Did this Little Woman Have Lyme Disease?
by M.M. Drymon
“Is it not meningitis?” were Louisa May Alcott's last words.
"Little Women" is one of the most beloved books that I remember from my childhood. When PBS advertised a television documentary about Louisa May Alcott's life, I was thrilled to be able to watch it. My joy, however, quickly turned to dread when I watched the actress portraying the author run several times through a shrubby, weedy, forested area in a long skirt, albeit, the skirt was tied up a bit. I wanted to reach in to the television and shout at her "watch out for the ticks." If that television special was shot almost anywhere in New England today, the actress was at great risk for becoming infected with Lyme disease. I also wished that I could reach back through the centuries to warn Alcott herself about how risky her daily run could be.
Several years ago, in association with a book I was researching, I participated in an experiment that showed with clear results how risky wearing a long skirt in a tick-infested area [Crescent Beach in Cape Elizabeth, Maine] could be. The enlarged flowing cloth profile makes the skirt into a collection flag or magnet for questing ticks, leaving the wearer especially vulnerable to infection. My warnings, however, would be a century and a lifetime of misery too late for Louisa May
Alcott.
Born in 1832, Louisa May Alcott was a direct descendant of Samuel Sewell, a judge during the Salem Witchcraft Trials in 1692. For most of her life she resided in Concord, Massachusetts, at a time when the New England landscape was being transformed from an agrarian terrain into the modernized, industrial, and tick-infested world that we know today. Farms were being abandoned in rocky New England in favor of the easily plowed and fertile soils of the Midwest. Alcott's friend, Henry David Thoreau, wrote about these changes in the famous work that he composed at nearby Walden Pond. The modern re-forestation of New England had just begun, bringing with it brushy undergrowth and weedy, neglected patches along with the early foundations of our modern suburban landscape.
In 1862 Louisa May Alcott contracted typhoid fever while serving as a Civil War Nurse in Washington, D.C. She was treated with calomel, a mercury-laden drug. Her brush with mercury could have left her vulnerable to Lyme infections or re-awakened a pre-existing infection. In subsequent years, when she suffered intermittently from a spectrum of ailments, she attributed them all to mercury poisoning. Alcott's journals and letters are filled with detailed accounts of her suffering: rashes, headaches, profound fatigue, nerve pain, digestive problems. "Sick from too hard work," she wrote in 1867, the year before Little Women was published. By 1888, at the age of 55, she wrote "I look about 70, grey & wrinkled & bent & lame."
When Ian Greaves and Norbert Hirschhorn, experts in mercury poisoning, studied Alcott's symptoms, they found that they didn't add up. Alcott did not have the telltale signals for mercury poisoning or signs of tremor in her handwriting. It seemed to them more like an immune system disorder. They suggested that, based upon her symptoms and a late portrait of her with a rash on her face, Louisa May Alcott suffered from the auto immune disease, Systemic Lupus Erythematosus.
Another possible diagnosis that needs to be considered is Lyme disease. The late Dr. Paul Lavoie firmly believed that in some people, Lupus or a Lupus-type syndrome was a reaction to an underlying Lyme infection. Modern patients suffering from chronic Lyme often exhibit the Alcott-like symptoms of extreme fatigue, re-occurring rashes, edema, nausea and the joint pain. Some have been diagnosed with Lupus due to elevated Anti-Nuclear Antibodies [ANA] in blood tests but then were subsequently diagnosed and treated for Lyme disease, which cleared up the Lupus-like symptoms in some. The butterfly face rash may be an infrequent symptom of Lyme disease as well as Lupus. There are several documented records of butterfly rashes on the faces of modern Lyme patients. One patient in Connecticut had such a rash, but it was only after she broke out all over her entire body that Lyme Disease was suspected, diagnosed, and treated. Another patient had a bulls-eye rash on her arm accompanied by a butterfly rash on her cheeks and eventually, a rash that covered most of her body.
There are lessons to be learned from history. An examination of Louisa May Alcott's afflictions may help to bring a spotlight onto modern sufferers of chronic Lyme disease, many of whom live in a medical limbo of pain and despair-their disease denied and their sufferings denigrated. Alcott's symptoms, her frequent interactions with a possibly tick-risky landscape, the scientific findings of extant infections in museum specimens that lived in Massachusetts during her lifetime, and the landscape itself point towards a diagnosis of Lyme borreliosis infection with possible brain involvement. Although she eventually died from a stroke, her suspicion that she suffered from meningitis may not have been very far off the mark.
People who are interested in reading Louisa May Alcott's descriptions of her afflictions should read:
The Journals of Louisa May Alcott [University of Georgia Press:1997]. Edited by Joel Myerson, Daniel Shealy, and Madeleine B. Stern
Resources:
See "Why Women?" on page 150 of Disguised as the Devil: How Lyme disease created witches and changed History. A female in a long skirt collected an astounding four times as many Ixodes scapularis ticks as her male counterpart walking in the same area of Crescent Beach, Cape Elizabeth, Maine.
Hirschhorn, Norbert and Greaves, Ian. "Louisa May Alcott: Her Mysterious Illness." Perspectives in Biology and Medicine. Volume 50, Number 2, Spring 2007, pp. 243-259.
W.F. Marshall III, S.R. Telford III, P.N. Rhys, B.J. Rutledge, and D. Mathiesen, "Detection of Borrelia burgdorferi DNA in museum specimens of Peromyscus leucopus," Journal of Infectious Disease 170 No.4 (Oct. 1994), 1027-32.
