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In the 19th century, being a child was very dangerous.
As of 1900, about 18%or one in five American children die before their fifth birthday. this The most common reasons Are infectious diseases – pneumonia, diphtheria, dysentery, measles and other diseases, through the family rampant, children are particularly at risk.
Especially the city is the “caul of infection”, Samuel Preston Fatal Year: Child Mortality Rate in the U.S. at the Late 19th Century,tell me. But nationwide, infectious diseases are “a ritual through childhood, some of which are much worse than others, but all have severe incidence rates, many of which cause deaths,” Howard Markel said.
By comparison, today, less than 1% of children die before the age of 5, and Until recentlyIn the United States, the once famous childhood illness is inherently unheard of. What has changed?
Better hygiene and understanding of bacterial theory is part of the story, but the key factor that has changed American childhood over the past century is the widespread adoption of vaccines. Today, American children are Routine vaccination Target measles, mumps, rubella, diphtheria, polio, certain types of pneumonia and meningitis, etc. Other vaccines, including Typhoid feverused all over the world.
This public health victory has saved hundreds of millions of lives and stopped billions of diseases. Markle said at least nine of the list of “10 biggest medical hot lists” are vaccines.
Because of a rise exist Anti-vaccine mood In the United States and around the world, recently Confirmation by Robert F. Kennedy Jr. As Minister of Health and Human Services, one of the country’s most prominent vaccine skeptics. Kennedy has been in office for only a few weeks Measles outbreak More than 100 people have been ill and killed an uninoculated child in Texas, the first death in measles in the United States Nearly ten years.
In this era Vaccination rate declines And the rising risk of preventable diseases, I want to go back to the long-term human history before the vaccine. Yes, childhood was a characteristic of the disease in the centuries before vaccination, but also tended to forget the sadness and loss due to disease outbreaks that are more rare. Understanding can teach us about the consequences of the choices we make today, family and society.
When disease and death are the norm
In the years leading up to the vaccine, the prevalence of the disease hit nearly every family’s death. “Most parents may expect to lose at least one child by 1900,” Steven Mintz, a history professor at UT Austin, who studied in childhood, told me in an email. This means that most children may expect to lose at least one sibling – sometimes, consider extended family time.
Historian James Marten recalls a tombstone in his family’s local cemetery with three names: “They were my grandfather’s sisters and brothers, and they both died within a week or two,” he told me.
Some people misunderstand that the larger family size and the near-incognito of childhood diseases have caused children to lose their survival. In fact, when a child dies, “the parents suffer extraordinary sorrow.”
For example, after her son Willie died in 1862 due to a fever of typhoid fever, her son Willie Mary Todd Lincoln wrote In a letter: “My question to myself is, ‘Is life tolerated?’”
The children were not spared. They may attend mourning-a Photos at the end of the 19th century The appearance of a young girl, Helen Frick, shows her a box with a picture of her dead sister. They may also encounter their losses in the form of new siblings, with the names of late siblings – a During periods of high infant mortality.
Although the disease hits people from all walks of life, poor children and children of color face additional risks. Nancy Tomes, a history professor at Stony Brook University, said new sanitation infrastructures that are rich in disease, such as sewers that limit the spread of disease, are first installed in wealthy white communities, leaving poor families vulnerable. Thousands of Native American childrenAt the same time, they are often sent to boarding schools by force, and poor sanitation conditions lead to Frequent disease outbreaks and A large number of deaths.
Death and severe illness were literary staples for the 19th century and children, often inspired by real life. Beth’s disease and death, complications of scarlet fever from infants, in Louisa May Alcott Little woman Alcott’s own sister died in 1858 and wrote Pediatrician Perri Klass. Laura Ingalls Wilder’s sister Mary was blind in 1879 (Laura 12, Mary 14), probably from Menyko encephalitis, the episode appeared in Wilder’s book By the coast of Silver Lake: “The fever stares into Mary’s eyes, Mary is blind.”
Mintz said that while many infectious diseases affected disproportionately, adults also died, and in the 19th century, up to half of children could lose their parents before the age of 21. “The psychological damage is huge.”
There are also economic and practical losses. Thomes said widow mothers and their children were unable to support themselves and usually had to enter alms or poor people in the 19th century. If the mother dies, the father may send the children to live with relatives or orphanages, which “crowds this time”, Thomes said.
Meanwhile, for those who are sick, the experience of the disease itself can be painful and fearful. For example, diphtheria can create a thick membrane at the back of the throat, making it difficult to breathe.
Mintz said the disease was called “stranger angel.” If children can do this in the first phase, they may die of heart failure six weeks later, Markle said.
Even survivors of infectious diseases may face life-long impacts. For example, polio can cause paralysis, and some children spend weeks, months, or even years Wrapped in iron lungs Help them breathe. (One of the last users of Iron Lung, Paul Alexander Death last year After more than 70 years of equipment. )
Although it may be devastating, in the years leading up to widespread vaccination, endemic diseases like measles were expected: “It’s the fact of childhood life, and you’ll get sick with one of them,” Markel said.
Polio, Arriving in the United States In the late 19th century Markle said the result of more isolated, unpredictable outbreaks caused more fear. Parents keep their children out of the pool and cinema. “It shapes your daily life to a large extent, and once people understand these things, you shape your work completely,” Merle Eisenberg, a history professor at Oklahoma State University, told me.
Polio vaccine, Launched in 1955end these fears. Today, it is one of a series of vaccines that allow most children in wealthy countries to escape from infections that have caused many of their predecessors to get sick and kill. “We take this for granted opportunity and the opportunities and possibilities that children have now,” Eisenberg said.
However, these diseases did not disappear. Preventable diseases still take children’s lives in high-poverty countries where vaccine allocation is more challenging, Rashida Ferrand, an epidemiologist at the London School of Hygiene and Tropical Medicine, told me. Diphtheria case is The Rise of Pakistanpolio is still endemic, In Afghanistan.
As the Texas measles outbreak suggests, the disease of devastating families over the centuries can come back here, too. Experts say it is now crucial to remember childhood history before the vaccine, a widely questioned period of vaccination, where rampant diseases and sadness of the last thousand years of human history have gradually faded from public memory (Covid Pandemative (although it exists).
“This is a very regrettable past that we have been largely forgotten, and it is a very regrettable prospect and we should keep in mind that this is the possibility that we will go this path,” Preston said.
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