I'm struggling to read the cause of death on this certificate:
I can make out: Chronic ? 6 years Exhaustion 2 years
? might be rheumatism, but I've never heard of that being fatal before.
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I agree that it reads Chronic Rheumatism.
While the rheumatism itself was unlikely to have been the actual cause of death, it could have been any one of several other common co-morbidities of rheumatism which may or may not have been clinically apparent at that time. Rheumatism can lead to disease in everything from the cardiovascular system to gastrointestinal tract to endocrine organs. Evidently no post-mortem was performed in this case, as none is noted on the death certificate and the death was certified by a doctor.
See the entry for Rheumatism on Antiquus Morbus, which gives several example death certificates containing this cause of death.
The 45th Annual Report of the Registrar General in 1882 records that in the prior year 410 males and 520 females died of rheumatism, while 1374 males and 1216 females died of rheumatic fever or rheumatism of the heart.
I also agree with @Harry Vervet that chronic rheumatism was unlikely to have been the actual cause of death.
The next lines in the death record reads to me '...exhaustion 2 years...certified by...(perhaps a person who signed an extant medical record that was available for reference to the registrar or medical person filling out the death certificate)...'
exhaustion may most likely mean consumption in this context. Yes, the reference does not mention direct exhaustion = consumption, but it may have to do with customary American versus British usage of the term.
Further, even if tuberculosis was known then (1882), it was not customarily directly mentioned as tuberculosis for stigma reasons. The term consumption is not limited to English-speaking people, as even old folks of hispanic heritage refer to tuberculosis as 'consumisiyon' (spelling depends on country of hispanic heritage). The afflicted, at least in those days, suffered from, among many things but not limited to, but most characteristic and visible terrible and advancing weight loss as if the disease consumes the body little by little until death.
Yes, I would say that a 76 year old person, with a 2-year history of exhaustion may well likely have died from it (aggravated by a 6 year history of living with chronic rheumatism).
Further, it may also be of help to decipher if the custom of filling out the death certificate begins with attendant causes of death, followed by direct cause of death, or vice versa. It would entail a small review of other death certificates if feasible, to compare entries. That may provide a more definite answer, if needed.