Infectious diseases killed Victorian children at alarming rates — their novels highlight the fragility of public health today

Thomas Worth’s 1872 illustration for the Household Edition of The Old Curiosity Shop highlights her grandfather’s grief at losing Little Nell. Thomas Worth via George P. Landow/Victorian Web by Andrea Kaston Tange, Macalester College 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 gutting depictions of losing a child, and I am reminded that not knowing the emotional cost of widespread child mortality is a luxury. In the first half of the 19th century, between 40% and 50% of children in the U.S. didn’t live past the age of 5. While overall child mortality was somewhat lower in the U.K., the rate remained near 50% through the early 20th century for children living in the poorest slums. Threats from disease were extensive. Tuberculosis killed an estimated 1 in 7 people in the U.S. and Europe, and it was the leading cause of death in the U.S. in the early decades of the 19th century. Smallpox killed 80% of the children it infected. The high fatality rate of diphtheria and the apparent randomness of its onset caused panic in the press when the disease...