Hi Nancy,

No, we can't say with precision just when Doc was diagnosed. Most people have argued that he went west because he was diagnosed with consumption (which is what TB was called in those days). I suspect that he knew that something was wrong by the time he left Georgia, but I am skeptical that it was the reason he left for a variety of reasons.

There are a couple of considerations. First, consumption was not that easy to differentiate from other respiratory disorders in those days. The tubercle bacillus was not discovered until 1882, and it was some years after that before most of the medical profession knew the implications of the discovery. Not until then did most doctors begin to concede that it was contagious. Doctors more often thought it hereditary. Diagnosis, in the beginning, amounted to a suspicion because most of its symptoms were also present in other ailments.

Second, there were a whole variety of treatment of options. There was actually even a "Southern cure," in which patients were advised to move to certain areas of the South. If Doc went west because of his TB, he picked a bad place. The climate in Dallas, Texas, was hardly an improvement over Georgia.

Third, Doc certainly had reason to expect the worst. Although it is not spelled out specifically in the record, his mother almost certainly died of consumption. Francisco E'Dalgo, the Mexican orphan that Henry Holliday brought home from the Mexican War and who grew up in the Holliday household, died of consumption. Dr. Arthur Ford, the dentist Doc worked with in Atlanta, died of consumption. By the way, Dr. Ford "took his treatment" at a spa not more than a hundred miles from Valdosta, and Doc's uncle, who was a physician, lived in a community in Florida which extolled the curative powers of the local springs.

Patients went through a process, first, simply of hoping that they had some other problem and that the doctors were mistaken. Once they realized that it really was consumption, it was, in effect, a death sentence. The object, then, became to prolong life. In the 19th century, consumption (called that because the disease gradually "consumed" the body)was romanticized. It was the disease of poets and scholars in the popular mind, so Doc missed the stigma that would be attached to TB in the early twentieth century that lingered for a long time. When I was a boy, my uncle was suspected of having TB. He was rushed away for treatment, and the family tried to keep it quiet because TB had become such a scary term. He was misdiagnosed and came home to the relief of the family. But I still remember (and I was very small at the time) the reaction to the news that he might have TB. Doc did not have to put up with that kind of response. He wasn't shunned because he was a consumptive and people were afraid they'd "catch" something.

As symptoms worsened, as they did in the high country of Colorado in his last years, he began to cough more, he relied more on alcohol and morphine as forms of relief, and it would have become more difficult for him to deal cards or handle a sixgun. The last phase was called "galloping consumption" because the deterioration of the body accelerated dramatically. Sores began to appear on the body. Weight loss accelerated. Walking short distances became a challenge. Once he was forced to bed in the last days of his life, he was able to get up only twice in thirty-three days. After that he became delerious and slipped in and out of a coma. He did not speak during the last twenty-four hours before he died.

The symptoms he exhibited and the progression of the disease over time pretty much confirm that he had TB. Had he been able to stay in Arizona, he might have lived longer. A book published about Leadville, where he chose to stay, warned people with lung diseases to stay away because the climate seemed to exacerbate symptoms, but the Colorado high country was where he spent most of his time after Tombstone.

There is a considerable and interesting literature about how nineteenth century consumptives treated and lived with the disease. Doc's symptoms were pretty much classic. Some environments seemed better than others. Dodge City was a bad environment. He left there in terrible shape. A few months at Las Vegas, New Mexico, and he was visibly better. Tombstone also seemed to give him some relief. He was able to join the vendetta ride, which must have been grueling for the healthiest of the group. By the 1880s, most European doctors were opposed to drinking alcohol as a means of coping with symptoms (they believed it worsened them), but in the U. S., it continued to be a way for persons who were dying anyway to cope.

What amazes me is the way that Glenwood Springs responded in his last days. He was in a hotel, not a hospital. Father Downey, Reverend Crook, a couple of bellboys, and a few members of the sporting crowd, took turns watching over him during the last month of his life. There was still compassion in Glenwood Springs.

Best! Gary