Daily Life in the Nineteenth Century437before their fifth birthday. The important facts, there-
fore, are the decline of infant mortality and the conse-
quent increase in life expectancy.
Disease in Nineteenth-Century Europe
The foremost explanation of falling death rates lies in
the history of contagious disease. One study has sug-
gested that diseases explain 94 percent of all European
deaths in the year 1850. The dominion of disease in-
cluded wars; typhus killed more of Napoleon’s soldiers
than Wellington’s army or the Russian army did (see il-
lustration 23.1). That pattern remained true across the
century: Typhus, typhoid, cholera, and smallpox killed
more soldiers than enemy fire did. As late as the Boer
War (1899–1902), the British army lost 6,425 soldiers
in combat and 11,327 soldiers to disease. Contagious
diseases killed more people than heart attacks or cancer
did, because fewer people lived long enough to experi-
ence degenerative problems. At midcentury, even
measles killed more people than cancer did. In 1848 the
British deaths from diseases carried by microorganisms
stood at 1,296 per 100,000 population (see table 23.2);
today’s death rate for acquired immune deficiency syn-
drome (AIDS, 8.6), cancer (199.2), and heart disease
(311.9) combined do not reach half of that 1848 rate
for contagious diseases.
In the late eighteenth century, European civiliza-
tion had begun the conquest of contagious diseases, but
the lesson of smallpox vaccination was learned very
slowly. In Jenner’s homeland, less than 1 percent of the
population was vaccinated in 1801. Bavaria adopted
compulsory vaccination in 1807, and the British gov-
ernment required it in 1835, but many states were
slower (see illustration 23.2). Vaccination of all Ger-
mans became mandatory in 1874, during the smallpox
epidemic of 1870–75, which killed more than 500,000
people in Europe. The Vatican outlawed vaccination,
and Catholic states suffered higher death rates. Spain
did not require vaccination until 1902, but the new pol-
icy did not come in time to prevent thirty-seven thou-
sand Spanish smallpox deaths between 1901 and 1910.
Even these numbers seem small compared with the hor-
rors of public health in Russia. Four hundred thousand
Russians died of smallpox in 1901–10, and one Ortho-
dox sect still fought against vaccination, calling the re-
sultant smallpox scar “the mark of the Anti-Christ.” In
contrast, Denmark recorded only thirteen smallpox
deaths during that decade, and Sweden became the first
country ever to go through an entire year (1895) with
no smallpox deaths.
Tragedies such as the smallpox epidemic of
1870–75, or the Spanish and Russian crises of 1901–10,
are noteworthy facts, but the virtual disappearance of
smallpox in Denmark and Sweden is more important in
understanding the nineteenth century as an age both of
disease and the conquest of it. Childhood diseases—
such as measles, whooping cough, and scarlet fever—
account for less than 0.1 percent of deaths in the
Western world today, but they remained virulent killers
during the nineteenth century. An outbreak of scarlet
fever killed nearly twenty-thousand children in Britain
in 1840. The inhabitants of Denmark’s Faeroe Islands
suffered badly in 1846 because they had experienced
sixty-five years without a case of the measles. No one
had acquired immunity to the disease in childhood, and
when a worker brought measles to the islands, 78 per-
cent of the population (6,100 people) caught the dis-
ease and 106 adults died.
The most persistent epidemic disease of nineteenth-
century Europe was cholera, an acute diarrheal disease
usually transmitted through contaminated drinking wa-
ter. Major epidemics swept Europe repeatedly—in
1817–23, 1826–37, 1846–63, 1865–75, and 1881–96.
They typically arrived from India, where cholera was
endemic along the Ganges River. That path of infection,
combined with poor public health standards, meant that
Russia suffered terribly from cholera. One study has
found that Russia endured fifty-eight years of choleraIllustration 23.1
Typhus and Warfare.Dreadful military hygiene meant that
eighteenth- and nineteenth-century armies regularly lost more
soldiers to typhus than they did on the battlefield. Typhus was a
febrile disease, spread by the bite of a body louse that thrives in
poor sanitary conditions. It was commonly found in armies, jails,
and slums. In this illustration, Napoleon’s army in Spain during
the Peninsular War (1808–14) is stricken with typhus.