Armstrong – Table of Contents

The “Devil’s Grip” in Virginia. (10, 11)
In mid-July 1923, requests arrived at the Hygienic Laboratory from health officers
of several communities in Virginia, including Danville and Waterview, for help with
outbreaks suspicious of botulism. Dr. George McCoy, Chief of the Laboratory, assigned
Armstrong to the investigation. The outbreaks were caused by an entity completely
unfamiliar to the generation of the physicians practicing in the area at that time. On July
23, 1923, Charles Armstrong (10), at the request of State Health Commissioner, Dr. E.G.
Williams of Virginia, accompanied State Epidemiologist, Dr. George E. Payne, to
Bowling Green and vicinity for the purpose of investigating an outbreak of disease of
unknown etiology. The symptoms described by physicians, patients and parents bore a
striking resemblance to an outbreak of illness in June 1888 first described by Professor
W.C. Dabney of the University of Virginia in and about Charlottesville among university
students and townspeople. One of the victims of the 1888 outbreak, suffering from the
characteristic severe, spasmodic discomfort around the rib cage and upper abdomen,
bestowed upon the affliction the colorful sobriquet “The Devil’s Grip.” The report by
Payne and Armstrong (11) described in greater detail the epidemic of 1923 (10) that was
prevalent in counties in northeastern Virginia. For this illness they used the more
descriptive name of “Epidemic Transient Diaphragmatic Spasm.”
The disease was characterized by acute onset with epigastric (mid upper
abdomen) pain, difficulty in breathing, fever, tenderness along the lower ribs and a
duration of one day to three weeks. The disease was often intermittent with periods of
recurrent chest pain and fever alternating with symptom-free intervals. The disease
spread within families and among persons in close contact with one another. In the 1923