jr., 31-year-old attorney, died unexpectedly at his home at 26 Holmes street shortly before 12:30 o'clock this morning.
According to police, Mr. Baker suffered a severe bronchial spasm and Glottal edema yesterday noon and he was attended at home by a physician. At 12:17 a.m. today, Mr. Baker's wife telephoned police and requested a pulmotor [an artificial respirator].
The Fire department emergency squad in the charge of Captain Shelly and a doctor were sent to the Baker home. Mr. Baker was pronounced dead on arrival of the doctor.
Mr. Baker first became ill on Tuesday while serving as an inspector at the polls in the Sixth ward for the Primary elections.
Born here, Oct. 18, 1917, Mr. Baker was the son of Henry I. and Edith Bell Kimlin Baker. He was educated in local schools and was graduated from Poughkeepsie High School in 1935, from Bard college in 1939 and from Columbia Law school in 1941. He was admitted to the Bar in October, 1941. He practiced for a year in New York City prior to his enlistment in the United States Army Signal corps. He returned to this city after his Army discharge in January 1946. He maintained his law office at 3 Catherine street.
During his tour of duty overseas, Mr. Baker was engaged in communications liaison work in joint amphibious operations in the Mediterranean Theater of Operations and participated in the invasions of Sicily and Southern France. After his return from overseas, Mr. Baker was assigned to the communications center of the Army General staff in the Pentagon building, Washington, DC. Mr. Baker was one of a small group of the Eighty Amphibious force, all members of which received commendation for meritorious service in the amphibious assault landing in Southern France.
A member of Christ church, Mr. Baker was a past president of the Young Adult Supper club of the church. He also was a member of the Young Republican club and of Poughkeepsie lodge, Free and Accepted Masons and of the Dutchess County and New York State Bar associations. He served as captain of the professional division for the lawyers in the 1949 Fund Drive of the Dutchess County chapter of the American Red Cross.
Surviving, in addition to his parents are his wife, Mrs. Ruth Abercrombie Baker, formerly of East Derry, N.H.; a son [...] and a sister, Miss Edith Bell Baker, here.
Funeral services will be conducted at the Schoonmaker chapel, 73 South Hamilton street, at 2 o'clock Monday. Burial will be in Poughkeepsie Rural cemetery.
Services of Poughkeepsie lodge of Masons wil be conducted at the chapel at 7:30 o'clock tomorrow night. Friends may call at the chapel between 7 and 9 o'clock tomorrow night.
While the obituary does give more information, it still leaves me dissatisfied. Certainly, it tells me that Henry Baker died of his airway closing and being unable to get enough oxygen. It does not tell me why.
Henry Baker was a previously healthy man. He trained as a lawyer just before WWII, an occupation he returned to after the war. He was a military veteran of the Signal Corps in WWII, specializing in cryptography. Health records from his enlistment note that he had a six-inch appendectomy scar from 1937, was just over 6 feet tall, and 145 pounds. He had blue eyes and blond hair. At enlistment, he was single, but had married before war's end and soon after fathered a child. His wife was pregnant again at his death, although she may not have known that yet. My aunt was born exactly 8 months after his death.
Several possibilities exist for his sudden death, but they fall into two basic categories -- bacterial or viral and anaphylaxis.
The first option is that he contracted a bacteria or virus
that closed his airway. There aren't many options for common illnesses that will do this, especially in adults.
Croup is an example of one well-known disease that can do this. Croup is caused by a virus (often parainfluenza or influenza) that manifests most prominently as a cold, but can close the airway such that patients develop a barking cough and possibly stridor (whistling breathing). It can be fatal. However, most cases of croup occur in children, as is true of the other diseases that are most likely. Recent case reports
, however, have indicated that croup in adults is much more severe that that in children. In 1949, it is entirely possible that a case of adult croup would not have been taken seriously and/or that there would not have been effective mechanisms to treat it.
Epiglottitis is another example of a disease that can close the airway in adults (and children). Epiglottitis is usually caused by the H influenzae type B bacteria which is now preventable by vaccine (it is also sometimes caused by other bacteria or viruses). It apparently caused George Washington's death and can be fatal to adults.
The primary early symptom is a sore throat. However, the described progression
of the disease
is rarely as long as a week, usually only a few days at most. Epiglottitis is often confused with pharyngitis
, however, which is listed on the death certificate.
Another option, however, is anaphylaxis, possibly due to a penicillin allergy. After a week-long cold, it is entirely possible that the doctor who treated Henry Baker at noon on the day of his death would have offered him penicillin. If he had a strep throat (which incidentally could have caused epiglottitis), antibiotics would absolutely have been the way to go. Penicillin would probably have cleared up the disease with no problems. That is, unless he had an allergy.
Penicillin, the first antibiotic to fight infections, was first discovered in 1929
and research on its use continued into the 1930s, but it was not used in civilian populations
until the mid-1940s. Prior to this, it had been used with some success on soldiers in WWII. Penicillin, in fact, so revolutionized the medical field that it is difficult to overstate its effects.
Early on, penicillin had to be given by injection and was rare enough and passed through the body quickly enough, that it had to be collected from the urine of patients to be reused. Nonetheless, its effects on diseases and injuries that had previously been incurable and often fatal was heralded as major progress.
In 1944, in a presentation
to the American Philosophical Society, Chester S. Keefer (a professor from Boston University) states unequivocally that penicillin is non-toxic. He does mention a few "side-reactions following its use that require comment", including "nausea, headache, tingling of the hands and feet, thrombophlebitis [blood clots in the vessels causing inflammation], urticaria [hives], fever, or chills and fever".
The first anaphylactic reaction to penicillin was described in the Journal of the American Medical Association by Dr. George Waldbott in May of 1949
(just months before Henry's death). By the early 1950s, several studies had been published bearing out Waldbott's conclusions. Researchers
noted that severe reactions were infrequent in the first nine years of penicillin's use and that over time allergic reactions to penicillins were becoming more frequent and more severe as exposed patients were more likely to develop hypersensitivity. Allergic patients are described as dying almost immediately of anoxia [lack of air] unless treated with antihistamines.
Penicillin allergy is now a widely recognized problem, and is the most common
drug allergy, causing a fatality
about 1 out of every 7.5 million uses. Actual allergic and anaphylactic reactions are much more common, since quick treatment with epinephrine can usually prevent fatality even in anaphylactic cases. This treatment would probably have been available in the 1940s if penicillin allergy had been recognized and a physician was readily available. Epinephrine was approved by the FDA in 1939
on the allergy lists anaphylaxis as the symptom for 2-4% of all allergic reactions to penicillin. Anaphylaxis includes the potentially deadly swelling of the throat and/or tongue as well as some more generalized symptoms. Less severe reactions include rashes or hives. These sound like infinitesimally small numbers, but do actually affect a large number of people each year. Between 300 and 500
people a year die from penicillin allergies.
Quite possibly, I will never know how Henry I. Baker actually died. Really, any of the above are options. It was a fluke that he caught the cold that he did, and quite unusual that he reacted the way he did. I lean toward epiglottitis as the most likely scenario, and will continue to explore for further information. Knowing this part of my family's history is not simply idle curiosity, but actually comes up regularly whenever a physician asks me about my family medical history.
Labels: family history