Daily Life in the Old Regime331first century. An examination of the 1740 death records
for Edinburgh, for example, finds that the leading
causes of death that year were tuberculosis and small-
pox, which accounted for nearly half of all deaths (see
table 18.2).
Some diseases were pandemic: The germs that
spread them circulated throughout Europe at all times.
The bacteria that attacked the lungs and caused tuber-
culosis (called consumption in the eighteenth century)
were one such universal risk. Other diseases were en-
demic: They were a constant threat, but only in certain
regions. Malaria, a febrile disease transmitted by mos-
quitoes, was endemic to warmer regions, especially
where swamps or marshes were found. Rome and
Venice were still in malarial regions in 1750; when
Napoleon’s army marched into Italy in 1796, his sol-
diers began to die from malaria before a single shot had
been fired.
The most frightening diseases have always been
epidemic diseases—waves of infection that periodically
passed through a region. The worst epidemic disease of
the Old Regime was smallpox. An epidemic of 1707
killed 36 percent of the population of Iceland. London
lost three thousand people to smallpox in 1710, then
experienced five more epidemics between 1719 and
- An epidemic decimated Berlin in 1740; another
killed 6 percent of the population of Rome in 1746. So-
cial historians have estimated that 95 percent of the
population contracted smallpox, and 15 percent of all
deaths in the eighteenth century can be attributed to it.
Those who survived smallpox were immune thereafter,
so it chiefly killed the young, accounting for one-third
of all childhood deaths. In the eighty years between
1695 and 1775, smallpox killed a queen of England, a
king of Austria, a king of Spain, a tsar of Russia, a queen
of Sweden, and a king of France. Smallpox ravaged the
Habsburgs, the royal family of Austria, and completely
changed the history of their dynasty. Between 1654 and
1763, the disease killed nine immediate members of the
royal family, causing the succession to the throne to
shift four times. The death of Joseph I in 1711 cost the
Habsburgs their claim to the throne of Spain, which
would have gone to his younger brother Charles. When
Charles accepted the Austrian throne, the Spanish
crown (which he could not hold simultaneously) passed
to a branch of the French royal family. The accession of
Charles to the Austrian throne also meant that his
daughter, Maria Theresa, would ultimately inherit it—
an event that led to years of war.
Although smallpox was the greatest scourge of the
eighteenth century, signs of a healthier future were evi-
dent. The Chinese and the Turks had already learned
the benefits of intentionally infecting children with a
mild case of smallpox to make them immune to the dis-
ease. A prominent English woman, Lady Mary Wortley
Montagu, learned of the Turkish method of inoculating
the young in 1717, and after it succeeded on her son,
she became the first European champion of the proce-
dure (see document 18.1). Inoculation (performed by
opening a vein and introducing the disease) won accep-
tance slowly, often through royal patronage. Empress
Maria Theresa had her family inoculated after she saw
four of her children die of smallpox. Catherine the
Great followed suit in 1768. But inoculation killed some
people, and many feared it. The French outlawed the
procedure in 1762, and the Vatican taught acceptanceDeaths in Edinburgh in 1740 Deaths in the United States in the 1990s
Rank Cause Percentage Cause Percentage
1 Consumption (tuberculosis) 22.4 Heart disease 32.6
2 Smallpox 22.1 Cancer 23.4
3 Fevers (including typhus and typhoid) 13.0 Stroke 6.6
4 Old age 8.2 Pulmonary condition 4.5
5 Measles 8.1 Accident 3.9
Source: Data for 1740 from John D. Post, Food Shortage, Climatic Variability, and Epidemic Disease in Preindustrial Europe(Ithaca, N.Y.: Cornell University Press,
1988), p. 241; data for the United States from The World Almanac and Book of Facts 1995(Mahwah, N.J.: World Almanac Books, 1994), p. 959.TABLE 18.2The Causes of Death in the Eighteenth Century Compared with the Twentieth Century