Milk sickness, attributed to a native plant called white snakeroot, was transmitted predominantly from cattle to humans via milk in the nineteenth- and twentieth-centuries in the states of Ohio, Indiana, Illinois, Missouri, Kentucky, and Tennessee, as well as in remote pockets of North Carolina. Milk sickness was responsible for many deaths throughout the region and is most commonly associated with the death of Nancy Hanks Lincoln, mother of President Abraham Lincoln. Milk sickness was more than an illness; it profoundly reshaped the landscape of an entire region, spawned a lesser-known regional conflict, and highlighted the question of what responsibilities were delegated to public officials as citizens were faced with looming environmental conditions that affected their mortality and economy.