Treating Sarah's Malady. Part 2

(See the post dated March 2, 2010, for Part 1. Note that Sarah Gratz was called Sally by her family.)

After Sarah's blistering, Rebecca wrote to her brother Jo: "You will find our dear Sally is not better and of course little comfort [is] enjoyed by the rest of the family. She is now suffering great pain from a blister but I hope it will prove beneficial. It will at least keep her in her room a few days which must be useful as I can perceive company and exercise increase her disease."

When their youngest brother Benjamin was able to get leave to come home for Yom Kippur, Sarah created emotional havoc. After he returned to camp, Rebecca wrote to him: "We have had no more such scenes as distrest you so much . . . [the doctors] have changed Sally's medicine. They now give her some powders that will confine her to her room (not ever easy) and I have some prospect of getting a very good nurse . . ." Sedation, then, was another method physicians used to counter her symptoms temporarily.

Sarah herself added a postscript to this letter, describing, "the formidable visit of Physicians." She maintained, "I sit alone and of course quarrel with no one." She also mentioned that she had been bled and felt "more tranquil today." The third treatment of choice was bleeding which was the universal panacea, and weakened Sarah enough to quiet her for a time.

The letters of September 1814 are the only ones from the time of Sarah's illness which give any hint of the strain her disorder was having on the family. The comfortable, loving home which Rebecca associated with her mother and would certainly have wished to maintain for her brothers was impossible with Sarah jibing at her siblings constantly. Also from September is a receipt for the repair of pieces of jewelry; perhaps this is just a coincidence but Sarah's energies may have led her to destructiveness. There is no indication that she was delusional or a danger to herself or others, but it is clear that Rebecca's plan for a nurse meant that Sarah needed to be under constant watch. (We don't know if a nurse was ever employed.)

In November 1814 Rebecca reported that Sarah had "lost all the exuberance of spirits that annoyed her so much last summer . . . now more languid, her nerves are so much shaken by these extremes that every sudden change alarms me." The few letters which exist from 1815-1816 make no mention of further episodes although their number is so small that Sarah could easily have endured another attack in the months intervening.

Then at the beginning of February 1817 Rebecca wrote to her friend Maria Fenno Hoffman that Sarah was sick, her disorder characterized by "sleepless nights," a symptom she had suffered in earlier manic episodes. This time the doctor ordered that she be dieted and bled, two sure ways to weaken her. Still, not sleeping could have been due to physical problems and dieting and bleeding could have been ordered for virtually everything. The disease which was affecting her is uncertain, but the outcome was not.

Sarah Gratz died on February 20, 1817. There are no letters describing her last days. Perhaps her death was tied to her nervous disorder: an accident or a suicide. Or perhaps the treatments to weaken her manic symptoms also weakened her body so much that she was susceptible to a physical disease which killed her.

(Rebecca's letter to Jo is in the Gratz Family Collection, Manuscript Collection No. 72, at the American Philosophical Society. The other three letters are in the Gratz Collection at the American Jewish Historical Society.)