Modern medicine has enabled citizens of wealthy, industrialized nations to forget that children once routinely died in shocking numbers. Teaching 19th-century English literature, I regularly encounter gut-wrenching depictions of child loss, a stark reminder that our ignorance of this widespread suffering is a privilege.
In the first half of the 19th century, between 40% and 50% of children in the U.S. died before age five. While overall child mortality was somewhat lower in the U.K., it remained near 50% through the early 20th century for children in the poorest slums. Diseases posed widespread threats. Tuberculosis killed an estimated one in seven people in the U.S. and Europe, leading the cause of death in the U.S. during the early 19th century. Smallpox killed 80% of infected children. The high fatality rate and unpredictable onset of diphtheria caused widespread panic in the British press when it emerged in the late 1850s.
Multiple technological advancements now prevent the epidemic spread of these and other common childhood illnesses, including polio, tetanus, whooping cough, measles, scarlet fever, and cholera. Closed sewers protect drinking water from fecal contamination. Pasteurization kills tuberculosis, diphtheria, typhoid, and other pathogens in milk. Federal regulations ended the adulteration of foods with chalk, lead, alum, plaster, and even arsenic, previously used to enhance the appearance or texture of inferior products. Vaccines created herd immunity to slow disease spread, and antibiotics offer cures for many bacterial illnesses. As a result of these sanitary, regulatory, and medical advances, child mortality rates in the U.S. and U.K. have remained below 1% since the 1930s.
Victorian novels poignantly chronicle the devastating grief of losing children. They depict the cruelty of diseases largely unknown today, serving as a cautionary tale against complacency and the assumption that child death is forever eradicated. These novels tapped into communal fears, mirroring the shared experience of helplessness in the face of such losses.
Little Nell, the angelic protagonist of Charles Dickens’ wildly popular *The Old Curiosity Shop*, succumbs to an unnamed illness in the novel’s final installments. The public’s intense investment in and grief over her fictional death reflected a shared societal experience of powerlessness: love alone could not save a child’s life. Similarly, eleven-year-old Anne Shirley of *Green Gables* fame became a hero for saving three-year-old Minnie May from diphtheria, a horrific disease where a membrane blocks the throat, leading to suffocation.
Children in Victorian England were acutely aware of disease risks. In *Jane Eyre*, typhus ravages a charity school, killing nearly half the girls. Thirteen-year-old Helen Burns battles tuberculosis, filling ten-year-old Jane with terror at the prospect of losing her only true friend. An entire chapter powerfully portrays this death, culminating in the heartbreaking image of Jane sleeping against Helen’s corpse. This unsettling scene resonates with mid-19th-century memento photographs of deceased children surrounded by their surviving siblings, highlighting the ever-present specter of death in Victorian childhood.
Victorian periodicals and personal accounts confirm that the frequency of death did not diminish its tragedy. Darwin’s agony at losing his ten-year-old daughter Annie to tuberculosis in 1851 is well documented. *Household Words* reported the 1853 death of a three-year-old from typhoid fever in a London slum, highlighting the dangers of unsanitary conditions, even with improved housing. President Abraham Lincoln and his wife were devastated by the death of their eleven-year-old son Willie from typhoid in the White House. In 1856, Archibald Tait, then headmaster of Rugby and later Archbishop of Canterbury, lost five of his seven children to scarlet fever in a single month—the most common pediatric infectious disease in the U.S. and Europe at the time, killing 10,000 children annually in England and Wales alone.
While scarlet fever is now curable with antibiotics, recent outbreaks serve as a reminder that vigilance against contagion remains crucial. Victorian fiction’s lingering focus on child deathbeds may seem sentimental to modern readers, but dismissing this as mere exaggeration avoids confronting the harsh reality of a dying child. Dickens’ words, “She was dead. Dear, gentle, patient, noble Nell was dead,” written in 1841 when a quarter of the children he knew might die before adulthood, powerfully encapsulates parental anguish.
These Victorian stories commemorate a profound, shared grief. Dismissing them as old-fashioned ignores that this collective pain was eradicated not by time, but by deliberate effort: rigorous sanitation reform, food and water safety standards, and widespread use of vaccines, quarantine, hygiene, and antibiotics. These achievements are not immutable; they are choices that can be reversed. Even small decreases in vaccination rates can compromise herd immunity, and infectious disease experts and public health officials are already warning of a dangerous resurgence of diseases that 20th-century advances helped wealthy societies forget. Those who seek to dismantle a century of public health measures invite the return of these horrors.
This article is republished from *The Conversation* under a Creative Commons license. Read the original article.
By Andrea Kaston Tange, Minnesota Reformer, December 18, 2024
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